Comparative evaluation of different debonding and reconditioning methods for orthodontic ceramic brackets regarding effectiveness for reuse

Abstract

Purpose To investigate the reusability of ceramic brackets in terms of shear bond strength, friction behavior, slot dimension, fracture strength, and color stability. Methods A total of 90 conventionally debonded and 30 by an Er:YAG laser debonded ceramic brackets were collected. All the used brackets were inspected under a stereomicroscope at 18 × magnification and sorted according to their adhesive remnant index (ARI). Five groups were formed (n = 10): (1) new brackets as a control group, (2) flamed and sandblasted, (3) flamed and acid bathed, (4) laser-reconditioned, and (5) laser-debonded brackets. The bracket groups were tested regarding different properties such as shear bond strength, friction behavior, slot size, fracture strength, and color stability. Analysis of variance (ANOVA) and nonparametric Kruskal–Wallis tests were used for statistical analysis (significance level: p < 0.05). Results Shear bond strength values of the acid reconditioned brackets were significantly lower (8.0 ± 3.1 MPa) compared to the control group (12.9 ± 2.9 MPa). Laser-reconditioned (32.8 ± 2.7%) and laser-debonded (30.9 ± 2.4%) brackets showed the lowest force loss due to friction (control group 38.3 ± 3.0%). No significant differences were observed between groups regarding slot size and fracture strength. All groups had color differences of $${\Updelta E}_{ab}^{\mathrm{*}}$$ ∆ E a b * < 10. Scanning electron microscope images and ARI scores indicated that most of the residues on the bracket bases were removed. Conclusion All reconditioning methods yielded adequate results regarding bracket properties. Yet, focusing on the need to protect the enamel and the bracket base, laser debonding seems to be the most suitable method for reconditioning ceramic brackets.