J Bagh College Dentistry                Vol. 29(3),  September 2017               The Effect of among 
   

Pedodontics, Orthodontics and Preventive Dentistry 75 
 

The Effect of Enamel Protective Agent on Shear and 

Tensile Bond Strength of Stainless Steel Brackets by Using 

Different Adhesive Agents (In Vitro Study) 
 

Dhuha Abdul-Qader, B.D.S. (a) 

Sami K. Al-Joubori, B.D.S., M.Sc. (b) 
 

ABSTRACT 
Background: Decalcification of enamel surface  adjacent to fixed orthodontic appliances, in the form of white spot 

lesions, is a wide spread and familiar well-known side effect of orthodontic treatment. The present study was carried 

out to evaluate the effect of enamel protective agent (Clinpro white varnish) on shear and tensile bond strength of 

Dentaurum orthodontic stainless steel brackets by using 3M Unitek and Ormco as orthodontic adhesive agents. 

Materials and methods: Sixty-four extracted human upper first premolar teeth were selected and randomly divided 

into two groups with 32 teeth each, representing the shear and tensile bond strength testing groups. Then according 

to the type of bonding adhesive and the addition of Clinpro before bonding (3M, Clinpro + 3M, Ormco, Clinpro + 

Ormco) each group was subdivided into four equal subgroups each with 8 teeth. After passing twenty-four hours of 

bonding procedure, where the samples were kept at 37˚C the brackets were debonded by using Tinius-Olsen 

universal testing machine to record the shear and tensile bond strength value. The difference in bond strength was 

analyzed by using ANOVA test at p≤0.05. 

Results: The use of Clinpro with 3M Unitek orthodontic bonding agent shows higher shear and tensile bond strength 

than Clinpro with Ormco orthodontic bonding agent. 

Conclusions: Using Clinpro white varnish before bonding can be successfully used with 3M Unitek orthodontic 

bonding agent. 

Keywords: Clinpro white varnish, bond strength, 3M and Ormco orthodontic bonding agent. (J Bagh Coll Dentistry 

2017; 29(3):75-79) 

INTRODUCTION 
The fixation of orthodontic brackets enhances 

plaque retention and when the oral hygiene of the 

patient is poor, this will favor the development of 

demineralization and initial caries around the 

brackets (1). 

As carbohydrates been taken daily, they are 

fermented by the bacteria that colonized in the 

plaque and lead to decrease the intraoral pH. The 

low pH results in dissociation of calcium and 

phosphate ions from the enamel in an attempt to 

reach chemical equilibrium in the oral cavity 

environment. Thus, one possible inseparable 

problem during the whole course of orthodontic 

treatment is the enamel demineralization around 

brackets, representing the primary phase of caries 

formation (2). 

Prevalence of these acquired surface lesions 

due to orthodontic treatment, white spot lesions 

(WSL) is relatively high, affecting more than 40% 

to 60% of the orthodontic patients. They can 

appear very quickly, as rapid as in a couple of 

weeks after fixation of the brackets (3, 4). 

Brackets are bonded to the surface of teeth 

with orthodontic adhesive. Bonding of 

orthodontic brackets to the tooth enamel has been 

an important issue since the introduction of direct 

bonding in orthodontics (5). 

 
(a)Master student, Department of Orthodontics, College of 
Dentistry, University of Baghdad. 
(b)Assistant Professor, Department of Orthodontics, College of 

Dentistry, University of Baghdad. 

Composite resins are one of the most 

frequently used adhesives in orthodontic bonding 
(6). Although they provide sufficient bonding 

strength and are easy to handle, they adhere to the 

tooth enamel only by micro-retention, require dry 

field and amount of fluoride release have not been 

found to be sufficient for anti-caries effect (7). 

The efficacy of preventive measures against 

the appearance of this phenomenon has been 

questioned during the last two decades. 

Preventive methods mainly target the 

remineralization process and the inhibition of 

present bacterial flora through the use of topical 

fluoride applications, use of adhesives with 

remineralization potential that contains 

amorphous calcium phosphate or fluoride, ozone 

applications, chlorhexidine mouth rinses, 

probiotics, xylitol, and sealants (8). 

The Preventive measures that do not require 

patient compliance are considered more 

predictable since only 13% of the patients were 

notified to achieve excellent cooperation with the 

use of mouth rinses and tooth brushing 
(9).Therefore, sealing the susceptible enamel prior 

to bracket placing in order to form a caries-

protective shield has been the focus of interest in 

previous studies that primarily intend to obviate 

patient compliance (10, 11). 

