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Dumbryte I, Narbutis D, Androulidaki M, Vailionis A, Juodkazis S, Malinauskas M. Teeth Microcracks Research: Towards Multi-Modal Imaging. Bioengineering (Basel) 2023; 10:1354. [PMID: 38135945 PMCID: PMC10740647 DOI: 10.3390/bioengineering10121354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
This perspective is an overview of the recent advances in teeth microcrack (MC) research, where there is a clear tendency towards a shift from two-dimensional (2D) to three-dimensional (3D) examination techniques, enhanced with artificial intelligence models for data processing and image acquisition. X-ray micro-computed tomography combined with machine learning allows 3D characterization of all spatially resolved cracks, despite the locations within the tooth in which they begin and extend, and the arrangement of MCs and their structural properties. With photoluminescence and micro-/nano-Raman spectroscopy, optical properties and chemical and elemental composition of the material can be evaluated, thus helping to assess the structural integrity of the tooth at the MC site. Approaching tooth samples having cracks from different perspectives and using complementary laboratory techniques, there is a natural progression from 3D to multi-modal imaging, where the volumetric (passive: dimensions) information of the tooth sample can be supplemented by dynamic (active: composition, interaction) image data. Revelation of tooth cracks clearly shows the need to re-assess the role of these MCs and their effect on the structural integrity and longevity of the tooth. This provides insight into the nature of cracks in natural hard materials and contributes to a better understanding of how bio-inspired structures could be designed to foresee crack propagation in biosolids.
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Affiliation(s)
- Irma Dumbryte
- Institute of Odontology, Vilnius University, LT-08217 Vilnius, Lithuania
| | - Donatas Narbutis
- Institute of Theoretical Physics and Astronomy, Vilnius University, LT-10222 Vilnius, Lithuania
| | - Maria Androulidaki
- Microelectronics Research Group, Institute of Electronic Structure & Laser, Foundation for Research and Technology FORTH-Hellas, 70013 Heraklion, Crete, Greece
| | - Arturas Vailionis
- Stanford Nano Shared Facilities, Stanford University, Stanford, CA 94305, USA
- Department of Physics, Kaunas University of Technology, LT-51368 Kaunas, Lithuania
| | - Saulius Juodkazis
- Optical Sciences Centre and ARC Training Centre in Surface Engineering for Advanced Materials (SEAM), School of Science, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- WRH Program International Research Frontiers Initiative (IRFI), Tokyo Institute of Technology, Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan
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Najjar YM, Burhan AS, Hajeer MY, Nawaya FR, Alam MK. Effects of the conventional, soft start, and pulse delay modes produced by light-emitting diode device on metal brackets bond strength and enamel damage: An in vitro comparative study. Int Orthod 2023; 21:100787. [PMID: 37393664 DOI: 10.1016/j.ortho.2023.100787] [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: 04/22/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES This study aimed to compare the bond strength and enamel damage following debonding of metal brackets cured by different light-curing modes: conventional, soft start, and pulse delay modes. MATERIAL AND METHODS Sixty extracted upper premolars were randomly divided into three groups according to the used light-curing mode. Metal brackets were bonded with a light-emitting diode device employing different modes. Group 1: conventional mode (10s mesial+10 s distal); group 2: soft start mode (15s mesial+15s distal); group 3: pulse delay mode (3s mesial+3s distal, followed by 3min of no photoactivation, then 9s mesial+9s distal). Radiant exposure was the same in all study groups. Shear bond strengths of the brackets were tested with a universal testing machine. A stereomicroscope was used to determine the number and length of enamel microcracks. One-Way ANOVA and Kruskal-Wallis tests were used to detect significant differences in shear bond strength and microcracks number and length among groups. RESULTS The soft start and pulse delay modes produced significantly greater shear bond strength than the conventional mode (19.46±4.90MPa; 20.47±4.97MPa; 12.14±3.79MPa, respectively, P<0.001). However, there was no significant difference between the soft start and pulse delay groups (P=0.768). The number and length of microcracks increased significantly after debonding in all study groups. The change in microcracks length was not different among study groups. CONCLUSION The soft start and pulse delay modes produced greater bond strength than the conventional mode without predisposing enamel to higher risk of damage. Conservative methods for debonding are still required.
