Scanning Electron Microscopic Examination of Enamel Surface after Fixed Orthodontic Treatment: In-Vivo Study

Abstract

Introduction Therapy with fixed orthodontic appliances starts with bracket bonding and ends with debonding of brackets, leaving enamel surface varied.

Objective The aim of this pilot study was to examine enamel surface before and after debonding of orthodontic brackets by the use of scanning electron microscopy (SEM).

Methods Epoxy replicas of four patients’ premolars indicated for therapy with fixed orthodontic appliances were made and brackets were bonded to their teeth with a different adhesives (Enlight, No-mix, Fuji Ortho LC and Heliosit Orthodontic) (n=4). Two months later, brackets on premolars were debonded and amounts of adhesive left on the tooth surfaces and the bracket bases were evaluated with the adhesive remnant index (ARI). After resin removal, epoxy replicas were made and the surface of premolars was evaluated with the enamel surface index (ESI). All replicas of premolars (n=32) were prepared for SEM examination and compared under different magnifications. Tooth damage was estimated based on correlation between ARItooth and ESI.

Results Pearson’s χ2 test showed no significant differences between ARItooth and ARIbracket of four materials used. Nonparametric correlations showed significant differences between ARItooth and ARIbracket, ESI and ARItooth, and between ESI and ARIbracket. Increasing of ARItooth is followed with the descent of ARIbracket and the ascent of ESI. Multivariate regression analysis showed a significant correlation between ESI and ARItooth.

Conclusion Most bond failures took place at enamel-adhesive interface. ARItooth was a predictor to enamel surface damage. The type of material did not affect enamel surface damage.

Keywords: adhesives; bracket debonding; materials testing; scanning electron microscopy (SEM)