Original Article

Evaluation of bond strength of brackets using various indirect

bonding techniques
Piyush Bolya1, Chandresh Shukla2, Gunjan Tiwari3, Sourabh Bhatt4, Saurabh Rathore5, Akbar Ali6

Abstract
Introduction: Accurate bracket placement has been always an area of interest for all orthodontists. Different types of adhesives for
indirect bonding techniques have been introduced recently. However, there is limited information regarding bond strength with these new
materials. The aim of this study is to compare and evaluate the bond strength in various indirect bonding techniques when using different
primers and adhesives. Materials and Methods: In this in vitro investigation, brackets were bonded to fifty extracted premolars which
were divided into five groups (A–E) of ten each. Results: The overall comparison of all the techniques produced comparable mean bond
strengths that were well within the clinically acceptable range. Group D produced the highest bond strength in comparison to other groups
followed by Group E, B, C, and A. Conclusion: In the present study, all the groups have shown shear bond strength of more than 7.8
MPa. Hence, all the five techniques are suitable for clinical use.

Key words: Bond strength, bonding, indirect bonding

Introduction An ideal orthodontic adhesive should have optimal bond strength

to withstand masticatory forces and forces of the orthodontic
Bonding of orthodontic attachments using orthodontic
appliance. On the other hand, it should also debond without
adhesives is one of the important procedures in clinical
causing any damage to the enamel. The bond strength and
orthodontic practice and is the most significant development
debonding character of Transbond XT have been extensively
over the past three decades.
studied and reported to have optimal bond strength.[4]
Buonocore [1] in 1955 demonstrated a simple method to
The quest to overcome the shortcomings of conventional
increase adhesion of acrylic filling material to enamel
filled composites has led to the development of “flowable
surface by acid pretreatment with 85% phosphoric acid.
composites.”[5]
Newman[2] in 1965 used this technique for bonding plastic
brackets with epoxy resin. This paved the way for direct Flowable composites achieved great attention due to their
bonding of bracket in orthodontic practice. Bowen’s resin clinical handling characteristics such as nonstickiness, fluid
or bisphenol‑a‑glycidyl dimethacrylate was developed injectability, adequate working time, and short cure time.
by Bowen in 1962.[3] Various modifications were made to Self‑curing resins, for a long time, were the only option for
Bowen’s resin to alter their properties and enhance their dental restorative and orthodontic bonding procedures. This
performance for the clinical use. kind of material boasts great clinical efficiency but its short
handling time hinders the procedure.
Access this article online
Quick Response Code Milne et al.[6] compared the shear and tensile bond strengths
Website:
and the accuracy of bracket placement of these two methods,
www.jios.in
and the results revealed no statistically significant differences
between the bond strengths.
DOI:
10.4103/0301-5742.199248
This is an open access article distributed under the terms of the Creative Commons
Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and
1,4,6
Senior Lecturer, Reader, Private Practitioner
2 3,5
build upon the work non‑commercially, as long as the author is credited and the new creations
1
Department of Orthodontics, Darshan Dental College, Udaipur, Rajasthan, are licensed under the identical terms.
2,3,4,5,6
Department of Orthodontics, PCDS, Bhopal, Madhya Pradesh, India
For reprints contact: reprints@medknow.com
Address for correspondence: Dr. Piyush Bolya,
Department of Orthodontics, Darshan Dental College, Udaipur, Rajasthan, India.
E‑mail: piyushbolya25@gmail.com How to cite this article: Bolya P, Shukla C, Tiwari G, Bhatt S, Rathore S,
Ali A. Evaluation of bond strength of brackets using various indirect bonding
Received: 02‑02‑2016, Accepted with Revisions: 03‑12‑2016 techniques. J Indian Orthod Soc 2017;51:15-21.

© 2017 Journal of Indian Orthodontic Society | Published by Wolters Kluwer - Medknow 15