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Affiliation(s)
| | - Ahmad S Burhan
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus countryside, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria.
| | - Fehmieh R Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus countryside, Syria
| | - Mohammad Khursheed Alam
- Orthodontic Unit, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
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Mocuta DE, Miron MI, Lungeanu D, Mateas M, Ogodescu E, Todea CD. Laser Er:YAG-Assisted Debonding May Be a Viable Alternative to the Conventional Method for Monocrystalline Ceramic Brackets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14564. [PMID: 36361441 PMCID: PMC9657488 DOI: 10.3390/ijerph192114564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
In orthodontic practice, due to the increased interest among patients in smile aesthetics, different types of brackets are now being used, with those most frequently applied being ones made of polycrystalline and monocrystalline ceramic. The aim of this study was to evaluate the laser Er:YAG-assisted debonding technique compared to conventional methods for removing monocrystalline ceramic brackets from human teeth. The study sample included 60 vital teeth (frontals of the upper jaw) from 10 patients who had monocrystalline ceramic brackets and were in the final phase of orthodontic treatment. The debonding procedure was carried out following a split-mouth study design, using either the conventional technique or laser Er:YAG 2940 nm radiation. For each tooth, three variables were evaluated: the patient's sujective tooth sensitivity associated with the debonding, the time required for debonding, and pulp blood flow microdynamics after the debonding. Three evaluation instruments were used to assess and quantify the treatment effects: (i) the Wong-Baker FACES Pain Rating Scale for pain assessment; (ii) a digital stopwatch/timer to measure the time required to remove the bracket; and (iii) laser Doppler flowmetry (LDF) for recording the pulp blood flow evolution. The statistical analysis of the recorded data showed a statistically significant difference between the two debonding methods regarding the tooth sensitivity during the debonding and the time required for the procedure. The subjective tooth sensitivity was reduced from a mean ± standard deviation of 3.07 ± 1.46 to 0.47 ± 0.86 on the Wong-Baker FACES scale (Wilcoxon signed rank, p < 0.001). The necessary time for debonding was reduced by 0.697 ± 0.703 s per tooth (paired t-test, p < 0.001). There was no difference in the blood microdynamics between the two debonding techniques. According to the results of this study, the laser Er:YAG-assisted debonding technique may be a viable alternative to the conventional method for monocrystalline ceramic brackets.
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Affiliation(s)
- Daliana-Emanuela Mocuta
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
| | - Mariana I. Miron
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Functional Sciences, Faculty of Medicine, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Marius Mateas
- Mechatronics Department, Polytechnic University of Timișoara, 300006 Timișoara, Romania
| | - Emilia Ogodescu
- Pediatric Dentistry Research Center, Department of Pediatric Dentistry, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Carmen D. Todea
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
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Rodríguez-Chávez JA, Arenas-Alatorre JÁ, Flores-Ruiz HM, Aguilar-Pérez FJ, Flores-Ledesma A, Moreno-Vargas YA, Pesqueira-Melgarejo R. Correlation between dental enamel chemical composition and bracket debonding, comparing adhesive systems through a scanning electron microscope. Microsc Res Tech 2022; 85:2567-2578. [PMID: 35349203 DOI: 10.1002/jemt.24111] [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: 05/16/2021] [Revised: 02/21/2022] [Accepted: 03/22/2022] [Indexed: 11/08/2022]
Abstract
Literature reports indicate that during bracket removal there can be enamel damage. We compare the shear bond strength (SBS) and tooth enamel loss of four adhesive systems and identify the Ca/P ratio. Then a total of 20 premolars were divided into four groups of five each. After prophylaxis, photographs were taken at 35× with a scanning electron microscope (SEM) and analyzed with X-ray spectroscopy (EDS) at 250×. Brackets were bonded with Transbond™ MIP(G1), Transbond™ PLUS SEP(G2), Enlight(G3) and Stylus®(G4) adhesives, 24 h after were debonded with a Instron universal testing machine at 1 mm/min. All the brackets were photographed with the SEM. The amount of lost enamel was measured with AutoCad. All the results were measured with a significance level p < .05. The SBS general average at debonding was 7.94 ± 2.26 MPa, meanwhile the SBS for G1, G2, G3 and G4 was 9.38 ± 1.46, 6.28 ± 0.69, 9.08 ± 2.45 and 7.04 ± 2.64 MPa respectively. 90% of the samples had no enamel loss, 10% had enamel loss. Only two samples in G1 presented an enamel loss area of 0.34mm2 and 0.80mm2 respectively. From EDS analysis, the Ca/P ratio was 1.6 ± 0.05, 1.61 ± 0.03, 1.64 ± 0.83 and 1.59 ± 0.07 for G1, G2, G3 and G4 respectively; no statistically significant differences were found. We conclude that no association was found between the Ca/P ratio and enamel damage when brackets are removed.
