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1.
Am J Orthod Dentofacial Orthop ; 159(2): e103-e111, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33390312

RESUMO

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.


Assuntos
Colagem Dentária , Braquetes Ortodônticos , Dente Pré-Molar , Cerâmica , Descolagem Dentária/efeitos adversos , Esmalte Dentário , Humanos , Braquetes Ortodônticos/efeitos adversos
2.
Angle Orthod ; 90(6): 758-765, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378510

RESUMO

OBJECTIVES: To evaluate the effects of adhesive precoated (APC) flash-free brackets on the level of pain, amount of remnant adhesive, and removal time during the debonding procedure. MATERIALS AND METHODS: Thirty patients (20 female, 10 male) aged 12 to 18 years undergoing nonextraction fixed orthodontic treatment were included in this study. APC flash-free and conventional ceramic brackets were bonded with a split-mouth study design. Bracket types were randomly allocated to quadrants. During the removal of the brackets, the visual analogue scale (VAS) was used to assess the level of pain for each tooth. The adhesive remnant index (ARI) was used to determine the amount of adhesive remaining on the tooth surface. Adhesive removal times were calculated per quadrant. The data were analyzed using the Wilcoxon test for comparisons between groups. RESULTS: Pain scores were generally higher for the conventional group than for the flash-free group. There were no differences in VAS scores across most tooth types during debonding. Overall, ARI results showed more adhesive remnants in the conventional bracket group (P < .001). Except for the right maxillary quadrant, the times required to remove the adhesive were significantly longer for the flash-free brackets than the conventional brackets (P ≤ .005). CONCLUSIONS: Although removal time was slightly longer for the flash-free adhesive than for the conventional adhesive, lower pain scores were generally observed for the flash-free adhesive brackets during the debonding procedure. Both time and pain differences could be considered clinically insignificant.


Assuntos
Colagem Dentária , Braquetes Ortodônticos , Adolescente , Cerâmica , Criança , Cimentos Dentários , Descolagem Dentária , Feminino , Humanos , Masculino , Teste de Materiais , Boca , Dor
3.
J Orofac Orthop ; 81(6): 419-426, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32696069

RESUMO

OBJECTIVE: To evaluate enamel roughness and color after debonding flash-free adhesive precoated brackets and brackets coated with conventional orthodontic adhesives using nonbonded enamel as control. MATERIALS AND METHODS: A total of 80 extracted human premolars were divided into the following four groups: group I: APCTM Flash-Free adhesive precoated brackets; group II: APCTM PLUS adhesive precoated brackets; group III: noncoated brackets, which were coated manually at the time of bonding (all three brackets were ClarityTM Advanced ceramic brackets [3M Unitek, Monrovia, CA, USA]); group IV: nonbonded enamel (control). Bonded premolars were subjected to demineralization, and then brackets were debonded. Each group was then divided into two subgroups to assess enamel around the debonded brackets, and also enamel in the control group, using an atomic force microscope and spectrophotometer. In addition, 12 samples were used to assess the bracket/adhesive/enamel junction with a scanning electron microscope. RESULTS: Mean values of root mean square roughness (Rq) and maximum profile valley depth (Rv) for APCTM Flash-Free, APCTM PLUS, and ClarityTM Advanced groups were 140 nm and 482 nm, 210 nm and 727 nm, and 447 nm and 1243 nm, respectively. All three groups showed higher roughness and depth values than the control enamel. Spectrophotometer results yielded ∆E* of 3.7 ± 0.6, 5.1 ± 0.4, and 7.1 ± 0.6 for APC™ Flash-Free, APC™ PLUS, and ClarityTM Advanced groups respectively. Color coordinates showed progressively higher L* and b* values and progressively lower a* values from group I to group III. CONCLUSIONS: Under the same demineralization conditions, enamel around debonded APC™ Flash-Free adhesive precoated brackets showed less roughness and color changes compared to the other two groups.


Assuntos
Colagem Dentária , Braquetes Ortodônticos , Cimentos Dentários , Descolagem Dentária , Esmalte Dentário , Humanos , Teste de Materiais , Cimentos de Resina
4.
J Esthet Restor Dent ; 32(7): 634-637, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32643229

RESUMO

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.


