Comparison of Enamel Surface Roughness after Bracket Debonding and Adhesive Resin Removal Using Different Burs with and without the Aid of a Magnifying Loupe
Ahmed A Thawaba, Nehal F Albelasy, Amira M Elsherbini, Ahmad M Hafez
Magnifying loupe, Profilometer, Scanning electron microscopy, Surface roughness
Citation Information :
Thawaba AA, Albelasy NF, Elsherbini AM, Hafez AM. Comparison of Enamel Surface Roughness after Bracket Debonding and Adhesive Resin Removal Using Different Burs with and without the Aid of a Magnifying Loupe. J Contemp Dent Pract 2022; 23 (11):1091-1099.
Aim: This study aimed to evaluate the impact of using a magnifying dental loupe on enamel surface roughness during adhesive resin removal by different burs.
Materials and methods: Ninety-six extracted premolar teeth were randomly divided according to the bur used with or without the aid of a magnifying loupe into four equal groups (N = 24): group I: naked eye tungsten carbide burs (NTC); group II: magnifying loupe tungsten carbide burs (MTC); group III: naked eye white stones (NWS); and group IV: magnifying loupe white stones (MWS). The initial surface roughness (Ra) T0 was evaluated using a profilometer, and the scanning electronic microscopy (SEM) technique. The metal brackets were bonded and debonded after 24 hours with debonding plier. After adhesive removal, Ra was evaluated again (T1) also the time spent on adhesive removal was recorded in seconds. The samples were finally polished by Sof-Lex discs and Sof-Lex spirals, and the third Ra evaluation was performed (T2).
Results: The results of two-way mixed analysis of variance (ANOVA) showed that all burs increased surface roughness at T1 as compared to T0 (p < 0.001) with the highest Ra values shown in group III followed by group IV, group I, and group II. After polishing, no significant difference was noted in Ra values in group I and group II at T0 vs T2 (p = 1.000), while it was significant in group III and group IV (p < 0.001). Regarding the time required for adhesive removal, the shortest time was in group IV followed by groups III, II, and I, respectively.
Conclusion: The use of a magnifying loupe affects the quality of the clean-up procedure by reducing the enamel surface roughness and the time spent on adhesive removal.
Clinical significance: Using a magnifying loupe was helpful during orthodontic debonding and adhesive removal.
Ryf S, Flury S, Palaniappan S, et al. Enamel loss and adhesive remnants following bracket removal and various clean-up procedures in vitro. Eur J Orthod 2012;34(1):25–32. DOI: 10.1093/EJO/CJQ128.
Ireland AJ, Hosein I, Sherriff M. Enamel loss at bond-up, debond and clean-up following the use of a conventional light-cured composite and a resin-modified glass polyalkenoate cement. Eur J Orthod 2005;27(4):413–419. DOI: 10.1093/EJO/CJI031.
Karan S, Kircelli BH, Tasdelen B. Enamel surface roughness after debonding: Comparison of two different burs. Angle Orthod 2010;80(6):1081–1088. DOI: 10.2319/012610-55.1.
Pont HB, Özcan M, Bagis B, et al. Loss of surface enamel after bracket debonding: an in-vivo and ex-vivo evaluation. Am J Orthod Dentofacial Orthop 2010;138(4):1–9. DOI: 10.1016/J.AJODO.2010.01.028.
Oliver RG, Griffiths J. Different techniques of residual composite removal following debonding—time taken and surface enamel appearance. Br J Orthod 1992;19(2):131–137. DOI: 10.1179/BJO.19.2.131.
Mohebi S, Shafiee HA, Ameli N. Evaluation of enamel surface roughness after orthodontic bracket debonding with atomic force microscopy. Am J Orthod Dentofacial Orthop 2017;151(3):521–527. DOI: 10.1016/J.AJODO.2016.08.025.
Stein S, Kleye A, Schauseil M, et al. 445-nm diode laser-assisted debonding of self-ligating ceramic brackets. Biomed Tech (Berl) 2017;62(5):513–520. DOI: 10.1515/BMT-2016-0027.
Mundethu AR, Gutknecht N, Franzen R. Rapid debonding of polycrystalline ceramic orthodontic brackets with an Er:YAG laser: An in vitro study. Lasers Med Sci 2014;29(5):1551–1556. DOI: 10.1007/S10103-013-1274-9.