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Affiliation(s)
| | | | - Hugo M Flores-Ruiz
- Departamento de Ciencias Naturales y Exactas, CUValles, Universidad de Guadalajara, Ameca, Mexico
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Dumbryte I, Vailionis A, Skliutas E, Juodkazis S, Malinauskas M. Three-dimensional non-destructive visualization of teeth enamel microcracks using X-ray micro-computed tomography. Sci Rep 2021; 11:14810. [PMID: 34285299 PMCID: PMC8292334 DOI: 10.1038/s41598-021-94303-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Although the topic of tooth fractures has been extensively analyzed in the dental literature, there is still insufficient information about the potential effect of enamel microcracks (EMCs) on the underlying tooth structures. For a precise examination of the extent of the damage to the tooth structure in the area of EMCs, it is necessary to carry out their volumetric [(three-dimensional (3D)] evaluation. The aim of this study was to validate an X-ray micro-computed tomography ([Formula: see text]CT) as a technique suitable for 3D non-destructive visualization and qualitative analysis of teeth EMCs of different severity. Extracted human maxillary premolars were examined using a [Formula: see text]CT instrument ZEISS Xradia 520 Versa. In order to separate crack, dentin, and enamel volumes a Deep Learning (DL) algorithm, part of the Dragonfly's segmentation toolkit, was utilized. For segmentation needs we implemented Dragonfly's pre-built UNet neural network. The scanning technique which was used made it possible to recognize and detect not only EMCs that are visible on the outer surface but also those that are buried deep inside the tooth. The 3D visualization, combined with DL assisted segmentation, enabled the evaluation of the dynamics of an EMC and precise examination of its position with respect to the dentin-enamel junction.
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Affiliation(s)
| | - Arturas Vailionis
- Stanford Nano Shared Facilities, Stanford University, Stanford, USA
- Department of Physics, Kaunas University of Technology, Kaunas, Lithuania
| | - Edvinas Skliutas
- Laser Research Center, Faculty of Physics, Vilnius University, Vilnius, Lithuania
| | - Saulius Juodkazis
- Optical Sciences Centre and ARC Training Centre in Surface Engineering for Advanced Materials (SEAM), School of Science, Swinburne University of Technology, Hawthorn, Australia
- Tokyo Tech World Research Hub Initiative (WRHI), School of Materials and Chemical Technology, Tokyo Institute of Technology, Tokyo, Japan
| | - Mangirdas Malinauskas
- Laser Research Center, Faculty of Physics, Vilnius University, Vilnius, Lithuania
- Tokyo Tech World Research Hub Initiative (WRHI), School of Materials and Chemical Technology, Tokyo Institute of Technology, Tokyo, Japan
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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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Rodríguez-Chávez JA, Arenas-Alatorre JÁ, Flores-Ruiz HM, Flores-Ledesma A, Aguilar-Pérez FJ. Evaluation of enamel loss by scanning electron microscopy after debonding brackets place with four different adhesives. Microsc Res Tech 2020; 84:912-920. [PMID: 33242361 DOI: 10.1002/jemt.23652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/10/2022]
Abstract
The clinically adequate shear bond strengths (SBS) should be from 2.8 to 10 MPa. The aim of this research is to observe tooth enamel loss through a scanning electron microscope (SEM) during the debonding of braces of four adhesive systems. Then, 100 premolars were used in 4 groups of 25 specimens each, for Transbond MIP (G1), Enlight (G2), Stylus (G3), and Transbond Plus SEP (G4). The research was done under the NOM ISO/TS 11405:2015. Gemini 3M were placed under the manufacturer's recommendations. The SBS test was done at 24 hr in an Instron electromechanical universal testing machine at 1 mm/1 min. Adhesive remnant index (ARI) was measured, all of the brackets where examined in the SEM. For the shear bonding strength G1 = 10.09 ± 2.73 MPa, G2 = 9.27 ± 3.99 MPa, G3 = 7.83 ± 4.46 MPa, and G4 = 6.40 ± 2.85 MPa statistically significant differences were found when comparing the four groups (p = .002). In the Tukey post hoc test, G1 versus G4 and G2 versus G4, statistically significant differences were found. For the ARI a value of 1 in 46%, followed by a value of 2 in 38%, a value of 3 in 13% and a value of 0 in 3% of the total samples, finding statistically significant differences (p < .001). In relation to the tooth enamel loss due to SBS, statistically significant differences were found (p = .326). G1 and G4 had not statistically significant differences. Even though our results concur with the appropriate clinical values, we observed tooth enamel loss with Transbond Plus SEP and Stylus.
