Evaluation of a Fluorescence-aided Identification Technique (FIT) to assist clean-up after orthodontic bracket debonding

Abstract

Objectives: To compare a fluorescence-aided identification technique (FIT) with a conventional light source (CLS) for removing composite during debonding of brackets with respect to time needed, composite remnants, and tooth substance loss. Materials and Methods: Twelve maxillary models with 10 bovine teeth each were digitally surface-scanned and metal brackets were bonded on each tooth with Opal Seal and Opal Bond. Two operators: an experienced orthodontist (A) and an undergraduate student (B) received six models each and were asked to remove the composite remnants with a tungsten carbide bur and Sof-Lex discs by both a conventional light source (CLS group, n = 3), and fluorescent inducing light (FIT group, n = 3). The time taken was recorded, and a postoperative scan was digitally superimposed on the preoperative scan to quantify number of teeth with composite remnants and volume and thickness of enamel loss and composite remnants. Chi-square test and independent t-tests were performed to compare methods with a significance level of 5%. Results: Compared to CLS, both operators needed significantly less time when using the FIT method and degree of enamel loss, height, and volume of composite remnants and total remaining composite remnants were significantly reduced. By FIT, the volume of enamel loss was significantly reduced for operator A only. Operator B removed the same enamel volume with either method. Conclusions: Cleanup after orthodontic debonding with the FIT was superior regarding time needed and removal of composite remnants. Total enamel loss reduction was operator-dependent.

Evaluation of enamel surface after bracket debonding and adhesive removal with six different methods

“…The operator's control and proficiency in the use of the instruments for adhesive removal is another important factor to be considered in enamel surface evaluation [6,8,27,28]. In the present study, two types of tungsten carbide burs have been applied: a 12-fluted round end tapered fissure tungsten carbide bur and a 12-fluted round tungsten carbide bur with reduced vibrations.…”

“…Previous studies refer to a variety of instruments that can be used for adhesive removal after brackets debonding. Rotary instruments (diamond, carbide burs, and abrasive discs), hand instruments (pliers and scalers), and ultrasonic scalers are among the most widely used [5][6][7][8][9][10]. An optimal procedure for adhesive removal that leaves no damage to the enamel surface has not been accepted yet [5].…”

Novel Digital Technique to Quantify the Area and Volume of Cement Remaining and Enamel Removed after Fixed Multibracket Appliance Therapy Debonding: An In Vitro Study

“…SEM allows the identification of the remaining cement on the enamel surface after fixed multibracket appliance therapy removal [16] and the rugosimetry devices incorporated with SEM allow profilometric analysis of enamel surface orography [20]. However, none of these techniques measure the volumes of cement and enamel removed and require tooth extraction [28]. Additional measurement techniques were described for analyzing the enamel surface alterations after fixed multibracket appliance therapy removal: fluorescence [28], atomic force microscope [18], and optic coherence tomography [22].…”

“…However, none of these techniques measure the volumes of cement and enamel removed and require tooth extraction [28]. Additional measurement techniques were described for analyzing the enamel surface alterations after fixed multibracket appliance therapy removal: fluorescence [28], atomic force microscope [18], and optic coherence tomography [22]. The fluorescence measurement visual technique has been widely used to differentiate composite from enamel and for identifying the remaining cement after fixed multibracket appliance therapy removal, due to the luminescent differences between composite resin and tooth structures, but cannot measure the volumes of cement and enamel removed [29,30].…”

Enamel Surface Roughness after Lingual Bracket Debonding: An In Vitro Study

“…As such, brackets with customized metal bracket bases may lead to a more extensive ground enamel areas due to their increased basal profile. On top of the usual careful consideration on patient selection in conjunction with individual oral hygiene characteristics, clinical procedures that allow better the identification of bonding materials at debonding should be considered [10,[26][27][28]. The limitations pertain to the fact that there is a lack of an aging process involved in the protocol, which could have some implications in altering the extent of results in either direction (alleviating or enhancing them).…”