This study aimed to evaluate the bonding abilities and long-term durability of different repair agents when applied to lithium disilicate ceramics (LDS). Blocks of IPS e.max CAD were prepared and divided into four groups according to the surface treatment: Monobond Etch & Prime (ME), K-etchant GEL+Clearfil Universal Bond (UB), Bondmer Lightless (BL), and K-etchant GEL+G-Multi Primer (GMP). All treated ceramic specimens were bonded to resin composite and light-cured. The micro-shear bond strength was measured after 24 h of water storage or 5,000 thermocycles. ME and BL showed significantly higher initial bond strengths than UB and GMP (p<0.05). After 5,000 thermocycles, there was no significant difference in ME (p>0.05), but BL and GMP showed considerable reduction in bond strength (p<0.05); moreover, the samples of UB were all de-bonded before testing. ME and BL proved to be effective surface treatment materials for LDS.

The fluorescence and physical properties of thulium and erbium co-doped dental zirconia were investigated. The high-translucency yttria-stabilized dental zirconia specimens co-doped with Tm₂O₃ powder 0.8 wt% and Er₂O₃ powder at proportions from 0.1 to 0.8 wt% were used. The specimens co-doped with Tm₂O₃ powder 0.8 wt% and Er₂O₃ from 0.3 to 0.5 wt% exhibited the fluorescence similar to that of natural tooth. All the specimens had a tetragonal peak and no major change in the Vickers hardness, fracture toughness and bending strength on addition of Tm₂O₃ and Er₂O₃. These results suggest that the method of co-doping trace amounts of Tm₂O₃ and Er₂O₃ into high-translucency dental zirconia powder can effectively improve the esthetics of zirconia monolithic fixed dental prothesis.

In this study, the influence of primer contamination on enamel bonding was analyzed. Adper Scotchbond Multi-Purpose (SMP), CLEARFIL SE Bond 2 (SE2), Scotchbond Universal (SBU) Adhesive, and Scotchbond Etchant (35% phosphoric acid; PA) were used. Ground bovine enamels were divided into eight groups based on the bonding protocols. The bonding interfaces after an acid–base challenge were observed via scanning electron microscopy to determine the acid–base resistant zone (ABRZ). Moreover, the bonding interfaces after the nanoleakage challenge were analyzed via energy-dispersive X-ray spectroscopy. ABRZ was observed in all the samples except PA_ONLY (applied PA etching, No primer and No adhesive resin). The funnel-shaped erosion was detected only in X_SBU (applied SBU without PA etching). The nanoleakage test revealed silver patterns in some groups. The nanoleakage, i.e., the penetration of the silver ions, was detected in the groups wherein primer was applied on PA–pre-etched enamel.

The present study aimed to evaluate the dentin bond strengths of all-in-one adhesives in combination with flowable-resin-composites of different manufacturers. The materials used in this study were two all-in-one adhesives (BeautiBond Multi, BM, and Clearfil Bond SE ONE, SE) and four flowable resin composites (Clearfil Majesty ES Flow, CME; Estelite Flow Quick, EFQ; MI Flow II, MIF; and Beautifil Flow Plus F03, BFP). By combining each all-in-one adhesive and flowable resin composite, eight experimental groups were established. The shear bond strengths (SBSs) in each group were measured, and the data were statistically analyzed using one-way analysis of variance. The SBSs of the group that used SE showed no significant differences among all flowable resin composites (p>0.05), whereas those of the group that used BM showed significant differences between BFP and CME, and CME and EFQ. The combinations showed dentin bond strength ranging approximately from 20 to 30 MPa.

The aim of this study was to optimize the preparation method of polymethyl methacrylate (PMMA) denture base loaded with nano silver (NAg), to more effectively and safely impart sustainable antibacterial functions. NAg solution was synthetized and mixed with acrylic acid and methyl methyacrylate (MMA) monomer in order to prepare a new type of NAg solution (NS)/polymer methyl methacrylate denture base specimens (NS/PMMA). The surface morphology, mechanical strength, antimicrobial activity, anti-aging performance, cytotoxicity and biocompatibility of NS/PMMA denture base were evaluated in comparison with specimens fabricated using traditional NAg adding methods and NAg-free denture base. The aesthetic characteristics and mechanical strength of NS/PMMA denture base met the clinical application requirements. Meanwhile, NS/PMMA denture base showed better antibacterial activity, anti-aging properties, no cytotoxicity and displayed exceptional biocompatibility. NS/PMMA denture base thus has great potential for clinical application.