Fluoride has been proven to be effective in 

reducing the development of WSLs associated 

with fixed orthodontic treatment (12). Clinpro, is a 
fluoridated varnish, has been introduced to the 

market and supposed to be most beneficial in a 



J Bagh College Dentistry                Vol. 29(3),  September 2017               The Effect of among 
   

Pedodontics, Orthodontics and Preventive Dentistry 76 
 

neutral pH environment. Sealants were suggested 

as protective enamel agents that do not require 

patient cooperation (11). 

 

MATERIALS AND METHODS 
The sample 

After examination with magnifying lens (10X) 

and light transillumination (13), sixty-four freshly 

extracted human maxillary first premolars   

(extracted for orthodontic reason) were collected 

and stored in closed containers filled with distilled 

water with 0.1% concentration of thymol crystals 

(Volume/Weight) (14), to prevent dehydration and 

bacterial growth (15, 16).  

The teeth were divided into two groups: one 

for shear bond testing and the other group for 

tensile bond testing. Then each group was 

subdivided equally into 4 subgroups according to 

the orthodontic adhesive agent and the use of 

Clinpro (white varnish). 

Shear bond group:  

A1: 3M bonding agent,  

A2: Clinpro with 3M,  

B1: Ormco bonding agent,  

B2: Clinpro with Ormco. 

Tensile bond group:  

C1: 3M bonding agent,  

C2: Clinpro with 3M,  

D1: Ormco bonding agent,  

D2: Clinpro with Ormco. 

 

Construction of the acrylic block 
By using dental surveyor, the teeth assigned 

for shear testing were mounted vertically on a 

glass slide, and the teeth assigned for tensile 

testing were mounted horizontally (17, 18). Then the 

acrylic were poured to the level of the cemento-

enamel junction of each tooth (19) using two L-

shaped metal plate placed in opposite side to 

make the mold for the acrylic block. After setting, 

slight adjustment of the acrylic blocks was made 

by using a portable engine. 

After mounting, the specimens were coded and 

then stored in normal saline solution containing 

crystals of thymol to prevent dehydration and 

bacterial growth until bonding (20). 

 

Bonding procedure 

The buccal surface of the teeth was polished 

using non-fluoridated pumice with a brush (one 

brush used for each subgroup for standardization 

attached to a low speed handpiece for 10 seconds 

(21), then each tooth was rinsed with water spray 

for 10 seconds, and dried with oil-free air for 10 

seconds (19). 
The distance of 1cm was used as 

standardization to hold the air water syringe away 

from tooth surface (22). Thirty-two teeth (sixteen 

for shearing test group and sixteen for tensile test 

group) were bonded directly without using the 

enamel protective agent (Clinpro) (A1, B1, C1 

and D1). Subgroup A1 + subgroup C1 (control) 

The bonding agent was done according to 

manufacturer instructions and at room 

temperature (24˚ C) with bracket placement in the 

middle of the buccal surface of the tooth. For 

standardization of pressure on the bracket, a 

constant load was placed on the bracket for 10 

seconds (23) (by fixing 200 gm load on the upper 

part of the vertical arm of the surveyor, and fixing 

a hard rubber polishing bur in the lower part of 

the vertical arm of the surveyor and put it in 

contact with the bonded bracket), to make sure 

that each bracket was seated under an equal force 

and to ensure a uniform thickness of the adhesive 
(24). 

Any excess adhesive material around the 

bracket base was gently removed by using dental 

probe before it has been set without disturbing the 

seated bracket (25). Then curing the bracket 

adhesive (according to manufacturer instructions), 

at a distance of 5 mm (26). 

The same procedure had been made with the 

samples of subgroups B1 and D1 using Ormco 

orthodontic bonding agent. 

Clinpro was used with subgroups A2, B2, C2 

and D2 before etching the tooth surface according 

to manufacturer instructions of application. The 

samples, after application of Clinpro, were 

immersed in artificial saliva at 37˚C for 24 hours 
(27).Then the subgroup A2 and subgroup C2 was 

bonded with 3M bonding agent as we did with the 

subgroups A1 and C1.The subgroup B2 and 

subgroup D2 was bonded with Ormco bonding 

agent as it has been done with the subgroups B1 

and D1. 

After completion of the bonding procedure, 

the specimens were immersed in distilled water 

and stored in the incubator at 37˚C for 24 hours 

prior to bracket debonding (28). 

 

Shear bond strength test 

The shear bond strength test was accomplished 

using a Tinius-Olsen Universal testing machine 

with a 5 KN load cell, a custom made chisel rod 

and a cross head speed of 0.5mm/minute (29), and 

the maximum load necessary to de-bond the 

bracket was registered (30). 

