Importance of pumice prophylaxis for bonding with self-etch primer

Introduction: Self-etching primers (SEP) have simplified the orthodontic bonding process, but questions have arisen regarding their reliability and efficiency. The goal of this study was to assess the importance of a pumice prophylaxis before bonding in reducing bond failures. Methods: Thirty orthodontic patients volunteered to participate in this prospective clinical trial. A split-mouth design was used; in each patient, 1 quadrant was randomly assigned to the pumice prophylaxis experimental group and the contralateral quadrant to the nonpumice group. A total of 508 teeth were bonded with SEP (Transbond Plus; 3M Unitek, Monrovia, Calif) and monitored for 3 months for bond failures. Results: Thirty-five failures (6.9%) were recorded, with 6 (2.4%) in the pumice group and 29 (11.4%) in the nonpumice group. Chi-square analysis was used to compare bond failures as a total number between groups and also as the number of patients who experienced bond failures with each method. Statistically significant differences were found both in the total number of bond failures (P <.001) and in the number of patients with bond failures between groups (P <.01). A significantly lower and clinically acceptable bond failure rate was demonstrated with Transbond Plus SEP after pumice prophylaxis. Conclusions: This study produced strong evidence suggesting the need for pumice prophylaxis when using SEP for orthodontic bonding.