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Yamagata S, Yamamoto T, Sato Y, Akasaka T, Yoshida Y. Synthesis and evaluation of fluorescent resins with europium-β-diketonate complex for orthodontic use. Dent Mater J 2024; 43:531-538. [PMID: 38925979 DOI: 10.4012/dmj.2023-319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
No effective technique exists for removing adhesive remnants following bracket debonding. We propose that fluorescence imaging using europium ions (Eu3+) offers an effective solution for minimizing iatrogenic enamel damage. This study aimed to assess the impact of different mixing ratios of monomer mixtures on the photoluminescence and flexural properties of a newly developed fluorescent adhesive. Four monomer blends with varying urethane dimethacrylate (UDMA) to triethylene glycol dimethacrylate (TEGDMA) ratios were prepared and polymerized. The blends contained 0.1 wt% of tris(1,3-diphenyl-1,3-propanedionato)(1,10-phenanthroline) Eu(III), [Eu(DBM)3Phen], as the phosphor. Optical measurements and flexural tests were conducted for each resin specimen. The emission spectra exhibited narrow bands corresponding to the 4f-4f transitions of the Eu3+ ions. The photoluminescence properties remained unaffected by the mixing ratio, whereas the mechanical properties tended to improve with higher UDMA content. We conclude that the Eu(DBM)3Phen-containing resin shows promise as a fluorescent orthodontic adhesive that contributes to preserving enamel health.
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Affiliation(s)
- Shuichi Yamagata
- Department of Orthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University
| | - Takaaki Yamamoto
- Department of Orthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University
| | - Yoshiaki Sato
- Department of Orthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University
| | - Tsukasa Akasaka
- Department of Biomedical Materials and Engineering, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University
| | - Yasuhiro Yoshida
- Department of Biomedical Materials and Engineering, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University
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Abdulaziz A, El-Kholy MM, Bushra SS, Ali SM, Shehab KA. Performance of two laser motion modes versus conventional orthodontic ceramic brackets debonding technique on enamel surface topography. Lasers Med Sci 2024; 39:156. [PMID: 38869676 DOI: 10.1007/s10103-024-04097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024]
Abstract
The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding them without harmful effects. This in-vitro study is intended to compare the effects of two different laser modes (scanning and circular) and a conventional method on the enamel surface after debonding orthodontic brackets. 66 extracted premolars were assigned into 3 groups. After that, light-cure composite resin was used to attach the ceramic brackets to the teeth. Amongst the test groups, Group I: specimens that were debonded using conventional debonding using pliers; Group 2: specimens that were debonded using Er, Cr: YSGG laser applications using the circular motion method; and Group 3: specimens that were debonded using Er, Cr: YSGG laser applications using the scanning motion method. Adhesive Remnant Index (ARI) assessment, intra-pulpal temperature increase, enamel surface roughness after polishing, and assessment of the microstructure of enamel were carried out with scanning electron microscopy. The gathered information was examined statistically. The conventional debonding method had a significantly higher proportion of adhesive remnant index (ARI) scores of 2 and 3 in comparison to the circular (p < .004) and scanning laser groups (p < .001). There was no significant difference in ARI scores between the circular and scanning laser groups (p > .05). Moreover, the circular and scanning laser debonding methods resulted in a significantly higher proportion of Enamel Surface Roughness (ESR) scores of 0 and a lower proportion of ESR scores of 3 compared to the conventional technique group (p < .001). However, there was no significant difference in ESR scores between the circular and scanning laser methods (p = .945). Lastly, the average intra-pulpal temperature was significantly higher in the circular laser group (1.9 ± 0.5 ) compared to the scanning laser group (0.9 ± 0.2) with p < .001. Er, Cr: YSGG laser irradiation is a tool that shows promise for debonding ceramic brackets with minimal harm to the enamel surface. The scanning laser technique is more desirable due to the lower intra-pulpal temperature increase.
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Affiliation(s)
- Alarifi Abdulaziz
- Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Moataz Mohamed El-Kholy
- Oral Pathology, Faculty of Dentistry, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Sherif Samir Bushra
- Fixed Prosthodontics, Faculty of Dentistry, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Sara Mohamed Ali
- Oral Pathology, Faculty of Dentistry, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Karim A Shehab
- Orthodontics, Faculty of Dentistry, October University for Modern Sciences and Arts (MSA), Giza, Egypt.
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Inchingolo F, Inchingolo AM, Riccaldo L, Morolla R, Sardano R, Di Venere D, Palermo A, Inchingolo AD, Dipalma G, Corsalini M. Structural and Color Alterations of Teeth following Orthodontic Debonding: A Systematic Review. J Funct Biomater 2024; 15:123. [PMID: 38786634 PMCID: PMC11121904 DOI: 10.3390/jfb15050123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
AIM The objective of this study was to explore the effects of fixed orthodontic appliances on enamel structure by assessing microfractures, surface roughness, and alterations in color. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of online databases was conducted using the keywords 'enamel' AND 'orthodontic debonding'. Eligibility criteria included both in vivo and ex vivo clinical trials conducted on human teeth. RESULTS AND DISCUSSION A total of 14 relevant papers were analyzed. Various instruments and techniques were utilized across different studies to assess surface roughness, color change, and surface fractures. CONCLUSIONS The findings of this study suggest that ceramic brackets may lead to an increase in enamel fractures, particularly during bracket removal. The surface roughness of enamel exhibits variability depending on the adhesive substance and polishing methods used post-removal. Fixed orthodontic appliances could induce changes in enamel color, which may be alleviated by the use of nano-hydroxyapatite or specific polishing techniques. Further research is necessary to identify effective strategies for managing these color changes and improving the overall outcomes of fixed orthodontic treatment.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Lilla Riccaldo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Roberta Sardano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.I.); (L.R.); (R.M.); (R.S.); (D.D.V.); (A.D.I.); (M.C.)
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Ranjan A, Khan W, Achalkar P, Pawar A, Makdum D, Kharkhar V. Comparative Evaluation of Shear Bond Strength, Enamel Microfracture, and Adhesive Remnant Index of APC Flash-Free System Versus Traditional Bonding: An In-Vitro Study. Cureus 2024; 16:e60928. [PMID: 38910749 PMCID: PMC11193447 DOI: 10.7759/cureus.60928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/10/2024] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION In orthodontics, shear bond strength plays an important role because it provides a good bond between the brackets and tooth surface; it avoids fracture of the tooth surface and prevents debonding of brackets from the tooth surface. All of these allow sufficient treatment time. Many factors, including the adhesive, its thickness, its strength, the bonding procedure, the clinician's ability, the base design, the geometry of the bracket, the material, and the kind of bracket all contribute to the shear bond strength. Brackets joined using conventional adhesive and adhesive pre-coated (APC) flash-free glue were the subjects of this comparison and evaluation research, which aimed to measure shear bond strength, enamel microfracture, and adhesive residual index. METHOD 60 recently removed premolars from humans were used in this investigation. Before mounting on the acrylic block, the teeth were meticulously cleaned and preserved in artificial saliva. Two groups were formed from the collected premolars the control group and the experimental group. For the control group, we used American Orthodontics (AO) Master/Mini Master series brackets glued with resin composite kits. To make sure the adhesive was uniformly thick, we flashed extra adhesive around the brackets. In the meantime, samples were bonded using 3M Unitek APC flash-free technology in the experimental group. RESULTS The research indicated that there was a statistically significant difference between the two groups to the adhesive remnant index (ARI) and mean shear bond strength. The shear bond strength of the experimental group averaged 10.96 megapascals (MPa), whereas the control group's was 5.70 MPa. The control group's ARI score was 2.97, whereas the experimental group's score was 2.4. There was no statistically significant change seen in enamel microfracture. CONCLUSION A more robust shear bond may be possible using APC flash-free brackets. Compared to conventional bonding techniques and brackets, APC flash-free brackets have a lower adhesive residual index. The APC flash-free bracket technology also causes more enamel microfracture than conventional bonding and bracketing methods.
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Affiliation(s)
- Alok Ranjan
- Orthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Waseem Khan
- Orthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | | | - Ankita Pawar
- Orthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, IND
| | - Dilip Makdum
- Oral Pathology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
| | - Viraj Kharkhar
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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Migliorati M, DE Mari A, Posadino M, Drago S, Calzolari C, Silvestrini Biavati A. Pulp chamber temperature changes and enamel surface analysis during orthodontic composite removal using 3 different burs in a repeatable approach: an experimental study. Minerva Dent Oral Sci 2024; 73:61-68. [PMID: 35912539 DOI: 10.23736/s2724-6329.22.04692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND During the debonding phase every clinician has to take care of preserving the enamel structure and tooth temperature. The objective of this study was to analyze in vitro the increase of the pulp chamber temperature and the wearing of enamel surface, during adhesive removal after debonding. METHODS Sixty extracted human teeth were selected. An orthodontic bracket was bonded on each tooth and after bracket removal, intraoral scanner pictures were used to evaluate ARI for each tooth. Three different burs were tested: tungsten-carbide multiple blades, arkansas stone and ceramic bur. A mechanical arm controlled by a dedicated software was used to reproduce a repeatable act of composite removal. To analyze in vitro the pulp chamber temperature during the composite removal procedure, teeth were treated endodontically placing a thermocouple through the root canal from the apex. A software registered temperature changes in a continuous manner. The enamel surface of every tooth was tested after the removal of composite with an optical stereoscopic microscope. RESULTS An association existed between maximum internal pulp chamber temperature variation and irrigation (P<0.0001) and between maximum internal pulp chamber temperature variation and bur type (P=0.0133), with a significantly lower temperature increase produced by the arkansas bur. A significant difference among groups was detected for ESI and EDI assessment (P=0.002, P=0.010). CONCLUSIONS Considering the initial setup, temperature variation analysis showed more conservative results using the arkansas burs with irrigation. ESI and EDI indexes showed significant enamel surface damage using tungsten-carbide burs.
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Affiliation(s)
- Marco Migliorati
- Dental School, Department of Orthodontics, University of Genoa, Genoa, Italy
| | - Anna DE Mari
- Dental School, Department of Orthodontics, University of Genoa, Genoa, Italy -
| | - Marco Posadino
- Dental School, Department of Orthodontics, University of Genoa, Genoa, Italy
| | - Sara Drago
- Dental School, Department of Orthodontics, University of Genoa, Genoa, Italy
| | - Chiara Calzolari
- Dental School, Department of Orthodontics, University of Genoa, Genoa, Italy
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Křivková T, Tichý A, Tycová H, Kučera J. The Influence of Various Adhesive Systems and Polishing Methods on Enamel Surface Roughness after Debonding of Orthodontic Brackets: A Three-Dimensional In Vitro Evaluation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5107. [PMID: 37512378 PMCID: PMC10384124 DOI: 10.3390/ma16145107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
A slight alteration of the enamel surface is inevitable upon debonding of orthodontic brackets, adhesive removal, and finishing/polishing. The aim of this in vitro study was to compare two adhesives and three polishing methods by measuring enamel surface roughness using confocal laser scanning microscopy (CLSM). Brackets were bonded on 42 extracted human premolars using Transbond XT (Transbond group) or Fuji Ortho (Fuji group). After debracketing, adhesives were removed with a tungsten carbide bur, and surfaces were polished using Sof-Lex discs, a rotary brush with a prophylactic paste (Depural), or a prophylactic cup with two polishing pastes (n = 7 in each subgroup). Surface roughness (Sa, Sku, Sq, and Sz) was measured using CLSM and compared before treatment (T1), after debracketing and adhesive removal (T2), and after polishing (T3). The data were statistically analyzed using the Mann-Whitney U and Kruskal-Wallis tests with Bonferroni correction. The time required for adhesive removal was measured and compared using a two-sample t-test. Surface roughness at T2 increased compared to T1, but the difference was significant only for the Fuji group (p < 0.01). The time required to remove Transbond XT (94.1 ± 6.8 s) was significantly higher compared to Fuji (72.1 ± 5.9 s, p < 0.0001). Polishing with Sof-Lex discs resulted in lower surface roughness compared to T1 (p = 0.018). Using Depural and polishing pastes showed no significant difference in surface roughness compared to T1, except for a significant decrease in Sa and Sq for Transbond (p = 0.043) and in Sku for Fuji (p = 0.018) after polishing with Depural. In conclusion, the removal of Transbond took significantly longer, but there were fewer residues of composite resin on the enamel surface. Sof-Lex discs decreased enamel roughness, whereas enamel morphology and roughness were similar to the pre-treatment state after polishing with polishing pastes.