 

Tensile bond strength test 

Tensile testing was accomplished using the 

same Universal testing machine by using long 

orthodontic archwires to pull the bracket in a 

vertical direction (18). 



J Bagh College Dentistry                Vol. 29(3),  September 2017               The Effect of among 
   

Pedodontics, Orthodontics and Preventive Dentistry 77 
 

The readings were in megapascal (MPa) by 

dividing the force values by the bracket basal area 

(each 1 MPa equals1 N/mm²) (31). 

 

Statistical analyses 
   Data were analyzed using SPSS (statistical 

package of social science) software version 19 by 

using the following statistics: 

A. Descriptive statistics: including mean, 

standard deviation, minimum, maximum, 

statistical tables. 

B. Inferential statistics: including; 

1. Shapiro-Wilk test: To Test the normality 
of distribution of the data. 

2. One way analysis of variance (ANOVA): 
To test any statistically significant 

difference among the tested groups. 

3. Tukey’s honestly significant difference 
test: To test any statistically significant 

differences between each 2 groups when 

ANOVA showed a statistical significant 

difference. 

In the statistical evaluation, the following 

levels of significance are used: 

P > 0.05 NS Non-significant 

0.05 ≥ P > 0.01 S Significant 

P ≤ 0.01 HS Highly significant 

 

RESULTS 
Testing the normality of data distribution was 

carried out by using Shapiro-Wilk test, and the 

results showed that the data was normally 

distributed within the shear and tensile subgroups 

(p>0.05). 

The descriptive statistics of the shear bond 

strength subgroups were shown in Table (1). 

It was clearly that subgroup A1 (samples with 

3M Unitek bonding agent) showed the highest 

shear bond strength value; while subgroup B2 

(samples with Clinpro with Ormco bonding agent) 

demonstrated the least shear bond strength value 

among the shear bond subgroups. 

ANOVA exhibited there was statistically 

highly significant difference among the mean 

values of the shear bond subgroups (P≤0.01). 

 

Table 1: Descriptive statistics of the shear 

bond strength (MPa) subgroups. 

G
r
o

u
p

s 

Descriptive statistics 
Comparison 

(d.f.=31) 

Mean S.D. Min. Max. 
F- 

test 

p-

value 

A1 14.90 1.93 12.29 17.81 

47.345 
0.000 

(HS) 

A2 6.16 1.89 4.08 8.96 

B1 12.02 2.51 9.59 15.38 

B2 4.61 1.51 3.04 7.77 

 

Testing the mean differences by using Tukey 

honestly significant difference test showed that 

there was a high significant difference between 

the subgroups A1 and A2, B1 and B2, and a 

significant difference between A1 and B1. 

Nevertheless, the difference between the 

subgroups A2 and B2 was not significant; as 

shown in Table (2). 

 

Table 2: Tukey HDS test of the shear bond 

strength subgroups. 

Groups 
Mean  

difference 
p-value 

A1 
A2 8.74 0.000 (HS) 

B1 2.88 0.035 (S) 

A2 B2 1.55 0.417 (NS) 

B1 B2 7.42 0.000 (HS) 

 

The descriptive statistics of the tensile bond 

strength subgroups were shown in table (3). It was 

clearly obvious that the subgroup C1 (samples 

with 3M Unitek bonding agent) had shown the 

highest tensile bond strength value; while 

subgroup D2 (samples with Clinpro and Ormco 

bonding agent) presented the least tensile strength 

value. 

ANOVA showed that statistically there was a 

highly significant difference among the mean 

values of the tensile bond subgroups (P≤0.01). 

  

Table 3: Descriptive statistics of the tensile 

bond strength (MPa) subgroups 

G
r
o

u
p

s 

Descriptive statistics 
Comparison 

(d.f.=31) 

Mean S.D. Min. Max. 
F- 

test 

p-

value 

C1 5.11 1.36 3.18 7.19 

18.391 
0.000 

(HS) 

C2 4.54 1.51 3.08 7.42 

D1 2.42 1.58 0.51 4.77 

D2 0.87 0.19 0.65 1.15 

 

Testing the mean differences between the 

tensile subgroups by using Tukey HDS test 

revealed statistically that there were non 

significant differences between the subgroups C1 

and C2, D1 and D2; whereas there were high 

significant differences between the subgroups C1 

and D1, C2 and D2 as shown in the Table (4). 

