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Background and Objectives: Some of these adult patients have ceramic crowns, to which orthodontists have concerns about bonding brackets. The aim of the present study was to evaluate the effect of a Ti:Sapphire femtosecond (fs) laser (Integra-C-3.5, Quantronix, NY) on the surface roughness of two ceramic surfaces (feldspathic and IPS Empress e-Max) and to compare results with those of two other lasers (Er:YAG and Nd:YAG) and conventional techniques, i.e., sandblasting (50 µm) and hydrofluoric (HF) acid., Materials and Methods: Ceramic discs were fabricated (n = 150) and divided into two groups, each of which was then divided into five subgroups prepared with Ti:Sapphire fs, Nd:YAG, or Er:YAG lasers, sandblasting, or HF acid (n = 15). The surface roughness of the ceramic discs was evaluated using a profilometer (Mitotoyo Surf Test SJ 201 P/M; Mitutoyo Corp, Japan) before and after each surface treatment. Three traces were recorded for each specimen at three different locations in each direction, providing nine measurements per sample, which were then averaged to obtain the surface roughness value. Data were analyzed using the Wilcoxon signed-rank test (P < <0.05), two-way ANOVA, and Tukey's HSD test (P < 0.05). Additional samples were prepared for each group and evaluated using atomic force microscopy (AFM; NTEGRA Solaris, NTMDT, Russia)., Results: No significant difference was found between the feldspathic and IPS Empress e-Max ceramics. The Ti:Sapphire fs laser was associated with the highest mean roughness value. AFM images of the ceramic surfaces treated confirmed that the fs-laser-treated surfaces had the highest degree of irregularity., Conclusion: Within the limitations of this in vitro study, the Ti:Sapphire fs laser yielded the highest surface roughness and could be an alternative ceramic surface treatment to increase bond strength., (© 2015 Wiley Periodicals, Inc.)

Background and Objectives: With increasing demand for orthodontic treatments in adults, orthodontists continue to debate the optimal way to prepare ceramic surfaces for bonding. This study evaluated the effects of a Ti:sapphire laser on the shear bond strength (SBS) of orthodontic brackets bonded to two ceramic surfaces (feldspathic and IPS Empress e-Max) and the results were compared with those using two other lasers (Er:YAG and Nd:YAG) and 'conventional' techniques, i.e., sandblasting (50 µm) and hydrofluoric (HF) acid., Materials and Methods: In total, 150 ceramic discs were prepared and divided into two groups. In each group, the following five subgroups were prepared: Ti:sapphire laser, Nd:YAG laser, Er:YAG laser, sandblasting, and HF acid. Mandibular incisor brackets were bonded using a light-cured adhesive. The samples were stored in distilled water for 24 hours at 37°C and then thermocycled. Extra samples were prepared and examined using scanning electron microscopy (SEM). SBS testing was performed and failure modes were classified. ANOVA and Tukey's HSD tests were used to compare SBS among the five subgroups (P < 0.05)., Results: Feldspathic and IPS Empress e-Max ceramics had similar SBS values. The Ti:sapphire femtosecond laser (16.76 ± 1.37 MPa) produced the highest mean bond strength, followed by sandblasting (12.79 ± 1.42 MPa) and HF acid (11.28 ± 1.26 MPa). The Er:YAG (5.43 ± 1.21 MPa) and Nd:YAG laser (5.36 ± 1.04 MPa) groups were similar and had the lowest SBS values. More homogeneous and regular surfaces were observed in the ablation pattern with the Ti:sapphire laser than with the other treatments by SEM analysis., Conclusions: Within the limitations of this in vitro study, Ti:sapphire laser- treated surfaces had the highest SBS values. Therefore, this technique may be useful for the pretreatment of ceramic surfaces as an alternative to 'conventional' techniques., (© 2015 Wiley Periodicals, Inc.)