 Bolya, et al.: Bond strength - Indirect bonding techniques

Because indirect bracket placement involves the use of a • Human premolars which had complete root formation
composite that has been placed previously, Shiau et al.[7,8] • Human premolars with intact crown.
investigated whether a loss in bond strength occurs when the
base composite is placed 7 days before placement in the mouth Exclusion criteria
and found no differences in bond strength. • Human premolars with any sign of cracks or fractures
• Human premolars with buccal restoration or root canal
Hocevar and Vincent[9] compared the shear bond strength (SBS) treatment
of brackets attached by the Thomas indirect technique[10] and • Human premolars with history of bleaching.
the direct bonding technique. They mention about the problem
of inaccurate placement of the right amount of adhesive in Armamentarium used
the indirect bonding method and draw attention to voids that • 37% phosphoric acid etchant
often occurs during indirect bonding. Their results show no • Alginate
differences in SBS when there are no marginal voids or when • B.P. Blade and Handle
the voids were covered in indirect technique. • Bioplast
The literature lacks studies evaluating the strengths of indirect • Black‑lead pencil 0.05 mm
bonding resins. There are only two studies that investigate • Bonding resin
the bond strengths of indirect bonding resins. One of them • Bracket Holding Tweezers
compared the retention rates of thermally cured and light‑cured • Brackets
custom bases. The results showed no significant differences in • Cotton pliers
the retention rates of either of the custom‑base materials when • Deli (water soluble glue)
used with metal brackets. • Denticon bracket positioning gauge
• Light‑emitting diode (LED) light‑curing unit
Klocke et al.[11] investigated the bond strengths of indirect
• Microetcher
bonding resins and found that indirect bonding with Sondhi
• Millimetric probe
Rapid Set showed similar strength compared with a control
group bonded directly with Transbond XT. • Millimetric ruler
• Orthokal (Dental Stone)
• Pumice
Materials and Methods • Scissors
A total of fifty human premolars extracted for orthodontic • Self Cure Resin
purpose were collected and stored in 0.5% aqueous thymol • Slow‑speed handpiece (contra‑angle) and prophylaxis cup
solution at room temperature. The samples were kept • Sondhi Rapid Set
submerged in 0.5% aqueous thymol solution at all times except • Transbond XT
when the brackets were being bonded or debonded. The teeth • Transbond Supreme LV.
were randomly divided into five groups of ten each [Table 1].
Brackets
Each group was assigned with different colors which were
Orthodontic preadjusted edgewise appliances metal
as follows:
brackets having 0.022 × 0.028 MBT slot for right maxillary
Group A: Black, Group B: Light Green, Group C: Pink, Group premolar (Gemini 3M, UNITEK, Monrovia, CA, USA)
D: Red, and Group E: White. were used for bonding. The surface area of bracket was
10.61 mm2.
Inclusion criteria
• Human premolars extracted for orthodontic purpose Sample mounting
Before bonding, the teeth were divided randomly into
group of five each. A wax box of approximately 40 mm
Table 1: Various indirect bonding groups length, 10 mm width, and 15 mm height was fabricated. The
Group Technique Bonding on Number Bonding boxes were filled with acrylic resin (DPI Self Cure Resin).
cast of teeth technique Teeth were embedded in the acrylic to just 2 mm below
Group A No‑base Deli 10 Sondhi Rapid the cement‑enamel junction, which provided the adequate
technique Set technique retention but at the same time maintained sufficient amount
Group B No‑base Deli 10 Transbond XT
of tooth structure. The mounted blocks were allowed to
technique
Group C Custom‑base Transbond LV 10 Sondhi Rapid
completely cure. Interproximal contact between the adjacent
technique Set technique teeth was maintained. Care was taken to keep the buccal
Group D Custom‑base Transbond XT 10 Transbond XT surfaces of the teeth perpendicular to the acrylic bases. Two
technique blocks for each group was made. Each block was engraved
Group E Custom‑base Transbond XT 10 Transbond LV its number using micromotor and straight handpiece
technique [Figure 1a and b].

