Debonding Of Ceramic Brackets Research Articles

Effect of Different Chemical Solvents on Bond Strength of Orthodontic Brackets: An In Vitro Study.

The purpose of the present study was to evaluate the impact of various chemical solvents on bond strength of orthodontic brackets. One hundred healthy human premolars with undamaged buccal surfaces that were extracted for orthodontic purposes were gathered. Using 37% orthophosphoric acid, primer, and Transbond XT adhesive, ceramic 0.018" × 0.022" slot orthodontic brackets were adhered to the tooth surface. Following thermocycling, all samples were divided into four groups, with 25 samples in each group: group I: control; group II: application of ethanol; group III: application of acetone; and group IV: application of dimethyl sulfoxide (DMSO). Following the debonding tests, a double-ocular stereomicroscope was used to inspect the tooth surfaces. Additionally, adhesive remnant index (ARI) values were evaluated at 40× magnification. Data were recorded and statistically analyzed. The bond strength was lesser in acetone applied group (16.18 ± 3.64) followed by DMSO applied group (22.08 ± 2.86), ethanol applied group (24.36 ± 4.02), and control group (27.14 ± 3.68). There was a highly significant difference found between the chemical solvents group. The ARI score 3 was present in control (12%), ethanol (8%), and DMSO (4%), and it was absent in acetone applied group. The ARI score 0 was more in acetone applied group (24%). The present study concluded that the reduced debonding force was found with the application of acetone solvent followed by DMSO, ethanol, and control groups. Applying acetone can be a substitute technique to help with ceramic bracket debonding. Orthodontic bracket debonding cannot occur without shear bond strength (SBS). The need for an ideal debonding technique for ceramic brackets without negative consequences arises from the risk of enamel damage that frequently follows the process. Acetone treatment prior to ceramic bracket debonding could be an alternate clinical technique to preventing enamel damage and facilitating debonding. How to cite this article: Bhushan R, Singh S, Sam G, et al. Effect of Different Chemical Solvents on Bond Strength of Orthodontic Brackets: An In Vitro Study. J Contemp Dent Pract 2023;24(12):940-943.

The Effects of Eucalyptus Oil, Glutathione, and Lemon Essential Oil on the Debonding Force, Adhesive Remnant Index, and Enamel Surface During Debonding of Ceramic Brackets

The present study aimed to find a chemical reagent that would reduce the debonding force to enable easier debonding of the ceramic brackets, thus reducing enamel damage as well as chair side time. The study included 4 groups -control (distilled water), eucalyptus oil, glutathione and lemon essential oil for immersing teeth bonded with ceramic brackets. Samples (25 in each group), extracted first premolars, were mounted and immersed in their respective solution for a duration of 10 minutes following which they were tested to evaluate the debonding force using the INSTRON universal testing machine. The amount of adhesive left behind on the enamel surface was evaluated using adhesive remnant index (ARI) score and surface changes were checked using a scanning electron microscope. Teeth immersed in glutathione showed the greatest amount of reduction in debonding force (p=0.001) compared with other groups. ARI scores were low for specimens immersed in glutathione. SEM images showed that teeth in the glutathione group had a cleaner enamel surface, suggesting less or no adhesive was left behind and no sign of enamel damage after debonding ceramic brackets. Specimens that were immersed in glutathione for a duration of 10 minutes before debonding of ceramic brackets showed the greatest reduction in debonding force compared with control and demonstrated peel off effect with no enamel damage. Glutathione can be used as an effective reagent during the clinical debonding of ceramic brackets.

<i>In Vitro</i> Evaluation of the Effects of Different Chemical Solvent Agents on Shear Bond Strength of Ceramic Orthodontic Brackets

In this study, the effects of different chemical solvents such as acetone, ethanol, dimethyl sulfoxide (DMSO), peppermint oil, and hot water on the shear bond strength (SBS) of mechanically and chemically bonded ceramic brackets were examined. Their use for facilitation of the debonding process in practice was evaluated regarding the purposes of this study. One hundred and thirty-two human premolar teeth extracted for orthodontic purposes were randomly divided into 11 groups. SBS were applied using a universal test machine. The amount of residual adhesives was determined through adhesive remnant index scoring. Scanning electron microscopy (SEM) images were examined to determine the effects of solvents on the enamel surface. In all test groups, the highest SBS values were found in the ethanol 5- and 15-minutes groups. SEM examination showed micro-cracks in all groups. Increased SBS values were also found in 5- and 15-minutes groups of hot water and DMSO, while both peppermint oil groups had similar SBS values as the control group. SBS values of both acetone 5- and 15-minutes groups were found to be lower than the control and other groups. Acetone application for 5 or 15 minutes before debonding of ceramic brackets could be an alternative clinical approach to prevent enamel damage and facilitate debonding.

