Evaluation of Different Adhesive Resin Removal Methods after Debonding Ceramic Orthodontic Molar Tubes: A Scanning Electron Microscope Study

Abstract

Objectives. To evaluate and compare the impacts, bond strength, residual adhesive, and time invested on the enamel surface after debonding of recently introduced ceramic buccal molar tubes with different systems. Materials and Methods. Ceramic molar tubes were bonded to fifty-four maxillary molar teeth, and a shear bond strength (SBS) test was performed. The adhesive remnant index (ARI) scores were recorded, and the samples were divided into two groups for adhesive removal with low-speed instruments: tungsten carbide bur or diamond-coated micropolisher point. The time to clean the enamel surfaces was also noted down for each tooth. The enamel surfaces were investigated with scanning electron microscope (SEM) after adhesives were cleaned. Shapiro-Wilk’s, Kolmogorov-Smirnov’s, and Student’s independent $t$ tests were used for statistical analysis. Results. The mean SBS value of the tested ceramic molar tubes was $9.78\pm 1.85$  MPa, and the majority of the samples were scored as ARI 1 and ARI 2. No statistically significant difference between PoGo micropolisher and TCB was found in terms of time values for surface cleaning. The enamel surface characteristics of TCB for adhesive remnant removal resulted in a better enamel surface than the single-step diamond polisher when the samples were investigated by using SEM. Conclusions. Ceramic molar tubes may be an enamel-safe product for patients seeking for fully aesthetic orthodontic treatment, if used in carefully handled clinical conditions. One-step polishing systems utilised with low-speed instruments could be used confidentially for cleaning the resin remnants on enamel after orthodontic treatment.