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Affiliation(s)
- Tereza Křivková
- Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, Kateřinská 32, 121 11 Prague, Czech Republic
| | - Antonín Tichý
- Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, Kateřinská 32, 121 11 Prague, Czech Republic
| | - Hana Tycová
- Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, Kateřinská 32, 121 11 Prague, Czech Republic
| | - Josef Kučera
- Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, Kateřinská 32, 121 11 Prague, Czech Republic
- Department of Orthodontics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Palackého 700/12, 779 00 Olomouc, Czech Republic
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Jeon GH, Seon SW, Lee SW. Comparative Results of Vocal Fold Injury According to the Fiber-Based Laser in a Rabbit Vocal Fold Model. J Voice 2023:S0892-1997(23)00029-2. [PMID: 36849301 DOI: 10.1016/j.jvoice.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES We assessed the safety of flexible fiber-based lasers including the potassium-titanyl-phosphate (KTP), CO2, and Holmium lasers using a rabbit vocal fold model and provided the safety evidence of laser before human clinical trial. METHODS In all, 120 male New Zealand white rabbits were used. Each laser was used to induce acute and chronic vocal fold injuries in 40 rabbits. The same laser energy with the same intensity and frequency were used in all cases, and we evaluated outcomes via surface scanning electron microscopy (SEM) and histological examination 1 day after injury. Histological and high-speed vocal fold vibration examinations were evaluated 1 month after injury. Surface injury roughness grading was done via SEM, and the Acute injury ratio and lamina propria (LP) ratio were also calculated. The dynamic glottal gap was measured through functional analyses based on recordings from a high-speed digital camera. RESULTS The Holmium laser caused significantly more vocal fold damage than did the KTP and CO2 lasers as revealed by SEM and evaluation of acute and chronic injuries. Functional analysis with high-speed digital camera indicated that the holmium laser reduced dynamic glottal gap compared with the normal vocal fold, where the other lasers did not. CONCLUSIONS The histological and functional analyses of rabbit vocal fold experiments indicated that fiber-based laryngeal laser surgery for vocal fold lesions could be performed relatively safely using a KTP or CO2 laser.
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Affiliation(s)
- Gyeong Hwa Jeon
- Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Sang Woo Seon
- Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Seung Won Lee
- Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
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Khachatryan G, Markaryan M, Vardanyan I, Manrikyan M, Manrikyan G. Morphological Characteristics and Prevention of Tooth Enamel Demineralization during Orthodontic Treatment with Non-Removable Appliances. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:540. [PMID: 36612862 PMCID: PMC9819192 DOI: 10.3390/ijerph20010540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Despite the large number of studies on the effect of braces on teeth, there is no information on the dynamics of the state of the ultrastructure of the hard tissues of teeth during orthodontic treatment. The purpose of this study is to examine the state of the hard tissues of the teeth and carry out preventive measures to reduce the risk of complications in the process of orthodontic treatment using a non-removable device. Methods: For the in vitro study, 68 teeth were randomly divided into group A-no prophylactic treatment, and group B-treated with the fluorine varnish Tiefenfluorid. After 35 days, all the teeth were prepared for microscopic examination. The clinical study included 59 patients aged 12-17 years with orthodontic brackets. The split-mouth technique was used. The areas around the bracket of one-half of the oral cavity were treated with Tiefenfluorid every 6 months during the entire treatment period. The teeth of the second half of the oral cavity served as the control group. The data were processed in the SPSS19 package. Results: In vitro and clinical study results showed a statistically significant difference between the prophylactic and control groups of teeth in favor of the prophylactic group, where the statistical significance was p ≤ 0.01.
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Affiliation(s)
- Gagik Khachatryan
- Department of Dental and Pharmacological Professional Education, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Marina Markaryan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Izabella Vardanyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Mikayel Manrikyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Gayane Manrikyan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
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Doddavarapu S, K B, Singaraju GS, Yamini Priyanka JS, Vivek Reddy G, Mandava P. A Comparative Evaluation of Enamel Surface Roughness of Two Different Bonding Adhesives After Debonding With Atomic Force Microscopy. Cureus 2022; 14:e31661. [DOI: 10.7759/cureus.31661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
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10
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Atmaca Z, Ulusoy M, Ulusoy C. Evaluation of Different Adhesive Resin Removal Methods after Debonding Ceramic Orthodontic Molar Tubes: A Scanning Electron Microscope Study. SCANNING 2022; 2022:4853035. [PMID: 36474710 PMCID: PMC9683980 DOI: 10.1155/2022/4853035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To evaluate and compare the impacts, bond strength, residual adhesive, and time invested on the enamel surface after debonding of recently introduced ceramic buccal molar tubes with different systems. MATERIALS AND METHODS Ceramic molar tubes were bonded to fifty-four maxillary molar teeth, and a shear bond strength (SBS) test was performed. The adhesive remnant index (ARI) scores were recorded, and the samples were divided into two groups for adhesive removal with low-speed instruments: tungsten carbide bur or diamond-coated micropolisher point. The time to clean the enamel surfaces was also noted down for each tooth. The enamel surfaces were investigated with scanning electron microscope (SEM) after adhesives were cleaned. Shapiro-Wilk's, Kolmogorov-Smirnov's, and Student's independent t tests were used for statistical analysis. RESULTS The mean SBS value of the tested ceramic molar tubes was 9.78 ± 1.85 MPa, and the majority of the samples were scored as ARI 1 and ARI 2. No statistically significant difference between PoGo micropolisher and TCB was found in terms of time values for surface cleaning. The enamel surface characteristics of TCB for adhesive remnant removal resulted in a better enamel surface than the single-step diamond polisher when the samples were investigated by using SEM. CONCLUSIONS Ceramic molar tubes may be an enamel-safe product for patients seeking for fully aesthetic orthodontic treatment, if used in carefully handled clinical conditions. One-step polishing systems utilised with low-speed instruments could be used confidentially for cleaning the resin remnants on enamel after orthodontic treatment.
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Affiliation(s)
- Zeynep Atmaca
- Gazi University Faculty of Dentistry, Department of Orthodontics, Ankara, Turkey
| | - Mutahhar Ulusoy
- Faculty of Dentistry of Near East University, Department of Prosthodontics, Nicosia, Cyprus
| | - Cagri Ulusoy
- Gazi University Faculty of Dentistry, Department of Orthodontics, Ankara, Turkey
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Thawaba AA, Albelasy NF, Elsherbini AM, Hafez AM. Comparison of Enamel Surface Roughness after Bracket Debonding and Adhesive Resin Removal Using Different Burs with and without the Aid of a Magnifying Loupe. J Contemp Dent Pract 2022; 23:1091-1099. [PMID: 37073931 DOI: 10.5005/jp-journals-10024-3432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
AIM This study aimed to evaluate the impact of using a magnifying dental loupe on enamel surface roughness during adhesive resin removal by different burs. MATERIALS AND METHODS Ninety-six extracted premolar teeth were randomly divided according to the bur used with or without the aid of a magnifying loupe into four equal groups (N = 24): group I: naked eye tungsten carbide burs (NTC); group II: magnifying loupe tungsten carbide burs (MTC); group III: naked eye white stones (NWS); and group IV: magnifying loupe white stones (MWS). The initial surface roughness (Ra) T0 was evaluated using a profilometer, and the scanning electronic microscopy (SEM) technique. The metal brackets were bonded and debonded after 24 hours with debonding plier. After adhesive removal, Ra was evaluated again (T1) also the time spent on adhesive removal was recorded in seconds. The samples were finally polished by Sof-Lex discs and Sof-Lex spirals, and the third Ra evaluation was performed (T2). RESULTS The results of two-way mixed analysis of variance (ANOVA) showed that all burs increased surface roughness at T1 as compared to T0 (p < 0.001) with the highest Ra values shown in group III followed by group IV, group I, and group II. After polishing, no significant difference was noted in Ra values in group I and group II at T0 vs T2 (p = 1.000), while it was significant in group III and group IV (p < 0.001). Regarding the time required for adhesive removal, the shortest time was in group IV followed by groups III, II, and I, respectively. CONCLUSION The use of a magnifying loupe affects the quality of the clean-up procedure by reducing the enamel surface roughness and the time spent on adhesive removal. CLINICAL SIGNIFICANCE Using a magnifying loupe was helpful during orthodontic debonding and adhesive removal.
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Affiliation(s)
- Ahmed A Thawaba
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Phone: +0020 1121411384; +0020 1112895996, e-mail:
| | - Nehal F Albelasy
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Amira M Elsherbini
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmad M Hafez
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Pereira PM, Bugaighis I, Matos PM, Porença L. The effect of different reconditioning methods on bond strength of rebonded brackets: An in-vitro study. J Orthod Sci 2022; 11:56. [PMID: 36411804 PMCID: PMC9674941 DOI: 10.4103/jos.jos_61_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/26/2022] Open
Abstract
AIM To evaluate the effect of three different reconditioning techniques on the shear bond strength (SBS) of rebonded brackets. MATERIALS AND METHODS Forty-five orthodontic brackets were bonded to human premolar teeth using Transbond™ XT. After debonding, the samples were randomly assigned into equal groups to assess three techniques for the removal of residual adhesive from bracket bases: in Group A, each bracket base was sandblasted with aluminum oxide; in Group B1, each base was cleaned superficially with a greenstone bur; and in Group B2, the bases were thoroughly abraded with a greenstone bur. Subsequently, brackets were rebonded and the SBS and the adhesive remnant index (ARI) were determined. Data were analyzed using one-way analysis of variance (ANOVA), plus Tukey and Kruskal-Wallis post-hoc tests (P ≤ 0.05). RESULTS The average SBSs were: Group A, 11.75 (±4.83) MPa; Group B1, 8.22 (±4.01) MPa; and Group B2, 7.54 (±2.85) MPa. No statistically significant differences in SBS were found between Groups A and B1(P = 0.051) and Groups B1 and B2(P = 0.885), but there was a significant difference between Groups A and B2(P = 0.016). Regarding ARI scores, there were statistically significant differences between Groups A and B2(P < 0.001) and between B1 and B2(P = 0.014), but not between Groups A and B1(P = 0.068). CONCLUSION All reconditioning methods were found to have a positive effect, but the sandblasting technique performed best. Brackets reconditioned by sandblasting and superficial grinding mainly showed mixed-type failure, while in samples thoroughly reconditioned by greenstone bur, bonding failure occurred predominantly at the adhesive/bracket interface.