16 Journal of Indian Orthodontic Society | Vol 51 | Issue 1 | January‑March 2017

 Bolya, et al.: Bond strength - Indirect bonding techniques

Model preparation
Accurate, bubble‑free alginate impressions for each block (5 teeth)
were made using regular set alginate, diluted one part in three
parts of water. The impressions were poured with orthodontic
stone (Orthokal, Kalabhai). The stone models were then allowed
to set for 24 h. Reference lines were marked on the models with
0.3 mm lead pencil on the stone models [Figure 2]. Reference
lines were drawn so that the brackets could be positioned on the
Facial Axis of Clinical Crown (FACC) of the tooth.
Bracket positioning on models
No‑base technique
Brackets were placed on the working models in marked positions
using a Bracket Holding Tweezers, with Deli (water soluble
glue) for Group A and B. Brackets were held in position firmly
with a sickle probe until the glue sets [Figure 3]. Models are
kept for approximately 2 h so that the glue achieves sufficient
strength for holding brackets during tray fabrication [Figure 4].
Custom‑base technique
Group C (pink)
For the indirect Group C, Transbond Supreme LV (3M UNITEK,
Monrovia, CA, USA), a low‑viscosity flowable light‑cured
composite, was used for placing the brackets on the working
models in marked positions using a Bracket Holding Tweezers.
The brackets were held firmly onto the cast, and the excess
material was removed using a sickle scaler. The brackets were
light cured with a LED light cure machine for 20 s.
Group D (red) and Group E (white)
For the indirect Group D and E, Transbond XT (3M UNITEK,
Monrovia, CA, USA) was used for placing the brackets on the
working models in marked positions using a Bracket Holding
Tweezers. A small amount of resin was applied on the mesh
and then positioned on the cast. The brackets were held firmly
onto the cast, and the excess material was removed using a
sickle scaler. The brackets were light cured with a LED light
cure machine for 20 s.
Fabrication of transfer trays
The indirect bonding transfer trays were vaccum formed
for each group with Biostar Machine (Scheu-Dental) using
1.5 mm × 125 mm bioplast (Scheu-Dental) clear sheet. The
excess material is trimmed off with a scissor [Figure 5].

Figure 2: Reference lines

a b
Figure 1: (a) Teeth mounted in acrylic blocks; Group A: Black, Group B:
Blue, Group C: Pink. (b) Teeth mounted in acrylic blocks: Group D: Red,
Group E: White

Figure 3: Bracket positioning on stone models Figure 4: Brackets positioned on stone models using Deli

Journal of Indian Orthodontic Society | Vol 51 | Issue 1 | January‑March 2017 17

 Bolya, et al.: Bond strength - Indirect bonding techniques
For Group A and B, the trays were immersed in water for
20 min so that the glue dissolves. For Group C, D, and E, the
trays were additional cured for 20 s after removal to ensure that
any uncured resin is cured. The trays were lightly sandblasted
to remove any impurity present. The trays were kept under
running water and cleaned using a painting brush. The trays
were then dried with oil‑free air flow source.
All the trays were checked on their respective blocks before
bonding on teeth, for proper seating and stability.
Bonding procedure on teeth
All teeth were cleaned using a coarse pumice and water slurry
with rubber prophylaxis cups for 5 s and thoroughly rinsed
using an air/water spray for 10 s. The teeth were then dried
using an air‑water syringe for 10 s. For all bonding steps,
manufacturer’s instructions for each bonding material were
followed.
After all the teeth were prepared and cleaned thoroughly,
they were etched with etchant gel (solo etch) containing 37%
phosphoric acid, which was applied to the bonding area of the
tooth for 30 s, rinsed for 20 s, and thoroughly dried with oil‑free
compressed air for 10 s to get a frosty white appearance.
The trays were carefully examined before placement for any
remaining impurity or tray material that might be covering
bracket base. A liberal coat of Transbond XT primer was
painted onto the enamel surface and dried with air source for
2 s for all the groups.
Group A (black) and C (pink)
A small amount of Sondhi Rapid Set resin A and resin B were
poured into the wells. A thin coat of resin A was painted on
teeth and resin B was painted on the bracket mesh (Group A)
or resin pads (Group C). The trays were seated onto the teeth
in hinge motion. With fingers, equal pressure was applied on
occlusal and buccal surfaces of the teeth. The trays were hold
firmly in position for minimum 30 s and then allowed for
5 more min to cure.
Group B (blue) and Group D (red)
A small amount of Transbond XT adhesive was applied on the
bracket base for Group B and on the custom resin pads for the
Group D. The trays were seated onto the teeth in hinge motion.
Figure 5: External view of the bonding tray
18
Once seated, each tooth was light cured for 20 s through the
transfer trays.
Group E (white)
A small amount of Transbond Supreme LV adhesive was
applied on the custom resin pads for the Group E with the
20‑gauge syringe delivery provided by the manufacturer. The
trays were seated onto the teeth in hinge motion. Once seated,
each tooth was light cured for 20 s through the transfer trays.
Removal of transfer trays
The trays were sectioned using Bald and Parker blade and
handle from the occlusal part of teeth [Figure 6a]. The lingual
part was removed from the teeth. The buccal portion of the
tray holding was peeled off with care [Figure 6b]. The teeth
bonded with light‑cured adhesives Group B, D, and E were
additional cured for 10 s to ensure complete curing of the
resin [Figure 6c].
Shear bond strength test
The SBS of each group was determined approximately 72 h
after the bonding procedure at Advanced Materials and Process
Research Institute. A custom‑made chisel‑shaped rod was
locally fabricated for debonding of brackets. The chisel was
attached to the crosshead of a universal testing machine (Lloyd
Instruments; LRX Plus).
The rod applied an occlusogingival load to the bracket,
producing a shear force at the bracket tooth interface. Samples
were mounted so that the long axis of the bracket was parallel
to the debonding chisel. Care was taken to apply the force of
the chisel edge at the junction of the bracket base and bracket
body but not on the fine lip of the base pad [Figure 7]. The
bracket base pad is too thin for the chisel to consistently “catch”
during the debonding procedure and thus was not used as the
site for force application.
The results of each test were recorded by a computer that
is electronically connected to the testing machine. The
universal testing machine (cell capacity = 5 kN) recorded the
results from each test in Newton (N) at a crosshead speed of
0.5 mm/min. SBS in megapascals was determined by dividing
a b
c
Figure 6: (a) Sectioning of the tray. (b) Labial portion being peeled off.
(c) Light cure adhesives additional cured for 10 s
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 Bolya, et al.: Bond strength - Indirect bonding techniques

