COMPARING THE EFFECT OF TWO DIFFERENT POLISHING TECHNIQUES ON THE ENAMEL COLOR CHANGE AFTER REPEATED DEBONDING OF METAL BRACKETS

Year 2023, Volume: 9 Issue: 2, 1 - 9, 31.08.2023

Joudi Shehada Goksu Trakyalı

Abstract

Objectives: Repeated bracket failure is a common problem during orthodontic treatment of Class II division 2 malocclusions leading to unaesthetic results due to enamel color-change. This study aims to examine the effect of repeated debonding of two different metal-brackets followed by two different polishing procedures on enamel color.
Material and Methods: Randomly selected 40 intact-non-carious-premolars were separated into two main groups of 20 as Group 1 (G1) and Group 2 (G2). 80-gauge foil-mesh-base and micro-etched-base metal-brackets were bonded to teeth in G1 and G2, respectively. Both groups were subdivided into two subgroups as A or B, according to polishing techniques with whitestone-bur and sof-lex-disks respectively. Color evaluations were performed using Vita EasyShade before bonding brackets (T0) and after each debonding (T1, T2, T3). Adhesive Remnant Index (ARI) scores were evaluated visually. ANOVA with post-hoc analysis with a Bonferroni adjustment was utilized to compare color difference (ΔE) between time points in each group.
Results: Most significant difference in ΔE (11.7 ± 3) was in G1A at T1. In T2 the most significant difference in ΔE was noticed in G1B and G2A. There was no significant difference in ARI scores according to the brackets or the polishing methods. Repeated debonding of micro-etched-base-brackets followed by adhesive removal with a tungsten-carbide-bur and polishing with sof-lex-disks did not cause any significant change in ΔE.
Conclusion: Repeated bracket bonding after bracket loss may cause damage and subsequent discoloration of the enamel surface causing a negative effect on esthetics if correct cleaning protocols are not followed.

Keywords

Color, Orthodontic bracket, Debonding, Dental polishing, Esthetics

METAL BRAKETLERİN TEKRARLANAN SIYRILMASINDAN SONRA İKİ FARKLI POLİSAJ TEKNİĞİNİN MİNE RENK DEĞİŞİMİ ÜZERİNDEKİ ETKİSİNİN KARŞILAŞTIRILMASI

Abstract

Amaç: Tekrarlayan braket kopmaları, mine renk değişikliği nedeniyle estetik olmayan sonuçlara yol açabilir ve Sınıf II bölüm 2 maloklüzyonların ortodontik tedavisi sırasında sıklıkla karşılaşılan yaygın bir sorundur. Bu çalışma, iki farklı metal braketin tekrarlı olarak koparılması ardından iki farklı polisaj işleminin mine rengi üzerindeki etkisini incelemeyi amaçlamaktadır.
Gereç ve Yöntem: Rastgele seçilen 40 sağlam-çürüksüz-küçük azı dişi Grup 1 (G1) ve Grup 2 (G2) olmak üzere 20'şerli iki ana gruba ayrılmıştır. Sırasıyla G1 ve G2'de dişlere 80-gauge folyo örgü tabanlı ve mikro asitli tabanlı metal braketler yapıştırılmıştır. Her iki grup da sırasıyla whitestone-bur ve sof-lex-disc ile polisaj tekniklerine göre A ve B olarak iki alt gruba ayrılmıştır. Renk değerlendirmeleri, braketlerin yapıştırılmasından önce (T0) ve her koparma işleminden sonra (T1, T2, T3) Vita EasyShade kullanılarak yapılmıştır. Yapışkan Kalıntı İndeksi (ARI) skorları görsel olarak değerlendirilmiştir. Her gruptaki zaman noktaları arasındaki renk farkını (ΔE) karşılaştırmak için Bonferroni düzeltmeli post-hoc analizli ANOVA kullanılmıştır.
Bulgular: ΔE'deki (11.7 ± 3) en önemli fark, T1'de G1A'da ve T2'de ΔE'deki en önemli fark G1B ve G2A'da tespit edilmiştir. Braketlere veya polisaj yöntemlerine göre ARI skorlarında anlamlı fark gözlenmemiştir. Mikro asitle pürüzlendirilmiş tabanlı braketlerin tekrarlanan koparılması, ardından bir tungsten-karbit-frez ile yapışkanın çıkarılması ve sof-lex-disklerle cilalama uygulandığında, ΔE'de en az değişikliğe neden olmuştur.
Sonuç: Braket kaybından sonra tekrarlanan braket yapıştırılması, doğru temizlik ve cila protokollerine uyulmazsa, mine yüzeyinde hasara ve ardından estetik üzerinde olumsuz etkiye neden olacak şekilde renk bozulmasına neden olabilir.