The aim of the present study was to investigate the effects of casein in a remineralization solution on enamel remineralization. Bovine blocks were demineralized for 21 days, then, allocated into four groups. The specimens were remineralized for 21 days in the following artificial saliva solutions: 1) 0 µg/mL casein, 0 ppm fluoride (F) (C0–F0); 2) 0 µg/mL casein, 1 ppm F (C0–F1); 3) 10 µg/mL casein, 0 ppm F (C10–F0); and 4) 10 µg/mL casein, 1 ppm F (C10–F1). Micro-CT analyses were performed once a week. Specimens were characterized by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The present results suggest that casein by itself inhibits remineralization, whereas the coexistence of casein and F promotes the remineralization of caries bodies by interrupting mineral deposition on the enamel surface.

This study aimed to evaluate the Cirrus high-definition (HD) spectral-domain optical coherence tomography (SD-OCT) for the remineralization of artificial enamel caries and to compare it with the comparison surface microhardness (SMH) analysis. Artificial caries lesions were produced on forty human enamel samples. Then, three different remineralization agents containing casein phosphopeptide amorphous calcium phosphate; casein phosphopeptide amorphous calcium fluoride phosphate; calcium glycerophosphate, magnesium chloride, and xylitol; and remineralization solution (control) were applied with pH cycling for six days. The optical depth of backscattered light and microhardness of enamel were measured using SD-OCT and SMH. All remineralization agents were significantly efficient in reducing optical lesion depth on enamels (p₁=0.001, p₂=0.002, p₃=0.006, p₄=0.025), and in increasing the SMH of enamels (p₁₋₃=0.005, p₄=0.017). However, the optical lesion depths of the enamel showed no correlation with the SMH in the groups. In conclusion, demineralization and remineralization of artificial lesions can be assessed with both SD-OCT and SMH.

This study aimed to assess the effects of a temporary sealing material and cleaning method of resin-coated dentin on the bond strength of computer-aided design/computer-aided manufacturing (CAD/CAM) inlay restorations. Resin-coated dentin surfaces were unsealed or temporarily sealed for 1 h or 1 week. For the temporarily sealed group, a hydraulic temporary sealing material was removed and further divided into four groups: without cleaning, cleaned with a rotational brush, a universal cleaner or an air-polishing device. Some specimens were investigated with energy dispersive X-ray spectroscopy and the others were used for microtensile bond strength (MTBS) test. A sealing material could not be removed with a rotational brush, which resulted in pretest failures in all specimens after 1 h and which resulted in low MTBS after 1 week. An air-polishing device can clean resin-coated dentin temporarily sealed with a hydraulic temporary sealing material and resulted in the similar MTBS as in the unsealed group.

This study evaluated the cyclic fatigue resistance for six types of 25# NiTi instruments. A traditional manufacturing instrument, an M wire instrument, a gold treatment instrument, a controlled memory (CM) wire instrument, a CM wire instrument with electrical discharge machining (EDM), and an R-phase heat treatment instrument, were operated in the different curved artificial canals. The fracture time (FT) and number of cycles to fracture (NCF) of the NiTi instruments were higher at 45° angles and double-curvature canals than at 60° angles. Except for the instruments with gold technology and EDM technology, others showed the longest FT and the highest NCF at an 8 mm radius of curvature. Morphological characteristics of cyclic fatigue were exhibited on the cross-section and lateral view of fracture fragments. The use of M-wire, R-phase wire, CM-wire, gold technology, EDM technology, and reciprocating movement were beneficial to enhance the cyclic fatigue resistance of NiTi files.

This study aimed to investigate the effect of the multi-ion releasing paste (MP) on the acid resistance of the enamel surface of an extracted human tooth. Five kinds of MP were prepared according to the content (wt%) of S-PRG fillers: 0 wt% (MP0, control), 1 wt% (MP1), 5 wt% (MP5), 20 wt% (MP20), and 30 wt% (MP30). The buccal coronal surfaces of the extracted anterior teeth were polished with each kind of MP for 1 min. After removing radicular parts, the coronal parts underwent a pH cycling, and then sliced to make thin sections. The lesion depth of each section was measured using a polarization microscope. Each lesion’s depth of enamel polished with MP5, MP20, and MP30 was significantly shallower than that polished with MP0.