Effect Of Er, Cr: YSGG And Er: YAG Lasers During Debonding Of Orthodontic Ceramic Brackets: In Vitro Study

Effect Of Er, Cr: YSGG And Er: YAG Lasers During Debonding Of Orthodontic Ceramic Brackets: In Vitro Study

Comparative Study of Transmission of 2940 nm Wavelength in Six Different Aesthetic Orthodontic Brackets.

Previous studies have confirmed the superiority of using erbium lasers (2940, 2780 nm) over other lasers in the debonding of ceramic brackets due to their safety and effectiveness. The most important factor in the debonding of aesthetic brackets is the transmission of the erbium laser through the aesthetic bracket to the adhesive resin. To identify the transmission of the 2940 nm wavelength through different types of aesthetic brackets. A total of 60 aesthetic brackets were divided into six equal groups (10 monocrystalline sapphire brackets-Radiance, AO; 10 monocrystalline sapphire brackets-Absolute, Star Dentech; 10 polycrystalline brackets-20/40, AO; 10 polycrystalline brackets-3M Unitek Gemini Clear Ceramic; 10 silicon brackets-Silkon Plus, AO; 10 composite brackets-Orthoflex, OrthoTech). The aesthetic brackets were mounted in a Fourier transform infrared spectrophotometer (FTIR IRPrestige-21, SHIMADZU) following the typical spectroscopy lab procedure for such samples. The transmission ratio for the 2940 nm wavelength was obtained using IRsolution software. The mean transmission values of the tested groups were compared using a one-way analysis of variance (ANOVA) test followed by a Bonferroni test (post-hoc test). The highest transmission ratio was observed for the Radiance sapphire brackets (64.75%) and the lowest was observed for the 3M polycrystalline brackets (40.48%). The differences among the Aesthetic brackets were significant (p < 0.05). The thick polycrystalline and composite brackets have the lowest transmissibility, whereas the monocrystalline sapphire brackets have the highest transmissibility for the 2940 nm wavelength, meaning that there is a higher possibility of debonding them with a hard tissue laser through thermal ablation.

Effect of ER, CR: YSGG laser debonding on enamel surface changes in stainless steel and ceramic brackets - An in-vitro study.

The aim of this in-vitro study was to observe and analyze the various enamel surface changes that occur due to laser debonding of metal and ceramic brackets, done by means of Er, Cr:YSGG laser. 90 extracted premolars were randomly allocated into one of six groups with 15 teeth each. The groups represent metal brackets (Groups A1, A2, A3) and ceramic brackets (Groups B1, B2, B3). Each sub-group represents the mode of debonding used in the study. Debonded teeth were analyzed under scanning electron microscopy (SEM) at 80X and at 1000X magnification at three sites. The adhesive remnant index (ARI) scores were analyzed and the presence of enamel damage was observed. ARI showed high score in Groups A1 and B1. SEM images of large composite remnants at the site of bracket in Groups A1 and B1 at the site of bracket and multiple enamel microcracks and fractures at interface and enamel adjacent to bracket in Groups A1 and B1. SEM images of minimal composite remnants at the site of bracket in Groups A2, A3, B2, and B3 and little to no presence of enamel microcracks or fractures at interface and enamel adjacent to bracket in Groups A2, A3, B2, and B3. The use of Er, Cr:YSGG laser in orthodontic practice, especially in the debonding procedures of orthodontic brackets provide quality care to patient with minimal post-treatment damages.

