Endodontology, Vol.

15, 2003

Bond strength of wire-composite resin interface of dental splints using different wire surface treatments - An in vitro study
*Jacob J **Nandlal B

ABSTRACT
The study was undertaken to evaluate the optimal method of enhancing the wire-composite bond strength of dental splints using different wire surface treatments. Further, a comparison of bond strength of the wirecomposite resin interface with commonly used composite materials for dental splints was also attempted. The study sample consisted of 360 bovine mandibular incisors embedded in acrylic resin which were utilized as bonding surfaces for evaluation of the bond strength of the wirecomposite interface when using light activated composite resin (Gluma) and chemically activated composite resin (Rely-a-bond) with both flexible (0.016" round, 0.017" X 0.025" rectangular) and rigid (0.036" round) stainless steel wires. The results of the study indicated that sandblasting the portions of the stainless steel wires embedded in composite resin enhanced the strength of the wire-composite bond for both the types of composite materials. The use of metal primer on stainless steel wires either separately or in combination with sandblasting had lower wire-composite interface bond strength than sandblasting alone, while no surface treatment on the wire had the least, for both the light activated and chemically activated composite resins. Key words : Bond strength, dental splint, luxation injuries, surface treatment of dental wires.

Introduction
Of the traumatic injuries occurring in children, avulsion and displacement of teeth are some of the common problems encountered in the primary as well as mixed dentition period. Dental splinting after traumatic tooth injury is needed to stabilize subluxated, luxated, avulsed and root fractured teeth1. Rigid
* Post Graduate Student ** Professor & Head

Dept. of Pedodontics & Preventive Dentistry J.S.S. Dental College & Hospital Mysore - 570 015

dental splinting has been the treatment of choice until the 1970s which were based on the principles of bone fracture immobilization in which total immobility improves healing without callus formation 1 . However, experimental and clinical studies have shown that early restoration of masticatory function improves pulpal and periodontal healing2. The bond strength of the wire to the composite resin is an important factor in a successful wire-composite splint. Most of the failures of this wire-composite splint occurs at the wire-composite resin interface.

Jacob and Nandlal

Wire-composite interface...

Methods of increasing the bond strength between metals and composites were through mechanical retention methods like undercuts and roughening of the metal surface, microretention methods like sandblasting, electrolytic etching and tinplating and chemical adhesion through the use of metal bonding agents (Metal Primers)3,4,5. Thin flexible wires have been recommended for the wire- composite splint6. Two types of composite materials have been advocated for the wire- composite splint; namely the chemically cured composite and the light cured composite resin6,7. This study was to evaluate the optimal method of enhancing the wirecomposite bond strengths of dental splints using different wire surface treatments.

4.4mm. This was done to have a uniform etching and bonding area for all the test

Materials and Methods

The study sample consisted of 360 bovine mandibular incisors embedded in acrylic blocks in test groups of 15 samples each. The test group were different wire surface treatments like Sandblasting (Sb), Sandblasting + Metal Primer (Sb+Mp), Metal Primer alone (Mp) and No surface treatment (Nst). Two different types of composite materials namely light activated composite resin (Gluma) and chemically activated composite material (Rely-a-bond) were tested on 0.036" round S.S. wire, 0.016" round S.S. wire and 0.017" X 0.025" rectangular S.S. wire for the different wire surface treatments. Bovine mandibular incisors were cleaned of soft tissue and stored in a refrigerated Chloramine-T solution. Before bonding, the facial surface was cleaned with distilled water to remove debris and dried with tissue paper. The apical 1/3rd of the roots were sliced with a diamond disc. The mounting of the bovine tooth was done using a split rectangular aluminum box and the tooth was stabilized with self cure acrylic resin. The bovine tooth surface was covered with adhesive tape except for bonding site of radius