This study employed an in-air micro-proton-induced X-ray/gamma-ray emission system to assess the effectiveness of fluoride-containing materials (FCMs) incorporating calcium in preventing root caries. Dentin surfaces of human third molars were coated with one of three FCMs: fluoride-releasing glass-ionomer cement (F7) and experimental materials in which half (P1) or all (P2) of the strontium in F7 was replaced with calcium. Dentin without FCM coating served as the control. Specimens were immersed in saline at 37°C for 1 month, sectioned, and then demineralized. Calcium loss after demineralization was lower in the Ca-substituted groups than in the Ca-unsubstituted groups (p<0.05). Calcium loss was negatively correlated with fluoride uptake (p<0.01). In the F7, P1, and P2 groups, the retraction of the dentin surface was significantly suppressed as compared with the control group. FCMs incorporating calcium improved the acid resistance of root dentin and could help prevent root caries.

The purpose of this multicenter clinical study was to compare the mid-term clinical effectiveness of direct resin composite restorations using one-step or two-step self-etch adhesives (1-SEAs or 2-SEAs). In total, 352 restorations of class I–V cavities and non-carious cervical lesions in vital teeth (1-SEAs; 52 cases, 2-SEAs; 300 cases) were placed at nine university hospitals and evaluated according to the modified USPHS criteria at baseline, and after 1, 2, and 3 years. The recall rates were 86.6% (1 year), 80.1% (2 years), and 62.2% (3 years). Two restorations failed due to fracture during the follow-up, and there was no significant difference in survival rates between 1-SEAs (97.6%) and 2-SEAs (99.4%). However, 2-SEAs exhibited significantly lower occurrences of discoloration, marginal discoloration, fracture, and plaque retention. Moreover, the subjects reported a significantly lower postoperative hypersensitivity and higher overall satisfaction at all evaluation periods if 2-SEAs were used.

The purpose was to evaluate the effect that deviations from the recommended protocol of a two-step etch-and-rinse adhesive system has on permeability and nanoleakage. One hundred and twenty dentin disks were treated with a two-step etch-and-rinse adhesive system, according to the manufacturer’s instructions, or using five simulated deviations from the recommended protocol: applying potassium oxalate, reducing the application time of the adhesive, avoiding adhesive drying, aggressively drying the adhesive, and double application of adhesive. Kruskal–Wallis and Tukey’s post hoc comparisons were used to evaluate the permeability reduction (α=0.05). Twelve additional dentin disks were prepared for transmission electron microscope (TEM) analysis of nanoleakage. Aggressive drying, adding additional layers of adhesive or using oxalate reduced dentin permeability and yielded a better infiltration of the hybrid layer, whereas reducing the application time or less drying the adhesive did not to reduce dentin permeability, caused extensive nanoleakage, showing immediate compromised dentin sealing.

This study was to evaluate the acid-buffering capacity and antibacterial properties of orthodontic adhesives containing bioactive glasses (BAGs) (45S5, 45S5F, S53P4), Hydroxyapatite, beta-tricalcium phosphate, and Canasite. Fillers comprising 15 wt% bioactive glasses, HAp, β-TCP, and Canasite incorporated with 55 wt% silanated glass were added to a mixture of UDMA/TEGDMA. Acid-buffering capacity was tested by exposing disc-shaped samples of each adhesive to medium of bacteria-produced acids, and pH changes were recorded at 24 and 48 h. Antibacterial properties were assessed by indirect testing by exposing polymerized adhesive samples to a medium and direct testing by immersing the specimens in solutions containing S. mutans and S. sanguinis. A significant buffering capacity was shown by the 45S5, 45S5F and S53P4 BAG adhesives. The antibacterial properties were not significant in all experimental adhesives. Therefore, the experimental orthodontic adhesives containing BAGs demonstrated a significant buffering capacity but did not show significant antibacterial properties against S. mutans and S. sanguinis.

