Morphometric analysis of enamel surface integrity after chemical, ultrasonic, and Er:YAG laser-assisted bracket...

Ceramic brackets are widely used in modern orthodontics due to their esthetic advantages. However, their removal remains associated with a risk of enamel damage. This in vitro study aimed to compare chemical, ultrasonic, and Er:YAG laser-assisted ceramic bracket debonding methods. Eighty extracted human premolars were randomly allocated into four groups (n = 20 each): control, chemical debonding using peppermint oil, ultrasonic debonding, and Er:YAG laser-assisted debonding. The primary quantitative outcome was adhesive remnant area percentage (ARA%), while enamel surface morphology was evaluated using scanning electron microscopy (SEM). The Er:YAG laser group demonstrated significantly higher ARA% values, indicating preferential retention of adhesive on the tooth surface and suggesting bond failure closer to the bracket-adhesive interface. SEM analysis revealed fewer structural enamel alterations in the laser group than in the other groups. Within the limitations of this in vitro study, Er:YAG laser-assisted debonding showed the most favorable enamel-preservation profile among the investigated methods. Further studies incorporating clinically relevant aging protocols, thermal safety assessment, and clinical validation are required to establish an optimized ceramic bracket debonding protocol.