The purpose of this study was to evaluate and compare enamel micro-crack characteristics of adult patients before and after removal of metal brackets. After the examination with scanning electron microscopy (SEM), 45 extracted human teeth were divided into three groups of equal size: group 1, the teeth having enamel micro-cracks, group 2, the teeth without initial enamel micro-cracks, and group 3, control group to study the effect of dehydration on existing micro-cracks or formation of new ones. For all the teeth in groups 1 and 2, the same bonding and debonding procedures of metal brackets were conducted. The length and width of the longest enamel micro-crack were measured for all the teeth before and after removal of metal brackets. The changes in the location of the micro-cracks were also evaluated. In group 3, teeth were subjected to the same analysis but not bonded. The mean overall width of micro-cracks after removal of metal brackets was 3.82 μm greater than before bonding procedure (P < 0.05). Also, a significant difference was noticed between the width of micro-cracks in first zone (cervical third) and third zone (occlusal third) after debonding procedure (P < 0.05). New enamel micro-cracks were found in 6 of 15 (40 per cent) examined teeth. Greatest changes in the width of enamel micro-cracks after debonding procedure appear in the cervical third of the tooth. On the basis of this result, the dentist must pay extra care and attention to this specific area of enamel during removal of metal brackets in adult patients.

Although the topic of tooth fractures has been extensively analyzed in the dental literature, there is still insufficient information about the potential effect of enamel microcracks (EMCs) on the underlying tooth structures. For a precise examination of the extent of the damage to the tooth structure in the area of EMCs, it is necessary to carry out their volumetric [(three-dimensional (3D)] evaluation. The aim of this study was to validate an X-ray micro-computed tomography ($$\mu $$ μ CT) as a technique suitable for 3D non-destructive visualization and qualitative analysis of teeth EMCs of different severity. Extracted human maxillary premolars were examined using a $$\mu $$ μ CT instrument ZEISS Xradia 520 Versa. In order to separate crack, dentin, and enamel volumes a Deep Learning (DL) algorithm, part of the Dragonfly’s segmentation toolkit, was utilized. For segmentation needs we implemented Dragonfly’s pre-built UNet neural network. The scanning technique which was used made it possible to recognize and detect not only EMCs that are visible on the outer surface but also those that are buried deep inside the tooth. The 3D visualization, combined with DL assisted segmentation, enabled the evaluation of the dynamics of an EMC and precise examination of its position with respect to the dentin-enamel junction.

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Objective: To find a correlation between the severity of enamel microcracks (EMCs) and their increase during debonding and residual adhesive removal (RAR). Materials and Methods: Following their examination with scanning electron microscopy (SEM), 90 extracted human premolars were divided into three groups of 30: group 1, teeth having pronounced EMCs (visible with the naked eye under normal room illumination); group 2, teeth showing weak EMCs (not apparent under normal room illumination but visible by SEM); and group 3, a control group. EMCs have been classified into weak and pronounced, based on their visibility. Metal brackets (MB) and ceramic brackets (CB), 15 of each type, were bonded to all the teeth from groups 1 and 2. Debonding was performed with pliers, followed by RAR. The location, length, and width of the longest EMCs were measured using SEM before and after debonding. Results: The mean overall width (W overall ) was higher for pronounced EMCs before and after debonding CB (P , .05), and after the removal of MB. Pronounced EMCs showed greater length values using both types of brackets. After debonding, the increase in W overall of pronounced EMCs was 0.57 mm with MB (P , .05) and 0.30 mm with CB; for weak EMCs, 2 0.32 mm with MB and 0.30 mm with CB. Conclusions: Although the teeth having pronounced EMCs showed higher width and length values, this did not predispose to greater EMCs increase after debonding MB and CB followed by RAR. (Angle Orthod. 2016;86:437-447.)

The study aimed at introducing current available techniques for enamel microcracks (EMCs) detection, and presenting a method for direct quantitative analysis of an individual EMC. Measurements of the detailed EMCs characteristics (location, length, and width) were taken from the reconstructed images of the buccal tooth surface (teeth extracted from two age groups of patients) employing a scanning electron microscopy (SEM) and our derived formulas before and after ceramic brackets removal. Measured parameters of EMCs for younger age group were 2.41 µm (width), 3.68 mm (length) before and 2.73 µm, 3.90 mm after debonding; for older -4.03 µm, 4.35 mm before and 4.80 µm, 4.37 mm after brackets removal. Following debonding EMCs increased for both groups, however the changes in width and length were statistically insignificant. Regardless of the age group, proposed method enabled precise detection of the same EMC before and after debonding, and quantitative examination of its characteristics.

The objective of this in vitro study was to evaluate the effect of the enamel cracks on the tooth damage during the debonding. Measurements of the cracks characteristics (visibility, direction, length, and location) were performed utilizing a scanning electron microscopy (SEM) technique and mathematically derived formulas (x=h/30, l=n*x) before and following the removal of mechanically retained metal and ceramic brackets. The likelihood of having greater extent enamel defects was higher for the teeth with pronounced cracks (odds vatios, OR=3.728), increased when the crack was located in more than one zone of the tooth (OR=1.998), and the inclination did not exceed 30-45° (OR=0.505). Using ceramic brackets the risk of greater amount tooth structure defects raised 1.45 times (OR=1.450). Enamel crack showing all these characteristics at the beginning of the orthodontic treatment and the use of ceramic brackets might predispose to higher risk of greater extent tooth surface damage after the debonding by 20.4%.