Damage on tooth enamel after removal of orthodontic adhesive by Arkansas’ stone and tungsten carbide burs

Abstract

a b s t r a c t a r t i c l e i n f oObjectives: The main aim of this study was to compare the effectiveness of two different methods to remove orthodontic composite adhesives from enamel concerning the surface damage and remnant composite adhesive on the surfaces. Methods:Human molars were stored in buffer solution at room temperature before bonding the brackets. Teeth were ultrasonically cleaned in distilled water before bonding procedure.Ninety two brackets were randomly bonded to the buccal surface of twenty three molars using a composite-based adhesive system. After 15 days, the orthodontic composite adhesives were removed by using Arkansas' stone or multi-blade tungsten burs. After debonding process, the remnant composite adhered to the tooth as well as the teeth surfaces were analyzed by photographic images at x40 magnification concerning the (ARI) adhesive remnant or (SRI) surface roughness index. Also, enamel surfaces were inspected by field emission guns scanning electron microscopy (FEGSEM) before bonding and after bracket detachment.The statistical analysis was performed using SPSS ® Statistics vs.18.0, considering a significance level of 0.05 to one-way ANOVA. Tukey's test was used for multiple comparisons and Chi-square tests were used to analyze the association between categorical variables.Results: ARI results revealed no statistically significant differences between the two methods of bracket removal (p=0.283). Considering SRI, statistically significant differences were detected between the two procedures (p<0.001) considering all worn surfaces revealed lower surface roughness after removal of adhesive by Arkansas stone than that recorded on worn surfaces after removal using tungsten carbide burs. Conclusion:The removal of orthodontic adhesive promoted less damage on enamel surfaces by using Arkansas stone at low rotation. Nevertheless, finishing procedures can decrease the roughness on enamel without additional damage. Conclusão: Menor dano ao esmalte foi promovido pela remoção de adesivo ortodóntico com uso da pedra de Arkansas. Entretanto, polimento adicional diminui a rugosidade da superfície sem danos adicionais ao esmalte.

Orthodontic debonding and tooth sensitivity of anterior and posterior teeth:

“…Arkansas stones and abrasive discs were used under constant irrigation to accomplish debonding finishing, according to studies assessing lower damage than use of carbide burs. 12 Just before debonding (T 0 , baseline), immediately after debonding completion (T 1 ), and 7 days after debonding (T 2 ), the following two thermal stimuli were applied with a syringe on the buccal cervical surface of each mandibular incisor and first molar with an interval of 1 minute: compressed air at first (198C -248C, 1 second), and freshly melted ice water afterward (08C, 1-3 seconds). 11,13 Teeth were chosen considering previous studies assessing the lowest threshold at debond for lower incisors 14 and a major sensitivity for molars.…”

Avaliação dos Efeitos da Remoção da Resina Residual e do Polimento na Superfície do Esmalte após Descolagem do Braquete

“…Um dos maiores desafios após o tratamento ortodôntico é a remoção precisa do remanescente adesivo, de modo a evitar não apenas lesões iatrogênicas irreversíveis, como superfícies rugosas, trincas verticais, necrose pulpar, perda da superfície externa rica em flúor, mas também a presença de resquícios de adesivo na área de adesão. ( 6) Os protocolos utilizados para a remoção dos braquetes e do adesivo residual causaram irregularidades e ranhuras no esmalte e severos danos à superfície de esmalte, e o polimento não conseguiu amenizar os danos, (1)(2)(3)(4)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

“…A remoção de remanescentes resinosos da superfície dentária com o uso de instrumentos rotatórios, após o tratamento ortodôntico, podem, eventualmente, causar danos ao esmalte (2,6,9,11,13,15) e perda de estrutura superficial com exposição das terminações do prisma do esmalte para o ambiente bucal, acúmulo de placa bacteriana e pigmentos nas microfissuras, podendo causar uma diminuição da resistência superficial aos ácidos orgânicos e isso, eventualmente, torna o esmalte mais propenso à desmineralização e resulta em manchas na interface resina/esmalte (1,2,6,9,12,14,(16)(17)(18), podendo acarretar risco de danos irreversíveis ao esmalte (3,8,10,19). Por isso, é preciso considerar a importância de se tentar, após a remoção da resina residual do esmalte, restaurar a superfície tão próxima quanto possível das condições do pré-tratamento (9), apesar de nenhuma superfície do esmalte ter sido restaurada ao seu aspecto original (19).…”