Ma T, Marangoni RD, Flint W. In vitro comparison of debonding force and intrapulpal temperature changes during ceramic orthodontic bracket removal using a carbon dioxide laser. Am J Orthod Dentofacial Orthop 1997;111(2):203–210. DOI: 10.1016/S0889-5406(97)70217-8.
Hong YH, Lew KKK. Quantitative and qualitative assessment of enamel surface following five composite removal methods after bracket debonding. Eur J Orthod 1995;17(2):121–128. DOI: 10.1093/EJO/17.2.121.
Kim SS, Park WK, Son WS, et al. Enamel surface evaluation after removal of orthodontic composite remnants by intraoral sandblasting: A 3-dimensional surface profilometry study. Am J Orthod Dentofacial Orthop 2007;132(1):71–76. DOI: 10.1016/J.AJODO.2005.07.027.
Bandιca M, Tonetto M, Frizzera F, et al. Methods for removal of resin remaining after debonding of orthodontic brackets: A literature review. J Dent Res Rev 2014;1(2):105–107. DOI: 10.4103/2348-2915.133960.
Wajngarten D, Botta AC, Garcia PPNS. Magnification loupes in dentistry: A qualitative study of dental students’ perspectives. Eur J Dent Educ 2021;25(2):305–309. DOI: 10.1111/EJE.12605.
Braga T, Robb N, Love RM, et al. The impact of the use of magnifying dental loupes on the performance of undergraduate dental students undertaking simulated dental procedures. J Dent Educ 2021;85(3):418–426. DOI: 10.1002/JDD.12437.
Shanelec DA. Optical principles of loupes. J Calif Dent Assoc 1992;20(11):25–32. PMID:1284393.
Baumann DF, Brauchli L, van Waes H. The influence of dental loupes on the quality of adhesive removal in orthodontic debonding. J Orofac Orthop/Fortschritte Der Kieferorthopädie 2011;72(2):125–132. DOI: 10.1007/s00056-011-0010-y.
Gwinnett AJ, Gorelick L. Microscopic evaluation of enamel after debonding: clinical application. Am J Orthod Dentofacial Orthop 1977;71(6):651–665. DOI: 10.1016/0002-9416(77)90281-0.
Bishara SE, Trulove TS. Comparisons of different debonding techniques for ceramic brackets: An in vitro study. Part II. Findings and clinical implications. Am J Orthod Dentofacial Orthop 1990;98(3): 263–273. DOI: 10.1016/S0889-5406(05)81604-X.
Janiszewska-Olszowska J, Tandecka K, Szatkiewicz T, et al. Three-dimensional analysis of enamel surface alteration resulting from orthodontic clean-up-comparison of three different tools. BMC Oral Health 2015;15(1):131–136. DOI: 10.1186/S12903-015-0131-6.
Erdur EA, Akin M, Cime L, et al. Evaluation of enamel surface roughness after various finishing techniques for debonding of orthodontic brackets. Turkish J Orthod 2016;29(1):1–5. DOI: 10.5152/turkjorthod.2016.15-00016r1.
Swanson T, Dunn WJ, Childers DE, et al. Shear bond strength of orthodontic brackets bonded with light-emitting diode curing units at various polymerization times. Am J Orthod Dentofacial Orthop 2004;125(3):337–341. DOI: 10.1016/J.AJODO.2003.04.011.
Shafiee H-A, Mohebi S, Ameli N, et al. Enamel surface roughness after orthodontic bracket debonding and composite resin removal by two types of burs. J Dent Sch Shahid Beheshti Univ Med Sci 2015;33(3):210–219. DOI: 10.22037/jds.v33i3.24711.
Albuquerque G de S, Filho MV, Lucato AS, et al. Evaluation of enamel roughness after ceramic bracket debonding and clean-up with different methods. Brazilian J Oral Sci 2010;9(2):81–84. DOI: 10.20396/bjos.v9i2.8641848.
Bishara SE, Ortho D, Truiove TS. Comparisons of different debonding techniques for ceramic brackets: An in vitro study. Part I. Background and methods. Am J Orthod Dentofacial Orthop 1990;98(2):145–153. DOI: 10.1016/0889-5406(90)70008-Z.