 

Table 4: Tukey HDS test of the tensile 

subgroups. 
Groups Mean difference p-value 

C1 
C2 0.57 0.816 (NS) 

D1 2.69 0.001 (HS) 

C2 D2 3.67 0.000 (HS) 

D1 D2 1.55 0.099 (NS) 

 



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Pedodontics, Orthodontics and Preventive Dentistry 78 
 

DISSCUSION 
In this study, the mean SBS of the two 

orthodontic adhesives; 3M Unitek (14.90 MPa) 

and Ormco (12.02 MPa) bonding agents was 

higher than the clinically adequate SBS (5.9 to 

7.8 MPa) as proposed by Reynolds (32), which 

means that both of the adhesives can resist shear 

stress to adequate level. 

In addition to that, 3M Unitek orthodontic 

bonding adhesive gave a greater value in shear 

test than Ormco orthodontic bonding adhesive, 

and this could be attributed to the composition of 

the adhesive including the type, shape, size, and 

amount of inorganic fillers, and the type of 

coupling agent present in the adhesive itself (33). 

While, after the pretreatment with the enamel 

protective agent (Clinpro), the mean SBS of the 

3M Unitek bonding agent (6.16 MPa) was  higher 

than the mean SBS of the Ormco (4.61 MPa) 

bonding agent, although both of them were higher 

than the required minimum SBS for direct 

bonding (3 MPa) suggested by Lopez  (34). 

The mean SBS of the Ormco bonding agent 

with the pretreatment with Clinpro (4.61 MPa)  

was lower than that of the control subgroup, and 

this could be attributed to the resistance effect that 

the outer enamel layer acquires from the fluoride 

content of the Clinpro which may be of significant 

effect (35). 

The result of the present study showed that the 

mean tensile bond strength of the 3M Unitek 

bonding agent (5.11 MPa) was higher than the 

mean tensile bond strength of the Ormco bonding 

agent (2.42 MPa). 

The findings of the present study showed with 

the pretreatment of the samples with the enamel 

protective agent (Clinpro), the mean tensile bond 

strength of the 3M Unitek bonding agent (4.54 

MPa) was higher than the mean tensile bond 

strength of the Ormco bonding agent (0.87 MPa) 

and this might be due to the more flowable acid 

etch of the Ormco orthodontic bonding agent that 

might have a less penetrating effect than the gel 

acid etch of the 3M Unitek orthodontic bonding 

agent, but both of the mean tensile bond strength 

values were lower than their corresponding 

control groups (36). 

 

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مة للصدأتأثير المادة الواقية لمينا السن على قوى القص والشد باختالف مواد لصق الحاصرات المعدنية المقاو  

)دراسة مختبرية(   
 الخالصة

تصاحب التي زوال كلس المينا لسطوح االسنان المجاورة ألجهزة تقويم األسنان الثابتة، في شكل بقع بيضاء، من االثار الجانبية المعروفة والمألوفة 

( على قوة القص والشد لحاصرات التقويم المعدنية Clinproعالج االسنان باستخدام التقويم. لقد أجريت هذه الدراسة لتقييم تأثير عامل وقائي المينا )

 . Ormco)و ) (3M)باستخدام مواد لصق حاصرات التقويم 

لكل منهما، تمثل مجموعات  سن 23ية وقسمت عشوائيا إلى مجموعتين  ن البشراختيار أربعة وستين سن من الضواحك العلوية األولى من االسناتم 

 + Clinpro( )3M ،Clinpro + 3M ،Ormco ،Clinproاختبار قوة القص وقوة الشد, ثم وفقا لنوع المادة الالصقة وإضافة عامل واقي المينا )

Ormcoرين ساعة من إجراء الربط، حيث تم أربع وعش أسنان. بعد مرور 8وية لكل منها ( تم تقسيم كل مجموعة إلى أربع مجموعات فرعية متسا

( لقياس قيمة قوة القص والشد للحاصرات المعدنية. (Tinius-Olsenاختبار فك االرتباط  باستخدام الة الفحص العالمية  تم C°37العينات في  حفظ

 .(p≤0.05)ل  (ANOVA)تم تحليل الفرق في القوى باستخدام اختبار 

كمادة رابطة لحاصرات التقويم يظهر أعلى قوة قص وقوة شد للحاصرات المعدنية،  3M UNITEK)كشفت الحقائق من هذه الدراسة أن استخدام )

 أدنى قوة قص وقوة شد لحاصرات التقويم المعدنية. Ormco)مع مادة لصق الحاصرات ) Clinpro)بينما يظهراستخدام واقي المينا )

كمادة لصق  3M UNITEK)قبل مادة لصق حاصرات التقويم المعدنية, يمكن أن تستخدم بنجاح مع ) Clinpro)تخدام واقي المينا )الخالصة: باس

 حاصرات تقويم األسنان.