Debonding of Orthodontic Ceramic brackets: A comprehensive review of the literature – Part 2

Karthikeyan Subramani,Prashanti Bollu

doi:10.18231/j.ijodr.2020.024

Karthikeyan Subramani, Prashanti Bollu

Open Access

https://doi.org/10.18231/j.ijodr.2020.024

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Abstract

The purpose of this 2 part review is to evaluate various debonding techniques for orthodontic ceramic bracket removal and their clinical applications.In this part 2 of the literature review, and studies on electrothermal debonding and Laser debonding techniques have been reviewed. Electrothermal debonding is a physiologically acceptable alternative to mechanical debonding. It requires minimal force following thermal softening of adhesive material and produces minimal changes to enamel surfaces compared to conventional methods. Minimal effects on enamel and intrapulpal temperature changes are noted with ytterbium fiber laser, diode laser and Tm:YAP laser. Different parameters are possible with CO laser, Nd:YAG laser and Er:YAG laser that may need further research before considering them in clinical practice.

Highlights

In part 1 of the 2 part literature review, studies on mechanical and ultrasonic debonding techniques have been reviewed
Electrothermal Debonding (ETD) was first described by Sheridan et al 1 as a method to debond ceramic brackets utilizing cordless battery devices that generated heat, which was transferred to ceramic brackets resulting in softening of adhesive material and bracket removal without use of excessive force
The results showed that the patients reported that ETD was comfortable than mechanical debonding

Summary

Introduction

In part 1 of the 2 part literature review, studies on mechanical and ultrasonic debonding techniques have been reviewed. Histologic examination revealed no evidence of cellular pathosis or modification other than cellular modification that corresponded to placement of the extraction forceps From both these studies, they concluded that ETD is a physiologically acceptable alternative to conventional debonding techniques. Scanning electron microscopic evaluation showed a predictable and favorable adhesive failure pattern at the bracket base/resin interface with no enamel damage They concluded that ETD using Dentaurum Ceramic Debonding Unit as a safe, reliable, efficient method to debond ceramic brackets while maintaining a physiologically acceptable rise in pulpal temperature without damage to tooth enamel or pulpal tissue. Dovgan et al 9 clinically evaluated ETD of premolars which were planned for orthodontic extraction in patients They studied the time required for debonding, patient acceptance and histologic effect on the pulp. The study concluded that ETD was less traumatic and produced minimal enamel surface changes compared to a mechanical debonding plier

Laser Debonding

Er:YAG Laser

Electrothermal Debonding

Conclusions