Reliability of qualitative and quantitative assessment of adhesive remnants after debonding of ceramic brackets bonded with Transbond™XT on human molar teeth: An in vitro study

To test the hypothesis that there are any differences between qualitative and quantitative methods of adhesive remnants index (ARI) scores on the buccal surfaces of the upper molar. The study included 34 upper first human molars. After etching for 20seconds by using 35% orthophosphoric acid (Ultra-Etch, Ultradent Products Inc., USA) and then rinsed with distilled water for 15seconds, the adhesive (Transbond™XT, 3M™, USA) was applied and cured with the polymerization lamp (Bluephase Style, Ivoclar Vivadent, Liechtenstein) for 10seconds. Ceramic brackets (Damon® Clear™, Ormco, USA) were placed by composite (Transbond™XT, 3M™, USA) on the buccal surface of the molars. Following 24-hour storage of the samples in distilled water (WB-12, Phoenix Instrument, Gabsen, Germany) at 37°C, the brackets were debonded using a debonding plier (Damon Clear Debonding Plier, Ormco, USA). ARI and a modified ARI-scoring system were used. Three independent observers scored the ARI with the naked eye under 10x, 20x, and 32x magnifications using Stereomicroscope Stemi DV4 (Zeiss, Germany). Afterward, the digital microscope VHX-5000 (Keyence, Japan) under 50x magnification was used for the quantitative analysis of the adhesive remnants by just one evaluator. The Fleiss' Kappa-coefficient test was used to assess interrupter reliability. Fleiss' Kappa-coefficient test show that the highest amount of agreement between observers is observed using the naked eye for both of the scoring methods P<0.001. Increasing the magnification led to the moderate decrease of inter-observer agreement. For evaluations with naked eye, a higher agreement is observed for the modified ARI score compared to the ARI scored. The agreement between the quantitative and qualitative evaluation of the ARI score rose with increasing magnification. The assessment of adhesive remnants should be done either with naked eye or under 10x magnification, as they showed the highest rate of intra-observer agreement.

Assessment of chemical, ultrasonic, diode laser,\xa0and Er:YAG laser application on debonding of ceramic brackets

BackgroundRisk of enamel damage that often accompanies ceramic brackets debonding raises the demand of finding an optimal method for debonding of them without adverse effects. Different techniques were proposed in an attempt to facilitate their debonding. Comparison of these techniques is crucial. The aim of this study was to evaluate and compare different techniques for debonding of ceramic brackets in terms of shear bond strength and adhesive remnant index.Materials and methodsA total of 100 extracted premolars were randomly allocated into 5 groups. Ceramic brackets were then bonded to teeth using light cure composite resin. Among test groups; group I: served as control, group II: chemical aided debonding via peppermint oil, group III: ultrasonic aided debonding, group IV: diode laser aided debonding, and group V: Er:YAG laser aided debonding. Brackets were shear tested using universal testing machine followed by ARI assessment and evaluation of enamel microstructure was performed using scanning electron microscopy.ResultsA significantly lower shear bond strength was found in ultrasonic, diode, and Er:YAG laser groups. However, no significant difference was found in the chemical group. A significantly higher adhesive remnant index was found solely in Er:YAG laser group with minimal enamel microstructure alterations.ConclusionsEr:YAG laser is a promising tool in debonding ceramic brackets. Ultrasonic and diode laser significantly reduced shear bond strength. Yet, adhesive remnant index in both groups revealed no difference. Chemical aided debonding had little effect and hence, it cannot be recommended without further development.

Effect of Volatile Oils on De-Bonding of Polycarbonate Bracket Reinforced with Ceramic Filler: A Quantitative Study (Part 1)

Introduction: The introduction of esthetic brackets is a new clinical approach in the field of orthodontics. Two main types of esthetic brackets have been developed and became widely available; the polycarbonate brackets, and the ceramic brackets. Both types have faced two significant de-bonding problems: (1) enamel and bracket fracture. The two problems have been well documented and continue to be of concern to clinicians.&#x0D; Aim: The aim of this in vitro study was to evaluate quantitatively the effect of three volatile oils and their combinations on the de-bonding of ceramic brackets. &#x0D; Material and Method: Polycarbonate brackets reinforced with ceramic filler were bonded to one hundred and eighty (180) sound extracted human premolars using Transbond XT light curing adhesive. The teeth were then distributed into the following groups according to the type of volatile oil and period of application: clove oil (5 &amp; 30 minutes), peppermint oil (5 &amp; 30 minutes), Black seed volatile oil (5 &amp; 30 minutes), and mixture of peppermint + Black seed volatile oils (5 &amp; 30 minutes) in addition to control group. The brackets were then de-bonded using the Instron Universal Testing Machine and the de-bonding force was recorded for each type of the volatile oils in different times of application. &#x0D; Result: The result revealed that the Black seed volatile oil gave the lowest de-bonding force in 5 minutes and 30 minutes of application whereas the mixture of the Black seed oil + peppermint oils gave the highest force in both time of application. Further, the peppermint oil application for 5-minute was found to be in the second rank whereas the Clove oil was in the third rank. Furthermore, in the 30 minutes of application the Clove oil was in the second rank whereas the peppermint was found to be in the third rank and the combination of Black seed oil + peppermint oil shows the highest debonding force.&#x0D; Conclusion: Despite the limitation of the present study result, an assumption has been drawn from the results obtained that (1) the 5- minutes of black seed or peppermint volatile oils application can be considered the best debonding agent compared to the other volatile oils; (2) the clove oil can be used after de-bonding to facilitate the final cleansing-up of enamel surface. To confirm the latter assumption, further investigations are needed.