Table 2: Mean shear bond strength in MPa of different

groups
Groups Mean SBS in MPa
Group A 8.147
Group B 10.600
Group C 9.662
a b
Group D 10.93
Figure 7: (a) Acrylic block fixture: front. (b) Acrylic block fixture: side view Group E 10.644
SBS: Shear bond strength
the peak debonding force (N) by the surface area of the bracket
base (10.6 mm2), i.e., MPa = N/mm2.
Table 3: Comparison of shear bond strength of Group A
to all the groups
Results
Groups Mean±SD n t P Result
Statistical analysis
Group A 8.147±2.421 10 1.2845 0.2152 NS
The obtained data were subjected to following statistical
Group B 10.600±5.532 10
analyses.
Group A 8.147±2.421 10 2.2668 0.2937 NS
Unpaired t‑test was used to determine whether significant Group C 9.662±3.711 10
differences existed between the different groups of the bond Group A 8.147±2.421 10 0.2250 0.0360 S
strength values calculated. Significance for all statistical tests Group D 10.93±3.034 10
was predetermined at P ≤ 0.05. Group A 8.147±2.421 10 2.8383 0.0109 S
Group E 10.644±1.369 10
Mean of all groups was obtained [Table 2]. SBS of each group Significance for statistical tests was predetermined at P≤0.05. SD: Standard
was compared with all other groups [Tables 3‑6]. A linear deviation, NS: Not significant, S: Significant
and bar graph was formed for comparison between groups
[Graphs 1 and 2].
Table 4: Comparison of shear bond strength of Group B
to Group C, D, and E
Discussion Groups Mean±SD n t df P Result
In the previous generation, good orthodontists were those Group B 10.600±5.532 10 0.4449 18 0.6617 NS
with the good wire bending skills, but in coming generation, Group C 9.662±3.711 10
good orthodontist will be the one who can place brackets more Group B 10.600±5.532 10 0.1653 18 0.8705 NS
accurately. Many reports indicated that indirect bonding is Group D 10.93±3.034 10
superior in terms of accurate bracket placement Silverman Group B 10.600±5.532 10 0.0244 18 0.9808 NS
et al. 1972;[12] Thomas 1979;[10] Hickman 1993;[13] Bon Chan Group E 10.644±1.369 10
Koo et al. 1999.[14] Significance for statistical tests was predetermined at P≤0.05. SD: Standard
deviation, NS: Not significant
Different types of adhesives were used in this study, with
different chemical properties and different application
techniques. Group A and B comprised no‑base technique, in Table 5: Comparison of shear bond strength of Group C
which water soluble glue was used for positioning of brackets to Group D and E
on the working models, whereas in Group C, D, and E, Groups Mean±SD n t df P Result
custom‑base techniques were used. All the groups presented Group C 9.662±3.711 10 0.8359 18 0.4142 NS
clinically acceptable bond strength. Group D 10.929±3.034 10
In Group A, n o‑mix chemically cured adhesive Group C 9.662±3.711 10 0.7844 18 0.4430 NS
(Sondhi Rapid Set) was used for bonding on teeth. The results Group E 10.644±1.369 10
Significance for statistical tests was predetermined at P≤0.05. SD: Standard
for Group A (8.147 ± 2.4) presented a clinically acceptable deviation, NS: Not significant
bond strength according to Reynolds.[15] This technique was
previously used by Moin and Dogon(1977),[16] in which
they used sticky wax on cast followed by chemically cured Table 6: Comparison of shear bond strength of Group D
adhesive on teeth. However, this chemically cured adhesive to Group E
was unable to provide sufficient chair‑side time to the operator.
Groups Mean±SD n t df P Result
Scholz (1983)[17] used sugar daddy for positioning of the
Group D 10.929±3.034 10 0.2715 18 0.789 NS
brackets on the cast. The use of sugar daddy (water soluble)
Group E 10.644±1.369 10
allowed the clinician to reevaluate the bracket positions done Significance for statistical tests was predetermined at P≤0.05. SD: Standard
by the technicians. deviation, NS: Not significant

