Evaluation of Lithium Disilicate Ceramic Surfaces before Bonding and after Removal of Orthodontic Brackets

ORIGINAL ARTICLE
Blerim Mehmeti, Granita Muhaxheri, Rina Caka, Bleron Azizi

 
For citation: Mehmeti B, Muhaxheri G, Caka R, Azizi B. Evaluation of Lithium Disilicate Ceramic Surfaces before Bonding and after Removal of Orthodontic Brackets. International Journal of Biomedicine. 2025;15(2):391-395. doi:10.21103/Article15(2)_OA20
 
Originally published June 5, 2025
 

Abstract: 

Background: In modern dental practice, it is critical to maintain surface integrity and achieve optimal aesthetics after orthodontic treatment in high-cost ceramics, such as lithium disilicate, used in restorative materials (e.g., crowns or veneers). This study aimed to evaluate the surface roughness (Ra) of lithium disilicate ceramic conditioned with hydrofluoric acid (HFA) or phosphoric acid (PPA) before bonding, after the removal of orthodontic brackets, and following surface polishing. Additionally, the Porcelain Fracture Index (PFI) was used to assess the ceramic surface condition after debonding.
Methods and Results: Surface condition and roughness were analyzed on 35 lithium disilicate, all-ceramic semi-crowns, divided into the following groups: control group (no surface conditioning performed), HFA-conditioned group, PPA-conditioned group, HFA post-debonding group (HFA-SBS), PPA post-debonding group (PPA-Surface roughness (Ra) was measured using a stylus instrument by taking five roughness profiles on each sample. Subsequently, surface modifications were evaluated using scanning electron microscopy to analyze the ceramic condition after bracket removal. Significant differences in Ra were observed among the groups, indicating non-random variations (P<0.001). The control group differed significantly from all other groups except PPA-P. Significant differences were also observed between the HFA and PPA groups and their respective post-debonding groups (HFA-SBS and PPA-SBS). Furthermore, HFA-P and PPA-P differed significantly from the debonded groups (HFA-SBS and PPA-SBS) that did not undergo polishing.
Conclusion: Phosphoric acid is a safer option for surface conditioning before bracket bonding on lithium disilicate glass ceramic restorations, as it facilitates achieving high aesthetics after polishing.

Keywords: 
lithium disilicate • surface roughness • orthodontic brackets • hydrofluoric acid • phosphoric acid
References: 
  1. Haralur SB, Alqahtani NA, Alhazmi AM, Alqahtani NA, Alhazmi AA, Al-Maflehi N. Evaluation of shear bond strength of metal and ceramic brackets to all-ceramic CAD-CAM materials after different surface treatments and thermocycling. J Int Soc Prev Community Dent. 2023;13(4):354-60.
  2. Mehmeti B, Kelmendi J, Iiljazi-Shahiqi D, Azizi B, Jakovljevic S, Haliti F, Anić-Milošević S. Comparison of Shear Bond Strength Orthodontic Brackets Bonded to Zirconia and Lithium Disilicate Crowns. Acta Stomatol Croat. 2019 Mar;53(1):17-27. doi: 10.15644/asc53/1/2. PMID: 31118529; PMCID: PMC6508926.
  3. Costa TRF, Isolan CP, Borges GA, Amaral R, Valandro LF. Surface treatment for ceramic bonding: Systematic review and meta-analysis. J Clin Exp Dent. 2021;13(1):e92-102.
  4. Aboushady AY, Zaher AR, Abdullah EM. Shear bond strength of ceramic brackets bonded to glazed lithium disilicate using different bonding protocols. Egypt Orthod J. 2021;60(1):10-20.
  5. Abuelenain DA, Linjawi AI, Alghamdi AS, Alsadi FM. The effect of various mechanical and chemical surface conditioning on the bonding of orthodontic brackets to all ceramic materials. J Dent Sci. 2021 Jan;16(1):370-374. doi: 10.1016/j.jds.2020.02.003. Epub 2020 Mar 16. PMID: 33384822; PMCID: PMC7770247.
  6. de Jager N, Feilzer AJ, Davidson CL. The influence of surface roughness on porcelain strength. Dent Mater. 2000 Nov;16(6):381-8. doi: 10.1016/s0109-5641(00)00030-0. PMID: 10967186.
  7. Fischer H, Marx R. Fracture toughness of dental ceramics: comparison of bending and indentation method. Dent Mater. 2002 Jan;18(1):12-9. doi: 10.1016/s0109-5641(01)00005-7. PMID: 11740960.
  8. Kawai K, Urano M. Adherence of plaque components to different restorative materials. Oper Dent. 2001 Jul-Aug;26(4):396-400. PMID: 11504440.
  9. Fragomeni Stella JP, Galarza C, Borges GA, Oliveira WJ, Miyagawa CS, Semenoff TA. Effect of surface treatment on the bond strength of different adhesives to porcelain. Braz Dent J. 2015;26(5):484-9.
  10. Herion DT, Ferracane JL, Covell DA Jr. Porcelain surface alterations and refinishing after use of two orthodontic bonding methods. Angle Orthod. 2010 Jan;80(1):167-74. doi: 10.2319/010909-19.1. PMID: 19852657; PMCID: PMC8978724.
  11. Maruo IT, Maruo H, Tanaka OM, Camargo ES, Vieira S, Guariza-Filho O, et al. Influence of acid etching and silane agent application on shear bond strength of metallic brackets to ceramic. Angle Orthod. 2017;87(3):391-7.
  12. Jungbauer R, Schauseil M, Wichelhaus A. Bonding of orthodontic brackets to ceramic crowns: Influence of different surface conditioning methods. J Orofac Orthop. 2022;83(1):1-9.
  13. Stella JP, Galarza C, Borges GA, Oliveira WJ, Miyagawa CS, Semenoff TA. Effect of surface treatment on the bond strength of different adhesives to porcelain. Braz Dent J. 2015;26(5):484-9.
  14. Viksic J, Knezovic Zlatarić D, Celebic A, Komar D, Mehulić K. Shear bond strength of orthodontic brackets bonded to zirconia ceramic with different surface treatments and adhesives. Int J Prosthodont. 2019;32(1):75-7.
  15. Fornaini C, Merigo E, Vescovi P, Rocca JP, Bertrand MF, Nammour S. Use of laser in dentistry: scientific review and guidelines for clinical practice. J Oral Laser Appl. 2007;7(4):165-76.

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Received March 2, 2025.
Accepted May 5, 2025.
©2025 International Medical Research and Development Corporation.