The enamel loss and adhesive remnants after bracket removal and various adhesive removal methods: an in vitro...

This study evaluated the effectiveness of various adhesive removal methods following orthodontic bracket debonding. Eighty extracted human premolars were bonded, debonded, and randomly assigned to four groups (n = 20) based on the adhesive removal method: (1) low-speed round tungsten carbide (TC) bur, (2) high-speed, 18-fluted tapered TC bur, (3) high-speed extra-fine needle-shaped diamond bur, and (4) sequential polishing discs. Each group was further subdivided into two subgroups (n = 10) based on the inspection method for surface cleanliness: tactile examination with a dental explorer or marking the surface with a black pencil. Adhesive removal time was recorded for each group, and surface roughness was measured. Pre- and post-treatment tooth surface scans were superimposed using Geomagic Wrap software to quantify enamel loss and residual adhesive height. Data were analyzed using two-way ANOVA (α = 0.05). The 18-fluted TC bur had the shortest adhesive removal time (52.80 ± 6.74 s) but caused the greatest enamel loss (70.56 ± 56.44 μm) and highest residual adhesive height (75.60 ± 57.35 μm) (P < 0.05). Surface roughness was significantly higher in the 18-fluted TC bur group (186.20 ± 65.98 μm) than in the polishing disc (123.70 ± 40.64 μm) group (P < 0.05). Adhesive removal time was significantly longer for the polishing disc group (P < 0.05). Using a black pencil for surface inspection did not affect enamel characteristics, but significantly increased treatment time (P < 0.001). A low-speed round-shaped TC bur or an extra-fine needle-shaped diamond bur is recommended for adhesive removal after bracket debonding. Enamel inspection with a dental explorer provides comparable results to black pencil marking regarding enamel preservation.