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Affiliation(s)
- Jacqueline Adelina Rodríguez-Chávez
- Departamento de Clínicas Odontologicas Integrales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta 228, Guadalajara, Jalisco, 44340, Mexico
| | - Jesús Ángel Arenas-Alatorre
- Departamento de Materia Condensada, Instituto de Física, Universidad Nacional Autónoma de México, Circuito de la Investigación Científica S/N, Ciudad Universitaria, Delegación Coyoacán, Ciudad de México, 04510, Mexico
| | - Hugo M Flores-Ruiz
- Departamento de Ciencias Naturales y Exactas, Universidad de Guadalajara, CUValles Campus, Carretera Guadalajara-Ameca Km 43.5, Ameca, Jalisco, 46600, Mexico
| | - Abigailt Flores-Ledesma
- Facultad de Estomatología, Benemerita Universidad Autónoma de Puebla, 31 Poniente #1304, Colonia Volcanes, Puebla, Puebla, 72410, Mexico
| | - Fernando Javier Aguilar-Pérez
- Facultad de Odontología, Campus de Ciencias de la Salud, Universidad Autónoma de Yucatán, Calle 61-A num 492-A, Centro, Mérida, Yucatán, 97000, Mexico
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Ferreira FG, da Silva EM, Vilella ODV. A Novel Method Using Confocal Laser Scanning Microscopy for Three-Dimensional Analysis of Human Dental Enamel Subjected to Ceramic Bracket Debonding. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2020; 26:1053-1060. [PMID: 32843117 DOI: 10.1017/s1431927620024319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this in vitro study was to present a method using confocal laser scanning microscopy for three-dimensional analysis of human dental enamel subjected to ceramic bracket debonding. The labial enamel surfaces of three upper central incisors were prepared and mounted in the form of standardized specimens. A sample repositioning protocol was established to enable surface measurement and analysis before and after bracket debonding. Observations were made of representative areas measuring 1,280 × 1,280 μm2, in the center of the enamel samples, as well as of the total topography (2,500 × 3,500 μm) of the bonding areas provided by the equipment software. Noncontact three-dimensional high-resolution image analyses revealed the capabilities of the employed technique and methodology to permit the examination of specific characteristics and alterations on the surfaces, before and after the debonding and finishing procedures. The new protocol was effective to provide qualitative and quantitative assessments of changes on the same dental surfaces at different trial times. The methodology constitutes a feasible tool for revealing the effects of debonding of ceramic brackets on sound and previously injured dental enamel surfaces.
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Affiliation(s)
- Fabiano G Ferreira
- Department of Orthodontics, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro24020-140, Brazil
| | - Eduardo M da Silva
- Analitical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro24020-140, Brazil
| | - Oswaldo de V Vilella
- Department of Orthodontics, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro24020-140, Brazil
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Evaluation of Enamel Topography after Debonding Orthodontic Ceramic Brackets by Different Er,Cr:YSGG and Er:YAG Lasers Settings. Dent J (Basel) 2020; 8:dj8010006. [PMID: 31936500 PMCID: PMC7175227 DOI: 10.3390/dj8010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
In the last decade, the success of lasers in simplifying many dental procedures has heightened the need for research in the orthodontic field, in order to evaluate the benefits of laser-assisted ceramic brackets debonding. Conventional ceramic brackets removal delivers a high shear bond strength (SBS), which might lead to enamel damage. Nowadays, debonding ceramic brackets by Er:YAG laser seems a viable alternative technique; however, there is no data on the use of Er,Cr:YSGG in the literature. We aimed to evaluate the difference in enamel topography derived from different erbium laser settings used during debonding. One hundred and eighty bovine incisors teeth were randomly divided into fifteen experimental groups, according to different erbium laser settings using scanning methods. SBS testing was performed after debonding; stereomicroscopic and SEM analyses were done after cleaning the remaining adhesive so as to assess the incidence of enamel microcracks formation and enamel loss. There were no statistically significant differences between the proportions of teeth with normal enamel topography within the control group when compared with any of the Er:YAG groups. However, the proportion of teeth with a normal enamel topography in Er,Cr:YSGG was 4 W/20 Hz (83.3%) and in Er:YAG was 5 W/20 Hz (91.7%), which was statistically significantly higher than the control group (41.7%). The selection of erbium lasers' optimal parameters during debonding influences the enamel topography. When considering the evaluation of both microscopic and statistical analyses, irradiation by Er:YAG (120 mJ/40 Hz) displayed a significant reduction in microcracks compared with conventional debonding, even though some microstructural changes in the enamel could be noted. Er,Cr:YSGG (4 W/20 Hz) respected the enamel topography the most out of the studied groups.
