Effects of refinement procedures on enamel surface integrity in clear aligner therapy: a 3D micro-CT study

Area of Science:

• Dental Materials Science
• Orthodontic Technology
• Biomaterials

Background:

• Clear aligner therapy is increasingly popular for orthodontic treatment.
• Attachment debonding is a necessary procedure during clear aligner treatment.
• Enamel surface changes after debonding require investigation.

Purpose of the Study:

• To evaluate topographic changes on the enamel surface after different clear aligner attachment debonding methods.
• To compare the effects of two distinct debonding protocols on enamel integrity.
• To assess the cumulative impact of repeated debonding procedures on enamel.

Main Methods:

• Twenty premolars were used, with vertical rectangular attachments bonded.
• Two debonding methods were applied: carbide burs and specialized polishing kits.
• Three-dimensional micro-computed tomography (Micro-CT) was employed to analyze enamel surfaces at three time points (T0, T1, T2).

Main Results:

• Both debonding methods resulted in significant decreases in enamel demineralization volume, area, and mineral density.
• Enamel mineral density was better preserved with the specialized polishing kit (Group 2) after repeated debonding.
• Cumulative effects of debonding led to more pronounced tissue loss after the second application.

Conclusions:

• Repeated clear aligner attachment debonding significantly impacts enamel integrity.
• The choice of debonding method influences the preservation of enamel mineral density.
• Careful consideration of refinement procedures is crucial to minimize cumulative enamel damage.