Evaluation of enamel surface after bracket debonding and polishing

Abstract

INTRODUCTION: Preserving the dental enamel structure during removal of orthodontic accessories is a clinician's obligation. Hence the search for an evidence based debonding protocol. OBJECTIVE: to evaluate and compare, by means of scanning electron microscopy (SEM), the effects of four different protocols of bracket debonding and subsequent polishing on enamel surface, and to propose a protocol that minimizes damage to enamel surface. METHODS: Twelve bovine permanent incisors were divided into four groups according to the instrument used for debonding and removal of the adhesive remnant. In groups 1 and 2, brackets were debonded with a straight debonding plier (Ormco Corp., Glendora, California, USA), and in groups 3 and 4, debonding was performed with the instrument Lift-Off (3M Unitek, Monrovia, California, USA). In groups 1 and 3, the adhesive remnant was removed using a long adhesive removing plier (Ormco Corp., Glendora, California, USA) and in groups 2 and 4, residual adhesive was removed with a tungsten carbide bur (Beavers Dental) at high-speed. After each stage of debonding and polishing, enamel surfaces were replicated and electron micrographs were obtained with 50 and 200X magnification. RESULTS: All four protocols of debonding and polishing caused enamel irregularities. CONCLUSION: Debonding brackets with straight debonding plier, removal of adhesive remnant with a tungsten carbide bur and polishing with pumice and rubber cup was found to be the protocol that caused less damage to enamel surface, therefore this protocol is suggested for debonding brackets.

Effect of adhesive remnant removal on enamel topography after bracket debonding

“…Although early enamel quality was restored (regular topography) and large scratches were eliminated, as in agreement with Ryf et al,11 deep scratches remained, similarly to Rouleau Jr, Marshall Jr and Cooley9 and Pignatta et al7 Enamel layer remained with irregular thickness (µm), which was highlighted by the rugosimeter as Ra increase. …”

“…, 10 , 14 , 17 For polishing, rubber cup with pumice and water5 , 6 , 7 , 9 , 18 as well as diamond paste5 are used.…”

The effect of using Er,Cr:YSGG laser in debonding stainless steel orthodontic brackets: an in vitro study

“…A greater risk of damage to the tooth surface occurs in cases of adhesive failure between resin and enamel. This happens especially with the use of ceramic brackets, but enamel fracture may also occur with metal brackets [4][5][6][7]. Small-scale enamel damage following debonding, such as that associated with ruptures, cracks, or avulsion fractures, is considered to be crucial in the context of the etiology of caries [8].…”

Comparison of Debonding Characteristics of the Conventional Metal and Self-Ligating Brackets to Enamel: An in Vitro Study

“…At the end of orthodontic treatment with fixed appliances, bonded brackets and any remnant of adhesive must be removed from teeth surface (1). Maximum preservation of enamel surface structure during debonding the brackets and polishing the enamel surface is one of the orthodontic treatment goals (2). To achieve these objectives, correct debonding techniques are of fundamental importance.…”