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Hoteit M, Nammour S, Zeinoun T. Assessment of microcracks and shear bond strength after debonding orthodontic ceramic brackets on enamel priorly etched by different Er,Cr:YSGG and Er:YAG laser settings without acid application: An in vitro study. Int Orthod 2019; 17:744-757. [PMID: 31543426 DOI: 10.1016/j.ortho.2019.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND DATA Enamel microcrack formation has a high incidence after mechanical debonding of ceramic brackets. This may be due to high delivered shear bond strength values when enamel is priorly etched by phosphoric acid. It is still not well elucidated in the literature if laser etching affects enamel the same way. The aim of the research was to analyze different Er,Cr:YSGG and Er:YAG laser etching settings as an alternative to phosphoric acid, in an attempt to prevent enamel microcrack formation during laser etching and mechanical debonding, while reducing the shear bond strength to the minimal clinical acceptable value. MATERIALS AND METHODS One hundred and thirty-three teeth were randomly divided into 7 experimental groups according to their etching modalities. Settings used for enamel etching were in Er,Cr:YSGG groups: Er,Cr:YSGG (1.5Watt, W/20Hertz, Hz); Er,Cr:YSGG (1.5W/15Hz) and Er,Cr:YSGG (2W/20Hz) and settings used for enamel etching in Er:YAG groups were: Er:YAG (60 millijoules, mJ), Er:YAG (80mJ) and Er:YAG (100mJ). Group C etched with 37% phosphoric acid served as control. Microscopic analysis was performed to assess presence of enamel microcracks. Shear bond strength was evaluated after thermocycling using Weibull survival analysis. RESULTS All groups showed a reduction in additional microcracks after debonding when compared to control, but only group Er:YAG (60mJ) exhibited a statistically significant difference. Groups Er:YAG (80mJ), control and Er:YAG (100mJ) showed respectively the highest probability of survival at various stress levels followed by groups Er:YAG (60mJ); Er,Cr:YSGG (1.5W/15Hz); Er,Cr:YSGG (2W/20Hz) and Er,Cr:YSGG (1.5W/20Hz) that presented a relatively considerable risk of failure, even at low stress levels. CONCLUSIONS When considering reduction of enamel microcrack formation and clinical acceptable shear bond strength, none of the groups succeeded both. Etching by Er:YAG (60mJ) and Er,Cr:YSGG (1.5W/15Hz), showed the least overall microcrack incidence between groups, but Er:YAG (60mJ) displayed significant reduction compared to phosphoric acid. However, etching by Er:YAG (80mJ) had the most predictable results in term of shear bond strength.
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Affiliation(s)
- Marwan Hoteit
- Lebanese University, Faculty of Dental Medicine, Department of Orthodontics, Hadath, Lebanon.
