Evaluation of enamel surface after bracket debonding and polishing

Lilian Maria Brisque Pignatta,Eduardo César Almada Santos,Sillas Duarte Júnior

doi:10.1590/s2176-94512012000400017

Lilian Maria Brisque Pignatta, Eduardo César Almada Santos + Show 1 more

Open Access

https://doi.org/10.1590/s2176-94512012000400017

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Abstract

INTRODUCTION: Preserving the dental enamel structure during removal of orthodontic accessories is a clinician's obligation. Hence the search for an evidence based debonding protocol. OBJECTIVE: to evaluate and compare, by means of scanning electron microscopy (SEM), the effects of four different protocols of bracket debonding and subsequent polishing on enamel surface, and to propose a protocol that minimizes damage to enamel surface. METHODS: Twelve bovine permanent incisors were divided into four groups according to the instrument used for debonding and removal of the adhesive remnant. In groups 1 and 2, brackets were debonded with a straight debonding plier (Ormco Corp., Glendora, California, USA), and in groups 3 and 4, debonding was performed with the instrument Lift-Off (3M Unitek, Monrovia, California, USA). In groups 1 and 3, the adhesive remnant was removed using a long adhesive removing plier (Ormco Corp., Glendora, California, USA) and in groups 2 and 4, residual adhesive was removed with a tungsten carbide bur (Beavers Dental) at high-speed. After each stage of debonding and polishing, enamel surfaces were replicated and electron micrographs were obtained with 50 and 200X magnification. RESULTS: All four protocols of debonding and polishing caused enamel irregularities. CONCLUSION: Debonding brackets with straight debonding plier, removal of adhesive remnant with a tungsten carbide bur and polishing with pumice and rubber cup was found to be the protocol that caused less damage to enamel surface, therefore this protocol is suggested for debonding brackets.

Highlights

Preserving the dental enamel structure during removal of orthodontic accessories is a clinician’s obligation
Debonding brackets with straight debonding plier, removal of adhesive remnant with a tungsten carbide bur and polishing with pumice and rubber cup was found to be the protocol that caused less damage to enamel surface, this protocol is suggested for debonding brackets
Enamel damage can be attributed to tooth prophylaxis using abrasive materials,[8] enamel acid-etching technique,[5,8,9] enamel fractures caused by bracket debonding,[10] and removal of residual adhesive with rotary instruments.[5,8,11]

Summary

Introduction

Preserving the dental enamel structure during removal of orthodontic accessories is a clinician’s obligation. Maximum preservation of enamel surface structure after orthodontic treatment with minimum enamel loss during bracket debonding and polishing is one of the goals of orthodontists.[2,3,4,5] the clinical sequence to debond brackets and to remove the adhesive remnant has been empirically proposed,[3,6] i.e., without a deep scientific investigation on how debonding techniques affect enamel surface.[7] Enamel damage can be attributed to tooth prophylaxis using abrasive materials,[8] enamel acid-etching technique,[5,8,9] enamel fractures caused by bracket debonding,[10] and removal of residual adhesive with rotary instruments.[5,8,11]. Techniques that promote the union failure at the bracket-adhesive interface are most appropriated, because the adhesive remnant minimizes the risk of enamel loss during debonding.[4,12]

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