Effect of mangosteen peel extract as an antioxidant agent on the shear bond strength of orthodontic brackets bonded to bleached teeth

Abstract

Abstract Introduction: The number of patients who seek orthodontic treatment that may have a history of tooth bleaching is increasing over the time. Bleaching may influence the decrease of the bond strength of orthodontic brackets. Objective: To determine and prove the effect of mangosteen peel (MP) extract to reverse the reduced shear bond strength (SBS) of orthodontic brackets after bleaching. Methods: A total of 150 maxillary first premolar teeth were randomly divided into 6 experimental groups as follow (n=25): negative-control (N: no bleaching), positive-control (P: bleaching + no treatment), and the treatment groups (bleaching + 10% sodium ascorbate (SA), 10% (MP-10), 20% (MP-20) and 40% (MP-40) MP extract gel). After treatment, the brackets were bonded with the resin-modified glass ionomer cement, SBS testing was performed using universal testing machine, and the adhesive remnant index (ARI) was examined using stereoscopic microscope after debonding. The SBS data were analyzed by analysis of variance (Anova) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed. Result: There was significant SBS difference (p< 0.001) between various groups. The group without bleaching showed significantly higher SBS (8.19 ± 2.26 MPa) compared to others, while SBS in the group treated with 40% MP gel was significantly higher (7.93 ± 1.92 MPa) than other groups treated with antioxidants. The failure of orthodontic brackets bonded after bleaching and treatment using MP extract occurred at the enamel-adhesive interface. Conclusion: The application of MP extract as an antioxidant after bleaching was effective in reversing the reduced shear bond strength of orthodontic brackets after bleaching.