Saghiri MA, Asgar K, Lotfi M, et al. Back-scattered and secondary electron images of scanning electron microscopy in dentistry: a new method for surface analysis. Acta Odontol Scand 2012;70(6):603–609. DOI: 10.3109/00016357.2011.645057.
Schuler FS, van Waes H. SEM-evaluation of enamel surfaces after removal of fixed orthodontic appliances. Am J Dent 2003;16(6):390–394. PMID: 15002953.
Palmer JA, Mang T, Tabbaa S, et al. Analysis of enamel surface roughness after different adhesive removal techniques for orthodontic bracket debonding. Lasers Dent Sci 2018;2(2):95–101. DOI: 10.1007/s41547-018-0024-5.
Alessandri Bonetti G, Zanarini M, Incerti Parenti S, et al. Evaluation of enamel surfaces after bracket debonding: An in-vivo study with scanning electron microscopy. Am J Orthod Dentofacial Orthop 2011;140(5):696–702. DOI: 10.1016/J.AJODO.2011.02.027.
Janiszewska-Olszowska J, Szatkiewicz T, Tomkowski R, et al. Effect of orthodontic debonding and adhesive removal on the enamel – Current knowledge and future perspectives – A systematic review. Med Sci Monit 2014;20:1991–2001. DOI: 10.12659/MSM.890912.
Özer T, Başaran G, Kama JD. Surface roughness of the restored enamel after orthodontic treatment. Am J Orthod Dentofacial Orthop 2010;137(3):368–374. DOI: 10.1016/J.AJODO.2008.02.025.
Aboalshamat K, Daoud O, Mahmoud LA, et al. Practices and attitudes of dental loupes and their relationship to musculoskeletal disorders among dental practitioners. Int J Dent 2020;11(3):1–7. DOI: 10.1155/2020/8828709.
Cochrane NJ, Lo TWG, Adams GG, et al. Quantitative analysis of enamel on debonded orthodontic brackets. Am J Orthod Dentofacial Orthop 2017;152(3):312–319. DOI: 10.1016/J.AJODO.2017.01.020.
Vidor MM, Felix RP, Marchioro EM, et al. Enamel surface evaluation after bracket debonding and different resin removal methods. Dental Press J Orthod 2015;20(2):61–67. DOI: 10.1590/2176-9451.20.2.061-067.oar.
Schiefelbein C, Rowland K. A comparative analysis of adhesive resin removal methods. Int J Orthod Milwaukee 2011;22(2):17–22. PMID:21827051.
Faria-Júnior ÉM, Guiraldo RD, Berger SB, et al. In-vivo evaluation of the surface roughness and morphology of enamel after bracket removal and polishing by different techniques. Am J Orthod Dentofacial Orthop 2015;147(3):324–329. DOI: 10.1016/j.ajodo.2014.10.033.
Pinzan-Vercelino CRM, Souza Costa AC, Gurgel JA, et al. Comparison of enamel surface roughness and color alteration after bracket debonding and polishing with 2 systems: A split-mouth clinical trial. Am J Orthod Dentofacial Orthop 2021;160(5):686–694. DOI: 10.1016/J.AJODO.2020.06.039.
Shah P, Sharma P, Goje SK, et al. Comparative evaluation of enamel surface roughness after debonding using four finishing and polishing systems for residual resin removal—an in vitro study. Prog Orthod 2019;20(1):18–28. DOI: 10.1186/s40510-019-0269-x.
Eliades T, Gioka C, Eliades G, et al. Enamel surface roughness following debonding using two resin grinding methods. Eur J Orthod 2004;26(3):333–338. DOI: 10.1093/EJO/26.3.333.
Soares Tenório KC, Neupmann Feres MF, Tanaka CJ, et al. In vitro evaluation of enamel surface roughness and morphology after orthodontic debonding: Traditional cleanup systems versus polymer bur. Int Orthod 2020;18(3):546–554. DOI: 10.1016/j.ortho.2020.04.006.
Bernardi S, Continenza MA, Macchiarelli G. Microscopic evaluation of the enamel surface after debonding procedures: An ex vivo study using scanning electron microscopy. Microscopie 2018;85(3):418–426. DOI: 10.4081/microscopie.2018.7190.
Ulusoy Ç. Comparison of finishing and polishing systems for residual resin removal after debonding. J Appl Oral Sci 2009;17(3):209–215. DOI: 10.1590/s1678-77572009000300015.