Comparison of feldspathic veneer surface treatments on ceramic bracket SBS, ARI and surface roughness after different debonding/polishing methods: An in vitro study

To analyse, in vitro, surface properties and the shear bond strength after debonding and polishing procedures of ceramic brackets directly bonded to 0.3-0.5-mm thick feldspathic veneers. Fifty six feldspathic ceramic veneers samples (0.3 to 0.5-mm thick) were allocated into groups according to veneers surface treatment procedures: (S) glaze layer was retained; (SHF) hydrofluoric (HF) acid etch; (SOXA) Al2O3 sandblasting; and (SB) diamond burs roughening. Specimens were treated with silane Monobond N® and ceramic brackets bonded with Transbond XT®. Shear bonding strength (SBS) was assessed with a universal testing machine and ARI evaluated under a stereomicroscopic coupled to a digital camera. Remaining bonding composite was removed using a porcelain polishing kit and surface roughness assessed with a stylus profilometer. No statistically significant differences were identified for SBS among the study groups (S, SHF, SOXA and SB) (P>0.05). The majority of the specimens presented ARI scores 3 and 2 (P>0.05). All of the study groups presented increased surface roughness after debonding and polishing procedures (P<0.05), with significant greater values observed in SB group (RaF: 1.27±0.41; RzF: 6.23±1.82), (P<0.05). Surface treatment with hydrofluoric acid etch, Al2O3 sandblasting and diamond bur did not enhance SBS of orthodontic brackets bonded to ceramic veneers. Ceramic surfaces treated with diamond burs presented significantly increased roughness after adhesive removal.

Safe Debonding of Fixed Appliances: A Comparison of Traditional Techniques and LODI Devices on Different Bracket Types in Terms of Enamel Cracks, Site of Bond Failure, and Bracket Reusability

The objective of this study was to compare the effects of the debonding of three different bracket types by means of three popular debonding methods. A total of 180 human third molars was divided into six groups, consisting of 20 teeth each. Three bracket types were bonded to the enamel (metal brackets with an integral base and a foil mesh base, and ceramic brackets) and three methods of bracket debonding were employed (bracket removal pliers, Weingart pliers, and Lift-Off Debonding Instrument). The samples were examined with scanning electron microscopy to assess the number of enamel cracks, measure the area of adhesive remaining on the enamel, and calculate the adhesive remnant index (ARI). There were no statistically significant differences between the groups in terms of the number of enamel cracks after bracket debonding. The amount of adhesive remaining on the teeth after the brackets were removed was significantly different between the groups. LODI and Weingart pliers are considered to be the safest methods of debonding brackets with an integral base, while LODI is the best tool for brackets with foil mesh. Bracket removal pliers are considered to be the preferred method for ceramic bracket debonding.

Effect of different resin removal methods on enamel after metal and ceramic bracket debonding : An in vitro micro-computed tomography study.

