Objective:

  To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding.

 Materials and Methods:

  Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed the brackets presenting some remnants on the base (n  =  818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n  =  100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data.

 Results:

  Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P < .0001 and P  =  .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%) group B, bases showing sizable enamel fragments (7%) group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P < .323 and P  =  .0001, respectively).

  Conclusion:

  The objective of an atraumatic debonding is not achieved yet in some cases the damage could be clinically relevant.

 Source: The Angel Orthodontists

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