Assuntos
Colagem Dentária , Braquetes Ortodônticos , Descolagem Dentária , Esmalte Dentário , Microscopia Eletrônica de Varredura , Propriedades de Superfície
5.
Niger J Clin Pract ; 23(7): 900-905, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620717

RESUMO

Objectives: This study aims to investigate the effects of various mouthwashes on bacteremia development following a debonding process, which is performed after orthodontic treatment. Subjects and Methods: The study included patients who received fixed orthodontic treatment and were indicated for debonding. A total of 40 patients in four groups were selected for the study; no mouthwash (Group 1), mouthwash containing 0.12% chlorhexidine-gluconate (Group 2), mouthwash containing essential-oils (Group 3), and mouthwash containing 7.5% povidone-iodine (Group 4). Before (T0) and following (T1) the debonding procedure, blood samples were obtained from the patients. Then, the blood samples were placed in blood culture bottles to investigate bacterial growth. Results: Based on the results of the study, it was determined that the blood samples obtained at T0did not indicate any bacterial growth. Furthermore, it was observed that the blood samples obtained at T1included Streptococcus viridans, Streptococcus oralis, Streptococcus mutans, and Staphylococcus aereus growth, respectively, in 4 patients from Group 1 while Streptococcus salivarius growth was observed in 1 patient from Group 3 in addition to Streptococcus mitis growth in 1 patient from Group 4. No bacterial growth was observed in Group 2. While the results obtained between Group 1 and Group 2 were statistically significant, no statistically significant difference was observed between other groups. Conclusions: Finally, it was determined that the mouthwash 0.12% chlorhexidine-gluconate was statistically significant in comparison to the control group. It can be concluded that this mouthwash can be used to decrease bacterial density in oral flora before debonding procedures.


Assuntos
Anti-Infecciosos Locais/farmacologia , Bacteriemia/tratamento farmacológico , Clorexidina/análogos & derivados , Antissépticos Bucais/farmacologia , Staphylococcus/efeitos dos fármacos , Streptococcus/efeitos dos fármacos , Adulto , Clorexidina/farmacologia , Descolagem Dentária , Feminino , Humanos , Masculino , Staphylococcus/classificação , Staphylococcus/isolamento & purificação , Streptococcus/classificação , Streptococcus/isolamento & purificação , Resultado do Tratamento
6.
Am J Orthod Dentofacial Orthop ; 158(3): 330-342, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32682661

RESUMO

The purpose of this critical review is to list the sources of aerosol production during orthodontic standard procedure, analyze the constituent components of aerosol and their dependency on modes of grinding, the presence of water and type of bur, and suggest a method to minimize the quantity and detrimental characteristics of the particles comprising the solid matter of aerosol. Minimization of water-spray syringe utilization for rinsing is suggested on bonding related procedures, while temporal conditions as represented by seasonal epidemics should be considered for the decision of intervention scheme provided as a preprocedural mouth rinse, in an attempt to reduce the load of aerosolized pathogens. In normal conditions, chlorhexidine 0.2%, preferably under elevated temperature state should be prioritized for reducing bacterial counts. In the presence of oxidation vulnerable viruses within the community, substitute strategies might be represented by the use of povidone iodine 0.2%-1%, or hydrogen peroxide 1%. After debonding, extensive material grinding, as well as aligner related attachment clean-up, should involve the use of carbide tungsten burs under water cooling conditions for cutting efficiency enhancement, duration restriction of the procedure, as well as reduction of aerosolized nanoparticles. In this respect, selection strategies of malocclusions eligible for aligner treatment should be reconsidered and future perspectives may entail careful and more restricted utilization of attachment grips. For more limited clean-up procedures, such as grinding of minimal amounts of adhesive remnants, or individualized bracket debonding in the course of treatment, hand-instruments for remnant removal might well represent an effective strategy. Efforts to minimize the use of rotary instrumentation in orthodontic settings might also lead the way for future solutions. Measures of self-protection for the treatment team should never be neglected. Dressing gowns and facemasks with filter protection layers, appropriate ventilation and fresh air flow within the operating room comprise significant links to the overall picture of practice management. Risk management considerations should be constant, but also updated as new material applications come into play, while being grounded on the best available evidence.