This study aimed to investigate pulp chamber and surface temperature development using different LED light curing units (LCUs). Eight brands of LED-LCUs were tested in a laboratory bench model. The pulp chamber and surface temperature were recorded with a type T thermocouple and infrared cameras, respectively. The highest pulp chamber and surface temperature increase was 6.1±0.3°C and 20.1±1.7°C, respectively. Wide-spectrum LED-LCUs produced higher pulp chamber temperature increase at 0 mm and 2 mm but lower at 4 mm. Narrow-spectrum LED-LCUs produced higher surface temperature increase. LED-LCU featuring modulated output mode resulted in lower increase in pulp chamber temperature but higher on surface temperature. LED-LCU with light guide tip delivering an inhomogeneous beam caused higher increase in temperature on the surface and in the pulp chamber. LED-LCUs with different spectral emission, output mode and light guide tip design contributed to different temperature development in the pulp chamber and at the surface of teeth.

This research aimed to evaluate the effect of cement space on the marginal discrepancy and retention of computer-aided design/computer-aided manufacturing (CAD/CAM) crowns. A total of 30 premolar Frasaco teeth were machined to receive crowns with cement spaces of 70, 90, and 110 μm. The marginal discrepancy measurements were done before and after cementation. Pull-off test was conducted using universal testing machine (UTM). Data was analyzed using two-way mixed ANOVA with post-hoc Bonferroni test and Kruskal-Wallis test. The crowns with cement space of 70 μm showed a significantly higher absolute marginal discrepancy than those with 90 and 110 μm. No significant effect on the crown retention was found. Within the limitations of this study, modifying cement space to 90 μm and 110 μm may improve the marginal adaptation of CAD/CAM crown, whereas adjusting cement space from 70 to 110 μm did not significantly affect the crown retention.

In guided bone regeneration (GBR), a barrier membrane is applied to provide a space for bone regeneration to promote cell adhesion, cell proliferation, and bone regeneration by inducing cell migration to the surface of the bone-deficient site. We prepared a non-woven absorbable membrane for GBR comprised of a copolymer of L-lactic acid and glycolic acid (PLLGA) using the dry spinning method. A thin and dense membrane comprising unsintered hydroxyapatite (uHA) and poly-L-lactic acid (PLLA) was used for comparison. Osteoblast TMS-12 cells were seeded onto the membranes, and cell adhesion and proliferation rates were examined. Calcification levels were quantified by Alizarin Red S staining after cell culture in calcification induction medium. Osteoblastic gene expression was examined by RT-PCR. Cell adhesion and proliferation rates and calcification on PLLGA membranes were significantly higher than those on uHA/PLLA membranes. PLLGA membranes upregulated osteogenic gene expression compared to on uHA/PLLA membranes. Non-woven PLLGA membranes may be useful in GBR for promoting bone formation and maturation.

Calcium carbonate-based bone substitutes derived from natural coral exoskeleton (aragonite) are resorbed and remodeled faster than calcium phosphate-based substitutes. However, coral species with structures appropriate for use as bone substitutes are very limited. Therefore, it is important to evaluate potential of artificial calcium carbonate ceramics as a bone substitute. In this study, calcium carbonate granules with various porosities and pore sizes were prepared by sintering a highly pure (>99.98%) calcium carbonate powder (calcite), and their resorption properties and bone formation abilities were examined in vivo for the first time. The sintered calcium carbonate was resorbed faster than β-tricalcium phosphate, which has a similar structure. However, sintered calcium carbonate did not promote new bone formation during long-term implantation. Furthermore, both resorption and new bone formation were affected by the pore structure. The optimal structures of the artificially sintered calcium carbonate bone substitute were also discussed.

The osteogenic effect of a composite electrospun core-shell nanofiber membrane encapsulated with Emdogain^® (EMD) was evaluated. The membrane was developed through coaxial electrospinning using polycaprolactone as the shell and polyethylene glycol as the core. The effects of the membrane on the osteogenic differentiation of periodontal ligament stem cells (PDLSCs) were examined using Alizarin Red S staining and qRT-PCR. Characterization of the nanofiber membrane demonstrated core-shell morphology with a mean diameter of ~1 µm. Examination of the release of fluorescein isothiocyanate-conjugated bovine serum albumin (FITC-BSA) from core-shell nanofibers over a 22-day period showed improved release profile of encapsulated proteins as compared to solid nanofibers. When cultured on EMD-containing core-shell nanofibers, PDLSCs showed significantly improved osteogenic differentiation with increased Alizarin Red S staining and enhanced osteogenic gene expression, namely OCN, RUNX2, ALP, and OPN. Core-shell nanofiber membranes may improve outcomes in periodontal regenerative therapy through simultaneous mechanical barrier and controlled drug delivery function.

