Emre Cesur1, Can Arslan2, Ayşe Işıl Orhan3, Burak Bilecenoğlu4, Kaan Orhan5. 1. Faculty of Dentistry, Mega Hospital Complex, Department of Orthodontics, İstanbul Medipol University, 34214, Bağcılar/İstanbul, Turkey. emre-cesur@hotmail.com. 2. Faculty of Dentistry, Department of Orthodontics, İstanbul Medipol University, İstanbul, Turkey. 3. Faculty of Dentistry, Department of Paediatric Dentistry, Yıldırım Beyazıt University, Ankara, Turkey. 4. Faculty of Dentistry, Department of Anatomy, Ankara Medipol University, Ankara, Turkey. 5. Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ankara University, Ankara, Turkey.
Abstract
PURPOSE: The aim of this study was to conduct an in vitro evaluation of the effects of different adhesive debonding and polishing techniques performed after metal and ceramic bracket removal on enamel using micro-computed tomography (micro-CT). METHODS: This study was performed on 42 extracted maxillary first premolars divided into 2 main groups and 6 subgroups as follows: metal (group 1) or ceramic (group 2) brackets were bonded to the teeth, then, after debonding, one of three different methods was used to remove the residual adhesive: tungsten carbide burs with pumice (A), fiber-reinforced composite burs and polishing paste (B), or Sof-Lex discs (C; 3M Dental, St Paul, MN, USA). The samples were evaluated by micro-CT before bracket bonding (T0) and after resin removal (T1). Demineralization area, demineralization depth, demineralization volume, mineral density, and mineral volume were measured. RESULTS: At T1, demineralization area was significantly larger in groups 1A and 2A compared to groups 1B, 1C, 2B, and 2C (P = 0.001). Group 2A (ceramic bracket/tungsten carbide-pumice) had the highest demineralization volume (P = 0.001). When the groups were compared in terms of change from T0 to T1, groups 1A and 2A showed significantly larger changes in demineralization area compared to the other 4 groups (P = 0.001). The increase in demineralization volume was larger in group 2A compared to all other groups (P = 0.001). CONCLUSION: All resin removal methods damaged the enamel surface to varying degrees. Regardless of bracket type, the use of tungsten carbide and pumice should be avoided when cleaning the tooth surface after debonding. Use of composite burs and Sof-Lex discs in particular after the debonding of ceramic brackets will help minimize damage.
PURPOSE: The aim of this study was to conduct an in vitro evaluation of the effects of different adhesive debonding and polishing techniques performed after metal and ceramic bracket removal on enamel using micro-computed tomography (micro-CT). METHODS: This study was performed on 42 extracted maxillary first premolars divided into 2 main groups and 6 subgroups as follows: metal (group 1) or ceramic (group 2) brackets were bonded to the teeth, then, after debonding, one of three different methods was used to remove the residual adhesive: tungsten carbide burs with pumice (A), fiber-reinforced composite burs and polishing paste (B), or Sof-Lex discs (C; 3M Dental, St Paul, MN, USA). The samples were evaluated by micro-CT before bracket bonding (T0) and after resin removal (T1). Demineralization area, demineralization depth, demineralization volume, mineral density, and mineral volume were measured. RESULTS: At T1, demineralization area was significantly larger in groups 1A and 2A compared to groups 1B, 1C, 2B, and 2C (P = 0.001). Group 2A (ceramic bracket/tungsten carbide-pumice) had the highest demineralization volume (P = 0.001). When the groups were compared in terms of change from T0 to T1, groups 1A and 2A showed significantly larger changes in demineralization area compared to the other 4 groups (P = 0.001). The increase in demineralization volume was larger in group 2A compared to all other groups (P = 0.001). CONCLUSION: All resin removal methods damaged the enamel surface to varying degrees. Regardless of bracket type, the use of tungsten carbide and pumice should be avoided when cleaning the tooth surface after debonding. Use of composite burs and Sof-Lex discs in particular after the debonding of ceramic brackets will help minimize damage.