Assuntos
Descolagem Dentária , Ortodontia , Aerossóis , Esmalte Dentário , Humanos , Pandemias
7.
BMC Oral Health ; 20(1): 142, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410609

RESUMO

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.


Assuntos
Descolagem Dentária , Microscopia Confocal , Braquetes Ortodônticos , Cimentos de Resina/análise , Esmalte Dentário , Humanos , Teste de Materiais , Propriedades de Superfície
8.
Adv Clin Exp Med ; 29(5): 557-563, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32396714

RESUMO

BACKGROUND: In orthodontics, erbium (Er:YAG) lasers can be used for bracket debonding. OBJECTIVES: To assess the changes in temperature of pulp and enamel during laser debonding of brackets. MATERIAL AND METHODS: A total of 13 brackets (n = 13; 2 metal and 11 ceramic brackets) were bonded to 13 caries-free premolars extracted for orthodontic reasons. Brackets were irradiated with 2 lasers. Laser No. 1 was an erbium-chromium (Er,Cr:YSGG) laser (Waterlase Express; Biolase, Irvine, USA) with a wavelength of 2,780 nm at a power of 2.78-2.85 W, energy of 185-190 mJ, fluence of 10 ns, frequency of 25 Hz, pulse duration of 300 µs, tip diameter of 0.6 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-25 s. Laser No. 2 was an Er:YAG laser (LiteTouch; Light Instruments Ltd., Yokneam, Israel) with a wavelength of 2,940 nm at a power of 4 W, energy of 200 mJ, fluence of 10 ns, frequency of 20 Hz, pulse duration of 300 µs, tip diameter of 0.8 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-15 s. Two thermographic cameras (FLIR Zenmuse XT and FLIR P65; FLIR Systems, Wilsonville, USA) and type K thermocouple (Zhangzhou Weihua Electronic Co., Fujian, China) were used for precise temperature measurement on the surface of the teeth and inside them. RESULTS: When laser No. 1 was in use, the mean difference between the inner and outer temperature of the examined teeth (1.4°C) was higher than when the laser No. 2 was in use (0.6°C) (p = 0.0974). The study found that the temperature inside the tooth did not increase, and it even decreased during treatment with Er:YAG laser using water cooling, provided that appropriate proportion of water and air was used. For laser No. 1, confidence interval (CI) was between 0.7 and 2.2 and for laser No. 2 it was between 0.500 and 1.23. Only experiment for ceramic brackets was described. CONCLUSIONS: These findings confirm that the use of Er:YAG family lasers for orthodontic bracket debonding in an in vitro study is safe and effective.


Assuntos
Cerâmica , Descolagem Dentária/métodos , Lasers de Estado Sólido , Braquetes Ortodônticos , Temperatura , China , Descolagem Dentária/instrumentação , Humanos , Metais/química
9.
Dent Mater J ; 39(3): 367-374, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31827057

RESUMO

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.


Assuntos
Descolagem Dentária , Braquetes Ortodônticos , Cimentos Dentários , Esmalte Dentário , Propriedades de Superfície
10.
Braz. dent. sci ; 23(4): 1-8, 2020. ilus, tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1122559

RESUMO

Objective: The objective of this study was to determine whether recently developed fiber reinforced composite burs provided better results by comparing tooth discoloration after debonding of orthodontic brackets. Material and Methods: A split-mouth, randomized controlled trial was carried out in one orthodontic office; including 23 patients with intact, vital and caries-free four upper incisors aged 12 to 30 years who completed their fixed orthodontic treatment. For each patient, upper central and lateral incisors on each side of the mouth were randomly selected to remove the adhesive with either a tungsten carbide bur (TC) (n = 46) or a fiber-reinforced composite bur (FC) (n=46). Color evaluation of each tooth was conducted at two time points: immediately after finishing and polishing procedure and two months afterwards. The primary outcome would be the amount of color change in each group during the post treatment phase. The participants, the person assessing the color change and the statistician were blinded to TC group assignment. Color changes in each group were analyzed with the Paired T-test. The color change corresponding to the resin removal method was also statistically analyzed with the Independent T-test at α=0.05 as the level of significance. Results: 86 teeth, 43 in each group, were analyzed. The ΔE value was 3.713±1.161, for teeth finished TC and 2.114±0.514 for teeth finished with FC (p<0.01). Conclusion: Adhesive removal with FC bur results in a more color-resistant tooth surface in comparison with tungsten carbide bur. (AU)


