Impulse debracketing compared to conventional debonding.

OBJECTIVE: To evaluate impulse debonding compared to three conventional methods for bracket removal in relation to the damage caused to the enamel surface. MATERIALS AND METHODS: Ninety-six osteotomed third molars were randomly assigned to two study groups (n = 48) for bracket bonding with either a composite adhesive system (CAS) or a glass-ionomeric cement (GIC). These two groups were then each randomly divided into four subgroups (n = 12) according to the method of debonding using (1) bracket removal pliers, (2) a side-cutter, (3) a lift-off debracketing instrument, or (4) an air pressure pulse device. Following debonding and corresponding postprocessing with either a finishing bur (CAS) or ultrasound (GIC), the enamel surfaces were assessed for damage, adhesive residues, and the need for postprocessing using scanning electron microscopy and the Adhesive Remnant Index, and the surfaces were compared in terms of mode of removal and type of adhesive using Fisher's exact test (alpha = 5%). RESULTS: No significant differences were found between the two different types of adhesives (CAS, GIC) in terms of the amount of damage to the enamel. Portions of enamel damage were found for impulse debonding/0%

Suitability of orthodontic brackets for rebonding and reworking following removal by air pressure pulses and conventional debracketing techniques.

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 2x magnification and by pull testing with a 0.017- x 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 (alpha = 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.