Enamel Surface Damage following Debonding of Ceramic Brackets: A Hospital-Based Study.

METHODS: The current study includes 80 extracted premolars of human from the patient visiting for orthodontic treatment of Coorg Institute of Dental Sciences, Karnataka, India. The brackets were debonded using four different methods. The enamel surface damage after the procedure was assessed with the Enamel Surface Index (ESI); similarly, the Adhesive Remnant Index (ARI) score was used to determine the adhesive residual deposit. Scanning electron microscopy (SEM) was used to visualize better microporosities and micromechanical retention of adhesive remnants on the enamel surface. The normality of the data was tested using the Kolmogorov-Smirnov test. Depending upon the normality test result, the one-way ANOVA test or Kruskal-Wallis test was used to test the mean ESI and mean ARI differences among different debonding methods along with the appropriate post hoc tests. The necessary ethical clearance was obtained from the Ethics Committee of the institute. RESULTS: The ultrasonic scaler (US) technique led to more significant enamel surface damage, with 13 (65%) samples in the ESI scores III and IV against the satisfactory surface in 2 (10%) samples with the ligature cutter (LC) technique (ESI-I) reflecting LC as a better technique. The ESI scores (III and IV) for debonding plier (DP) and thermal method (TM) reflected a higher value in 12 (60%) and 10 (50%) samples and caused more damage to the enamel surface as compared to the LC technique. The ARI score was highest (ARI-1 = 40%) with the LC technique, followed by the US (ARI-1 = 20%), TM (ARI-1 = 15%), and DP (ARI-1 = 5%) methods. We have observed a significant association (p value <0.05) of the ARI score among four different debonding ways in terms of each tooth's residual adhesive after the bracket removal. CONCLUSION: The result establishes the LC technique as a more acceptable one as it causes minimal harm to the debonded surface. The adhesive left on the debonded area is also minimum as compared to the other three methods tested. Therefore, it can be suggested as an ideal method.

Evaluation of Time Consumption for Debonding Brackets Using Different Techniques: A Hospital-Based Study.

Materials and Methods: A total of 80 human premolars were included in this study. The samples were first arranged following a standard protocol for bracketing and then debonded using the ultrasonic scaler (US), debonding plier (DP), ligature cutter (LC), and thermal method (TM). Depending on the technique applied for debonding, the specimens were randomly divided into four groups with 20 samples, each keeping a 1 : 1 ratio. During the debonding process, the time taken for each bracket removal was recorded using a stopwatch. To assess the difference in mean time required for debonding among the four techniques, one-way ANOVA test was applied along with Tukey's HSD to compare the two methods. Results: The time range and the mean time required for the four techniques analyzed show that the DP method has the highest range of time needed for debonding with 0.97-2.56 seconds, while LC methods have the least time range taking 0.46 to 1.79 seconds. TM's mean time to debond is the highest at 1.5880 seconds. LC method has the lowest mean debonding time of 0.9880 seconds. The one-way ANOVA test has shown the mean debonding time required by the four techniques to be significantly different (p < 0.001). Tukey's HSD multiple comparisons also show that the mean time to debond using the LC method is substantially less than the other three methods (p < 0.001). Conclusion: The mean debonding time for the TM was substantially the highest, followed by the US and DP. Debonding with the LC technique required the least time. This study shows some limelight towards the effectiveness of the LC method as it is the least time-consuming technique.