| | - Samir Nammour
- University of Liege, Faculty of Medicine, Department of Dental Science, 4020 Liege, Belgium
| | - Toni Zeinoun
- Lebanese University,Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Lebanon
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Dumbryte I, Vebriene J, Linkeviciene L, Malinauskas M. Enamel microcracks in the form of tooth damage during orthodontic debonding: a systematic review and meta-analysis of in vitro studies. Eur J Orthod 2019; 40:636-648. [PMID: 29474541 DOI: 10.1093/ejo/cjx102] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives To evaluate and compare the enamel microcracks (EMCs) characteristics (qualitative and quantitative) in the form of tooth damage before and after debonding from human teeth of in vitro studies. Eligibility criteria Laboratorial studies evaluating EMCs characteristics before and after debonding metal and ceramic brackets from human teeth with intact buccal enamel. Information sources An electronic search of four databases (all databases of the Cochrane Library, CA Web of Science, MEDLINE via PubMed, and Google Scholar) and additional manual searches were carried out, without language restrictions. Studies published between 2000 and 2017 years were selected. Reference lists of the included articles were screened, and authors were contacted when necessary. Risk of bias The following six parameters were analyzed: blinding of examiner and outcome assessment, incomplete outcome data before bonding and after debonding, selective outcome reporting, and incomplete reporting of EMCs assessment. Included studies Out of 430 potentially eligible studies, 259 were screened by title and abstract, 180 were selected for full-text analysis, 14 were included in the systematic review. Seven studies were selected for the meta-analysis. Synthesis of results The results for EMCs characteristics were expressed as mean differences (MDs) with their 95 per cent confidence intervals (CIs), and calculated from random-effects meta-analyses. Debonding was associated with the increase in number (three studies, MD = 3.50, 95% CI, 2.13 to 4.87, P < 0.00001), length (seven studies, MD = 3.09 mm, 95% CI, 0.75-5.43, P < 0.00001), and width (three studies, MD = 0.39 µm, 95% CI, -0.01 to 0.79, P = 0.06) of EMCs. Considerable statistical heterogeneity was found for two forest plots evaluating the changes of number and length characteristics during debonding. Conclusions There is weak evidence indicating length and width of EMCs increase following bracket removal and the scientific evidence concerning quantitative evaluation of the number parameter before and after debonding is insufficient. However, there is a strong evidence that after debonding the number of EMCs is likely to increase. Registration No registration was performed.
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Dumbryte I, Linkeviciene L, Linkevicius T, Malinauskas M. Does orthodontic debonding lead to tooth sensitivity? Comparison of teeth with and without visible enamel microcracks. Am J Orthod Dentofacial Orthop 2017; 151:284-291. [PMID: 28153157 DOI: 10.1016/j.ajodo.2016.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Our aim was to assess the possible changes in sensitivity of teeth with and without visible enamel microcracks (EMCs) up to 1 week after the removal of metal brackets. METHODS After debonding, 15 patients possessing teeth with visible EMCs and 15 subjects whose teeth were free of EMCs were enrolled in the study. For each experimental group, a control group was formed. The assessments of tooth sensitivity elicited by compressed air and cold testing were performed 5 times: just before debonding, immediately after debonding, and at 1, 3, and 7 days after debonding. Tooth sensitivity was recorded on a 100-mm visual analog scale. RESULTS For the patients without visible EMCs, discomfort peaked immediately after debonding and started to decrease on day 1; at 1 week after debonding, the visual analog scale scores were lower than just before debonding and immediately after debonding. For the subjects possessing teeth with visible EMCs, the pattern of sensitivity dynamic was inherently the same. However, the patients with visible EMCs showed higher visual analog scale values at each time interval. CONCLUSIONS Debonding leads to a short-term increase in tooth sensitivity. EMCs, a form of enamel damage, do not predispose to greater sensitivity perception in relation to bracket removal.
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Affiliation(s)
| | - Laura Linkeviciene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Linkevicius
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Mangirdas Malinauskas
- Department of Quantum Electronics, Physics Faculty, Vilnius University, Vilnius, Lithuania
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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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Rocha RS, Salomão FM, Silveira Machado L, Sundfeld RH, Fagundes TC. Efficacy of auxiliary devices for removal of fluorescent residue after bracket debonding. Angle Orthod 2016; 87:440-447. [PMID: 28035838 DOI: 10.2319/081916-629.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate four protocols for removal of fluorescent materials after bracket debonding. MATERIALS AND METHODS Resin removal from 40 bovine enamel surfaces was performed according to groups (n = 10): conventional (C), white LED (W), LED that evidenced fluorescence (F), and fluorescent lens (FL). The following analyses were performed: sample thickness, superficial area of resin residue, and areas of resin residue or worn enamel in depth. ANOVA and Tukey tests were used to analyze sample thickness (P ≤ .05). Area measurements were analyzed by Kruskal-Wallis and Dunn's tests (P ≤ .05). RESULTS The FL group showed the highest reduction in enamel thickness. F group final thickness was similar to that of other groups. The largest superficial areas of resin residue were found for the C and W groups, while the FL group had the greatest removal of resin residue. The C group exhibited the largest area in depth of resin residue. The FL and F groups exhibited the most loss of enamel with the least amount of resin residue; in contrast, the C and W groups presented the fewest areas of worn enamel and the most areas of resin residue. CONCLUSION Auxiliary devices were useful for removal of fluorescent residue after bracket debonding.
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