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Nano- and microscale evaluation of human enamel after different debonding methods
TianYou Wu1, Mauro Farella1, Guangzhao Guan2
1Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Background:
Numerous debonding methods are used in clinical practice to remove orthodontic brackets; it remains unclear, however, whether the most commonly used method is also the most appropriate. The aim of the study was to compare the effect of 6 commonly used debonding methods on enamel surface roughness, enamel volume loss, enamel color change, and debonding time.
Methods:
Metal brackets were bonded to the buccal surfaces of 60 extracted teeth and then removed using debonding pliers. The teeth were randomly assigned to 6 groups (n = 10), with each group undergoing adhesive removal with 1 of the following: (1) low-speed tungsten carbide bur (LS-TCB); (2) high-speed tungsten carbide bur (HS-TCB); (3) Sof-Lex discs; (4) fiberglass bur; (5) Enhance disc; or (6) adhesive removal pliers and pumice (ARP-P). Enamel roughness and nanotopography were assessed using atomic force microscopy and scanning electron microscopy, volume loss by micro-computed tomography, color change with a digital spectrophotometer, and debonding time was recorded. Data were analyzed with 1-way analysis of variance.
Results:
ARP-P, LS-TCB, and HS-TCB resulted in significantly increased enamel roughness (634.5 ± 88.4 nm, 488.7 ± 183.2 nm, and 302.1 ± 52.9 nm, respectively) compared with the control (prebracketing enamel surface, 164.3 ± 64.9 nm; P <0.01). HS-TCB caused the greatest enamel volume loss (0.93 ± 0.40 mm3), whereas the fiberglass bur caused the least (0.14 ± 0.10 mm3). All methods resulted in clinically detectable color changes (ΔE >3.7), with Sof-Lex discs causing a significantly greater change than other methods (ΔE = 13.4 ± 2.5; P <0.01). HS-TCB was significantly faster (44.4 ± 10.4 seconds) than the fiberglass bur method (83.7 ± 30.2 seconds; P = 0.003), whereas ARP-P was the slowest (92.3 ± 39.2 seconds; P <0.01).
Conclusions:
Debonding methods vary in their impact on enamel. Faster techniques, such as HS-TCB, cause greater damage, whereas gentler methods are slower but safer. Clinicians should prioritize enamel preservation over speed.
