Influence of surface treatments on bond strength of metal and ceramic brackets to a novel CAD/CAM hybrid ceramic material

This study evaluated the effect of four different surface treatments methods on the shear bond strength (SBS) of ceramic and metal brackets to Vita Enamic (VE) CAD/CAM hybrid ceramic. A total of 240 plates (10 mm x 10 mm x 3 mm) were cut from VE ceramic blocks and divided into two groups. In each group, four subgroups were prepared by hydrofluoric acid (HF); phosphoric acid (H3PO4); diamond ceramic grinding bur; and silica coating using CoJet system (CJ). Maxillary central incisor metal (Victory Series) and ceramic (Clarity) brackets were bonded with light-cure composite and then stored in artificial saliva for 1 week and thermocycled. The SBS test was performed, and the failure types were classified with adhesive remnant index scores. Surface morphology of the ceramic was characterized after treatment using a scanning electron microscope. Data were analyzed using two-way ANOVA, Tukey HSD test, and Weibull analysis. SBS was significantly affected by the type of bracket and by type of treatment (P < 0.001). Specimens treated with CJ presented with significantly higher SBS compared to other groups (P < 0.05). Improvements in SBS values (MPa) were found in the following order: CJ > HF > Bur > H3PO4. Ceramic bracket showed higher SBS compared to metal bracket. Adhesive failures between the ceramic and composite resin were the predominant mode of failure in all groups. Surface treatment of VE CAD/CAM hybrid ceramic with silica coating enhanced the adhesion with ceramic and metal brackets.