This study systematically compared the mechanical performances and polymerization shrinkage of two novel dual-cured resin composites (DCRC) with one conventional packable light-cured resin composite (LCRC) for their application as core build-up material by micro-hardness test, flexural strength test, push-out test, and digital image correlation analysis. The LCRC had a significantly higher micro-hardness (p<0.05) whereas the bond strength demonstrated no difference. The mean values of three materials ranged from 35.16 and 64.82 for the Vickers hardness and from 4.66 MPa to 11.53 MPa for the bond strength. The flexure strength of the three materials was not statistically different from each other. LCRC demonstrated 1.88% of volumetric shrinkage while the two DCRC showed 5.06% and 4.91%, respectively. In general, the DCRC demonstrated a comparable flexural strength and bond strength as the LCRC, however, the significant polymerization shrinkage of DCRC should be emphasized.

The aim of the study was to investigate the wear of luting materials (Variolink Esthetic LC/DC, Multilink Automix, Panavia V5 paste) compared to a resin composite (Tetric EvoFlow) with an ACTA-machine (three-body-wear simulator) using steel and 3D-printed polymer wheels. Wear was measured (software Match3D) and statistically analyzed (ANOVA). Worn surface was examined with a field-emission-scanning-electron-microscope. Finite element analysis was carried out to analyze differences in the mechanical stress of the two different sample wheels. Using the steel wheel, Variolink Esthetic DC exhibited significantly less wear than Tetric EvoFlow after 200,000 cycles (p=0.037). Luting composites on polymer wheels exhibited significantly lower wear values compared to the steel wheels (p<0.001). Finite element analysis showed higher stresses for the steel wheel compared to the polymer wheel. Mechanical properties of the sample wheels had a high influence on wear properties. Dual- or auto-polymerizing materials seem to have a small advantage over the light-curing materials.

This study aimed to propose an evaluation method for testing the mechanical strength of film-formed self-adhesive resin cements (SARCs) while reflecting cement layer thickness. Three commercially available dual-cure type SARCs were used for tensile and shear tests using specimens with varying thicknesses (0.05, 0.2, and 0.4 mm). There were no significant differences in tensile strengths among the various specimen thicknesses. In the shear test, there was a significant decrease in the strength with a reduction in specimen thickness. Stress distribution and fracture patterns were analyzed using in silico nonlinear dynamic finite element analysis. Finite element analysis demonstrated that stress distribution on the specimen surface was homogeneous even with different thicknesses in the tensile test, whereas it was inhomogeneous and induced different fracture patterns on the 0.05-mm-thick specimen in the shear test. These results suggest that the tensile test is useful for testing the mechanical strength of film-formed SARCs.

This study aimed to evaluate the impact of fluoride-releasing 4-META/MMA-TBB resin on the degree of enamel demineralization typically detected around orthodontic brackets using μCT. Enamel-dentin blocks were prepared from bovine teeth. Brackets were attached with either 4-META/MMA-TBB resin (SBC), fluoride-releasing 4-META/MMA-TBB resin (SBF), or fluoride-releasing RMGIC (FLC). The specimens were subjected to demineralization (pH 4.5, 21 days) and scanned by μCT (0, 7, and 21 days). Fluoride ion release under the experimental conditions was measured. The degree of demineralization detected in SBF and FLC was significantly lower than that in SBC; there were no significant differences in the degree of demineralization detected in SBF and FLC. The level of fluoride ion detected in FLC was significantly higher than that detected in SBC. Fluoride-releasing 4-META/MMA-TBB resin protected against enamel demineralization around orthodontic brackets when compared to the results from the fluoride-free resin.

