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Title Saliva Contamination May Not Reduce the Success Rate of Orthodontic Bracket Bonds with Self-Etching Primer
Clinical Question To what extent does saliva contamination, before or after the application of self-etching primer, weaken the bonding of orthodontic brackets?
Clinical Bottom Line Saliva contamination pre- or post- application of self-etching primer does not increase the risk of failure of orthodontic bracket bonds. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20451788Campoy / 201046 patients, 531 bracketsCohort split-mouth control
Key resultsChi-square analysis revealed no difference in failure rate (p=0.11) nor survival rate (p=0.51) between uncontaminated control sites (263 brackets, 16 failures), contamination before primer (153 brackets, 16 failures), or contamination after primer (115 brackets, 5 failures).
Evidence Search (("Dental Cements"[Mesh]) AND "Orthodontic Brackets"[Mesh]) AND "Saliva"[Mesh] AND ("self etching primer" OR "self-etching primer") ...view in PubMed
Comments on
The Evidence
This was an internally controlled (split-mouth) design in which each patient received contamination-free priming, as well as pre-priming, and post-priming saliva contamination. Patients were followed for at least 6 months post-bonding, and only first-time failures were recorded per tooth.
Applicability Patient demographics were not described in the article. Patients were said to have "malocclusion as symmetrical as possible," bonded teeth were caries-free, restoration-free, and free of enamel disorders, and opposing tooth/bracket interferences were avoided. The bonding technique itself seems to be within the range of any orthodontic practice.
Specialty/Discipline (Orthodontics)
Keywords orthodontic brackets, saliva contamination, self-etching primer
ID# 883
Date of submission: 05/05/2011spacer
E-mail chaudharyg@uthscsa.edu
Author Gaurang Chaudhary
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Wesley Shute, Kristin Saunders (San Diego, CA) on 10/03/2014
An October 2014 PubMed database search revealed two more recent articles regarding enamel surface contamination during bonding of orthodontic brackets. Santos, 2010, PubMed ID 20578870, a comparative study; and Goswami, 2014, PubMed ID 25143933, a RCT. Both articles support the conclusion of the CAT published in 2010, that saliva contamination does not significantly effect the bond strength to enamel when using a hydrophilic bonding agent.

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