Microscopic evaluation of the enamel surface after debonding procedures: An ex vivo study using scanning electron microscopy

The bracket placement on the dental surface includes the enamel conditioning to improve the adhesive bonding at enamel-adhesive and at adhesive-bracket interfaces. The final stage of the orthodontic therapy, after the bracket removal, is the debonding procedure. This stage aims to polish enamel surface to prevent the plaque accumulation and future enamel injures. The aim of this study is to evaluate and compare the enamel surface underwent to four different debonding procedures on two groups of extracted teeth, by using of the Scanning Electron Microscopy. The teeth were extracted at the Dental Clinic of University of L’Aquila for periodontal reasons and donated for research with the patients consent. On one teeth group (group A) the enamel polishing techniques was performed with the aid of a magnifying loupe. On the other group (group B) the polishing was performed with naked eyes. The four techniques used included the use of i) Multiblade burr/soft-polisher tip Komet; ii) Multiblade burr/Blade; iii) Disks Sof-lex; and iv) Enhance/Pogo. The images were analysed by the Image J software and qualitative and quantitative considerations referring to Adhesive Index Residual and Enamel Damage Index were made. The quantitative and qualitative results showed the most conservative technique was the tungsten carbide bur followed by the polishing using the soft-polisher tip, under the aid of the magnification system. From the above considerations, it can be concluded the use of a magnifying loupe aids in significant way during the debonding procedures for the enamel surfaces’ preservation.