What is the best method for debonding metallic brackets from the patient's perspective?

Matheus Melo Pithon,Daniel Santos Fonseca Figueiredo,Dauro Douglas Oliveira,Raildo Da Silva Coqueiro

doi:10.1186/s40510-015-0088-7

Matheus Melo Pithon, Daniel Santos Fonseca Figueiredo + Show 2 more

Open Access

https://doi.org/10.1186/s40510-015-0088-7

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Abstract

BackgroundThe aim of this clinical investigation was to compare the level of discomfort reported by patients during the removal of orthodontic metallic brackets performed with four different debonding instruments.MethodsThe sample examined in this split-mouth study comprised a total of 70 patients (840 teeth). Four different methods of bracket removal were used: lift-off debonding instrument (LODI), straight cutter plier (SC), how plier (HP), and bracket removal plier (BRP). Prior to debonding with all experimental methods, the archwire was removed. Before appliance removal, each patient was instructed about the study objectives. It was explained that at the end of debonding in each quadrant, it would be necessary to assess the discomfort of the procedure using a visual analog scale (VAS). This scale was composed of a millimeter ruler scoring from 0 to 10, in which 0 = a lot of pain, 5 = moderate pain, and 10 = painless. The level of significance was predetermined at 5 % (p = 0.05), and the data were analyzed using the BioEstat 5.0 software (BioEstat, Belém, Brazil).ResultsThe pain scores with SC were significantly higher than in all other methods. There were no significant differences between HP and BRP pain scores, and the LODI group showed the lowest pain scores. Statistically, significant differences were observed in the ARI between the four debonding methods.LimitationsThe biggest limitation of this study is that each tooth was not assessed individually.ConclusionsPatients reported lower levels of pain and discomfort when metallic brackets were removed with the LODI. The use of a straight cutter plier caused the highest pain and discomfort scores during debonding.

Highlights

In an attempt to fill this gap in the literature, the aim of this clinical investigation was to compare the level of discomfort reported by patients during the removal of orthodontic metallic brackets performed with four different debonding instruments and to verify the integrity of the enamel after debonding
The Friedman test indicated that pain scores were statistically significantly different depending on the debonding method
There were no significant differences between how plier (HP) and bracket removal plier (BRP) pain scores, and the lift-off debonding instrument (LODI) group showed the lowest pain scores

Summary

Introduction

The aim of this clinical investigation was to compare the level of discomfort reported by patients during the removal of orthodontic metallic brackets performed with four different debonding instruments. The existing literature shows that procedures such as the use of elastic separators, archwire placement and activations, as well as the application of orthopedic forces may cause pain in orthodontic patients [3–5]. It is known that the possibility of experiencing pain or discomfort may negatively influence the willingness of patients to undergo orthodontic treatment [6–9]. In an attempt to fill this gap in the literature, the aim of this clinical investigation was to compare the level of discomfort reported by patients during the removal of orthodontic metallic brackets performed with four different debonding instruments and to verify the integrity of the enamel after debonding

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