Comparative Assessment of the Shear Bond Strength of Ceramic Brackets Bonded to the Enamel Surface with a Self-adhesive System

Objectives: This study aimed to evaluate the shear bond strength of ceramic brackets bonded to the enamel surface using Vertise Flow, with or without the application of phosphoric acid. Materials and Methods: Forty-five extracted human premolar teeth were randomly assigned to three groups (N=15) based on the adhesive used for bonding: 1) Transbond XT, etch, and bond; 2) Vertise Flow; 3) Etch and Vertise Flow. After a 500-round thermocycling procedure, the shear bond strength was measured using a universal testing machine. The samples were then evaluated under a stereomicroscope to determine failure modes, and the Adhesive Remnant Index (ARI) was measured for each group. The data were analyzed with one-way ANOVA and post-hoc Tamhane at a significance level of P<0.05. Results: The highest shear bond strength values were observed in the Transbond XT (13.5±5.38MPa), acid etch and Vertise Flow (11.2±2.89MPa), and Vertise Flow (6.2±3.16MPa) groups, respectively, in descending order. The Vertise Flow group exhibited a significantly lower shear bond strength value compared to the other two groups, with no significant difference between the latter two. Conclusion: While all three study groups demonstrated clinically acceptable shear bond strength values, Vertise Flow showed lower values compared to the other two adhesives. The Vertise Flow composite resin system, whether used alone or with acid etching, remains a suitable choice for bonding ceramic brackets, offering the advantage of a simplified bonding procedure.