A Repeatable and Reproducible Digital Method to Quantify the Cement Excess and Enamel Loss after Debonding Lingual Multibracket Appliance Therapy

Abstract

The aim of the present study is to present a repeatable, reproductible, and accurate morphometric measurement method for measuring and quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances. Ten conventional lingual brackets were cemented in 10 extracted teeth embedded into an epoxy resin model simulating a dental arch. This model was scanned before and after bonding the lingual brackets, after debonding, and after polishing the surfaces. We also performed a Micro-Computed Tomography scan of the lingual brackets used. Afterward, the standard tessellation language (STL) digital file was aligned, each tooth was segmented individually, and the file was re-aligned using engineer morphometry software. Inter-operator and intra-operator comparative analyses were performed using the ANOVA test, and the repeatability and reproducibility of the morphometric measurement technique were analyzed using Gage R&R statistical analysis. Repeatability showed 0.07% and 0.16% variability associated with the area and volume measures, respectively, while reproducibility showed 0.00% variability associated with the area and volume measures, respectively. In conclusion, the morphometric measurement technique is a repeatable, reproductible, and accurate morphometric measurement method for quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances.

Digital technique to analyze the wear of the slot after orthodontic treatment through fixed multibracket appliances

“…However, Zubizarreta-Macho et al used the morphometric measurement technique to accurately quantify the area and volume of the remaining cement after removal of fixed multibracket appliances, the area and volume of remaining cement removal, the area and volume of enamel removed after cement removal, and the volume of cement used to adhere fixed multibracket appliance by a repeatable and reproducible measurement technique [38] and Triduo et al also used the morphometric measurement technique to accurately quantify the area and volume of enamel removed after interproximal enamel reduction [39]. This measurement technique has also been used by Belanche et al to quantify the cement excess and enamel loss after debonding lingual multibracket appliance therapy [40,41]. Furthermore, the morphometric measurement technique has been also applied to accurately analyze the influence of drilling technique on the wear of dental implant drills and hence on the osteotomy site preparations after 30 uses [42].…”

“…The present study selected two operators to analyze the repeatability and reproducibility of the digital measurement technique to quantify the area and volume of wear associated to the bracket slot walls of the fixed multibracket appliance after orthodontic treatment. The addition of more operators will not provide different results, since the Gage R&R statistical analysis is not sensible to the number of operators, since two operators have demonstrated reliability in previous studies [38][39][40][41].…”

Evaluación de los remanentes de cemento tras el descementado de brackets linguales customizados y el posterior pulido con diferentes tipos de fresas y sistemas rotatorios: un estudio in vitro

“…Los STLs son una imagen tridimensional del objeto escaneado y pueden ser superpuestos unos con otros con el objetivo de analizar los cambios entre ellos (58). Algunos softwares que han sido utilizados con este fin son VRMesh Studio (VirtualGrid) y 3D Geomagic Wrap (58,61,64). Estos programas informáticos nos permiten realizar mediciones volumétricas mientras que otros softwares solo permiten tomar medidas lineales.…”

“…Para ello, se superpusieron los STLs iniciales, STLs tras el descementado y STLs tras el pulido con un espectro de ±100 µm y una tolerancia de ±10 µm. Se obtuvieron con este software medidas volumétricas y lineales de los remanentes de cemento y de esmalte removido (61,64,65).…”

“…Sin embargo, el procedimiento del escáner intraoral tiene la ventaja de ser mucho más rápido en la captura de las imágenes mientras que la utilización de SEM requiere de 60-90 minutos para capturar la imagen de cada pieza dental. A su vez, posterior a la toma de registros Kuskomaz et al realizaron un análisis visual o cualitativo de los remanantes utilizando el índice ARI mientras que en nuestro estudio se ha realizado de forma cuantitativa, siendo demostrada la metodología de medición como repetible y reproducible (64,65,69). Cabe destacar que en el estudio de Kuskonmaz et al se han excluido los dientes anteriores con exceso de curvatura siendo estos los dientes con mayor dificultad en el pulido por la irregularidad de su anatomía macroscópica (69).…”