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[Enamel cracks: influence of orthodontic process]
L' Orthodontie Francaise
|August 28, 2014
Summary
Preventing enamel cracks during orthodontic treatment requires considering all stages, not just debonding. Risk factors, bracket type, placement, and bonding techniques significantly influence enamel integrity.
Area of Science:
- Orthodontics
- Dental Materials Science
Context:
- Enamel cracks are a common concern in orthodontic treatment, often associated with bracket debonding.
- However, factors preceding bracket removal significantly contribute to enamel integrity.
- Understanding these pre-treatment and treatment-related risks is crucial for minimizing iatrogenic damage.
Purpose:
- To highlight that enamel crack formation is multifactorial, extending beyond the bracket removal process.
- To identify key stages and factors throughout orthodontic treatment that influence enamel susceptibility to cracking.
- To explore potential strategies and material considerations for reducing enamel damage.
Summary:
- Pre-treatment risk factors (e.g., existing cracks, trauma) must be identified and communicated to patients.
- Buccal bracket placement is associated with fewer enamel cracks compared to lingual placement.
- Ceramic brackets require higher debonding forces; metal-reinforced ceramic brackets and alternative bonding agents like CVIMR may offer advantages.
- Rebonding procedures should avoid re-etching enamel, focusing instead on resin leveling.
- Investigating alternative debonding methods (heat, laser) for ceramic brackets is essential to mitigate high debonding forces.
Impact:
- Provides a comprehensive understanding of enamel crack etiology in orthodontics.
- Informs clinical decision-making regarding patient risk assessment, bracket selection, and bonding protocols.
- Suggests avenues for material development and technique refinement to enhance patient safety and outcomes.
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