Objetivo: O objetivo deste estudo foi determinar se as brocas de material compósito reforçadas com fibras, recentemente desenvolvidas, proporcionam melhores resultados, pela comparação da descoloração dentária após a remoção de braquetes ortodônticos. Material e Métodos: Um ensaio clínico controlado randomizado com boca dividida foi realizado em um consultório ortodôntico, incluindo 23 pacientes, com idade entre 12 e 30 anos, com incisivos superiores intactos, vitais e livres de cárie, que completaram o tratamento ortodôntico com aparelho fixo. Para cada paciente, incisivos centrais e laterais superiores de cada lado da boca foram selecionados aleatoriamente para remover o adesivo ortodôntico com uma broca carbide de tungstênio (TC) (n = 46) ou uma broca de compósito reforçada com fibra (FC) (n = 46). A avaliação da cor de cada dente foi realizada em dois momentos: imediatamente após o acabamento e polimento e dois meses após. O resultado primário foi a quantidade de mudança de cor em cada grupo durante a fase pós-tratamento. Os participantes, a pessoa que avaliou a mudança de cor e o estatístico não tinham conhecimento da atribuição ao grupo TC. As mudanças de cor em cada grupo foram analisadas com o teste-t pareado. A mudança de cor correspondente ao método de remoção da resina também foi analisada estatisticamente com o teste-t independente considerando um nível de significância α = 0,05. Resultados: foram analisados 86 dentes, 43 em cada grupo. O valor de ΔE foi 3,713 ± 1,161, para dentes finalizados com broca TC e 2,114 ± 0,514 para dentes finalizados com broca FC (p <0,01). Conclusão: A remoção do adesivo com broca FC resulta em uma superfície de dente mais resistente à cor em comparação com a broca carbide de tungstênio (AU)


Assuntos
Humanos , Adulto , Descoloração de Dente , Descolagem Dentária , Aparelhos Ortodônticos Fixos
11.
Ortho Sci., Orthod. sci. pract ; 13(51): 75-81, 2020. tab
Artigo em Português | BBO - Odontologia | ID: biblio-1128536

RESUMO

A descolagem de bráquetes ortodônticos são frequentes na prática clínica. O conhecimento dos fatores associados à descolagem é relevante para maior efetividade clínica na movimentação dentária. Este estudo teve por objetivo avaliar a ocorrência de descolagem de bráquetes e fatores associados em pacientes que concluíram tratamento ortodôntico. Foram avaliados os prontuários de 205 pacientes de uma clínica privada tratados ortodonticamente por um único operador entre 2000 e 2013, nos quais foram utilizados o mesmo tipo de bráquete e sistema adesivo para a colagem. Para a análise univariada foram utilizadas tabelas de frequências e médias de tendência central e dispersão. Na análise bivariada foram utilizadas tabelas de dupla entrada e teste Qui-quadrado ou Exato de Fisher. Em 45,9% dos pacientes não ocorreu descolagem de bráquetes durante todo o tratamento ortodôntico. Dos 54,1% pacientes que descolaram bráquetes, 46,3% descolaram de um a cinco bráquetes. Houve associação entre a descolagem e o tempo de tratamento. O dente que apresentou maior frequência de descolagem de bráquete foi o pré-molar inferior (44,7%). Descolagens ocorreram em 54,1% dos pacientes ao longo de todo o tratamento ortodôntico e houve associação entre descolagem e tempo de tratamento. (AU)