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Affiliation(s)
- Pedro Mariano Pereira
- Department of Orthodontics, Egas Moniz University Institute, Monte de Caparica, Portugal
| | - Iman Bugaighis
- Department of Orthodontics, Egas Moniz University Institute, Monte de Caparica, Portugal,Address for correspondence: Dr. Iman Bugaighis, Assistant Professor, Egas Moniz-Cooperativa de Ensino Superior, CRL 2829-511 Caparica, Campus Universitário, Quinta da Granja, Monte de Caparica, Portugal. E-mail:
| | - Pedro M. Matos
- Department of Orthodontics, Egas Moniz University Institute, Monte de Caparica, Portugal
| | - Luis Porença
- Quantitative Methods for Health Research Unit, Egas Moniz University Institute, Monte de Caparica, Portugal
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Efficacy of Bracket Adhesive Remnant Removal by a Fluorescence-Aided Identification Technique with a UV Light Handpiece: In Vitro Study. Int J Dent 2022; 2022:4821021. [PMID: 36249726 PMCID: PMC9553495 DOI: 10.1155/2022/4821021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study aims to analyze the fluorescence-aided identification technique efficacy on adhesive remnant removal from the enamel surface after orthodontic bracket debonding. Materials and Methods Forty-five extracted human upper central incisors were divided into 3 groups (n = 15) according to the kind of adhesive for bracket bonding and the use or absence of near UV light for remnant removal: BF/UV- fluorescent adhesive/UV light, BF/0-fluorescent adhesive/no UV light, and TB/0-nonfluorescent adhesive/no UV light. For all teeth, 100% of the adhesive used remained on the enamel surface after debonding. Fifteen dentists performed adhesive removal on the enamel surface using a carbide bur. The specimens were analyzed by a stereomicroscope, and the adhesive remnant percentage from each specimen was calculated. The time used by each dentist to perform the removal was recorded. The data were analyzed by one-way ANOVA and Tukey's test. Results Significant differences were observed among groups for adhesive remnant (p=0.0008) and for time (p=0.0001). The means of adhesive remnant were BF/UV (5.84), BF/0 (34.37), and TB/0 (37.02). The mean times necessary to remove adhesive were BF/UV (1 min 40 s), BF/0 (3 min 03 s), and TB/0 (2 min 46 s). For the BF/UV group, significantly lower values of adhesive remnants and time for debonding were found (p < 0.05). Conclusion The fluorescence-aided identification technique significantly reduced the amount of adhesive remnant, and the time necessary to perform this clinical procedure.
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Kerayechian N, Bardideh E, Bayani S. Comparison of self-etch primers with conventional acid-etch technique for bonding brackets in orthodontics: a systematic review and meta-analysis. Eur J Orthod 2022; 44:385-395. [PMID: 35022707 DOI: 10.1093/ejo/cjab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/25/2021] [Accepted: 11/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Bonding with self-etch primers (SEPs) is one of the most popular systems for attaching orthodontic brackets to the enamel surface. There are conflicting reports about the efficacy and success of these systems compared with acid-etch (AE) bonding. OBJECTIVE This systematic review and meta-analysis was performed to compare SEP with conventional AE technique for bonding brackets in fixed orthodontics. SEARCH METHODS Articles related to the subject of interest were searched in electronic databases, including PubMed, ISI Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL, from inception to 2 June 2021. Search for grey literature, and hand search for relevant studies were also performed. SELECTION CRITERIA Based on the PICO model, randomized clinical trials using full-arch bonded fixed orthodontic appliances comparing SEP and conventional AE systems were included in the review process. DATA COLLECTION AND ANALYSIS After assessing the risk of bias, data from the included studies were extracted using custom piloted forms. Inverse-variance random-effects meta-analyses were performed to combine the results of bracket failure, adhesive remnant index (ARI), and bonding time. RESULTS Nineteen randomized clinical trials were included in the systematic review and 17 randomized clinical trials [5 parallel-group (PG) and 12 split-mouth (SM) studies] were included in the meta-analysis. No significant difference in bracket failure at 6 months [risk ratio (RR) = 1.50, P = 0.26, 12 SM] and (RR = 0.68, P = 0.34, 2 PG), 12 months (RR = 1.6, 8 SM) and (RR = 1.17, P = 0.54, 2 PG), and ≥18 months (RR = 0.84, P = 0.31, 3 SM) and (RR = 1.20, P = 0.3, 3 PG) between SEP and AE groups could be found. Also, ARI score was similar between different bonding systems [mean difference (MD) = -0.44, P = 0.06, 4 SM]. The bonding time per tooth was faster in the SEP group (MD = -26.55, P < 0.001, 2 SM) and (MD = -24.00, P < 0.001, 2 PG). LIMITATIONS inclusion of three studies with a high risk of bias and high amount of inconsistency between the results of individual studies were the biggest limitations of our review. CONCLUSIONS The bracket bonding failure and ARI score were not significantly different between self-etch and conventional AE bonding systems. The bonding time was lower for the SEP, but some other requirements for SEPs like pumice prophylaxis could diminish this advantage. REGISTRATION The protocol for this systematic review was registered at PROSPERO with the ID CRD42021248540.
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Affiliation(s)
- Navid Kerayechian
- Department of Orthodontics, School of Dentistry, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Erfan Bardideh
- Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahin Bayani
- School of Orthodontics, Jacksonville University, Jacksonville, FL, USA
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15
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Melvin EA, Yu Q, Xu X, Laird CG, Armbruster PC, Ballard RW. A comparison of traditional orthodontic polishing systems with composite polishing systems following orthodontic debonding. Saudi Dent J 2021; 33:877-883. [PMID: 34938028 PMCID: PMC8665166 DOI: 10.1016/j.sdentj.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/10/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction At the completion of treatment, the orthodontic practitioner's goal is to effectively remove all traces of adhesive and return enamel to its initial state. With the advent of new polishing systems being released each year, there may be one product that is superior to others. Aim The purpose of this study is to determine the efficacy of new polishing systems (in the last 5-10 years) used in general dentistry on enamel surface roughness following debond utilizing profilometery and scanning electron microscopy and compare them to established orthodontic polishing systems results. Methods Fifty-two mandibular incisors were randomly assigned to one of five test groups (N = 10) and two incisors (untreated enamel) were used for profilometer and scanning electron microscopy analysis at the end of testing. After bracket removal, the teeth were polished using traditional polishing products (Komet H48L bur, Reliance 'Renew' point) and newer polishing products (Coltene Spiral Composite Plus Polisher, Ultradent Jiffy Composite Polishing Spiral or 3M Sof-Lex™ Diamond Polishing System). The results were evaluated using a profilometer and scanning electron microscopy images. Results The results of a one-way analysis of variance (ANOVA) determined that the mean change in enamel surface roughness was not statistically different both in the traditional and novel groups. Tukey's Honestly Significant Difference (HSD) test found that there was no statistically significant difference in the change in enamel surface roughness between instrument groups. Conclusions There was no statistically significant difference in enamel surface roughness after polishing between traditional orthodontic polishing systems and the selected novel polishing systems. SEM analysis revealed similar findings. This supports previous research suggesting that a wide variety of polishing systems or none at all, may be used to restore enamel smoothness after removal of orthodontic appliances.
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Affiliation(s)
- Elizabeth A Melvin
- Private Practice of Orthodontics, 1540 Rock Springs Road, Smyrna, TN 37167, USA
| | - Qingzhao Yu
- LSU Health Sciences Center School of Public Health, 2020 Gravier Street, Department of Statistics, New Orleans, LA 70112, USA
| | - Xiaoming Xu
- LSU Health Sciences Center School of Dentistry, 1100 Florida Ave, Department of Prosthodontics, New Orleans, LA 70119, USA
| | - Camille G Laird
- LSU Health Sciences Center School of Dentistry, 1100 Florida Ave, Department of Orthodontics, New Orleans, LA 70119, USA
| | - Paul C Armbruster
- LSU Health Sciences Center School of Dentistry, 1100 Florida Ave, Department of Orthodontics, New Orleans, LA 70119, USA
| | - Richard W Ballard
- LSU Health Sciences Center School of Dentistry, 1100 Florida Ave, Department of Orthodontics, New Orleans, LA 70119, USA
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Pinzan-Vercelino CRM, Souza Costa AC, Gurgel JA, Salvatore Freitas KM. Comparison of enamel surface roughness and color alteration after bracket debonding and polishing with 2 systems: A split-mouth clinical trial. Am J Orthod Dentofacial Orthop 2021; 160:686-694. [PMID: 34332796 DOI: 10.1016/j.ajodo.2020.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 06/01/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This split-mouth randomized clinical trial aimed to compare the enamel surface roughness (SR) and color alteration after bracket debonding and polishing using 2 systems. METHODS After removal of excess adhesive using a 12-blade tungsten carbide bur on a low-speed handpiece, a randomized polishing procedure using Sof-Lex discs was applied on 1 side (n = 36) and Sof-Lex Spiral Wheels on the contralateral side (n = 36). Dental replicas were obtained with epoxy resin before bracket bonding and after tooth polishing. The SR was evaluated using a profilometer. The color was assessed using an Easyshade spectrophotometer before bracket bonding, immediately after tooth polishing, and 30 days after polishing. Two-way analysis of variance and t tests were applied for statistical analysis. RESULTS The SR of enamel showed similar results between the polishing systems (P = 0.309) and between moments (before bracket bonding and after tooth polishing) (P = 0.317). The color change was also similar between the polishing systems (P >0.05). CONCLUSIONS The Sof-Lex discs and Sof-Lex Spiral Wheel polishing systems used after removal of excess adhesive using a 12-blade tungsten carbide bur on a low-speed handpiece did not appear to significantly damage the enamel surface, and the color change was similar between them.
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Affiliation(s)
| | | | - Júlio Araújo Gurgel
- Department of Orthodontics, State University of São Paulo, Marília, São Paulo, Brazil
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Ravichandran NK, Lakshmikantha HT, Park HS, Jeon M, Kim J. Micron-scale human enamel layer characterization after orthodontic bracket debonding by intensity-based layer segmentation in optical coherence tomography images. Sci Rep 2021; 11:10831. [PMID: 34035385 PMCID: PMC8149424 DOI: 10.1038/s41598-021-90354-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/10/2021] [Indexed: 11/09/2022] Open
Abstract
In clinical orthodontic practice, fixed brackets are widely used for tooth movement and adjustments. Although years of research and development have improved the workability of fixed orthodontic brackets, there are still controversies regarding its plausible destructive influence on the enamel surface of tooth. This, in turn, makes the quantitative assessment of the enamel surface after specific orthodontic treatment procedures important in order to opt for the most effective treatment procedure. Through this study, we show the practical applicability of optical coherence tomography (OCT) as a non-ionizing and nondestructive assessment tool for measuring enamel loss after each step of orthodontic bracket bonding. Two-dimensional and volumetric OCT images are used for the evaluation of the tooth enamel. From the depth intensity profile analysis of cross-sectional OCT images, the changes in the individual internal layer thickness are calculated. A software algorithm was developed to evaluate the structural connectivity in the enamel for analyzing enamel loss on the tooth surface and for detecting enamel abrasion. An intensity-based layer segmentation algorithm is also developed to analyze and evaluate enamel wear in the tooth after each step. Using the proposed algorithms, the total enamel present after each treatment procedure was measured and tabulated for analysis.
