Evaluation of Enamel Staining Susceptibility after Using Three Kinds of Orthodontic Adhesives and Four Different Clean-Up Techniques

Abstract

Background: The present study tried to find the proper bonding and debonding technique to preserve the natural enamel surface and avoid its discoloration. Methods: Sixty newly extracted human premolars were randomly divided into three groups, and three orthodontic adhesives were applied to bond the brackets: chemically cured System 1 Plus adhesive (Ormco, USA) (CC), light-cured resin (Transbond XT, 3Munitek, USA) (LC), and resin-modified glass ionomer cement (Fuji Japan) (GI). The specimens were immersed in black tea for one week and debonded, and four prophylactic methods were applied to remove residual resin: 1) tungsten carbide bur (TC), 2) tungsten carbide bur + Sof-Lex polisher (TC + SL), 3) tungsten carbide bur + One Gloss Polisher (TC + OG), and 4) tungsten carbide bur + Po-Go polisher (TC + PG). The enamel color was measured according to the CIE standard system (Commission Internationale de l’Eclairage) by Konica Minolta CS Spectroradiometer equipment twice: 1) natural enamel color before bonding and 2) after bonding, staining, debonding, and polishing. The ΔE value is the tooth discoloration, which is measured from the mean Δa*, Δb*, and ΔL* values using the following formula ΔE = [(ΔL*)2 + (Δa*)2 + (Δb*)2]1/2 for each group. Then, it was statistically analyzed using a t-test. Results and Conclusions: Regarding adhesive materials, CC adhesive showed higher discoloration than LC in all the polishing methods. The lowest discoloration was observed in GI. The highest ΔE* values were obtained using TC only, which was deemed insufficient to remove the residual adhesives. Applying TC + Sof-Lex and TC + PoGo equally enhanced the results; therefore, they were the best polishing methods.