Enamel surface evaluations after clinical treatment and removal of orthodontic brackets

Methods for the removal of resins attached to acid-etched enamel are receiving increased attention. An evaluation method which permitted convenient statistical comparisons of the effectiveness of various removal procedures was used. The method was based on ranking of SEM photomicrographs of epoxy replicas of teeth from clinical cases. Forty-five orthodontically treated teeth were evaluated after removal of brackets and a heavily filled bonding resin, using three basic procedures. Eleven raters ranked photomicrographs on the basis of the apparent smoothness of the replicated enamel surface. There was no significant difference in the judgment of smoothness by the raters. Significant differences were found between the three removal techniques. Enamel roughness decreased with removal technique in the following order: (1) hand scaler, (2) twelve-fluted carbide bur, and (3) ultrafine bur. A final pumicing treatment was also found to be beneficial, although it did not remove any deep scratches.