Comparative Evaluation of Shear Bond Strength, Adhesive Remnant Index and Cytotoxicity of Different Orthodontic Adhesives: An In-vitro Study

Introduction: Orthodontic adhesives should possess adequate bond strength and biocompatibility. Inadequate bond strength may lead to bond failures, and if the adhesive is not biocompatible, it may result in allergic reactions. Therefore, it is of prime importance to study the cytotoxicity and Shear Bond Strength (SBS) of commercially available orthodontic materials. Aim: This study aimed to comparatively evaluate in-vitro cytotoxicity, the Adhesive Remnant Index (ARI), and SBS of various orthodontic adhesives. Materials and Methods: This in-vitro study was conducted in an institutional setting as a collaborative effort between the Department of Orthodontics and White Lab-Blue Lab at Saveetha Dental College and Hospital, Chennai, India, from July 2023 to August 2023. Forty extracted human premolar teeth were bonded with four different ARI adhesives (U Bond, Enlight, Transbond XT, Aqualine LC) (n=10/group) and mounted on acrylic blocks. They were evaluated for SBS using a Universal Testing Machine (UTM), ARI using Scanning Electron Microscopy (SEM), and cytotoxicity using the MTT {3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide} assay on Human Gingival Fibroblast Cells (HGFC). Statistical analysis was performed using One-way ANOVA, with a post-hoc test for pairwise comparison to evaluate the SBS values, and the Kruskal-Wallis Test to analyse ARI inter group scores and cytotoxicity levels. Statistical Package for the Social Sciences (SPSS) software (Version 23.0) was used to conduct the statistical tests. Results: Significant differences in SBS values (p=<0.001) and ARI scores (p=<0.001) were noted between the different adhesives. No significant difference (p-value=0.534) in cytotoxicity was observed among all adhesives, with all exhibiting acceptable levels of biocompatibility. Conclusion: Primer-based adhesive (Transbond XT) demonstrated the highest SBS and ARI scores among the various orthodontic adhesives, with acceptable levels of biocompatibility. No significant difference was found between the conventional primer-based adhesive (Transbond XT) and the Single Component Adhesive (SCA) (Aqualine LC). Therefore, this study advocates for the use of SCA in routine clinical practice.