Enamel microcracks in terms of orthodontic treatment: A novel method for their detection and evaluation

Abstract

The study aimed at introducing current available techniques for enamel microcracks (EMCs) detection, and presenting a method for direct quantitative analysis of an individual EMC. Measurements of the detailed EMCs characteristics (location, length, and width) were taken from the reconstructed images of the buccal tooth surface (teeth extracted from two age groups of patients) employing a scanning electron microscopy (SEM) and our derived formulas before and after ceramic brackets removal. Measured parameters of EMCs for younger age group were 2.41 µm (width), 3.68 mm (length) before and 2.73 µm, 3.90 mm after debonding; for older -4.03 µm, 4.35 mm before and 4.80 µm, 4.37 mm after brackets removal. Following debonding EMCs increased for both groups, however the changes in width and length were statistically insignificant. Regardless of the age group, proposed method enabled precise detection of the same EMC before and after debonding, and quantitative examination of its characteristics.

Evaluation of Enamel Topography after Debonding Orthodontic Ceramic Brackets by Different Er,Cr:YSGG and Er:YAG Lasers Settings

“…Group control showed a high percentage (58.3%) of EMC, some of which were ramified and extended apical and incisal to the bracket area, as described also by Dumbryte [18,19]. This group displayed a minor area of enamel loss that appeared only on the SEM observations.…”

A Novel Method Using Confocal Laser Scanning Microscopy for Three-Dimensional Analysis of Human Dental Enamel Subjected to Ceramic Bracket Debonding

“…Several qualitative and quantitative methods have been used to diagnose alterations on enamel surfaces subjected to ceramic bracket bonding, including SEM, optical stereomicroscopy (with or without a digital camera), a magnifying lens (10×) and transillumination with a fiber optic light head, and 3D OCT scanning (Ahrari et al, 2012; Kitahara-Céia et al, 2008; Bishara et al, 2008; Dumbryte et al, 2015, 2017; Janiszewska-Olszowska et al, 2015; Leão Filho et al, 2015; Machoy et al, 2019). To date, SEM has been the method most widely used for the evaluation of enamel quality after ceramic bracket debonding.…”

“…Previous studies revealed an association between the ceramic bracket debonding process and increases in the length (Heravi et al, 2008;Dumbryte et al, 2016Dumbryte et al, , 2017 and width (Dumbryte et al, 2016(Dumbryte et al, , 2017 of enamel microcracks. Recently, a systematic review pointed out that although quantitative studies show weak evidence because of the lacking of parameter number analysis, there is strong evidence for the increasing of the enamel microcracks after debonding (Dumbryte et al, 2018).…”

“…Moreover, some techniques concerning the examination of the same dental enamel surfaces before and after ceramic bracket debonding have not described protocols to ensure that the analyses were performed at the same specific areas (Habibi et al, 2007;Bishara et al, 2008;Ahrari et al, 2012). Nevertheless, recent studies have proposed a method to quantitatively measure crack characteristics (visibility, direction, location, length, and width) in specific surface sites, before and after ceramic bracket debonding, employing SEM (Dumbryte et al, 2015(Dumbryte et al, , 2017. The authors concluded the technique might enable precise detection as well as the prediction of the presence of enamel microcracks even before the beginning of the orthodontic treatment.…”

The orthodontic bonding properties of human enamel after cryopreservation

“…Future research should focus on the effect of cryopreservation itself on enamel. Interesting methods using SEM were described by Dumbryte et al 32) .…”