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Suitability of orthodontic brackets for rebonding and reworking following removal by air pressure pulses and conventional debracketing techniques
Authors:Michael Knsel  Simone Mattysek  Klaus Jung  Dietmar Kubein-Meesenburg  Reza Sadat-Khonsari  Dirk Ziebolz
Abstract:Aim:To test the null hypothesis that there are no significant differences in the reusability of debonded brackets with regard to debonding technique and adhesive used.Method:Ninety-six osteotomed third molars were randomly assigned to two study groups (n  =  48) for bonding of a 0.018-inch bracket (Ormesh, Ormco) with either a composite adhesive (Mono-Lok2; RMO) or a glass ionomer cement (GIC; Fuji Ortho LC;GC). Each of these two groups were then randomly divided into four subgroups (n  =  12) according to the method of debonding using (1) bracket removal pliers (BRP; Dentaurum), (2) a side cutter (SC; Dentaurum), (3) a lift-off debracketing instrument (LODI; 3M-Unitek), or (4) an air pressure pulse device (CoronaFlex; KaVo). The brackets were subsequently assessed visually for reusability and reworkability with 2× magnification and by pull testing with a 0.017- × 0.025-inch steel archwire. The proportions of reusable brackets were individually compared in terms of mode of removal and with regard to adhesives using the Fisher exact test (α  =  5%).Results:The null hypothesis was rejected. Not taking into account the debonding method, brackets bonded with GIC were judged to a significant extent (81%; n  =  39; P < .01) to be reworkable compared with those bonded with composite (56%; n  =  27). All brackets in both adhesive groups removed with either the LODI or the CoronaFlex were found to be reusable, whereas 79% (46%) of the brackets removed with the BRP (SC) were not. The proportion of reusable brackets differed significantly between modes of removal (P < .01).Conclusion:With regard to bracket reusability, the SC and the BRP cannot be recommended for debonding brackets, especially in combination with a composite adhesive.
Keywords:Debonding  Rebonding  Bracket reusability  CoronaFlex
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