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Affiliation(s)
- Naresh Kumar Ravichandran
- School of Electronic and Electrical Engineering, Kyungpook National University, 80 Daehakro, Bukgu, Daegu, 41566, Republic of Korea.,Center for Scientific Instrumentation, Korea Basic Science Institute, 169148 Gwahakro Yuseonggu, Daejeon, 34133, Republic of Korea
| | | | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Mansik Jeon
- School of Electronic and Electrical Engineering, Kyungpook National University, 80 Daehakro, Bukgu, Daegu, 41566, Republic of Korea.
| | - Jeehyun Kim
- School of Electronic and Electrical Engineering, Kyungpook National University, 80 Daehakro, Bukgu, Daegu, 41566, Republic of Korea
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Enamel Surface Damage following Debonding of Ceramic Brackets: A Hospital-Based Study. ScientificWorldJournal 2021; 2021:5561040. [PMID: 34035672 PMCID: PMC8124004 DOI: 10.1155/2021/5561040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 11/18/2022] Open
Abstract
Methods The current study includes 80 extracted premolars of human from the patient visiting for orthodontic treatment of Coorg Institute of Dental Sciences, Karnataka, India. The brackets were debonded using four different methods. The enamel surface damage after the procedure was assessed with the Enamel Surface Index (ESI); similarly, the Adhesive Remnant Index (ARI) score was used to determine the adhesive residual deposit. Scanning electron microscopy (SEM) was used to visualize better microporosities and micromechanical retention of adhesive remnants on the enamel surface. The normality of the data was tested using the Kolmogorov–Smirnov test. Depending upon the normality test result, the one-way ANOVA test or Kruskal–Wallis test was used to test the mean ESI and mean ARI differences among different debonding methods along with the appropriate post hoc tests. The necessary ethical clearance was obtained from the Ethics Committee of the institute. Results The ultrasonic scaler (US) technique led to more significant enamel surface damage, with 13 (65%) samples in the ESI scores III and IV against the satisfactory surface in 2 (10%) samples with the ligature cutter (LC) technique (ESI-I) reflecting LC as a better technique. The ESI scores (III and IV) for debonding plier (DP) and thermal method (TM) reflected a higher value in 12 (60%) and 10 (50%) samples and caused more damage to the enamel surface as compared to the LC technique. The ARI score was highest (ARI-1 = 40%) with the LC technique, followed by the US (ARI-1 = 20%), TM (ARI-1 = 15%), and DP (ARI-1 = 5%) methods. We have observed a significant association (p value <0.05) of the ARI score among four different debonding ways in terms of each tooth's residual adhesive after the bracket removal. Conclusion The result establishes the LC technique as a more acceptable one as it causes minimal harm to the debonded surface. The adhesive left on the debonded area is also minimum as compared to the other three methods tested. Therefore, it can be suggested as an ideal method.
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19
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Pavani CC, Vieira LR, Schott TC, Sundfeld D, Pini N, Bertoz A, Pacheco RR, Sundfeld RH. Case Reports of Enamel Microabrasion Associated with At-home Dental Bleaching After Orthodontic Bracket Removal. Oper Dent 2021; 46:237b-245. [PMID: 34437705 DOI: 10.2341/19-198-t] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 11/23/2022]
Abstract
Adequate removal of residual bonded materials from the enamel surface after orthodontic bracket debonding is critical, since any remaining composite may compromise enamel surface morphology and esthetics. The following clinical case reports present the association of at-home dental bleaching using 10% carbamide peroxide and the removal of residual bonded material using a super fine, tapered diamond bur followed by the use of an enamel microabrasion product after orthodontic bracket debonding. The proposed treatment considerably improved the esthetics and successfully removed the grooves created during the removal of the bonding composite, resulting in a smooth enamel surface.
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Comparison of Orthodontic Bracket Debonding Force and Bracket Failure Pattern on Different Teeth In Vivo by a Prototype Debonding Device. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6663683. [PMID: 33959664 PMCID: PMC8075675 DOI: 10.1155/2021/6663683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
Objective To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. Materials and Method. Thirteen (13) patients at the end of comprehensive fixed orthodontic treatment, awaiting for bracket removal, were selected from the list. A total of 260 brackets from the central incisor to the second premolar in both jaws were debonded by a single clinician using a validated prototype debonding device equipped with a force sensitive resistor (FSR). Mean bracket debonding forces were specified to ten (10) groups of teeth. Following debonding, Intraoral microphotographs of the teeth were taken by the same clinician to assess the bracket failure pattern using a 4-point scale of adhesive remnant index (ARI). Statistical analysis included one-way ANOVA with post hoc Tukey HSD and independent sample t-test to compare in vivo bracket debonding force, Cohen's kappa (κ), and a nonparametric Kruskal-Wallis test for the reliability and the assessment of ARI scoring. Results A significant difference (p < 0.001) of mean debonding force was found between different types of teeth in vivo. Clinically, ARI scores were not significantly different (p = 0.921) between different groups, but overall higher scores were predominant. Conclusion Bracket debonding force should be measured on the same tooth from the same arch as the significant difference of mean debonding force exists between similar teeth of the upper and lower arches. The insignificant bracket failure pattern with higher ARI scores confirms less enamel damage irrespective of tooth types.
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21
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Dumbryte I, Malinauskas M. In vivo examination of enamel microcracks after orthodontic debonding: Is there a need for detailed analysis? Am J Orthod Dentofacial Orthop 2021; 159:e103-e111. [PMID: 33390312 DOI: 10.1016/j.ajodo.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Our aim was to assess changes in the number of enamel microcracks (EMCs) after removing metal brackets in teeth with and without visible EMCs before the bonding procedure. METHODS Before bonding, 13 patients having teeth with visible EMCs and 13 subjects whose teeth were free of EMCs were included in the study. All patients were asked to complete a questionnaire with a detailed medical history at the beginning of treatment and after removing metal brackets. The number of teeth with visible EMCs and the number of premolars without EMCs were recorded for each subject twice, that is, before bonding and after debonding, together with the tooth sensitivity assessments elicited by compressed air and cold testing. RESULTS The number of visible EMCs in premolars increased after removing metal brackets. EMCs were recorded in at least 25.0% of all evaluated teeth for the patients having teeth with and without visible EMCs at the beginning of treatment. However, the changes in the number of visible EMCs were not significantly different (P = 0.619) between the groups. For the subjects with visible EMCs, tooth sensitivity caused by cold was registered nearly 3 times more often after removing brackets compared with the patients without EMCs prior bonding. CONCLUSIONS Formation of EMCs was noticed after debonding. Changes in the number appeared to be similar for the subjects with and without visible EMCs before bonding. Higher incidence of EMCs was associated with more frequent tooth sensitivity perceptions after removing brackets.
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Affiliation(s)
- Irma Dumbryte
- Institute of Odontology, Vilnius University, Vilnius, Lithuania.
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22
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Kuskonmaz C, De Stefani A, Artioli G, Zanarini M, Bonetti GA, Bruno G, Gracco A. The use of the laser confocal scanning microscopy to measure resin remnants on customized lingual bracket. BMC Oral Health 2020; 20:142. [PMID: 32410609 PMCID: PMC7226939 DOI: 10.1186/s12903-020-01132-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background The study aimed to evaluate the permanence of resin and enamel remains on lingual brackets at the end of orthodontic treatment and after the debonding procedure. The evaluation of resin remnants on customized lingual brackets bases has never done before in other studies because they are curved, and traditional techniques are not applicable. Methods The sample consisted of 100 lingual brackets (25 incisors, 25 canines, 25 premolars, 25 molars) scanned with a confocal laser microscope (OLS4000). We measured the brackets' surface and the area of resin remnants with the software of the microscope. Median and quartiles were presented to describe the data. ARI calculation was indirect for each tooth, measuring the resin remnants to the total surface of the bracket. The Kruskal-Wallis test and Fisher test were applied respectively to compare the percentages of remnants and the frequencies of the ARI between the four groups. Results After the analyses, 13 brackets had no adhesive remnants (ARI 0), 29 brackets had less than 50% of resin remnants (ARI 1), 50 brackets had more than 50% of resin remnants (ARI 2), and 8 brackets had 100% of adhesive (ARI 3). Canines brackets presented the lower amount of resin followed by premolars, incisors, and molars. Conclusion Lingual brackets showed a high frequency of ARI = 2. The median percentage of the bracket surface covered by resin was 41%. We observed a slight tendency of more resin remnants on molar brackets, due to half-pad configuration. The authors suggest paying attention during the debonding procedure of molar brackets since a stronger connection between the adhesive and the bracket mesh means a higher risk of enamel damage.
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Albertini P, Albertini E, Siciliani G, Lombardo L. Fluorescence-aided composite removal during lingual bracket debonding. J ESTHET RESTOR DENT 2020; 32:634-637. [PMID: 32643229 DOI: 10.1111/jerd.12618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/31/2020] [Accepted: 06/15/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This report describes the fluorescence-aided composite removal during lingual bracket debonding with an ultraviolet light emitting diode flashlight. The purpose of this technique is to help clinicians in composite removal without enamel surface damage. CLINICAL CONSIDERATIONS The bracket debonding requires clinical attention in order to remove all composites and resins without enamel surface damage. Different protocols can be used in order to minimize the enamel damages and the excess bonding remnants. The fluorescence-aided composite removal permits to have an immediate visualization of the composites and adhesives, especially for the uneven lingual surfaces, of which the interindividual morphological variability is greater than the buccal surfaces. CONCLUSIONS The fluorescence-aided composite removal during lingual brackets debonding minimizes the risks described in literature and it is an easier, more accurate, reliable, noninvasive, inexpensive, and time-saving method. CLINICAL SIGNIFICANCE The application of this technique allows, with inexpensive flashlights, to remove all the composite on the lingual surfaces during debonding, without damaging the tooth and saving time.
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Affiliation(s)
- Paolo Albertini
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Enrico Albertini
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | | | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
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Cicek O, Ozkalayci N, Yetmez M. Mean Shearing Stroke Frequency of Orthodontic Brackets under Cycling Loading: An In Vitro Study. MATERIALS 2020; 13:ma13194280. [PMID: 32992817 PMCID: PMC7579618 DOI: 10.3390/ma13194280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/05/2022]
Abstract
Based on the development of many adhesive systems and bonding techniques, bonding strength of orthodontic brackets has become even more important in modern clinical orthodontics. The aim of this study was to determine mean shearing stroke frequency of different orthodontic bracket types and bonding agents under cycling loading. Therefore, 10 different types of orthodontic bracket from 4 different brands were divided into 2 groups. Two different adhesives, namely Transbond™ XT etch-and-rinse for Group 1 and Transbond™ Plus self-etching-primer adhesive for Group 2 were considered. The brackets were tested under cycling loading force of 10-N and a crosshead speed of 300 mm/min and 40 cycle/min. The frequency of strokes that the brackets failed were determined and these data were analyzed by statistical analysis using an independent sample t-test and one-way analysis of variance (ANOVA). The level of significance was set at p < 0.05. Generally, differences between the frequency of shearing strokes of the bracket failures were found to be statistically significant depending on the type of adhesives and brackets (p < 0.05). The bonding technique for Group 1 was found to have a significantly higher shear bonding strength than Group 2. It is also seen that different types of bracket belonging to the same or different brands had different shear bonding strength. It may be concluded that: (i) all bracket types used in this study can be applied with both bonding techniques, (ii) in order to minimize the risk of hard tissue damage, ceramic brackets should be carefully bonded using the self-etching primary adhesive technique.
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Affiliation(s)
- Orhan Cicek
- Department of Orthodontics, Faculty of Dentistry, Zonguldak Bulent Ecevit University, 67600 Zonguldak, Turkey;
- Correspondence: or
| | - Nurhat Ozkalayci
- Department of Orthodontics, Faculty of Dentistry, Zonguldak Bulent Ecevit University, 67600 Zonguldak, Turkey;
| | - Mehmet Yetmez
- Department of Mechanical Engineering, Faculty of Engineering, Zonguldak Bulent Ecevit University, 67100 Zonguldak, Turkey;
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Li Z, Zhang K, Li R, Xu L, He L, Pang X, Lu J, Cao B, Zhang B. [Effect of orthodontic traction on the microstructure of dental enamel]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:1165-1171. [PMID: 32895182 DOI: 10.12122/j.issn.1673-4254.2020.08.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effect of orthodontic traction on the microstructure of dental enamel. METHODS Forty-eight isolated premolars were randomly divided into 6 groups (n=8), including Group A (blank control group), in which the teeth were bonded with the orthodontic brackets without any loading force; Groups B1, B2, and B3 where the teeth were bonded with the orthodontic brackets using clinical adhesives and loaded with 50 g force for 6 months, 200 g force for 6 months, and 200 g force for 1 month, respectively; and Groups C1 and C2, where the teeth were bonded with straight wire brackets using light curing bonding and chemical curing bonding techniques, respectively. All the teeth were embedded with non-decalcified epoxy resin. Scanning electron microscope (SEM), atomic force microscope (AFM), and energy spectrometer (EDS) were used to analyze interface morphology and elemental composition of the teeth sliced with a hard tissue microtome. RESULTS Compared with those in Group A, the teeth in the other 5 groups showed increased adhesive residue index with microcracks and void structures on the enamel surface under SEM; AFM revealed microcracks on the enamel surface with angles to the grinding direction. A larger loading force on the bracket resulted in more microcracks on the enamel interface. The interface roughness differed significantly between Groups A and C2, and the peak-to-valley distance differed significantly between Groups A, C, and C2. CONCLUSIONS Orthodontic traction can cause changes in the microstructure of normal dental enamel.