samples8. To consistently place the wire within the composite resin, a standard splint acrylic template was devised. The template had a round well of 4.4mm diameter and 1.75mm depth with a uniform 15.2mm of composite bonding surface area. A slot for the wire extended from the end of the well to the end of the template. The length of the slot was 10cms and the width of the slot was 1mm more than the diameter of each of the test wire. The well ensured approximately 1mm of composite over the wire, placing the wire as close to the bovine tooth surface as possible while still surrounding it with the composite resin. The test sample was placed on a flat surface along with the aligning jig which aligned as well as stabilized the bonding template over the bovine tooth surface. Acid etching and bonding procedure for both the test composite resins were done following manufacturers' instructions. The wires were sandblasted with a 50 microns aluminium oxide at a pressure of 75 psi for approximately 15 seconds, resulting in approximately the last 6-7 mm of the wire etched to a dull finish. The metal bonding agent (Alloy Primer) was applied directly to the wire surface with a brush for 15 seconds and then air dried for 5 seconds. The wires were then immediately bonded to the composite resin. The cured samples were placed in distilled water and stored in an incubator at 37C for 48 hours and then thermocycled between 4C and 60C for 100 cycles with a dwell time in each thermal bath of 1 minute 9 . After thermocycling, the samples were further returned to the incubator for storage before testing 24 hours later. Testing of the samples was done using a Universal Testing Machine (Llyods) at a crosshead speed of 1mm per minute. The test samples were placed in the lower jaw of the testing machine and the wire was pulled along its long axis by the testing machine until the wire was fully dislodged from the composite resin. The maximum force needed to dislodge the wire was recorded. The force

was converted to MPa by using the

surface area of the wires. In analyzing the results of the variables under various methods considered in this study, the statistical techniques like Arithmetic Mean, Standard Deviation, Student's 't' test, Analysis of Variance (ANOVA) and the Duncan's Multiple Range Test (DMRT) were used appropriately.

300% 9. Claims have also been made that adhesion promoters (Metal Primers) can also increase the metal composite bond strength3,5. However, studies on the effect of sandblasting

Results
Results are shown numerically in Table 1, 2, 3. Different surface treatments of wires in both light activated and chemically cured composite resin were significantly different from each other (ANOVA, P<0.001) with higher values for sandblasting (Sb) followed by sandblasting + metal primer (Sb +Mp), metal primer alone (Mp) and no surface treatment (Nst) obtaining the lowest value (DMRT at 95% level). Further 't' test revealed that all the surface treatments of light activated composite resin for all the different types of wires had higher wirecomposite bond strength than chemically activated composite material (p<0.001). Sandblasting of the wires obtained highest bond strength for both light activated and chemically activated composite material.

Discussion
Dental trauma has become a frequent emergency in children and adults alike. Injuries to both the primary and the permanent teeth and to the supporting structures are commonly encountered in the dental practice. Dento- alveolar injuries like luxation and avulsion require splinting for stabilization of the displaced teeth. Thin flexible wires have been recommended for the wire-composite splint6. Different surface treatment has been tested on metals to enhance the bond strength of the composite to metals3,4,5. Studies have proven that sandblasting enhanced the bond strength between metals and composite resin by at least

Endodontology, Vol. 15, 2003

and adhesion promoters on the wirecomposite interface bond strength of dental splints are few. With both, the light activated composite resin (Gluma) and chemically activated (Rely- a-bond), sandblasting of the 0.036" stainless steel wires provided the strongest wire- composite interface. The bond strength of the wire-composite interface obtained with sandblasted wires (268.45MPa) was significantly higher than no surface treatment (13.59MPa) (p<0.001). The observed values were comparable with studies on resin to metal bonding where similar results have been obtained3. Oesterle 9 reported of similar bond strength for sandblasted 0.030" round wires (246.1Mpa) which were significantly higher than control wires (10.1Mpa). Surprisingly the application of metal primer to sandblasted wire actually decreased the bond strength of the joint (246.10 Mpa) when compared with only sandblasted wires (268.45MPa). This might be due to the metal primer masking the micro retention effects of sandblasting, thereby significantly lowering the bond strength (p<0.001). Studies on bonded retainers have reported of lower bond strength for the wire- composite interface on using a combination of sandblasting + metal primer (213.5MPa) when compared with sandblasting alone (246.1MPa)9. The use of metal primer alone on the wire resulted in an increase in the wire- composite interface bond strength (43.79MPa) when compared with no surface treatment (13.59MPa). Studies on composite to metal bonding, mediated by metal adhesive promoters have indicated that the bond strength obtained with metal primers (Primet, Fusion, ABC Bond) were generally not high5. However, these primers were tested on alloy systems commonly used in making ceramometal restorations and so direct comparison to wire-composite bond strength would not be ideal. In confirmation of the above findings, metal primer alone and no surface

treatment had significantly composite interface

lower

wire-

Jacob and Nandlal

Wire-composite interface...

