Bonding durability and remineralizing efficiency of orthodontic adhesive containing titanium tetrafluoride: an invitro study

BACKGROUND: Titanium tetrafluoride has been shown to protect tooth enamel from demineralization. This study investigated the effect of incorporating different concentrations of TiF4 (1, 2 and 3 Wt.%) into an orthodontic primer on the shear bond strength of orthodontic brackets and the enamel microhardness after cariogenic challenges. METHODS: Three different TiF4 concentrations (1, 2 and 3 Wt.%) were prepared and added to the etch and rinse orthodontic primer. Ninety freshly extracted premolars were randomly divided into five groups according to the experimental primers and ageing conditions: TF0, TF0C, TF1C, TF2C, and TF3C. The TF0C group had no TiF4 in the primer, while TF1C, TF2C, and TF3C had 1, 2 and 3 Wt.% TiF4 in the primer, respectively. In the TF0 group, specimens were immersed in deionized water for 24 h as a control group, while all other groups were immersed in a demineralizing solution for 28 days. Each of the five groups was divided into two subgroups: The first group was subjected to shear bond strength and adhesive remnant index testing (N = 50 teeth, 10/group), while the second group was subjected to enamel surface microhardness testing (N = 25 teeth, 50 tooth halves, 10 tooth halves/group). Fifteen teeth (N = 15 teeth, n = 3/group) representing the five groups were subjected to SEM and microelemental analysis (EDX). SBS, ARI, microhardness, and Ca/P ratio were measured, and the data were analyzed using ANOVA and Tukey's tests. RESULTS: The TF2C group had the highest SBS value (9.93 ± 1.23), while the TF0C (5.24 ± 0.65) and TF3C (5.13 ± 0.55) had the lowest SBS values. The enamel microhardness in the TF0C group was significantly reduced (p < .001). Enamel microhardness values were significantly (p < .001) higher in groups TF1C, TF2C, and TF3C than in TF0C. The highest Ca/P ratio was significantly recorded for the TF2C group (2.65 ± 0.02). CONCLUSIONS: Incorporation of 1 and 2 Wt.% TiF4 into the orthodontic primers showed adequate bond strength and better remineralization effect. However, 1 Wt.% TiF4 showed lower ARI values than 2 Wt.% TiF4.