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Affiliation(s)
- Zhixin Li
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Kailiang Zhang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.,Department of Prosthodontics, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Ruiping Li
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Lingdan Xu
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Lulu He
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Xiaochan Pang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Jiyuan Lu
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Baocheng Cao
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.,Department of Orthodontics, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Baoping Zhang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.,Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
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D’Amario M, Bernardi S, Di Lauro D, Marzo G, Macchiarelli G, Capogreco M. Debonding and Clean-Up in Orthodontics: Evaluation of Different Techniques and Micro-Morphological Aspects of the Enamel Surface. Dent J (Basel) 2020; 8:E58. [PMID: 32560482 PMCID: PMC7344892 DOI: 10.3390/dj8020058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022] Open
Abstract
There is currently no consensus on the best way to remove adhesive remnants from teeth following debonding. The main objective of this study is to evaluate and compare the effectiveness of four adhesive resin removal (clean-up) techniques, performed with or without the use of an operative microscope. Forty human teeth were duplicated using an epoxy resin for impregnation. Brackets were bonded to teeth and debonded from teeth. Then, the samples were randomly divided into two equal groups-the naked eye group and the magnification group-and further subdivided into four equal subgroups, in order to compare the different techniques used for the clean-up. Each subgroup was formed of five natural teeth with the respective pre- and post-bonding replicas. Macro- and micro-analysis by means of a stereomicroscope and scanning electron microscopy evaluated, qualitatively and quantitatively, the adhesive remnant index and the damage index of the enamel. Overall, the magnification improved the removal of resins compared to the naked eye (p < 0.001), and the use of magnification constantly reduced resin residual and surface damage. Enamel damage and adhesive residual from the clean-up procedures represent an ascertained risk in orthodontics. The use of a magnification system improves the quality of debonding and clean-up techniques in a significant way.
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Affiliation(s)
- Maurizio D’Amario
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
- Microscopy Center, University of L’Aquila, 67100 L’Aquila, Italy
| | - Daniele Di Lauro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
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27
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Bosco E, Potrubacz MI, Arrizza L, Chimenti C, Tepedino M. Enamel preservation during composite removal after orthodontic debonding comparing hydroabrasion with rotary instruments. Dent Mater J 2020; 39:367-374. [PMID: 31827057 DOI: 10.4012/dmj.2019-053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to evaluate how hydroabrasion performs during composite removal. A standardized amount of composite was bonded to 40 enamel surfaces of extracted third molars, then removed with either a tungsten carbide bur mounted on a micro-motor handpiece without irrigation, a tungsten carbide bur mounted on a micro-motor handpiece with irrigation, a tungsten carbide bur mounted on an air-rotor handpiece, or hydroabrasion. The four treatment methods were compared using the enamel-surface-index and the adhesive-remnant-index and performing a Kruskal-Wallis statistical test to detect differences between each method' scores. Hydroabrasion produced significantly less damage to the enamel surface compared to the other three methods. Hydroabrasion was the cleaning method that produced less damages to the enamel surface, at a cost of a less efficient composite removal than tungsten carbide burs on micro-motor handpiece.
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Affiliation(s)
- Elena Bosco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila
| | | | | | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila
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Sugsompian K, Tansalarak R, Piyapattamin T. Comparison of the Enamel Surface Roughness from Different Polishing Methods: Scanning Electron Microscopy and Atomic Force Microscopy Investigation. Eur J Dent 2020; 14:299-305. [PMID: 32392603 PMCID: PMC7274833 DOI: 10.1055/s-0040-1709945] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective
This study aimed to compare the enamel surface roughness created by four polishing methods after debonding, by using scanning electron microscopy (SEM) and atomic force microscopy (AFM).
Materials and Methods
Four experimental polishing groups (Sof-Lex disc, SD; sandblaster, SB; tungsten carbide bur, TB; and white stone bur, WB) and one control group were selected from 100 premolars (
n
= 20/group). The experimental teeth were bonded with a bracket, thermocycled, and debonded. Residual adhesive was removed by either of the respective methods. Pre and postdebonding root mean square (Rq) values were obtained from AFM evaluations. All specimens were examined and evaluated with SEM using a modified enamel surface index (modified ESI).
Statistical Analysis
Differences among the polishing methods were compared with analysis of variance and Fisher’s least significant difference test at
p
< 0.05.
Results
Both microscopic evaluations indicated that the surface with the greatest roughness herein belonged to the SD group, followed by that for SB, TB, and WB groups. AFM measurements indicated a maximum postdebonding Rq herein for the WB group and a significantly greater surface roughness for the TB and WB groups than for the SD and SB groups. Among the experimental groups, SEM followed by modified ESI evaluations revealed similar data to those obtained with AFM. Significant differences were seen among all paired groups, except for that between the SB and TB groups.
Conclusion
Within the limitations of this study, all four polishing methods were concluded to be clinically acceptable for removing residual orthodontic adhesives.
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Affiliation(s)
| | - Ratchawan Tansalarak
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thosapol Piyapattamin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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Triwardhani A, Djaharu'ddin I, Herawan PA. Effectivity comparison between three different enamel remineralizing agent postfix orthodontic treatment. J Clin Exp Dent 2019; 11:e906-e912. [PMID: 31636860 PMCID: PMC6797470 DOI: 10.4317/jced.55933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/09/2019] [Indexed: 11/09/2022] Open
Abstract
Background This study aims to compare the effectiveness of topical fluoride application, a toothpaste containing synthetic hydroxyapatite with one containing calcium sodium phosphosilicate (CSPS) in remineralizing enamel after the debonding process. Material and Methods The study constituted experimental laboratory research incorporating posttest-only control group design. A metal bracket was placed on the buccal surface of 40 premolar teeth and immersed in artificial saliva. After 1 month, the bracket was debonded. The teeth were then randomly divided into four groups, namely (n = 6) the control group (C), the 1st treatment group (T1), the 2nd treatment group (T2), and the 3rd treatment group (T3). There was no treatment of C group. For the T1 group, topical application of fluoride was conducted. For the T2 group, toothpaste containing synthetic hydroxyapatite was applied by brushing the teeth twice a day. The same treatment was administered to the T3 group, but using a different toothpaste containing CSPS. After a treatment of 14 days, the T1, T2, and T3 groups were prepared before being observed with a scanning electron microscope (SEM). The SEM data were examined visually and scored using an enamel surface index (ESI), an enamel damage index (EDI), and an enamel remineralization index. The data obtained were analyzed by means of Kruskal–Wallis and Mann–Whitney tests. The statistical significance value was P< 0.05. Results A review of the ESI and IRE scores showed that, compared to the C group, all treatment groups recorded a significantly lower score, with T2 registering the lowest. With regard to the EDI scores, only the T1 group showed no significant difference to the C group. Conclusions Sensitive toothpaste containing synthetic hydroxyapatite and CSSP proved to be more effective in forming the remineralization layer on tooth surfaces compared to topical fluoride application. Key words:Calcium sodium phosphosilicate, debonding process, enamel remineralization, synthetic hydroxyapatite, topical fluoride application.
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Affiliation(s)
- Ari Triwardhani
- Orthodontic Department, Faculty of Dental Medicine, Campus A Universitas Airlangga Jl. Indonesia
| | - Irwadi Djaharu'ddin
- Orthodontic Department, Faculty of Dental Medicine, Campus A Universitas Airlangga Jl. Indonesia
| | - Putu-Andy Herawan
- Orthodontic Department, Faculty of Dental Medicine, Campus A Universitas Airlangga Jl. Indonesia
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30
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Almoammar S, AlShahrani I, Asiry MA, Duarte S, Janal M, Khoo E. Non-thermal plasma treatment to enhance the adhesion between enamel surface and orthodontic bracket. Biomed Mater Eng 2019; 30:439-448. [PMID: 31476144 DOI: 10.3233/bme-191065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adhesion strength of orthodontic attachments to enamel should be within optimal range to resist occlusal forces and to allow debonding without enamel damage. OBJECTIVE The present study compared the effect of non-thermal plasma (NTP) and conventional surface treatment on the adhesion strength of orthodontic bracket to enamel. METHODS A total of 100 premolar teeth were allocated into 5 groups according to the bonding procedure followed: Group 1 (Etch, prime and composite adhesive); Group 2 (Prime and composite adhesive); Group 3 (Glass ionomer cement); Group 4 (NTP, prime and composite adhesive) and Group 5 (NTP and glass ionomer cement). Ten specimens in each group were subjected to artificial aging and the remaining ten specimens served as baseline specimens. Adhesion strength values were recorded after debonding and bond failure types were scored. Water contact angles of the NTP treated and untreated enamel surface were measured. RESULTS Group 1 specimen demonstrated highest bond strength at baseline (21.5 ± 3.01) and thermocycling (15.8 ± 2.87) and the least values were in Group 2 specimens at baseline (3.9 ± 1.01) and thermocycling (1.6 ± 0.7). Among the experimental (NTP) groups, Group 4 specimens exhibited high adhesion strength at baseline (10.2 ± 1.76) and after thermocycling (9.8 ± 2.15) compared to Group 5 specimens at baseline (10.1 ± 1.05) and thermocycling (6.5 ± 2.19). The water contact angle on untreated enamel surface was 53.1° ± 2.1° as compared to 1.4° ± 0.7° in treated surface. CONCLUSION Non-thermal plasma (NTP) treatment in conjunction with composite adhesives demonstrated clinically acceptable adhesion strength and was well within the optimal range (7-14 MPa) for enamel bonding.
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Affiliation(s)
- Salem Almoammar
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ibrahim AlShahrani
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Moshabab A Asiry
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Simone Duarte
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University, Indiana, USA
| | - Malvin Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, USA
| | - Edmund Khoo
- Department of Orthodontics, New York University College of Dentistry, New York, USA
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Ahmed T, Rahman NA, Alam MK. Validation and reliability of a prototype orthodontic bracket debonding device equipped with force-sensitive resistor (FSR): a novel method of measuring orthodontic bracket debonding force in vivo. Prog Orthod 2019; 20:26. [PMID: 31281954 PMCID: PMC6612523 DOI: 10.1186/s40510-019-0277-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/23/2019] [Indexed: 12/01/2022] Open
Abstract
Background To introduce an orthodontic bracket debonding device capable of measuring debonding force clinically by a novel sensor mechanism Materials and method A prototype orthodontic debonding device was constructed utilizing a lift-off debonding instrument (LODI) and force-sensitive resistor (FSR). For data interpretation, the force sensor was equipped with a microcontroller and C++ programming software running on a computer. Ninety-nine (99) 0.022-in. conventional metallic brackets were bonded to premolar teeth in vitro by a single clinician applying the same adhesive and bonding technique. For validation, the mean debonding force measured by the prototype debonding device (n = 30) and the universal testing machine (n = 30) was compared. Both intra- and inter-examiner reliability tests were done by holding and operating the device in a standardized manner. Following debonding by the prototype device, the bracket failure pattern was evaluated (n = 30) by adhesive remnant index (ARI) under the stereomicroscope at × 30 magnification. Statistical analysis included independent samples t test for validation and intraclass correlation coefficient (ICC) with a 95% confidence interval for both intra- and inter-examiner reliability. Results Mean orthodontic bracket debonding force measured by the prototype device (9.36 ± 1.65 N) and the universal testing machine (10.43 ± 2.71 N) was not significantly different (p < 0.05). The prototype device exhibited excellent intra- [ICC (3, 1) = 0.942] and inter-examiner reliability [ICC (2, 1) = 0.921] and was able to debond brackets mostly at the bracket-adhesive interface. Limitation Due to adjusting the position and mechanism of the force sensor, the device had to be held in a modified standardized position. Conclusion A novel method of measuring in vivo orthodontic bracket debonding force has been introduced which proved to be validated, reliable, and safe in terms of enamel damage.
