Document Type


Publication Date



School of Dentistry




Objective: To test the hypothesis that there is no difference between the bracket survival rate of brackets bonded to bleached and unbleached teeth.

Materials and Methods: Thirty-eight patients who required comprehensive orthodontic treatment were included in the study. A split mouth technique was used with one arch exposed to in-office whitening gel containing 38% hydrogen peroxide for 30 minutes, while the unbleached arch served as the control. Patients were divided into two groups: Brackets bonded within 24 hours after bleaching and brackets bonded 2–3 weeks after bleaching. The bracket survival rate was computed using the log-rank test (Kaplan-Meier Analysis).

Results: A significantly higher rate of bracket failure was found with bleached teeth (16.6%) compared with unbleached teeth (1.8%) after 180 days. Brackets bonded within 24 hours of bleaching resulted in significantly higher clinical failure (14.5%) compared with those bonded after 3 weeks (2.1%). Adhesive Remnant Index scores of failed brackets revealed that the majority of failure in bleached teeth occurred in the enamel/resin interface.

Conclusions: The hypothesis was rejected. Brackets bonded within 24 hours after bleaching have a significantly higher risk for bond failure. Orthodontic bonding should be delayed for 2–3 weeks if patients have a history of in-office bleaching with 38% hydrogen peroxide.

Source Citation

Mullins, J. M., Kao, E. C., Martin, C. A., Gunel, E., & Ngan, P. (2009). Tooth Whitening Effects on Bracket Bond Strength In Vivo. The Angle Orthodontist, 79(4), 777–783.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.