Clinical evaluations on thermal versus mechanical debonding of ceramic brackets

Removal of ceramic orthodontic brackets, utilizing orthodontic pliers, has resulted in significant patient discomfort, enamel trauma and bracket shattering. The purpose of this clinical study was to compare the safety and efficacy of standard orthodontic mechanical debonding with a new Dentaurum thermal debonding device. Fifteen healthy patients with maxillary or mandibular premolars scheduled for extraction completed this study. One week after bracket placement, removal was accomplished by mechanical pliers or a thermal debonding device. Both procedures were performed on each patient in random order. Efficacy was monitored using scanning electron microscopy (SEM) on impressions made before and at selected times after debonding. Extracted teeth were subjected to histological evaluation to check potential injury to the pulp. Comfort levels were determined by questionnaires. Data was analyzed by Chi square. No irritation or overt changes were reported or observed. Significant differences (p less than 0.05) favoring the thermal devices were determined from the questionnaire on comfort during the removal process. Evaluation of SEM surfaces found significantly less (p less than 0.05) changes produced with the thermal debonding device, compared to mechanical removal. No histological evidence of pulpal injury related to product treatments were determined. The Dentaurum thermal debonding device was judged less traumatic by patients and produced minimal enamel surface changes compared to a mechanical debonding plier.