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Affiliation(s)
- Tamzid Ahmed
- Department of Science of Dental Materials, Bangladesh Dental College, Dhaka, Bangladesh.,Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Norma Ab Rahman
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
| | - Mohammad Khursheed Alam
- Department of Orthodontics, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia.
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Ibrahim AI, Thompson VP, Deb S. A Novel Etchant System for Orthodontic Bracket Bonding. Sci Rep 2019; 9:9579. [PMID: 31270352 PMCID: PMC6610079 DOI: 10.1038/s41598-019-45980-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 06/17/2019] [Indexed: 02/07/2023] Open
Abstract
Orthodontic treatment is widely used to correct irregular teeth and/or jaw discrepancies to improve oral function and facial aesthetics. However, it is frequently associated with enamel damage that include chipping, demineralisation, and white spot formation. So far, current bonding systems that can maintain shear bond strengths (SBS) suitable for clinical performance are unable to limit enamel demineralisation, adhesive remnants and damage caused on removal of brackets after treatment. This study reports a novel "safe enamel etch" clinically viable procedure that was accomplished via application of novel etchant pastes developed with β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with citric acid (5 M) or phosphoric acid (37% PA) to yield BCA and BPA etchants respectively. Although enamel etched with clinically used PA gel yielded higher SBS than the BCA/BPA etchants, it exhibited greater adhesive remnants with evidence of enamel damage. In contrast, the experimental etchants resulted in unblemished enamel surfaces with zero or minimal adhesive residue and clinically acceptable SBS. Furthermore, the BPA etchant caused lower enamel decalcification with extensive calcium-phosphate precipitation. The study conclusively showed that BPA facilitated in vitro enamel adhesion without detrimental effects of the aggressive PA gel with potential for remineralisation and saving time at the post-debonding step.
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Affiliation(s)
- A I Ibrahim
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - V P Thompson
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - S Deb
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
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Stadler O, Dettwiler C, Meller C, Dalstra M, Verna C, Connert T. Evaluation of a Fluorescence-aided Identification Technique (FIT) to assist clean-up after orthodontic bracket debonding. Angle Orthod 2019; 89:876-882. [PMID: 31206307 DOI: 10.2319/100318714.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare a fluorescence-aided identification technique (FIT) with a conventional light source (CLS) for removing composite during debonding of brackets with respect to time needed, composite remnants, and tooth substance loss. MATERIALS AND METHODS Twelve maxillary models with 10 bovine teeth each were digitally surface-scanned and metal brackets were bonded on each tooth with Opal Seal and Opal Bond. Two operators: an experienced orthodontist (A) and an undergraduate student (B) received six models each and were asked to remove the composite remnants with a tungsten carbide bur and Sof-Lex discs by both a conventional light source (CLS group, n = 3), and fluorescent inducing light (FIT group, n = 3). The time taken was recorded, and a postoperative scan was digitally superimposed on the preoperative scan to quantify number of teeth with composite remnants and volume and thickness of enamel loss and composite remnants. Chi-square test and independent t-tests were performed to compare methods with a significance level of 5%. RESULTS Compared to CLS, both operators needed significantly less time when using the FIT method and degree of enamel loss, height, and volume of composite remnants and total remaining composite remnants were significantly reduced. By FIT, the volume of enamel loss was significantly reduced for operator A only. Operator B removed the same enamel volume with either method. CONCLUSIONS Cleanup after orthodontic debonding with the FIT was superior regarding time needed and removal of composite remnants. Total enamel loss reduction was operator-dependent.
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De Rosa A, Di Stasio D, Lauritano D, Santoro R, Marotta A, Itro A, Lucchese A. Non-invasive analysis of bleaching effect of hydrogen peroxide on enamel by reflectance confocal microscopy (RCM): study of series of cases. Odontology 2019; 107:285-290. [PMID: 30810841 DOI: 10.1007/s10266-019-00416-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/07/2018] [Indexed: 12/14/2022]
Abstract
The aim of this study is to evaluate in vivo the effects of in-office tooth whitening hydrogen peroxide (HP) agent on enamel-microstructured surface by a reflectance confocal microscopy (RCM). Ten healthy volunteers assisted at the Dental School presenting teeth with vital pulp were selected. The 35% HP whiteness product was applied in two visits on discolored teeth, 1-week interval between, via 20-min applications. A commercially available hand-held RCM (Vivascope3000®, Lucid, Rochester, NY, USA) was used to image in vivo the dental surface of the selected tooth of each volunteer. Twenty upper central incisors' vestibular surfaces were imaged, before bleaching (T0), immediately after (T1) and 1 week later (T2). The peculiar structure of the enamel was seen at T0. After bleaching, white reflective circular bodies were found all over the teeth surfaces, which disappear 1 week later (T2). When the HP gel® was imaged, the same white circular areas were observed. Going deeper, the regular enamel architecture was preserved. Textural analysis of the images in T0 and T2 was performed: GLCM parameters were extracted. Mann-Whitney U test was performed to evaluate statistical differences between two groups of data (p > 0.05). Finally, 35 prisms were randomly selected from T0 and T2 image and diameters were measured; a paired t test was performed (p = 0.381). The RCM is a promisor tool for investigating the features of enamel in vivo, immediately after bleaching procedures, as well as longitudinally.
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Affiliation(s)
- Alfredo De Rosa
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy.
| | - Dorina Lauritano
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore, 48, 20900, Monza, Italy
| | - Rossella Santoro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy
| | - Andrea Marotta
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy
| | - Angelo Itro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. de Crecchio, 16, 80138, Naples, Italy
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Lai C, Bush PJ, Warunek S, Covell DA, Al-Jewair T. An in vitro comparison of ultraviolet versus white light in the detection of adhesive remnants during orthodontic debonding. Angle Orthod 2019; 89:438-445. [PMID: 30653333 DOI: 10.2319/072018-526.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess the effectiveness and efficiency of ultraviolet (UV) illumination compared to conventional white light in the detection of fluorescent-tagged adhesive remnants during orthodontic debonding. MATERIALS AND METHODS Orthodontic brackets were bonded to extracted human premolars using one of two bonding resins having fluorescent properties (Pad Lock, Reliance Orthodontics, Itasca, Ill; Opal Bond MV, Opal Orthodontics, South Jordan, Utah; n = 40 each). The brackets were then debonded and, in each adhesive group, half the teeth had the remaining adhesive resin removed under illumination using the operatory light and the other half using a UV (395 nm) light emitting diode (LED) flashlight (n = 20/group). Time for teeth cleanup was recorded. Follow-up images were obtained under a dissecting microscope using UV illumination, and the surface area of adhesive remnants was calculated. Effectiveness of adhesive removal was also assessed using scanning electron microscopy imaging. Analysis of variance and Kruskal-Wallis tests were used to analyze time and adhesive remnants, respectively. RESULTS Assessment using the dissecting microscope found groups using UV light during adhesive removal had statistically significantly lower amounts of adhesive remnants than groups using white light (P ≤ .01). Time for adhesive removal was significantly lower with Opal Bond MV adhesive using UV light when compared with the white light (P ≤ .01). Assessment by scanning electron microscopy showed that thin remnants of adhesive (<2 μm) remained undetected by UV illumination. CONCLUSIONS UV light is more effective and tends to be more efficient than white light in the detection of fluorescent adhesive during orthodontic debonding. Although there are limitations, the use of UV LED lighting is a practical tool that aids in adhesive detection.
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Salomão FM, Rocha RS, Franco LM, Sundfeld RH, Bresciani E, Fagundes TC. Auxiliary UV light devices for removal of fluorescent resin residues after bracket debonding. J ESTHET RESTOR DENT 2018; 31:58-63. [PMID: 30194909 DOI: 10.1111/jerd.12412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/16/2018] [Accepted: 06/11/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this clinical report was to describe the detection of fluorescent resin residue after orthodontic bracket debonding with two UV light devices and analyze the surface morphology of enamel after 1 year. CLINICAL CONSIDERATIONS A 22-year-old woman had orthodontic brackets removed by a previous dentist; however, resin residue was left on the enamel of the maxillary teeth. After confirming the fluorescent property of the resin, different protocols were used for each half of the maxillary arch. The first method, a black light lens was attached to a light-curing device to detect resin fluorescence, followed by polishing with silicone rubber tips. The second method used a light emitting diode light system attached to and activated by a high-speed handpiece, followed by polishing with discs. Both methods were completed with diamond polishing paste applied with felt discs. Polyvinyl siloxane impressions were made initially, after residue removal, after finishing and after polishing for morphologic analysis. The results were evaluated with photographs and the scanning electron microscope images made of resin casts from the impressions. A follow-up was made after 1 year. CONCLUSIONS Both methods yielded a satisfactory clinical outcome, with a smooth surface, acceptable surface gloss and minimal tooth wear. The use of a UV device that excites fluorescence is recommended for the controlled removal of resin residue on enamel. CLINICAL SIGNIFICANCE The controlled removal of resin residue from enamel after orthodontic treatment is challenging but can be improved with auxiliary methods for detecting resin residues. This clinical report describes two types of devices that excite fluorescent resins in a more rapid and precise technique to guide the practitioner in the controlled removal of residual resin on teeth.
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Affiliation(s)
- Fabio Martins Salomão
- Department of Restorative Dentistry, São Paulo State University (Unesp), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Rafael Santos Rocha
- Department of Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Laura Molinar Franco
- Department of Restorative Dentistry, São Paulo State University (Unesp), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Renato Herman Sundfeld
- Department of Restorative Dentistry, São Paulo State University (Unesp), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Ticiane Cestari Fagundes
- Department of Restorative Dentistry, São Paulo State University (Unesp), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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Kim GM, Kim BR, Lee ES, de Josselin de Jong E, Kim BI. Detection of residual resin-based orthodontic adhesive based on light-induced fluorescence. Photodiagnosis Photodyn Ther 2018; 24:69-74. [PMID: 30179668 DOI: 10.1016/j.pdpdt.2018.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION This study evaluated the fluorescence of orthodontic adhesives using quantitative light-induced fluorescence-digital (QLF-D) images, and compared differences in the color characteristics of the fluorescence between adhesive and the adjacent tooth with that under white-light illumination in specimens containing residual adhesive of various thicknesses. METHODS Disc-shaped adhesive samples and samples comprising adhesive attached to extracted human teeth were prepared using Transbond XT, Blugloo, and Enlight, and they were ground to thicknesses ranging from 800 to 20 μm. Fluorescence and white-light images of the two types of specimens were taken with a QLF-D system. The color parameters for the fluorescence from the discs and the color difference (ΔE) between residual adhesive and the adjacent tooth were quantified in images using the CIE L*a*b* system. RESULTS The fluorescence color values of the discs differed significantly among the three adhesive products (P < 0.05). The ΔE values in fluorescence (ΔEF) and white-light (ΔEW) images for all three adhesives were lower for thinner residual adhesive specimens. The thickness of the adhesive could be perceived over a range of 50-100 μm for fluorescence images and 400-800 μm for white-light images (ΔE > 3.3). ΔEF was significantly larger than ΔEW for all of the residual adhesives, Blugloo specimens thicker than 100 μm, and Transbond XT and Enlight specimens thicker than 50 μm (P < 0.05). CONCLUSIONS Detecting and analyzing fluorescence signals can improve the ability to detect residual adhesive on a tooth and also provide thickness information.
