Area and Volume of Remaining Cement and Enamel after Removal and Polishing of Buccal or Lingual Multibracket Appliances

Abstract

The aim of the present study was to compare the area and volume of remaining cement after lingual and buccal multibracket appliance debonding. Further, the area and volume of cement remaining and the area and volume of enamel were also analyzed using a morphometric digital measurement technique. Ten buccal and 10 lingual multibracket appliances were cemented in 20 extracted teeth embedded into an epoxy resin model simulating a dental arch. The models were scanned before bonding the lingual and buccal multibracket appliances, after debonding the lingual and buccal multibracket appliances, and after polishing the remaining cement. Afterwards, the standard tessellation language (STL) digital files were aligned, segmented, and realigned by using engineer morphometry software. A comparative analysis was performed using Student’s t test statistical analysis. Lingual appliances showed statistically significantly (p < 0.001) less area (7.07 ± 4.85 mm2) and volume (0.87 ± 1.34 mm3) of remaining cement than the area (21.99 ± 4.18 mm2) and volume (p = 0.002) (3.48 ± 0.96 mm3) of buccal appliances. Moreover, lingual appliances showed statistically significantly (p = 0.001) less area (4.48 ± 3.08 mm2) and volume (0.13 ± 0.15 mm3) of remaining cement after polishing than the area (12.22 ± 5.98 mm2) and volume (p = 0.004) (0.70 ± 0.56 mm3) of buccal appliances. Lingual multibracket appliance therapy leads to less area and volume of cement remaining after multibracket appliance debonding and less area and volume of cement remaining after cement polishing than buccal multibracket appliance therapy; however, the area and volume of enamel removed after cement polishing were similar between both lingual and buccal multibracket appliance therapies.

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

“…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).…”

“…En el estudio presentado se puede observar que los dientes con mayor área de remanantes de esmalte tras el pulido son los incisivos y caninos en comparación con premolares y molares por lo que el pulido en estos dientes es más complejo por la dificultad de retirar el cemento completamente sin afectar al esmalte y por la difícil visibilidad y acceso a estas superficies (64,65). Además, la morfología de las superficies dentales es muy importante al realizar una correcta adhesión ortodóntica y en especial en ortodoncia lingual.…”