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. 2016 May;86(3):437-47.
doi: 10.2319/021115-93.1. Epub 2015 Aug 31.

The prognostic value of visually assessing enamel microcracks: Do debonding and adhesive removal contribute to their increase?

Irma Dumbryte  1 , Tomas Jonavicius  2 , Laura Linkeviciene  3 , Tomas Linkevicius  3 , Vytaute Peciuliene  4 , Mangirdas Malinauskas  5
Affiliations

The prognostic value of visually assessing enamel microcracks: Do debonding and adhesive removal contribute to their increase?

Irma Dumbryte et al. Angle Orthod. 2016 May.

Abstract

Objective: To find a correlation between the severity of enamel microcracks (EMCs) and their increase during debonding and residual adhesive removal (RAR).

Materials and methods: Following their examination with scanning electron microscopy (SEM), 90 extracted human premolars were divided into three groups of 30: group 1, teeth having pronounced EMCs (visible with the naked eye under normal room illumination); group 2, teeth showing weak EMCs (not apparent under normal room illumination but visible by SEM); and group 3, a control group. EMCs have been classified into weak and pronounced, based on their visibility. Metal brackets (MB) and ceramic brackets (CB), 15 of each type, were bonded to all the teeth from groups 1 and 2. Debonding was performed with pliers, followed by RAR. The location, length, and width of the longest EMCs were measured using SEM before and after debonding.

Results: The mean overall width (Woverall) was higher for pronounced EMCs before and after debonding CB (P < .05), and after the removal of MB. Pronounced EMCs showed greater length values using both types of brackets. After debonding, the increase in Woverall of pronounced EMCs was 0.57 µm with MB (P < .05) and 0.30 µm with CB; for weak EMCs, - 0.32 µm with MB and 0.30 µm with CB.

Conclusions: Although the teeth having pronounced EMCs showed higher width and length values, this did not predispose to greater EMCs increase after debonding MB and CB followed by RAR.

Keywords: Bracket; Crack; Damage; Enamel; Orthodontic debonding; Scanning electron microscopy.

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Figures

Figure 1. Graphic representation of the study protocol.
Figure 1.
Graphic representation of the study protocol.
Figure 2. Examination of the buccal enamel surface utilizing SEM. A measurement step (x, the distance between two measurement areas [MAs]) and length (l) of EMC were calculated. For l evaluation, the number (n) of MAs, that is, the distance between the first and last MA in which an EMC was located, was quantified.
Figure 2.
Examination of the buccal enamel surface utilizing SEM. A measurement step (x, the distance between two measurement areas [MAs]) and length (l) of EMC were calculated. For l evaluation, the number (n) of MAs, that is, the distance between the first and last MA in which an EMC was located, was quantified.
Figure 3. Bland-Altman plot. The solid line shows the mean of the differences between two width measurements; Dashed lines show the upper (mean +1.96 SD) and lower limits (mean −1.96 SD) of the 95% CI of agreement.
Figure 3.
Bland-Altman plot. The solid line shows the mean of the differences between two width measurements; Dashed lines show the upper (mean +1.96 SD) and lower limits (mean −1.96 SD) of the 95% CI of agreement.
Figure 4. Woverall of pronounced and weak EMCs with 95% CI before and after debonding MB followed by RAR.
Figure 4.
Woverall of pronounced and weak EMCs with 95% CI before and after debonding MB followed by RAR.
Figure 5. Woverall of pronounced and weak EMCs with 95% CI before and after debonding CB followed by RAR.
Figure 5.
Woverall of pronounced and weak EMCs with 95% CI before and after debonding CB followed by RAR.
Figure 6. Woverall of pronounced EMCs with 95% CI before and after debonding MB and CB followed by RAR.
Figure 6.
Woverall of pronounced EMCs with 95% CI before and after debonding MB and CB followed by RAR.
Figure 7. Woverall of weak EMCs with 95% CI before and after debonding MB and CB followed by RAR.
Figure 7.
Woverall of weak EMCs with 95% CI before and after debonding MB and CB followed by RAR.
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