Journal of Indian Orthodontic Society | Vol 51 | Issue 1 | January‑March 2017 19

 Bolya, et al.: Bond strength - Indirect bonding techniques
Graph 1: Between group and mean in MPa (linear)
In Group A, the mean bond strength was 8.14 MPa, which had
no significant difference in comparison with Group B and C,
but statically significant difference was found when compared
with Group D and E.
In Group B, a light‑cured adhesive (Transbond XT) was used
to adhere brackets onto teeth. The mean bond strength of
the Group B was 10.6 MPa, which is clinically acceptable
bond strength. This technique has been previously used
by Larry White (1999),[18] in which he used water soluble glue
(tacky glue) for bracket‑cast adhesion followed by light‑cured
resin on teeth.
Custom‑base technique was first introduced by Thomas
(1979),[10] which involved the formation of custom composite
pad that was then adhered to the tooth with a two‑part, unfilled
resin: one part was applied to set the composite on the base
pad, and the other part, a sealant to the tooth. This increased
the working time and reduced the cleanup.
Group C (Transbond LV/Sondhi) showed mean bond
strength of 9.66 MPa, which is optimum for orthodontic
purpose. Various authors have performed studies comparing
different chemically cured adhesives and with direct bonding
procedures. In contrary to this study, Anoop Sondhi 1999,[19]
Arndt Klocke et al. 2003,[11] showed greater bond strength for
this technique up to 11.2 MPa. Arndt Klocke (2003)[11] stated
the mean bond strength of 6.2 MPa for Sondhi Rapid Set when
used with cyanoacrylates. The difference in bond strength
is might be because of the various combinations used with
Sondhi.
Lower bond strength for was seen for chemically cured resin
in Group A and C might be because of time of debonding. In
this study, the samples were debonded after 72 h of bonding.
Arndt Klocke (2003)[11] observed highest bond strength for
chemically cured adhesives in first 30 min and followed by
fall in bond strength after 24 h. While in light‑cured adhesives,
maximum bond strength is seen after 24 h.
For Group D (Transbond XT), the mean bond strength
was found to 10.92 MPa, which was the highest among
all the groups. Read (1990) [20] advocated the use of
20 Journal of Indian Orthodontic Society | Vol 51 | Issue 1 | January‑March 2017
Graph 2: Between group and mean in MPa (bar)
light‑cured adhesives for indirect bonding. The factor of
most importance is the command set of the light‑cured
material. When a chemically cured material is used with
either bonding technique, polymerization begins as soon
as the two components of the material come into contact;
with the indirect technique, it is inevitable that the material
on the bracket bases that were loaded first will be at a more
advanced state of polymerization than the material on the
bases that were loaded at the end of the procedure. This
uneven rate of polymerization could result in an increase in air
inclusions. In contrast, when the light‑cured material is used,
the adhesive material does not begin polymerization until it
is exposed to the visible light source. Therefore, it is possible
that this results in optimum adaptation and penetration of the
adhesive material to the etched enamel, resulting in higher
bond strength.
In recent years, flowable composites have gained a lot of
attention. Miles (2002)[21] advocated the use of flowable
composite for indirect bonding. The flowable composites have
several advantages such as it reduces the voids at the enamel
resin interface.
Miles (2005)[22] compared the clinical failure rates between
flowable composite and chemically cured resin and found
lower with flowable composite. In this study, the mean bond
strength of the flowable composite Group E was found to
be 10.6 MPa, which is optimum for orthodontic purpose.
Transbond Supreme LV was used as a primer.
Conclusion
Many techniques have been developed for indirect bonding by
various researches, but few of them present appropriate data
on bond strength. Therefore, there was a need to evaluate bond
strength obtained using various indirect bonding techniques
for the use in the clinical practice.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 Bolya, et al.: Bond strength - Indirect bonding techniques
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