In vitro examination of different orthodontic treatment types, bonding methods and bonding adhesive types in terms of leaving composite residue on tooth surface and causing white lesions

In this study, we investigate the influence of different bonding adhesive types and different bonding techniques on the residual adhesive area and the white spot area around braces. In our study, 90 undamaged lower and upper first and second premolars without lesions and extracted for orthodontic treatment were used. The roots of these teeth were embedded in plaster blocks in groups of three, leaving the crowns outside. 5 groups were constructed and each group consisted of 18 teeth. In the 1st group, the bonding process was performed using direct technique and Transbond XT bonding adhesive (group A). In the 2nd group, the bonding process was performed using direct technique and colored bonding adhesive Transbond Plus (group B). In the 3rd group, the bonding process was performed using indirect technique and Transbond XT bonding adhesive (group C). In 4th group, clear essix retainer was applied (group D). The 5th group was the control group and no orthodontic appliance was administered (Group E). All tooth blocks were subjected to a pH cycle for 28 days after the relevant techniques and materials were applied. At the end of the pH cycle, which represents a cariogenic medium, the areas around the braces were examined with a SEM device and the amount of excess adhesive areas were calculated. Later, the brackets were removed, the tooth surfaces were cleaned, and the photographs of all teeth in groups were taken in a standardized setup. White spot lesion area calculations were made on the photographs. Shapiro-Wilk test was used for testing normality of the variable distribution, One Way ANOVA test was used for the comparisons between the groups and Pearson correlation analysis was used for testing the relationship between variables. The results of our research revealed that, the excess composite around the bracket can be cleaned more effectively when colored adhesives are used. White spot lesions were observed in all groups when a cariogenic medium was created. White spot area was found to be greater in the control and essix groups. Additionally, a negative correlation was observed between the sizes of excess adhesive area and white spot area in the indirect bonding group.