Editor's Comment and Q&A: Loss of surface enamel after bracket debonding: An in-vivo and ex-vivo evaluation

Abstract

Introduction The objective of this study was to evaluate the surface enamel after bracket debonding and residual resin removal. Methods Thirty patients (female, 20; male, 10; mean age, 18.4 years) who completed orthodontic treatment with fixed appliances (Twin Brackets, 3M Unitek, Monrovia, Calif) (n = 525) were included. The amounts of adhesive left on the tooth surfaces and the bracket bases were evaluated with the adhesive remnant index (ARI). ARI tooth (n = 498) was assessed on digital photographs by 2 operators. After resin removal and polishing, epoxy replicas were made from the maxillary anterior teeth (n = 62), and enamel surfaces were scored again with the enamel surface index. Elemental analysis was performed on the debonded bracket bases by using energy dispersive x-ray spectrometry mean area scanning analysis. The percentages of calcium and silicon were summed up to 100%. Tooth damage was estimated based on the incidence of calcium from enamel in relation to silicon from adhesive (Ca%) and the correlation between the ARI bracket and Ca%. Results and Conclusions While ARI tooth results showed score 3 as the most frequent (41%) ( P bracket results showed score 0 more often (40.6%) than the other scores ( P P tooth scores was found (Spearman rho=0.014, P = 0.91). The incidence of Ca% from the scanned brackets showed significant differences between the maxillary and mandibular teeth (14% ± 8.7% and 11.2% ± 6.5%, respectively; P P P