The aim of this study was to conduct an in vitro evaluation of the effects of different adhesive debonding and polishing techniques performed after metal and ceramic bracket removal on enamel using micro-computed tomography (micro-CT). This study was performed on 42 extracted maxillary first premolars divided into 2main groups and 6subgroups as follows: metal (group1) or ceramic (group2) brackets were bonded to the teeth, then, after debonding, one of three different methods was used to remove the residual adhesive: tungsten carbide burs with pumice(A), fiber-reinforced composite burs and polishing paste(B), or Sof-Lex discs(C; 3M Dental, St Paul, MN, USA). The samples were evaluated by micro-CT before bracket bonding (T0) and after resin removal (T1). Demineralization area, demineralization depth, demineralization volume, mineral density, and mineral volume were measured. At T1, demineralization area was significantly larger in groups1A and2A compared to groups1B, 1C, 2B, and2C (P = 0.001). Group2A (ceramic bracket/tungsten carbide-pumice) had the highest demineralization volume (P = 0.001). When the groups were compared in terms of change from T0 to T1, groups1A and2A showed significantly larger changes in demineralization area compared to the other 4groups (P = 0.001). The increase in demineralization volume was larger in group2A compared to all other groups (P = 0.001). All resin removal methods damaged the enamel surface to varying degrees. Regardless of bracket type, the use of tungsten carbide and pumice should be avoided when cleaning the tooth surface after debonding. Use of composite burs and Sof-Lex discs in particular after the debonding of ceramic brackets will help minimize damage.

Enamel surface damage during debonding of ceramic brackets: a brief review

Enamel surface damage during debonding of ceramic brackets: a brief review

Enamel Surface Damage following Debonding of Ceramic Brackets: A Hospital-Based Study.

Methods The current study includes 80 extracted premolars of human from the patient visiting for orthodontic treatment of Coorg Institute of Dental Sciences, Karnataka, India. The brackets were debonded using four different methods. The enamel surface damage after the procedure was assessed with the Enamel Surface Index (ESI); similarly, the Adhesive Remnant Index (ARI) score was used to determine the adhesive residual deposit. Scanning electron microscopy (SEM) was used to visualize better microporosities and micromechanical retention of adhesive remnants on the enamel surface. The normality of the data was tested using the Kolmogorov–Smirnov test. Depending upon the normality test result, the one-way ANOVA test or Kruskal–Wallis test was used to test the mean ESI and mean ARI differences among different debonding methods along with the appropriate post hoc tests. The necessary ethical clearance was obtained from the Ethics Committee of the institute. Results The ultrasonic scaler (US) technique led to more significant enamel surface damage, with 13 (65%) samples in the ESI scores III and IV against the satisfactory surface in 2 (10%) samples with the ligature cutter (LC) technique (ESI-I) reflecting LC as a better technique. The ESI scores (III and IV) for debonding plier (DP) and thermal method (TM) reflected a higher value in 12 (60%) and 10 (50%) samples and caused more damage to the enamel surface as compared to the LC technique. The ARI score was highest (ARI-1 = 40%) with the LC technique, followed by the US (ARI-1 = 20%), TM (ARI-1 = 15%), and DP (ARI-1 = 5%) methods. We have observed a significant association (p value <0.05) of the ARI score among four different debonding ways in terms of each tooth's residual adhesive after the bracket removal. Conclusion The result establishes the LC technique as a more acceptable one as it causes minimal harm to the debonded surface. The adhesive left on the debonded area is also minimum as compared to the other three methods tested. Therefore, it can be suggested as an ideal method.

Debonding of Orthodontic Ceramic brackets: A comprehensive review of the literature – Part 1

The purpose of this 2 part literature review is to evaluate various debonding techniques for orthodontic ceramic bracket removal and their clinical applications.In part 1, and studies on mechanical and ultrasonic debonding techniques have been reviewed. Mechanical debonding (use of diamond burs, special pliers) is most widely applicable in clinical practice. Use of recommended pliers by manufacturers is key to minimize bracket failure modes as these pliers are designed specifically for the brackets. Ultrasonic debonding is advantageous in minimizing bracket failure but requires greater time to debond ceramic brackets than mechanical debonding and it may be uncomfortable to the patient due to longer duration of use. Studies on electrothermal and Laser debonding have been reviewed in part 2 of the literature review.

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

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.

A Novel Method Using Confocal Laser Scanning Microscopy for Three-Dimensional Analysis of Human Dental Enamel Subjected to Ceramic Bracket Debonding.

