Impact of Fluorosis on the Tensile Bond Strength of Metal Brackets and the Prevalence of Enamel Microcracks

The objective of this in vitro study was to determine the effects of dental fluorosis on the tensile bond strength of metal brackets bonded to human teeth and to evaluate the changes in the tooth enamel surface after debonding. The study sample consisted of 68 recently extracted human upper premolars, which were divided into 2 groups: the fluorosis group (34 fluorosed teeth) and the control group (34 healthy teeth). Identical premolar metal brackets were bonded on the buccal surfaces of the teeth. Both groups were submitted to a tension test using a universal testing machine. The number and length of the enamel microcracks in the buccal surface of each tooth were determined before bracket bonding and after debonding using a stereomicroscope. The percentage adhesive remnant index (PARI) was calculated after debonding. The results showed that the tensile bond strength (TBS) of brackets bonded to fluorosed teeth was 21.08% lower than that of brackets bonded to healthy teeth (p < 0.0001). The length of the enamel microcracks on fluorosed teeth increased by 47.4% after debonding, whereas the control group showed an increase of only 12.6%. The PARI showed lower values for fluorosed teeth in comparison to the control group (p = 0.047). In conclusion, dental fluorosis has a negative impact on tensile bond strength and the length of microcracks formed after bracket debonding.