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Affiliation(s)
- Gyung-Min Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Bo-Ra Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea; Department of Health Services Research, University of Liverpool, Liverpool, United Kingdom; Inspektor Research Systems BV, Amsterdam, The Netherlands
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Taha AA, Hill RG, Fleming PS, Patel MP. Development of a novel bioactive glass for air-abrasion to selectively remove orthodontic adhesives. Clin Oral Investig 2018; 22:1839-1849. [PMID: 29185145 PMCID: PMC5906501 DOI: 10.1007/s00784-017-2279-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/19/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To develop a novel, bioactive glass for removing residual orthodontic adhesive via air-abrasion, following bracket debonding, and to evaluate its effectiveness against a proprietary bioactive glass 45S5(Sylc™)-air-abrasion, and a slow-speed tungsten carbide (TC) bur. MATERIALS AND METHODS Three glasses were prepared and their bioactivity was proved. One novel glass (QMAT3) was selected due to its appropriate hardness, lower than that of enamel/45S5(Sylc™). Sixty extracted human premolars were randomly assigned to adhesive removal using: (a) QMAT3-air-abrasion, (b) 45S5(Sylc™)-air-abrasion, and (c) TC bur, which were further subdivided (n = 10) based on the adhesive used (Transbond XT™ or Fuji Ortho LC™). Enamel roughness was assessed using scanning electron microscopy (SEM) and non-contact profilometry before bracket bonding, after removing residual adhesive following bracket debonding and after polishing. RESULTS QMAT3 formed apatite faster (6 h) than 45S5(Sylc™) (24 h) in Tris solution. QMAT3-air-abrasion gave the lowest enamel roughness (Ra) after removing the adhesives. SEM images showed a pitted, roughened enamel surface in the TC bur group and to a lesser extent with 45S5(Sylc™), while a virtually smooth surface without any damage was observed in the QMAT3-air-abrasion group. The time taken for adhesive removal with QMAT3 was comparable to 45S5(Sylc™) but was twice as long with the TC bur. CONCLUSIONS QMAT3-air-abrasion is a promising technique for selective removal of adhesives without inducing tangible enamel damage. CLINICAL RELEVANCE A novel bioactive glass has been developed as an alternative to the use of TC burs for orthodontic adhesive removal.
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Affiliation(s)
- Ayam A Taha
- Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.
- Department of Paedodontic, Orthodontic and Preventive Dentistry, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq.
| | - Robert G Hill
- Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
| | - Padhraig S Fleming
- Department of Orthodontics, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, Turner St, London, E1 2AD, UK
| | - Mangala P Patel
- Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
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Ahangar Atashi MH, Sadr Haghighi AH, Nastarin P, Ahangar Atashi S. Variations in enamel damage after debonding of two different bracket base designs: An in vitro study. J Dent Res Dent Clin Dent Prospects 2018; 12:56-62. [PMID: 29732022 PMCID: PMC5928475 DOI: 10.15171/joddd.2018.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/08/2017] [Indexed: 11/09/2022] Open
Abstract
Background. Bracket base design is a factor influencing shear bond strength. High shear bond strength leads to enamel crack formation during debonding. The aim of this study was to compare enamel damage variations, including the number and length of enamel cracks after debonding of two different base designs. Methods. Eighty-eight extracted human premolars were randomly divided into2 groups (n=44). The teeth in each group were bonded by two types of brackets with different base designs: 80-gauge mesh design versus anchor pylon design with pylons for adhesive retention. The number and length of enamel cracks before bonding and after debonding were evaluated under an optical stereomicroscope ×40 in both groups. Mann-Whitney U test was used to compare the number of cracks between the two groups. ANCOVA was used for comparison of crack lengths after and before debonding in each group and between the two groups. Results. There was a significant increase in enamel crack length and numbers in each group after debonding. There was no significant difference in enamel crack numbers after debonding between the two groups, whereas the length of enamel cracks was significantly greater in anchor pylon base design after debonding. Conclusion. Bracket bases with pylon design for adhesive retention caused more iatrogenic debonding damage to enamel surface.
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Affiliation(s)
| | - Amir Hooman Sadr Haghighi
- Department of Orthodontics, Faculty of dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parastou Nastarin
- Department of Orthodontics, Faculty of dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Ahangar Atashi
- Department of Orthodontics, Faculty of dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Enamel defects during orthodontic treatment. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: Orthodontic treatment has an inherent potential for causing defects to enamel in the course of bonding and debonding procedures, interproximal enamel stripping and induce the presence of white spot lesions, enamel discoloration or wear. The aim of this study is to present the stages of orthodontic therapy associated with potential damage to enamel and list the enamel alterations observed in each stage. Material and Methods: A literature search was carried out in MEDLINEPubMed database for papers published up to and including February 2015. Results: Enamel loss is induced by cleaning with abrasives before etching, the acid etching process itself, forcibly removing brackets, and mechanical removal of composite remnants with rotary instruments. Loss of enamel or topographic changes in the form of cracks, scarring and scratches may occur. Clinicians may cause structural damage of enamel by interproximal enamel stripping. Additionally, the enamel surface may become demineralized due to plaque accumulation around the orthodontic attachments. Additional complications are enamel color alterations due to its microstructural modifications or discoloration of adhesive remnants and enamel wear due to contact with the brackets of the opposing teeth. Conclusions: Therapeutic procedures performed in the course of orthodontic treatment may cause irreversible physical damage to the outermost enamel. To avoid this, the orthodontic practitioner should take great care in every stage of the treatment and manage the enamel surface conservatively. Moreover, patients should follow an effective oral hygiene regimen. Given these conditions enamel damage during orthodontic therapy is eliminated and longevity of the dentition is promoted.
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Enamel Resistance to Demineralization After Bracket Debonding Using Fluoride Varnish. Sci Rep 2017; 7:15183. [PMID: 29123323 PMCID: PMC5680324 DOI: 10.1038/s41598-017-15600-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/27/2017] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to evaluate the elemental content and morphology of enamel subjected to demineralization cycles after bracket debonding, adhesive remnant removal, and application of a fluoride varnish. 125 bovine teeth were divided into five groups (n = 25): 1) Intact enamel; 2) Intact enamel + demineralization cycles (DC); 3) Enamel after adhesive removal; 4)Enamel after adhesive removal + DC; 5) Enamel after adhesive removal + Profluorid + DC. The weight percentages of calcium (Ca), phosphorous (P) and fluoride (F) were calculated using energy dispersive X-ray spectroscopy (EDX). Samples were observed under scanning electron microscopy (SEM). Data were analyzed using Kruskal-Wallis and Mann-Whitney test. The weight percentages of Ca and P in Group 1 were significantly higher than Groups 2, 4, and 5. The weight percentages of Ca and P in Group 2 were significantly higher than Groups 4 and 5. Group 3 presented significantly higher percentages of Ca and P than Group 4. Group 5 showed a significantly higher percentage of Ca than Group 4. The presence of F was detected in Group 5. SEM images showed more signs of demineralization in Group 4 than Group 5. Fluoride varnish application may protect enamel from demineralization after bracket debonding.
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Stein S, Kleye A, Schauseil M, Hellak A, Korbmacher-Steiner H, Braun A. 445-nm diode laser-assisted debonding of self-ligating ceramic brackets. BIOMED ENG-BIOMED TE 2017; 62:513-520. [PMID: 28076292 DOI: 10.1515/bmt-2016-0027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 11/15/2016] [Indexed: 11/15/2022]
Abstract
AbstractObjectives:This study determined the influence of irradiation on aesthetic ceramic brackets with a novel 445-nm diode laser prior to debonding on the bracket failure mode.Materials and methods:Thirty ceramic brackets (In-Ovation® C, GAC) were standard-bonded to the oral and buccal planed and polished enamel surfaces of 15 caries-free human 3Results:In the laser group, the ARI-score was statistically significantly reduced (p<0.05) at 10-fold and 20-fold magnifications compared to the conventional group, while enamel fractures were not found at any magnification in either group at T1. Enamel fractures and grinding marks were increasingly found in the conventional group by SEM at T2.Conclusion:Irradiation with the novel diode laser prior to debonding of ceramic brackets significantly changes bonding failure in terms of less remaining adhesive. This is of clinical importance as the risk of enamel fractures and chair time can be reduced.
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Wishney M. Potential risks of orthodontic therapy: a critical review and conceptual framework. Aust Dent J 2017; 62 Suppl 1:86-96. [PMID: 27868202 DOI: 10.1111/adj.12486] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 11/30/2022]
Abstract
This review examines some of the potential risks of orthodontic therapy along with their evidence base. The risks of orthodontic treatment include periodontal damage, pain, root resorption, tooth devitalization, temporomandibular disorder, caries, speech problems and enamel damage. These risks can be understood to arise from a synergy between treatment and patient factors. In general terms, treatment factors that can influence risk include appliance type, force vectors and duration of treatment whilst relevant patient factors are both biological and behavioural. Hence, the natural variation between orthodontic treatment plans and patients gives rise to variations in risk. A good understanding of these risks is required for clinicians to obtain informed consent before starting treatment as well as to reduce the potential for harm during treatment. After considering each of these risks, a conceptual framework is presented to help clinicians better understand how orthodontic risks arise and may therefore be mitigated.
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Affiliation(s)
- M Wishney
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia.,Dental Hospital, Sydney South West Area Health Service, Sydney, Australia
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Naseh R, Fallahzadeh F, Atai M, Mortezai O, Setayeshrad R. Casein phosphopeptide- amorphous calcium phosphate effects on brackets shear bond strength and enamel damage. J Clin Exp Dent 2017; 9:e1002-e1007. [PMID: 28936291 PMCID: PMC5601100 DOI: 10.4317/jced.54017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 05/27/2017] [Indexed: 11/05/2022] Open
Abstract
Background The aim of study was to evaluate the application of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride regarding their effect on the shear bond strength (SBS), bond failure pattern of brackets using the adhesive remnant index (ARI) and assessing the quality of enamel surface using the enamel damage index (EDI). Material and Methods Sixty extracted premolar teeth were randomly divided into four groups regarding pretreatment application of CPP-ACP and fluoride. Brackets were bonded using the conventional method. Specimens were thermocycled for 1000 cycles and were subsequently tested for the SBS in a universal testing machine. After debonding, the teeth were examined under a stereomicroscope to evaluate the ARI. Then, The EDI was assessed using a scanning electron microscope (SEM). Data were analyzed using ANOVA and the Chi-square test. Results Evaluation of SBS, ARI and EDI scores showed no significant difference among the study groups. However, a correlation was found between the ARI and EDI scores, indicating that with more adhesive remnants on enamel surface, enamel damage was lower. Conclusions The use of CPP-ACP and fluoride can be considered a prophylactic application since these agents did not compromise bracket bond strength although they did not reduce iatrogenic damage to the enamel. Key words:CPP-ACP, Enamel damage, SEM, Shear bond strength, ARI.
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Affiliation(s)
- Roya Naseh
- Associate Professor of Orthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farnoosh Fallahzadeh
- Assistant Professor of Operative Dentistry, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Atai
- Professor of Polymer Science, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Mortezai
- Assistant Professor of Orthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Raheleh Setayeshrad
- Assistant Professor of Orthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Goel A, Singh A, Gupta T, Gambhir RS. Evaluation of surface roughness of enamel after various bonding and clean-up procedures on enamel bonded with three different bonding agents: An in-vitro study. J Clin Exp Dent 2017; 9:e608-e616. [PMID: 28512535 PMCID: PMC5429470 DOI: 10.4317/jced.53237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 02/15/2017] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this study was to analyze and compare the enamel surface roughness before bonding and after debonding, to find correlation between the adhesive remnant index and its effect on enamel surface roughness and to evaluate which clean-up method is most efficient to provide a smoother enamel surface. Material and Methods 135 premolars were divided into 3 groups containing 45 premolars in each group. Group I was bonded by using moisture insensitive primer, Group II by using conventional orthodontic adhesive and Group III by using self-etching primer. Each group was divided into 3 sub-groups on the basis of type of clean-up method applied i,e scaling followed by polishing, tungsten carbide bur and Sof-Lex disc. Enamel surface roughness was measured and compared before bonding and after clean-up. Results Evaluation of pre bonding and post clean-up enamel surface roughness (Ra value) with the t test showed that Post clean-up Ra values were greater than Pre bonding Ra values in all the groups except in teeth bonded with self-etching primer cleaned with Sof-Lex disc. Reliability of ARI score taken at different time interval tested with Kruskal Wallis test suggested that all the readings were reliable. Conclusions No clean-up procedure was able to restore the enamel to its original smoothness. Self-etching primer and Sof-Lex disc clean-up method combination restored the enamel surface roughness (Ra value) closest to its pre-treatment value. Key words:Enamel surface roughness, clean-up method, adhesive remnant index.
