Quantitative and qualitative assessment of enamel surface following five composite removal methods after bracket debonding.

The search for an ideal enamel surface finishing method following bracket debonding has met with equivocal response. In this study, four other methods were assessed to determine their effectiveness against the slow speed tungsten carbide bur which is regarded as the established method of removing residual composite. Orthodontic brackets were bonded on 50 premolar teeth extracted for orthodontic purpose. After debonding with a standardized technique, the teeth were randomly divided into five equal groups. Samples in each group were subjected to different finishing procedures: Group A--Ormco band removing plier. Group B--Komet slow speed tungsten carbide bur. Group C--High speed ultrafine diamond bur. Group D--Jet high speed tungsten carbide bur. Group E--High speed white stone finishing bur. For consistency, the finishing procedures were limited to 15 seconds with each particular method. The composite remnants which then remained on the enamel surface were graded by four independent raters using the Composite Remnant Index (CRI). Subsequent to this, the enamel surface was examined in a Scanning Electron Miscroscope at x203 magnification. The photomicrographs were then graded by the same four independent raters using the Surface Roughness Index (SRI). Statistical analysis with the Friedman test indicated that there was no significant difference in inter-examiner variability in both the CRI and SRI assessment, but there existed significant difference among groups (P < 0.01) for both the CRI and SRI. It was found that no single absolute method was considered to be ideal for composite removal.(ABSTRACT TRUNCATED AT 250 WORDS)