Shear bond strength evaluation of bonded molar tubes on fluorotic molars

Objective: To study the shear bond strength (SBS), sites of failure, and micromorphology of bonded molar tubes used on teeth affected by dental fluorosis. Materials and Methods: This in vitro study included 140 first molars classified according to Dean's index for dental fluorosis. Samples were divided into seven groups: (1) healthy teeth etched for 15 seconds, (2) teeth with moderate fluorosis (MOF) etched for 15 seconds, (3) teeth with MOF etched for 150 seconds, (4) teeth with MOF microabrasion etched for 15 seconds, (5) teeth with severe fluorosis (SEF) etched for 15 seconds, (6) teeth with SEF etched for 150 seconds, and (7) teeth with SEF microabrasion etched for 15 seconds. All samples were incubated and were then submitted to the SBS test and evaluated with the modified adhesive remnant index (ARI) and analyzed by using a scanning electronic microscope. Results: The SBS mean value for healthy enamel was 20 +/- 10.2 MPa. For the group with MOF, the etched 150-second mean value was the highest (19 +/- 7.6 MPa); for the group with SEF treated with microabrasion and etched for 15 seconds, the mean value was (13 +/- 4.1 MPa). Significant differences (P <= .05) were found in the ARI between healthy and fluorosed groups. Conclusions: Fluorotic enamel affects the adhesion of bonded molar tubes. The use of overetching in cases of MOF and the combination of microabrasion and etching in SEF provides a suitable adhesion for fixed appliance therapy. (Angle Orthod. 2013;83:152-157.)