Effect of Water Flosser on the Shear Bond Strength of Metal Orthodontic Brackets, an in vitro Study on Human Enamel
Author(s): Sarah A Alfaqeeh*, Abdullah Y Alshehri, Sultan I Alsalamh, Abdulelah A Alfehaid, Abdullah M Almuwainie
Background: The dental bonding agent with primer increases the strength between the tooth and orthodontic brackets by making a hydrophobic surface for the adhesive to bond to the etched tooth surface. This has controversial results in literature about the affects between bracket and teeth with use of primer bond strength. Aims: To determine the effect of water flosser on the shear bond strength (SBS) of metal orthodontic brackets. Materials and Methods: 45 sound premolars extracted for orthodontic reasons were randomly assigned into 3 groups (Gs), (G1: Control group), (G2: Teeth subjected to White Aquarius® Water Flosser device (WAWF) at quarter pressure) and (G3: Teeth subjected to WAWF at half pressure). G2 and G3 were subjected to the WAWF irrigation device for a period equivalent to 2-years of cleaning while the control group (G1) underwent no cleaning. Each group was tested using Instron® (Universal testing machine), by the aid of knife-edged rod running at a speed of 0.5 mm/min. Descriptive statistics (mean, standard deviation and range) for each group were calculated. One-way analysis of variance (ANOVA) using SPSS software version 24.0 (IBM, Chicago, IL) was used with the P-value set at 0.05.Differences in Adhesive Remnant Index (ARI) scores among groups were analyzed using the Chi-square test. Results: 15 (33.3%) teeth were located in each of the three groups. G1 had a mean shear bond strength of 23.3760 ± 9.3Mpa, G2 23.0940 ± 6.1Mpa while G3 24.3887 ± 5.2 Mpa. One-way ANOVA showed no significant differences in the bond strength measurements between the tested groups. Analysis of ARI scores showed no significant differences in the mode of bond failure among the groups (P-value ?0.88). Conclusion: WAWF has no effect on the SBS of metal orthodontic brackets, thus suggesting that WAWF is safe and can be included in the oral hygiene regimes of the patients wearing this type of appliance.