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Affiliation(s)
- Amit Goel
- Post Graduate Student, Dept. of Orthodontics, KD Dental College and Hospital, Mathura, UP
| | - Atul Singh
- Reader, Dept. of Orthodontics, KD Dental College and Hospital, Mathura, UP
| | - Tarun Gupta
- Sr. Lecturer, Dept. of Public Health Dentistry, MM University, Mullana, Ambala
| | - Ramandeep-Singh Gambhir
- Reader and Head, Dept. of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali
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Fan XC, Chen L, Huang XF. Effects of various debonding and adhesive clearance methods on enamel surface: an in vitro study. BMC Oral Health 2017; 17:58. [PMID: 28241812 PMCID: PMC5327509 DOI: 10.1186/s12903-017-0349-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 02/14/2017] [Indexed: 11/16/2022] Open
Abstract
Background The purpose of this study was to evaluate orthodontic debonding methods by comparing the surface roughness and enamel morphology of teeth after applying two different debonding methods and three different polishing techniques. Methods Forty eight human maxillary premolars, extracted for orthodontic reasons, were randomly divided into three groups. Brackets were bonded to teeth with RMGIC (Fuji Ortho LC, GC, Tokyo, Japan) (two groups, n = 18 each) after acid etching (30s), light cured for 40 s, exposed to thermocycling, then underwent 2 different bracket debonding methods: debonding pliers (Shinye, Hangzhou, China) or enamel chisel (Jinzhong, Shanghai, China); the third group (n = 12) comprised of untreated controls, with normal enamel surface roughness. In each debonded group, three cleanup techniques (n = 6 each) were tested, including (I) diamond bur (TC11EF, MANI, Tochigi, Japan) and One-Gloss (Midi, Shofu, Kyoto, Japan), (II) a Super-Snap disk (Shofu, Kyoto, Japan), and (III) One-Gloss polisher. The debonding methods were compared using the modified adhesive remnant index (ARI, 1–5). Cleanup efficiencies were assessed by recording operating times. Enamel surfaces were qualitatively and quantitatively evaluated with scanning electron microscopy (SEM) and surface roughness tester, respectively. Two surface roughness variables were evaluated: Ra (average roughness) and Rz (10-point height of irregularities). Results The ARI scores of debonded teeth were similar with debonding pliers and enamel chisel (Chi-square = 2.19, P > 0.05). There were significant differences between mean operating time in each group (F = 52.615, P < 0.01). The diamond bur + One-Gloss took the shortest operating time (37.92 ± 3.82 s), followed by the Super-Snap disk (56.67 ± 7.52 s), and the One-Gloss polisher (63.50 ± 6.99 s). SEM appearance provided by the One-Gloss polisher was the closest to the intact enamel surface, and surface roughness (Ra: 0.082 ± 0.046 μm; Rz: 0.499 ± 0.200 μm) was closest to the original enamel (Ra: 0.073 ± 0.048 μm; Rz: 0.438 ± 0.213 μm); the next best was the Super-Snap disk (Ra: 0.141 ± 0.073 μm; Rz: 1.156 ± 0.755 μm); then, the diamond bur + One-Gloss (Ra: 0.443 ± 0.172 μm; Rz: 2.202 ± 0.791 μm). Conclusions Debonding pliers were safer than enamel chisels for removing brackets. Cleanup with One-Gloss polisher provided enamel surfaces closest to the intact enamel, but took more time, and Super-Snap disks provided acceptable enamel surfaces and efficiencies. The diamond bur was not suitable for removing adhesive remnant.
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Affiliation(s)
- Xiao-Chuan Fan
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Li Chen
- Department of Orthodontics, Capital Medical University School of Stomatology, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Xiao-Feng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.
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Rodríguez-Chávez JA, Arenas-Alatorre J, Belio-Reyes IA. Comparative study of dental enamel loss after debonding braces by analytical scanning electron microscopy (SEM). Microsc Res Tech 2017; 80:680-686. [PMID: 28161895 DOI: 10.1002/jemt.22849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/18/2017] [Accepted: 01/23/2017] [Indexed: 11/10/2022]
Abstract
Clinical procedures when shear forces are applied to brackets suggest adhesion forces between 2.8 and 10.0 MPa as appropriate. In this study dental enamel was evaluated by scanning electron microscopy (SEM) before and after removing the brackets. Thirty bicuspids (previous prophylaxis) with metallic brackets (Roth Inovation 0.022 GAC), Transbond Plus SEP 3M Unitek adhesive and Transbond XT 3M resin were used. The samples were preserved to 37°C during 24 hr and submited to tangential forces with the Instron Universal machine 1.0 mm/min speed load strength resistance debonding. Also the Adhesive Remanent Index (ARI) test was made, evaluating the bracket base and the bicuspid surface. All the bracket SEM images were processed with AutoCAD to determine the enamel detached area. The average value was 6.86 MPa (SD ± 3.2 MPa). ARI value 1= 63.3%, value 2= 20%, value 3= 13.3% and 33% presented value 0. All those samples with dental enamel loss, presented different situations as fractures, ledges, horizontal, and vertical loss in some cases, and some scratch lines. There is no association between the debonding resistance and enamel presence. Less than half of the remanent adhesive on the dental enamel was present in most of the samples when the ARI test was applied. When the resin area increases, the debonding resistance also increases, and when the enamel loss increases, the resin free metallic area of the bracket base decreases in the debonding.
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Affiliation(s)
| | - Jesús Arenas-Alatorre
- Departamento de Materia Condensada, Instituto de Física. Universidad Nacional Autónoma de México, D.F. México
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DUMBRYTE I, LINKEVICIENE L, LINKEVICIUS T, MALINAUSKAS M. Enamel microcracks in terms of orthodontic treatment: A novel method for their detection and evaluation. Dent Mater J 2017; 36:438-446. [DOI: 10.4012/dmj.2016-264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Grassia V, Gentile E, Di Stasio D, Jamilian A, Matarese G, D'Apuzzo F, Santoro R, Perillo L, Serpico R, Lucchese A. In vivo confocal microscopy analysis of enamel defects after orthodontic treatment: A preliminary study. Ultrastruct Pathol 2016; 40:317-323. [PMID: 27736278 DOI: 10.1080/01913123.2016.1237603] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
After orthodontic treatment with fixed appliances, bonded brackets and residual adhesive must be removed. This procedure should lead to restitutio ad integrum of the enamel or, at least, restore the enamel surface as closely as possible to its pre-treatment conditions. The purpose of this study is the in vivo assessment at a microscopic resolution of enamel surfaces after bracket debonding while avoiding the tooth extraction. Nine orthodontic patients who had brackets removed at the conclusion of orthodontic treatment were enrolled. In vivo reflectance confocal microscopy imaging of dental enamel surface after debonding was performed for each patient. Eighteen upper incisors were analyzed, 10 in which the enamel demineralization appeared after the treatment and 8 in which the demineralization was present before the treatment. RCM analyses showed some speckled or roundish dark areas within the enamel. Moreover enamel alterations were detected at different levels of depth. The present in vivo microscopic study allowed for highlighting structural features in dental enamel, after debonding, at a microscopic resolution in real-time and in a non-invasive way, without the need for extraction or processing of the samples.
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Affiliation(s)
- Vincenzo Grassia
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Enrica Gentile
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Dario Di Stasio
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Abdolreza Jamilian
- b Department of Orthodontics, School of Dentistry , Islamic Azad University , Tehran , Iran
| | - Giovanni Matarese
- c Department of Orthodontics and Paediatric Dentistry , Dental School, University of Messina , Messina , Italy
| | - Fabrizia D'Apuzzo
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Rossella Santoro
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Letizia Perillo
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Rosario Serpico
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
| | - Alberta Lucchese
- a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy
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Janiszewska-Olszowska J, Tomkowski R, Tandecka K, Stepien P, Szatkiewicz T, Sporniak-Tutak K, Grocholewicz K. Effect of orthodontic debonding and residual adhesive removal on 3D enamel microroughness. PeerJ 2016; 4:e2558. [PMID: 27761343 PMCID: PMC5068349 DOI: 10.7717/peerj.2558] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/12/2016] [Indexed: 11/22/2022] Open
Abstract
Background Termination of fixed orthodontic treatment is associated with bracket debonding and residual adhesive removal. These procedures increase enamel roughness to a degree that should depend on the tool used. Enamel roughening may be associated with bacterial retention and staining. However, a very limited data exists on the alteration of 3D enamel roughness resulting from the use of different tools for orthodontic clean-up. Aims 1. To perform a precise assessment of 3D enamel surface roughness resulting from residual adhesive removal following orthodontic debonding molar tubes. 2. To compare enamel surfaces resulting from the use of tungsten carbide bur, a one-step polisher and finisher and Adhesive Residue Remover. Material and Methods Buccal surfaces of forty-five extracted human third molars were analysed using a confocal laser microscope at the magnification of 1080× and 3D roughness parameters were calculated. After 20 s etching, molar tubes were bonded, the teeth were stored in 0.9% saline solution for 24 hours and debonded. Residual adhesive was removed using in fifteen specimen each: a twelve-fluted tungsten carbide bur, a one-step finisher and polisher and Adhesive Residue Remover. Then, surface roughness analysis was repeated. Data normality was assessed using Shapiro–Wilk test. Analysis of variance (ANOVA) was used to compare between variables of normal distribution and for the latter—Kruskal-Wallis test. Results Sa (arithmetical mean height) was significantly different between the groups (p = 0, 01326); the smoothest and most repeatable surfaces were achieved using Adhesive Residue Remover. Similarly, Sq (root mean square height of the scale-limited surface) had the lowest and most homogenous values for Adhesive Residue Remover (p = 0, 01108). Sz (maximum height of the scale-limited surface) was statistically different between the groups (p = 0, 0327), however no statistically significant differences were found concerning Ssk (skewness of the scale-limited surface). Discussion Confocal laser microscopy allowed 3D surface analysis of enamel surface, avoiding the limitations of contact profilometry. Tungsten carbide burs are the most popular adhesive removing tools, however, the results of the present study indicate, that a one step polisher and finisher as well as Adhesive Residue Remover are less detrimental to the enamel. This is in agreement with a recent study based on direct 3D scanning enamel surface. It proved, that a one-step finisher and polisher as well as Adhesive Residue Remover are characterized by a similar effectiveness in removing residual remnants as tungsten carbide bur, but they remove significantly less enamel. Conclusion Orthodontic debonding and removal of adhesive remnants increases enamel roughness. The smoothest surfaces were achieved using Adhesive Residue Remover, and the roughest using tungsten carbide bur.
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Affiliation(s)
| | - Robert Tomkowski
- Faculty of Mechanical Engineering, Koszalin University of Technology , Koszalin , Poland
| | - Katarzyna Tandecka
- Faculty of Mechanical Engineering, Koszalin University of Technology , Koszalin , Poland
| | - Piotr Stepien
- Department of Technology and Education, Koszalin University of Technology , Koszalin , Poland
| | - Tomasz Szatkiewicz
- Faculty of Mechanical Engineering, Koszalin University of Technology , Koszalin , Poland
| | | | - Katarzyna Grocholewicz
- Department of General Dentistry, Pomeranian Medical University in Szczecin , Szczecin , Poland
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