Introduction: Orthodontic brackets debonding is common in clinical practice. The knowledge of the factors associated to bracket debonding is relevant for greater clinical effectiveness in tooth movement. Objective: This study aimed to evaluate the occurrence of brackets debonding and associated factors in patients who completed orthodontic treatment. Material and Methods: The records of 205 orthodontic patients from a private clinic treated by a single operator between 2000 and 2013 were analysed, the same type of bracket and adhesive system were used for the bonding. For univariate analysis, tables of frequency and average of central tendency and dispersion were used. In the bivariate analysis were used double-entry tables and Chi-square test or Fisher's exact test. Results: There was no bonding failure of brackets in 45.9% of the patients during the entire orthodontic treatment. Of the 54.1% patients with bonding failure, 46.3% occurred in one to five brackets. There was an association between debonding and treatment time. The tooth with the highest bracket debonding frequency was the lower premolar (44.7%). Conclusions: Orthodontic brackets bonding failure occurred in 54.1% of patients throughout the orthodontic treatment and was associated with treatment time. (AU)


Assuntos
Humanos , Aparelhos Ortodônticos , Ortodontia , Descolagem Dentária
12.
PLoS One ; 14(11): e0223924, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31689289

RESUMO

BACKGROUND: When implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval. MATERIAL AND METHODS: Twenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten cemented crowns were removed at 48 hours after cementation as a short-term group (ST), while another 10 were removed 6 months after cementation as a long-term group (LT). To mimicking repetitive recementation and retrieval, the LT crowns were then recemented and removed after 48 hours as a long-term recemention (LTR) group. The LTR crowns were then again recemented and removed after 48 hours as a long-term repeated recemention (LTRR) group. Er:YAG laser was used to facilitate the retrieval of these crowns. recorded and analyzed using ANOVA and t-test. The surfaces of the crown and the abutment were further examined using light microscopy and scanning electron microscopy (SEM). Temperature changes of the abutment and crown upto 10 minutes were also measured and statistically analyzed (paired t-test). RESULTS: The average times of crown removal from zirconia abutments were 4 minutes (min) and 42 second (sec) in LT to 3 min 24 sec in LTR, and 3 min 12 sec in LTRR and ST groups. LTR took the longest time to remove, statistically (ANOVA and t-test, p < .001). No statistical differences were observed among the removal times of LTR, LTRR, and ST groups (t-test, p = .246, .246 and 1). SEM examination of the material surface showed no visual surface damaging from treatment with Er:YAG laser. The temperatures during irradiation ranged from 18.4°C to 20°C and 22.2°C to 24.5°C (Paired t-test, p < .0001) for the abutment and the crown during irradiation from 1 min to 10 mins. CONCLUSIONS: Long-term cementation can increase time in lithium disilicate crown removal from zirconia abutment using Er:YAG. Er:YAG laser is a non-invasive tool to remove cement-retained implant prostheses and should be considered as a viable alternative to rotary instruments.


Assuntos
Coroas , Dente Suporte , Descolagem Dentária/métodos , Lasers de Estado Sólido/uso terapêutico , Cimentos Dentários , Implantes Dentários , Instrumentos Odontológicos , Porcelana Dentária , Reparação de Restauração Dentária/métodos , Remoção de Dispositivo/métodos , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Zircônio
13.
Int Orthod ; 17(4): 744-757, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31543426

RESUMO

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.


Assuntos
Colagem Dentária/métodos , Descolagem Dentária/métodos , Esmalte Dentário , Corrosão Dentária/métodos , Braquetes Ortodônticos , Resistência ao Cisalhamento , Fraturas dos Dentes/patologia , Condicionamento Ácido do Dente , Cerâmica , Esmalte Dentário/ultraestrutura , Análise do Estresse Dentário , Humanos , Lasers de Estado Sólido , Teste de Materiais , Ácidos Fosfóricos , Análise de Regressão , Propriedades de Superfície
14.
Shanghai Kou Qiang Yi Xue ; 28(2): 136-140, 2019.
Artigo em Chinês | MEDLINE | ID: mdl-31384897