The aim of this in vitro study was to present a method using confocal laser scanning microscopy for three-dimensional analysis of human dental enamel subjected to ceramic bracket debonding. The labial enamel surfaces of three upper central incisors were prepared and mounted in the form of standardized specimens. A sample repositioning protocol was established to enable surface measurement and analysis before and after bracket debonding. Observations were made of representative areas measuring 1,280 × 1,280 μm2, in the center of the enamel samples, as well as of the total topography (2,500 × 3,500 μm) of the bonding areas provided by the equipment software. Noncontact three-dimensional high-resolution image analyses revealed the capabilities of the employed technique and methodology to permit the examination of specific characteristics and alterations on the surfaces, before and after the debonding and finishing procedures. The new protocol was effective to provide qualitative and quantitative assessments of changes on the same dental surfaces at different trial times. The methodology constitutes a feasible tool for revealing the effects of debonding of ceramic brackets on sound and previously injured dental enamel surfaces.

Efficacy of Er,Cr:YSGG laser for debonding of ceramic brackets and prevention of enamel damage and intrapulpal temperature change

Debonding of ceramic brackets can cause problems such as bracket fracture and enamel damage due to high bond strength and low fracture toughness. Laser irradiation, aiming to decrease the bond strength, may be able to enhance ceramic bracket debonding. Nonetheless, temperature rise following laser therapy can adversely affect the dental pulp. The aim of this study is to assess enamel damage and intrapulpal temperature change after debonding ceramic brackets with or without Er,Cr:YSGG irradiation. In this experimental study, 80 Fascination ceramic brackets were bonded to the buccal surface of extracted human premolars. The teeth were randomly divided into two groups of 40. In group 1 (control), polycrystalline brackets were debonded using the pliers recommended by the manufacturer. In group 2, brackets were irradiated by Er,Cr:YSGG (Waterlase iPlus, Biolase, USA, 12/2013), gold handpieces, and tip MZ8 and were operated at 50 Hz, 4.5 W, H-Mode (60 μs), 80% water, and 60% air. After laser irradiation, the brackets were debonded as in group 1. Before bracket bonding and after debonding, the buccal surface of the teeth was inspected under a stereomicroscope to assess the presence of enamel cracks. The number and length of enamel cracks before bonding and after debonding were compared using Scope Image version 9.0. A K-type thermocouple with 0.2-mm diameter was used to assess the intrapulpal temperature change following laser irradiation. Data were analyzed using SPSS version 22. No enamel fracture was noted in the control or laser group. Bracket debonding with the help of laser decreased the number and length of enamel cracks compared with the control group. Temperature rise in the laser group (2.63 ± 1.3 °C) was significantly lower than the critical threshold of 5.5 °C. The two groups showed significant differences regarding the adhesive remnant index (ARI) scores (P < 0.05). Er,Cr:YSGG laser irradiation can minimize enamel damage with no thermal damage to the pulp, and is an efficient and safe modality for enhanced debonding of ceramic brackets.

Determination of Shear Bond Strength and Evaluation of Enamel Surface Changes Following Debonding of Different Ceramic Brackets: An-Vitro Study

Determination of Shear Bond Strength and Evaluation of Enamel Surface Changes Following Debonding of Different Ceramic Brackets: An-Vitro Study

Survey on awareness and preference of ceramic bracket debonding techniques among orthodontists.

BackgroundThe objectives of this study was to evaluate the awareness of different ceramic bracket debonding techniques among orthodontists in the USA and the most commonly used debonding technique for ceramic bracket removal. Material and MethodsA survey on preference for debonding and awareness of debonding techniques was emailed to 2,227 members of the American Association of Orthodontists (AAO). Results119 orthodontists completed the survey. 111 responses were included in the study analysis of ceramic bracket users. The most common technique used was mechanical debonding. 86.5% used a specially designed bracket removing plier from the manufacturer. Overall, there were 59.5% of surveyed orthodontists who were aware of electrothermal debonding, 73% were unaware of ultrasonic debonding and 83.8% were unaware of laser debonding. There were more orthodontists with an affiliation with an academic institution aware of electrothermal debonding (p=0.002). There also was a trend of orthodontists having no affiliation with an institution who were unaware of laser debonding (p=0.015). ConclusionsThis survey showed that the majority of orthodontists who responded to the questionnaire were unaware of alternative debonding techniques of ceramic brackets. All orthodontists who use ceramic brackets utilized mechanical debonding technique. Key words:Orthodontic ceramic brackets, mechanical, electrothermal, ultrasonic, laser debonding.