Evaluation of enamel surface integrity after orthodontic bracket debonding: comparison of three different system

Labib Ghaleb; Naseem Ali Al-Worafi; Ahmed Thawaba; Abbas Ahmed Abdulqader; Aqlan Alkamel; Yaser Abdo; Zhao Yang; Nashwan Noman; Maged Ali Al-Aroomi; Tian Yulou

doi:10.1186/s12903-024-04138-4

Evaluation of enamel surface integrity after orthodontic bracket debonding: comparison of three different system

BMC Oral Health. 2024 Mar 20;24(1):358. doi: 10.1186/s12903-024-04138-4.

Authors

Affiliations

¹ Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang, 110002, China.
² Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
³ Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
⁴ Department of orthodontics, College of dentistry, Manila central university, Manila, Philippines.
⁵ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Taiz University, Taiz, Yemen.
⁶ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
⁷ Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang, 110002, China. yltian@cmu.edu.cn.

^# Contributed equally.

Abstract

Objective: This study aimed to evaluate enamel surface integrity and time consumed during residual cement removal after bracket debonding using different adhesive removal burs with and without a dental loupe.

Material and methods: Sixty human-extracted premolars were collected, cleaned, mounted, and prepared for orthodontic bracket bonding. Teeth were randomly divided into three main groups (n = 20) based on the adhesive removal method: tungsten carbide system (TC), sof-lex discs system (SD), and diamond system (DB) groups. Then, each group was subdivided into two subgroups (naked eye and magnifying loupe subgroups). The brackets were bonded and then debonded after 24 h, and the Adhesive Remnant Index (ARI) was assessed. The adhesive remnants were removed by different systems, and the final polishing was performed by Silicone OneGloss. The enamel surface roughness was evaluated before bracketing (T0), after residual cement removal (T1), and finally after polishing (T2) using surface Mitutoyo SJ-210 profilometry and Scanning Electron Microscopy (SEM) to determine the Enamel Damage Index (EDI) score. The time consumed for adhesive removal was recorded in seconds.

Results: The Kruskal Wallis test showed a statistically significant difference in roughness values at T1 compared to T2 between subgroups (p < 0.001). When comparing EDI at T1 and T2, the Kruskal-Wallis H-test showed statistically significant differences in all subgroups. The pairwise comparisons revealed that EDI scores showed a statistically significant difference at T1 and T2 between DB vs. TC and SD (p = 0.015) but not between TC vs. SD (p = 1.000), indicating the highest roughness value observed in the DB group. The time for cement removal was significantly shorter in the magnifying loupe group than in the naked eye group and was shortest with the TC group, whereas the time was the longest with the DB group (p < 0.05).

Conclusion: All three systems were clinically satisfactory for residual orthodontic adhesive removal. However, TC system produced the lowest enamel roughness, while the DB system created the greatest. The polishing step created smoother surfaces regardless of the systems used for resin removal.

Keywords: Brackets; Debonding; Magnifying loupe; Orthodontic adhesive; Surface roughness.

Publication types

Randomized Controlled Trial

MeSH terms

Bicuspid
Dental Cements*
Dental Debonding
Dental Enamel
Glass Ionomer Cements
Humans
Orthodontic Brackets* / adverse effects
Surface Properties
Tungsten Compounds*

Substances

Dental Cements
Glass Ionomer Cements
tungsten carbide
Tungsten Compounds