RESUMO

PURPOSE: To compare enamel surface state and operating time following debonding by using 5 different resin removal methods. METHODS: Forty healthy human premolars extracted for orthodontic purpose were selected and then divided into 5 groups randomly based on different resin-removal methods, 8 in each group. After regular bonding brackets and debonding, tungsten carbide bur (group A), tungsten carbide bur+silicon particles(group B), corundum bur(group C), corundum bur+silicon particles (group D) and silicon particles (group E) were used respectively to deal with the enamel surfaces. The operating time(T) of each group was recorded. The samples were observed under scanning electron microscope (SEM), and enamel damage index(EDI) was recorded. The scores of EDI were analysed using SPSS 20.0 software package . RESULTS: The order of EDI was group C>group D>group A >group B>group E, significant difference was found between 5 groups (P<0.05). The order of operating time was group E>group D>group B>group A>group C, significant difference was found between 5 groups (P<0.05). CONCLUSIONS: Using tungsten carbide bur followed by silicon particles to remove residual resin on enamel surface causes less damage to the enamel surface, and requires reasonable time.


Assuntos
Colagem Dentária , Descolagem Dentária , Braquetes Ortodônticos , Resinas Acrílicas , Dente Pré-Molar , Esmalte Dentário , Humanos , Microscopia Eletrônica de Varredura , Distribuição Aleatória , Propriedades de Superfície
15.
Prog Orthod ; 20(1): 26, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31281954

RESUMO

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.


Assuntos
Braquetes Ortodônticos , Dente Pré-Molar , Descolagem Dentária , Reprodutibilidade dos Testes
16.
Angle Orthod ; 89(6): 876-882, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31206307

RESUMO

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.


Assuntos
Descolagem Dentária , Braquetes Ortodônticos , Animais , Bovinos , Esmalte Dentário , Fluorescência , Humanos , Propriedades de Superfície
17.
Am J Orthod Dentofacial Orthop ; 155(6): 767-778, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31153497

RESUMO

INTRODUCTION: The aim of this laboratory and randomized clinical trial was to investigate particulate production at debonding and enamel clean-up following the use of flash-free ceramic brackets and to compare them with non-flash-free metal and ceramic brackets. METHODS: In the laboratory study, brackets were bonded to bovine teeth. After 24 hours of immersion in water, the brackets were debonded, the adhesive remnant scores noted, and the enamel cleaned with the use of rotary instruments. Four bracket-adhesive combinations and 2 different enamel pretreatment regimens were tested, including metal and ceramic brackets (conventional, adhesive precoat [APC], and APC flash-free) and conventional acid etch and self-etching primer. Quantitative (mg/m3) and qualitative analysis of particulate production was made in each case. In the clinical trial, 18 patients treated with the use of fixed appliances were recruited into this 3-arm parallel-design randomized controlled trial. They were randomly allocated to 1 of 3 groups: experimental flash-free ceramic bracket or non-flash-free ceramic or metal bracket group. Eligibility criteria included patients undergoing nonextraction maxillary and mandibular fixed appliance therapy. At completion of treatment, the brackets were debonded, and the primary outcome measure was particulate concentration (mg/m3). Randomization was by means of sealed envelopes. Data were analyzed with the use of quantile plots and linear mixed models. The effect of etch, bracket, and stage of debonding of clean-up on particle composition was analyzed with the use of mixed-effects regression. RESULTS: In the laboratory study, the APC brackets produced the highest particulate concentration. Although statistically significantly higher than the metal and conventional ceramic brackets, it was not significantly higher than the ceramic flash-free brackets. In the clinical study, there was no statistically significant effect of bracket type on particulate concentration (P = 0.29). This was despite 3 patients with APC flash-free and 1 patient with conventional Clarity (with 1 bracket) having 1 or more ceramic bracket fracture at debonding requiring removal. No adverse events reported. CONCLUSIONS: Particulates in the inhalable, thoracic, and respirable fractions were produced at enamel clean-up with all bracket types. Although APC and APC flash-free brackets produced the highest concentrations in the laboratory study, there was no difference between any of the brackets in the clinical trial. REGISTRATION: The trial was not registered. FUNDING: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


Assuntos
Cerâmica/química , Cimentos Dentários/química , Descolagem Dentária/métodos , Aparelhos Ortodônticos Fixos , Braquetes Ortodônticos , Material Particulado/química , Animais , Bovinos , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Propriedades de Superfície
18.
Prog Orthod ; 20(1): 18, 2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31056715

RESUMO

BACKGROUND: Orthodontic bonding and debonding procedures involve risk of damaging the enamel surface and changing its original morphology. The rough surface inhibits proper cleaning, invites plaque deposition, bacterial retention, and stain formation thus dampening the esthetic appearance of the teeth. Restoring the enamel to its original morphology is a challenge. Researches on better adhesive removal methods which can effectively remove the residual resin and restore it best to its original form are continuing till date. No study has compared four contemporary finishing systems for their efficiency on a single platform. AIM: The objective of this study is to evaluate and compare enamel surface roughness after debonding using four different finishing and polishing systems. MATERIAL AND METHODS: Adhesive resin was removed from the buccal surface of 88 premolars after debonding with 4 groups. It included 22 teeth per group: group 1-One gloss system; group 2-Enhance finishing and polishing system; group 3-fiber reinforced stainbuster bur; and group 4-Soflex discs with wheels. Roughness was measured quantitatively and qualitatively with the help of surface roughness tester and scanning electron Microscope (SEM) respectively. RESULTS: No significant difference was found in baseline roughness in four groups. Highest post-polishing roughness was observed in Soflex group (4.62 µm) followed by One gloss system (3.36 µm), Enhance system (3.17 µm), and stainbuster bur (1.99 µm) (p value < 0.01). CONCLUSION: Stainbuster bur created the smoothest enamel surface that was close to the natural enamel followed by Enhance system, One gloss system, and Soflex disc and wheels.


Assuntos
Descolagem Dentária , Esmalte Dentário , Dente Pré-Molar , Propriedades de Superfície
19.
J Appl Oral Sci ; 27: e20180003, 2019 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-30624460

RESUMO

OBJECTIVE: The aim of this study was to evaluate patients' pain levels during four different debonding procedures. The null hypothesis was that the pain perception of the patients undergoing four different debonding applications was not statistically significant different. MATERIAL AND METHODS: One hundred and twenty orthodontic patients who underwent orthodontic debonding were included in this study. The patients were randomly divided into 4 groups according to technique used in the patients. Debonding groups were as follows: Group 1) Conventional debonding group, Group 2) Medication group (acetaminophen was given 1 hour before debonding), Group 3) Soft bite wax group, and Group 4) Soft acrylic bite wafer group. The patients' levels of anxiety and fear of pain were evaluated before debonding, and Numerical Rating Scale (NRS) was applied to evaluate their pain perception during debonding. Mann-Whitney U and Kruskal-Wallis tests were used to evaluate non-normally distributed data. Categorical data analysis were carried by chi-square and McNemar tests. The significance level was set at p<0.05. RESULTS: Anxiety scores of the patients were not statistically significant between both genders and debonding groups. In the quadrants in which the patients were perceived, the highest pain level was in the left side of the mandible. The teeth in which the highest pain level was perceived were the lower left and upper right lateral incisors. Although there was no statistically significant difference among the pain scores of the patients in each group, quadrant scores of female patients showed significant differences, being the lowest scores in the soft bite wax group. CONCLUSIONS: Majority of the patients had no fear of pain before debonding. Pain levels of the patients in the conventional debonding group were not significantly different from those of the other groups, except quadrant scores of females in the soft bite wax group. The null hypothesis was accepted.


Assuntos
Descolagem Dentária/efeitos adversos , Braquetes Ortodônticos/efeitos adversos , Percepção da Dor , Odontalgia/etiologia , Adolescente , Fatores Etários , Força de Mordida , Criança , Ansiedade ao Tratamento Odontológico/fisiopatologia , Descolagem Dentária/métodos , Descolagem Dentária/psicologia , Feminino , Humanos , Masculino , Medição da Dor/métodos , Estudos Prospectivos , Valores de Referência , Estatísticas não Paramétricas , Odontalgia/psicologia
20.
Angle Orthod ; 89(3): 438-445, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30653333

RESUMO

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.


Assuntos
Colagem Dentária , Descolagem Dentária , Braquetes Ortodônticos , Raios Ultravioleta , Cimentos Dentários , Esmalte Dentário , Humanos , Jordânia , Teste de Materiais , Cimentos de Resina , Propriedades de Superfície
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