TABLE 1: Mean Bond strength of the 0.036" wire-composite interface Surface treatments Light activated Mean S.D. (MPa) Sb Sb+Mp Mp Nst (d) (c) (b) (a) 268.454.84 246.102.83 43.791.46 13.590.49 F value Chemically activated Mean S.D. (Mpa) F value 69601.23 't' value 45.94*** 59.47*** 31.02*** 6.55***

31354.93 206.072.06 194.621.80 36.667.39 11.870.90

ANOVA : Mean bond strength were significantly different from each other (p<0.001) DMRT : Means with different alphabets are significantly different from each other at 95% level *** denotes p<0.001 Sb: Sandblasting Sb + Mp: Sandblasting + Metal Primer Mp: Metal primer alone Nst: No surface treatment

TABLE 2: Mean Bond strength of the 0.017" X 0.025" wire-composite interface Surface treatments DMRT Light activated Mean S.D. (MPa) 247.122.80 234.161.78 37.880.98 12.360.53 F value Chemically activated Mean S.D. (Mpa) F value 't' value

Sb Sb+Mp Mp Nst

(d) (c) (b) (a)

76433.72 198.950.77 190.171.37 28.150.56 10.960.50

202957.63

64.16*** 75.94*** 33.43*** 7.41***

TABLE 3: Mean Bond strength of the 0.016" wire-composite interface Surface treatments DMRT Light activated Mean S.D. (MPa) 235.102.92 227.890.98 31.821.20 11.890.44 F value Chemically activated Mean S.D. (Mpa) F value 't' value

Sb Sb+Mp Mp Nst

(d) (c) (b) (a)

79467.70 191.191.26 184.101.37 24.650.94 10.310.52

126574.78 053.52*** 100.83*** 018.19*** 009.00***

Endodontology, Vol. 15, 2003

bond strengths when compared with sandblasting (p<0.001).This further adds evidence to the view that micro mechanical retention provided by sandblasting significantly enhanced the wire-composite interface bond strength when compared with chemical adhesion techniques like the use of metal primers. Similarly, even for the 0.017" X 0.025" rectangular and the 0.016" round stainless steel wires, sandblasting had the highest bond strengths while the other surface treatments (viz sandblasting + metal primer, metal primer alone, no surface treatment) had lower wire to composite bond strengths. Student's 't' test revealed that all the wire surface treatments of light activated composite resin (Gluma) had higher wirecomposite interface bond strength than chemically activated composite material (Rely-a-bond) in the 0.036", 0.017" X 0.025" and 0.016" wires. This might be related to light activated composite resin's (Gluma) mechanical properties, particularly tensile strength and fracture toughness.

sandblasting + metal primer and metal primer alone for both light activated composite resin (Gluma) and chemically activated composite material (Rely-abond). Light activated composite resin (Gluma) had higher wire- composite bond strength for all the surface treatment of the wires than chemically activated composite material (Rely-a-bond). Hence, when using composite material for the wire- composite splint, it is desireable that some surface treatment of the wires should be done to enhance the wire-composite bond strength. References
1. Prevost J, Louis JP, Vador J and Granjon YA. A study of forces originating from orthodontic appliances for splinting of teeth. Endod. Dent. Traumatol 1994; 10: 179 184. 2. Andreasen JO. Periodontal healing after replantation of traumatically avulsed human teeth - Assessment by mobility testing and radiography. Acta Odont. Scand 1975; 33: 325 - 335. 3. Aboush YEY, Mudassir A and Elderton RJ. Technical note: Resin to metal bonds mediated by Adhesion promoters. Dent. Materials 1991; 7: 279 280. 4. McCaughey AD. Sandblasting and tinplating-surface treatment to improve bonding with resin cements. Dental Update 1993; 20: 153 - 157. 5. Tjan AHL, Dent Dr. and Nemetz H. Bond strength of composite to metal mediated by metal adhesive promoters. J. Prosthet. Dent 1987.; 5: 351 - 354. 6. Oikarinen K. Functional fixation of traumatically luxated teeth. Endod. Dent. Traumatol 1987; 3: 224 228. 7. Neaverth EG. and Goerig AC. Technique and rationale for splinting. J. Amer. Dent. Assoc. 1980; 100: 56 - 63. 8. Miyazaki M, Iwasaki K. and Onese H. Adhesion of single application bonding systems to bovine enamel and dentin. Oper. Dent. 2002; 27: 88 - 89. 9. Oesterle HJ, Shellhart WC. and Henderson S. Enhancing wire-composite bond strength of bonded retainers with wire surface treatment. Am. J. Orthod. Dentofacial Orthop 2001; 119: 625 - 663.

Conclusion
Sandblasting the portions of the stainless steel wires embedded in composite resin enhanced the strength of wire-composite bond for both the types of composite materials. The use of metal primers on stainless steel wires either separately or in combination with sandblasting had lower wire-composite interface bond strength than sandblasting alone for both the composite materials. No surface treatment on the wire had lower wirecomposite bond strength than sandblasting,