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Bracket Removal and Enamel Polishing Procedures After Completion of Orthodontic Treatment; A Survey Among Iraqi Orthodontists

Rawand A. Mahmood*, Mahmoud K. Mohsin*
*Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq.
Submitted: March 17, 2021, Accepted: June 19, 2021, Published: December 1, 2021.


Objective: To survey the orthodontic debonding techniques in Iraq and describe the most commonly used methods to remove the brackets and adhesive remnants from the enamel surfaces.  

MethodsA questionnaire survey consisting of 9 questions about general information of the participants (gender, work location, duration of practicing orthodontics), bracket debonding methods, and instruments used was electronically sent to Iraqi orthodontists.      

ResultsOverall, 91 orthodontists responded. 67% of participants found enamel damage after bracket removal. The most commonly used pliers for bracket debonding were bracket removal pliers (73.6%) and ligature cutters (23.1%). For adhesive removal, high-speed tungsten carbide burs were the most widely used technique for adhesive removal, followed by low-speed carbide burs and low-speed abrasive discs, respectively. The most frequently used instruments for polishing after debonding were rubber cups with pumice (40.65%).  

ConclusionsIn the present survey, it is shown that bracket debonding pliers are the most commonly used pliers for bracket removal. High-speed tungsten carbide bur is the most utilized method for adhesive removal, rubber cup together with pumice is the most commonly used technique for tooth polishing.                                                                                     

Keywords:  Adhesive remnant, Debonding, Iraqi orthodontist, Polishing, Survey.                                                                                                                                                                                                                                                Full Article - PDF           



1. Chen HY, Su MZ, Chang HF, Chen YJ, Lan WH, Lin CP. Effect of different debonding techniques on the debonding forces and failure modes of ceramic brackets in simulated clinical set-up. Am J Orthod Dentofac Orthop. 2007;132(5):680-6.
2. Hosein I, Sherriff M, Irland AJ. Enamel loss during bonding, debonding, and cleanup with use of a self-etching primer. Am J Orthod Dentofac Orthop. 2004;126(6):717-24.
3. Shuler FS, van Waes H. SEM-evaluation of enamel surface after removal of fixed orthodontic appliances. Am J Dent. 2003;16(6):390-4.
4. Ozer T, Basaran G, Kama JD. Surface roughness of the restored enamel after orthodontic treatment. Am J Orthod Dentofacial Orthop. 2010;137(3):368-74.
5. Eliades T, Gioka C, Eliades G, Makou M. Enamel surface roughness following debonding using two resin grinding methods. Eur J Orthod. 2004;26(3):333-8.
6. Alessandri Bonetti G, Zanarini M, Incerti Parenti S, Lattuca M, Marchionni S, & Gatto MR. Evaluation of enamel surfaces after bracket debonding: An in-vivo study with scanning electron microscopy Am J Orthod Dentofacial Orthop. 2011;140(5):696-702
7. Zarrinnia K, Eid NM, & Kehoe MJ. The effect of different debonding techniques on the enamel surface: An in vitro qualitative study Am J Orthod Dentofacial Orthop. 1995;108(3):284-93.
8. Ryf S, Flury S, Palaniappan S, Lussi A, van Meerbeek B, & Zimmerli B. Enamel loss and adhesive remnants following bracket removal and various clean-up procedures in vitro. Eur J Orthod. 2012;34(1):25-32. 
9. Ulusoy C. Comparison of finishing and polishing systems for residual resin removal after debonding J App Oral Sci. 2009;17(3):209-15.
10. Ogaard B, Fjeld M. The enamel surface and bonding in orthodontics. Semin Orthod. 2010;16(1):37-48.
11. Kley P, Frentzen M, Küpper K, Braun A, Kecsmar S, Jäger A, et al. Thermotransduction and heat stress in dental structures during orthodontic debonding. J Orofac Orthop. 2016;77(3):185-193.
12. Sfondrini MF, Scribante A, Fraticelli D, Roncallo S, Gandini P. Epidemiological survey of different clinical techniques of orthodontic bracket debonding and enamel polishing. J Orthod Sci. 2015;4(4):123-7.
13. Brian J. Webb, Jacob Koch, Joseph L. Hagan, Richard W. Ballard, Paul C. Armbruster. Enamel surface roughness of preferred debonding and polishing protocols. J Orthod. 2016;43(1): 39-46.
14. Maijer R, Smith DC. Corrosion of orthodontic bracket bases. Am J Orthod. 1982;81(1):43-8.
15. Cacciafesta V, Sfondrini MF, Scribante A, Klersy C, Auricchio F. Evaluation of friction of conventional and metal-insert ceramic brackets in various bracket-archwire combinations. Am J Orthod Dentofacial Orthop. 2003;124(4):403-9.
16. Matsui S, Umezaki E, Komazawa D, Otsuka Y, Suda N. Evaluation of mechanical properties of esthetic brackets. J Dent Biomech. 2015;6:1-7.
17. Schiefelbein C, Rowland K. A comparative analysis of adhesive resin removal methods. Int J Orthod Milwaukee. 2011;22(2):17-22. 18. KnöselM, Mattysek S, Jung K, Sadat-Khonsari R, Kubein-Meesenburg D, Bauss O, et al. Impulse debracketing compared to
 conventional debonding. Angle Orthod. 2010;80(8):1036-44.
19. