Impulse debracketing compared to conventional debonding

Abstract

Objective: To evaluate impulse debonding compared to three conventional methods for bracket removal in relation to the damage caused to the enamel surface. Materials and Methods: Ninety-six osteotomed third molars were randomly assigned to two study groups (n 5 48) for bracket bonding with either a composite adhesive system (CAS) or a glassionomeric cement (GIC). These two groups were then each randomly divided into four subgroups (n 5 12) according to the method of debonding using (1) bracket removal pliers, (2) a side-cutter, (3) a lift-off debracketing instrument, or (4) an air pressure pulse device. Following debonding and corresponding postprocessing with either a finishing bur (CAS) or ultrasound (GIC), the enamel surfaces were assessed for damage, adhesive residues, and the need for postprocessing using scanning electron microscopy and the Adhesive Remnant Index, and the surfaces were compared in terms of mode of removal and type of adhesive using Fisher's exact test (a 5 5%). Results: No significant differences were found between the two different types of adhesives (CAS, GIC) in terms of the amount of damage to the enamel. Portions of enamel damage were found for impulse debonding/0%,bracket removal pliers/4%,lift-off debracketing instrument/17%,sidecutter/21%. The highest Adhesive Remnant Index grades were seen for impulse debonding. GIC residues after postprocessing using ultrasound were seen in 79%, compared to 48% after rotational postprocessing of CAS residues. Conclusions: Impulse debonding provides a good alternative to conventional debonding methods, as the adhesion is usually separated at the bracket-adhesive interface, thereby avoiding enamel damage, independent of the adhesive used.

Influence of Primekote® polymer in orthodontic bonding

“…In contrast, when the control group was removed, an adhesive layer was left adhered to the enamel, which must be removed in subsequent steps. In this case, the tooth enamel is preserved 3,5 . Taking into account that, in any case, teeth have to be polished after orthodontic treatment and removal of accessories, the teeth that had TP  bonded brackets would present greater loss of tooth substance, despite the use fo the safest techniques.…”

“…However, the direct bonding technique is still under development 4 and has limitations. One of such limitations is the common unwanted detachment of accessories, a disadvantage that requires time-consuming clinical procedures for removing the remaining adhesive, and carrying out prophylaxis, surface preparation and rebonding 5 .…”

“…Fracture lines in bracket displacement in vivo and in vitro usually occur in the bracket/adhesive interface. For this reason, investment has been made in order to improve the adhesion means of orthodontic appliances to dental elements, thereby increasing the rate of success of orthodontic bonding 5 .…”

“…Removal of brackets and subsequent cleaning of teeth enamel can be time-consuming for the dental surgeon. Furthermore, the operator must be careful to avoid iatrogenic accidents, destruction of enamel or fractures 5,9 .…”

Comparison of the Debonding Characteristics of Conventional and New Debonding Instrument used for Ceramic, Composite and Metallic Brackets – An Invitro Study

“…So, to reduce the irreversible enamel surface damage, several methods of debonding ceramic brackets have been suggested. These methods include the conventional methods that use pliers or wrenches, an ultrasonic method that uses special tips, and electrothermal devices that transmit heat to the adhesive through the bracket, air pressure impulse devices which is common for crown removal in prosthodontics, diamond burs to grind the brackets off the tooth surface, and lasers [7,8].…”