Enamel loss following ceramic bracket debonding: A quantitative analysis in vitro

Abstract

Objective: To measure enamel surface changes after ceramic bracket debonding and after cleanup. Materials and Methods: Forty extracted teeth were scanned in three dimensions using an optical scanner (baseline). Two ceramic bracket systems were placed (19 metal-reinforced polycrystalline ceramic brackets; 21 monocrystalline ceramic brackets). Seven days later, brackets were debonded and teeth scanned (post-debond). Adhesive remnants and bracket fragments were recorded. Tooth surfaces were cleaned using a finishing carbide bur and scanned again (post-cleanup). Post-debond and post-cleanup scans were aligned with the baseline, and surface changes were quantified. Results were statistically compared using t-tests and Mann-Whitney tests (a 5 .05). Results: The depth of enamel loss (mean 6 standard deviation) post-debond was 21 6 8 mm and 33 mm and post-cleanup was 28 6 14 mm and 18 6 8 mm (P 5 .0191); the post-debond remnant thickness was 188 6 113 mm and 120 6 37 mm (P 5 .2381) and post-cleanup was 16 6 5 mm and 15 mm for polycrystalline and monocrystalline ceramic brackets, respectively. The monocrystalline ceramic brackets predominantly left all adhesive on the tooth; the polycrystalline ceramic brackets were more likely to leave bracket fragments attached. Conclusion: Both systems allowed successful removal of the brackets with minimal enamel loss. However, the polycrystalline ceramic brackets left more fragments on the tooth, which complicated cleanup efforts. (Angle Orthod. 2015;85:651-656.)

Priming and bonding metal, ceramic and polycarbonate brackets

“…A remaining part of the ceramic bracket on enamel can be shaped in a way that it cannot be removed with pliers, and therefore needs to be removed with a rotary instrument. Due to the hardness of the ceramic bracket, it needs to be done with a diamond bur, but this can result in enamel damage [33]. It has been reported that the chance of enamel fracture during debonding of ceramic brackets could be diminished e.g.…”

Comparative study of dental enamel loss after debonding braces by analytical scanning electron microscopy (SEM)

“…Although it has always been desired to use an adhesive which is strong enough to prevent bracket detachment prematurely, it has been described that when removing them there is an increase in the damage that can occur to dental enamel. This has been an acute clinical problem since the introduction of bonding brackets directly to the enamel (Suliman et al, ).…”

“…It is always desired to use an adhesive which is strong enough to prevent bracket detachment prematurely (Suliman, Trojan, Tantbirojn, & Versluis, ).…”

Evaluation of enamel surface changes by different enamel conditioners and de-bonding procedure using optical coherence tomography: An in-vitro qualitative study

“…The most significant development was introduction of enamel etching and use of adhesive resin to bond the brackets onto enamel surface of teeth. 1 Etching with 37% phosphoric acid produces micro-porosities into which fluid monomers penetrate. 2 This simplified the process of orthodontic bonding on to enamel which increased patient compliance.…”