Keywords

Renk, Ortodontik braket, Braket koparılması, Dental polisaj, Estetik

References

• Karamouzos A, Zafeiriadis AA, Kolokithas G, Papadopoulos MA, & Athanasiou, AE. In vivo evaluation of tooth colour alterations during orthodontic retention: A split-mouth cohort study. Orthod Craniofac Res 2019;22:124–130. https://doi.org/10.1111/ocr.12298.
• Pinzan-Vercelino CRM, Souza Costa AC, Gurgel JA, Salvatore Freitas KM. 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.
• Al Maaitah EF, Abu Omar AA, Al-Khateeb SN. Effect of fixed orthodontic appliances bonded with different etching techniques on tooth color: a prospective clinical study. Am J Orthod Dentofacial Orthop 2013;144:43-49. 10.1016/j.ajodo.2013.02.020.
• Janiszewska-Olazowska 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(20):1991-2001. 10.12659/MSM.890912.
• Vieira-Junior WF, Vieira I, Ambrosano GM, et al. Correlation between alteration of enamel roughness and tooth color. J Clin Exp Dent 2018;10(8):e815-20. 10.4317/ jced.54881.
• Eliades T, Kakaboura A, Eliades G, et al. Comparison of enamel changes associated with orthodontic bonding using two different adhesives. Eur J Orthod 2001;23(1):85- 90. 10.1093/ejo/23.1.85.
• Van der Burgt TP, ten Bosch JJ, Borsboom PCF, et al. A comparison of new and conventional methods for quantification of tooth color. J Prosthet Dent 1990;63(2):155-62 https://doi.org/10.1016/0022- 3913(90)90099-X.
• Jahangiri L, Reinhardt SB, Mehra RV, et al. Relationship between tooth shade value and skin color: an observational study. J Prosthet Dent 2002;87(2):149-52. 10.1067/ mpr.2002.121109.
• Baltzer A, Kaufmann-Jinoian V. The determination of the tooth colors. Special Reprint, Quintessenz Zahntech 2004;30(7):725-40.
• International Commission on Illumination (CIE). Colorimetry — Part 4: CIE 1976 L*A*B* Color Space. Vienna: Technical Committee ISO/TC 274, Light and lighting, 2019, publication no. ISO/CIE 11664-4:2019(E). Available from: https://standards.iteh.ai/catalog/standards/ iso/730a03a9-806c-4637-b423-5923094af0a7/isocie- 11664-4-2019.
• International Organization for Standardization, Dental materials: determination of color stability of dental polymeric materials Geneva: Technical Committee ISO/TC 106/SC 2, 2008, publication no. ISO 7491:2000. Available from: https://www.iso.org/obp/ui/#iso:std:iso:7491:ed- 2:v1:en.
• Joiner A, Luo W. Tooth color and whiteness: A review. J Dent 2017;67S:S3–S10. 10.1016/j.jdent.2017.09.006.
• Bocook Y, Çehreli ZC, Polat-Özsoy Ö. Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration. Angle Orthod 2014;84:634-41. 10.2319/060613-433.1.
• Kinch AP, Taylor H, Warltier R, et al. A clinical study of amount of adhesive remaining on enamel after debonding, comparing etch times of 15 and 60 seconds. Am J Orthod Dentofacial Orthop 1989;95(5):415–21. 10.1016/0889-5406(89)90303-x.
• Retief DH, Denys FR. Finishing of enamel surfaces after debonding of orthodontic attachments. Angle Orthod 1979;49(1):1–10.
• Tuncer NI, Pamukcu H, Polat-Ozsoy O. Effects of repeated bracket bonding on enamel color changes. Niger J Clin Pract 2018;21(9):1093–7. 10.4103/njcp.njcp_7_18.
• MacColl GA, Rossouw PE, Titley KC, Yamin C. The relationship between bond strength and orthodontic bracket base surface area with conventional and microetched foil-mesh bases. Am J Orthod Dentofacial Orthop. 1998;113(3):276-281. 10.1016/s0889-5406(98)70297-5
• Degrazia FW, Genari B, Ferrazzo VA, Santos-Pinto AD, Grehs RA. Enamel Roughness Changes after Removal of Orthodontic Adhesive. Dent J (Basel). 2018;6(3):39. doi:10.3390/dj6030039
• Howell S, Weekes WT. An electron microscopic evaluation of the enamel surface subsequent to various debonding procedures. Aust Dent J. 1990;35(3):245-252. 10.1111/j.1834-7819.1990.tb05402.x
• 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. 10.1016/j. ajodo.2016.08.025
• Henkin FS, Macêdo ÉO, Santos KD, et al. In vitro analysis of shear bond strength and adhesive remnant index of different metal brackets. Dental Press J Orthod 2016;21(6):67–73. 10.1590/2177-6709.21.6.067-073.oar