The purpose was to determine the effect of different environments (artificial saliva, human saliva, distilled water, dry storage) on frictional forces between various tribological systems made from self-ligating brackets in combination with stainless-steel wires (dimensions: 0.016″×0.022″, 0.018″×0.025″ and 0.019″×0.025″). An universal testing-machine applied a normal force of 1 N. Two-way ANOVA and Tukey post-hoc tests (α=5%) were used. Saliva had significantly higher frictional forces (p<0.001). Yet, the influence of the media depends on the wire dimensions. The results were not as straightforward as in 0.018″×0.025″, which had a clear order (dry storage<water<artificial saliva<human saliva, p<0.001 each). Except for human saliva, wire dimensions differed significantly from each other (p<0.001). Increasing wire cross-sections increases frictional force. Thus, saliva acts as adhesive. High frictional forces of larger wires are attributed to the contact between latch and wire. Still, in-vitro experiments can only approximate the quasi-static tooth movement and the various fluids in the mouth.

The bonding performance of a surface pre-reacted glass ionomer (S-PRG) filler-containing self-adhesive flowable resin composites to enamel and dentin were evaluated using a tensile bond test with thermal cycling. Also, the quantities of various ions released from the materials were measured using ICP atomic emission spectrometry and a fluoride ion electrode. The initial bond strengths of the materials were approximately 6 MPa, and decreased after thermal cycling. The S-PRG filler-containing self-adhesive flowable resin composites materials exhibited much higher ion release compared with the commercial self-adhesive flowable resin composite possibly due to different acidic monomers contained. It was suggested that the S-PRG filler containing self-adhesive flowable resin composites should be limited as a lining material or to restore small cavities in non-stress bearing areas.

The purpose of this study was to investigate the effects of fiber orientation, silane treatment, and thermal cycling on the retention force of fiber-reinforced composite resin (FRC) posts on resin composite. Two types of FRC posts (linear and woven) were prepared with and without silane treatment. Pull-out test specimens were made of FRC posts and resin composite for core buildup. Specimens were either incubated in distilled water for 24 h or subjected to 10,000 thermal cycles. The maximum fracture load obtained by a pull-out test was defined as the retention force. Fracture modes were observed after the test. Fiber orientation and thermal cycling did not affect the retention force on resin composite, and the retention force was improved by silane treatment. Whereas, fiber orientation affected the fracture mode. The result showed woven fiber orientation could contribute to the mechanically interlocking with the resin composite.

We aimed to elucidate stress distribution in miniscrews and the surrounding bone when miniscrews inserted at different depths were implanted vertically or obliquely. The distributions of the equivalent stress on the screw surface and the minimum principal stress in the surrounding bone were calculated using finite element models. When the miniscrews were inserted vertically and obliquely, screw head displacement, greatest equivalent stress on the miniscrew surface, and absolute value of minimum principal stresses in the surrounding bone decreased with increasing insertion depth. Stresses in the obliquely inserted miniscrew with upward traction were smaller than in other insertion conditions, irrespective of insertion depth. With the application of orthodontic force, stress distribution around the miniscrew and surrounding bone is closely related to the insertion depth and insertion angle, which mutually affect each other. In particular, the obliquely inserted miniscrew with upward traction might be the most secure against screw failure and fracture.

The purpose of this study was to investigate the effects of repetitive insertion/removal cycle tests on denture retainers with simulated occlusal loads on the retentive force and deformation of clasp. Abutment teeth in the form of mandibular secondary premolars and clasp in the form of Akers clasps were prepared. The retentive force of the clasp on the abutment teeth were evaluated before and after undergoing repetitive insertion/removal cycle tests with or without cyclic loading. Changes in the clasp shape were monitored using a 3D scanner and scanning electron microscope. The initial retentive force was approximately 10 N and this value later decreased due to deformation of the clasp tips. In contrast to the non-load group, the load group exhibited a reduction in retentive force during earlier stages. Therefore, cyclic loading was related to a decrease in retentive forces, specifically in the early stages of repetitive insertion/removal cycles.

The purpose of this study was to determine whether a system using a resin coating material (PRG Barrier Coat) with anticariogenic ability can effectively bond orthodontic brackets to human teeth. Resin-modified glass-ionomer cement system (Fuji Ortho LC, group 1) and resin composite cement systems (BeautyOrtho Bond) combined with a self-etching primer (group 2), with the resin coating material (group 3), and with the resin coating material after an organic acid etching agent (group 4) were used for bracket bonding. The mean shear bond strength (SBS) was significantly higher in group 1 than in groups 2, 3 and 4. Groups 2 and 4 exhibited a significantly higher mean SBS than group 3. The resin composite cement system combined with the resin coating material after the organic acid etching agent can serve as an alternative for orthodontic bracket bonding.