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Enamel loss following ceramic bracket debonding: A quantitative analysis in vitro
Authors:Sam N Suliman  Terry M Trojan  Daranee Tantbirojn  Antheunis Versluis
Abstract:Objective:To measure enamel surface changes after ceramic bracket debonding and after cleanup.Materials and Methods:Forty extracted teeth were scanned in three dimensions using an optical scanner (baseline). Two ceramic bracket systems were placed (19 metal-reinforced polycrystalline ceramic brackets; 21 monocrystalline ceramic brackets). Seven days later, brackets were debonded and teeth scanned (post-debond). Adhesive remnants and bracket fragments were recorded. Tooth surfaces were cleaned using a finishing carbide bur and scanned again (post-cleanup). Post-debond and post-cleanup scans were aligned with the baseline, and surface changes were quantified. Results were statistically compared using t-tests and Mann-Whitney tests (α  =  .05).Results:The depth of enamel loss (mean ± standard deviation) post-debond was 21 ± 8 µm and 33 µm and post-cleanup was 28 ± 14 µm and 18 ± 8 µm (P  =  .0191); the post-debond remnant thickness was 188 ± 113 µm and 120 ± 37 µm (P  =  .2381) and post-cleanup was 16 ± 5 µm and 15 µm for polycrystalline and monocrystalline ceramic brackets, respectively. The monocrystalline ceramic brackets predominantly left all adhesive on the tooth; the polycrystalline ceramic brackets were more likely to leave bracket fragments attached.Conclusion:Both systems allowed successful removal of the brackets with minimal enamel loss. However, the polycrystalline ceramic brackets left more fragments on the tooth, which complicated cleanup efforts.
Keywords:Enamel loss  Debonding  Ceramic bracket  Dental finishing  Digital scan
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