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Comparative Evaluation of Enamel Microfracture and Adhesive Remnant Index of Adhesive Precoated Flash-free System vs
Reem M Al Shaibah1, Reham I El-Gazzar2, Ahmed M Hafez2
1Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Phone: +97333833896,
Aims:
To evaluate and compare adhesive remnant index (ARI) between adhesive precoated (APC) flash-free (FF) appliance system and conventional brackets using four different debonding techniques, and to assess the relationship between debonding methods and enamel crack formation.
Materials And Methods:
A total of 80 sound human premolars were randomly allocated into two main groups (n = 40 each): APC-FF and conventional brackets. Each group was further subdivided into four subgroups (n = 10) based on debonding methods. Weingart plier, Howe plier (HP), straight cutter (SC), and bracket removing plier (BRP). Following standardized bonding protocols, brackets were debonded and evaluated for ARI scores. Scanning electron microscopy was used to assess enamel surfaces for crack formation before bonding and after debonding. Statistical analysis included Scheirer-Ray-Hare test and Cochran-Armitage test of trend.
Results:
Adhesive precoated flash-free group demonstrated significantly higher ARI scores compared to conventional group (p < 0.001). Straight cutters produced the lowest ARI scores and highest crack formation, while Howe and Weingart pliers showed the highest ARI scores with minimal crack formation. Conventional brackets exhibited significantly more enamel cracks (45%) compared to APC-FF brackets (20%) (p = 0.017). Significant inverse relationship was found between ARI scores and crack formation (p < 0.001).
Conclusion:
The resultant ARI after debonding serves as a reliable predictor of potential enamel microcrack formation. APC-FF brackets demonstrated superior enamel preservation compared to conventional brackets. Among debonding techniques, Howe and Weingart pliers proved most favorable, while SCs showed highest risk of enamel damage.
Clinical Significance:
Our findings posit that ARI can be a reliable predictor of enamel microcrack formation. Our findings also highlight the importance of selecting appropriate debonding methods and brackets to potentially minimize enamel harm. How to cite this article: Al Shaibah RM, El-Gazzar RI, Hafez AM. Comparative Evaluation of Enamel Microfracture and Adhesive Remnant Index of Adhesive Precoated Flash-free System vs Conventional Bonding Using Different Debonding Techniques: An In Vitro Study. J Contemp Dent Pract 2025;26(4):388-396.
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