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Quantitative analysis of enamel on debonded orthodontic brackets
Nathan J Cochrane1, Thomas W G Lo2, Geoffrey G Adams1
1Melbourne Dental School, Cooperative Research Centre for Oral Health Science, University of Melbourne, Melbourne, Australia.
Summary
Enamel damage, or tearouts, frequently occurs when removing orthodontic brackets. Ceramic brackets caused more damage than metal ones, with bonding material type also influencing the extent of enamel loss.
Area of Science:
- Dental materials science
- Orthodontic treatment outcomes
- Biomaterials
Background:
- Iatrogenic damage, specifically enamel tearouts, can occur during the removal of fixed orthodontic appliances.
- Understanding the frequency and extent of this damage is crucial for improving orthodontic procedures.
Purpose of the Study:
- To assess debonded metal and ceramic brackets bonded with various materials.
- To determine the frequency of enamel tearouts during orthodontic bracket removal.
Main Methods:
- Examined 486 debonded brackets from 81 patients using backscattered scanning electron microscopy and energy dispersive x-ray spectroscopy.
- Analyzed metal and ceramic brackets bonded with composite resin, self-etching primer, or resin-modified glass ionomer cement.
Main Results:
- 26.1% of brackets showed enamel on the bonding material.
- Enamel tearouts were more frequent with ceramic brackets (30.2%) than metal brackets (13.3%).
- The percentage of bracket base pad covered in enamel varied widely (0% to 46.1%).
Conclusions:
- Enamel damage during bracket debonding is common and highly variable.
- Ceramic brackets led to more frequent enamel damage compared to metal brackets.
- Resin-modified glass ionomer cement showed less damage with ceramic brackets than resin bonding systems.
