The use of debonding pliers in the removal of ceramic brackets: force levels and enamel cracks.

The purpose of this study was to determine the magnitude of the applied forces when using pliers as a debonding method for removing three types of ceramic brackets. The following variables were evaluated: debonding strengths, the Adhesive Remnant Index, and enamel damage with transillumination. All the brackets in this investigation was debonded with a direct bond remover plier. An Instron Model Universal testing machine was used to measure debonding strengths. From the results of this study, the following conclusions can be drawn: (1) The diamteral compression mean bond strengths for the three bracket types tested ranged from a low of 67.8 Kg/cm2 to a high of 102.9 Kg/cm2 and are in the clinically acceptable range for orthodontic force application. (2) There was no significant difference in the mean bond strengths of the three ceramic brackets tested. (3) The ARI scores were found to range between 2 and 4 indicating a cohesive type of bond failure. (4) Transillumination was used to evaluate minute enamel damage, and the results indicated that most of the teeth (82.02%) experienced no increase in enamel cracks after debonding. The teeth that showed an increase in the number of cracks after debonding had a significantly higher mean bond strength (113.0 Kg/cm2) than those with no increase in the number of cracks (72.9 Kg/cm2).