Comparative bond strength of new and reconditioned brackets and assessment of residual adhesive by light and electron microscopy.

An average rate of bracket loss of between 4.7 and 6 per cent is to be expected in daily clinical orthodontic practice during a typical 2 year treatment period. For reasons of economy, detached brackets are commonly reattached after sandblasting to remove adhesive, or replaced with used brackets reconditioned by specialist companies. In the present study, sandblasting and specialist bracket-reconditioning procedures were systematically compared by comparative shear testing of rebonded, reconditioned, and new brackets (n = 160) using light- and chemically cured adhesives. Statistical analysis was carried out with Kruskal-Wallis and Mann-Whitney tests. The mean bond strength of reconditioned brackets was, in each case, lower than that of new brackets, with the lowest value obtained with sandblasted brackets. This nevertheless exceeded the minimum recommended value of 5-8 MPa. Bond strength was generally higher with chemically than with light-curing adhesive; the chemically curing adhesive provided bond strength on previously bonded enamel higher than the light-curing adhesive on intact teeth. Consistent with this, the results of the adhesive remnant index (ARI) demonstrated improved bonding with the chemically curing than the light-curing adhesive to the bracket base. Despite resulting in a weaker bond strength compared with new brackets, sandblasting brackets accidentally detached during orthodontic treatment will generally allow effective reattachment to be achieved. Bond strength can be improved with the use of a chemically cured adhesive. Used brackets reconditioned by specialist companies provide a second alternative to new brackets and higher bond strengths than sandblasted brackets.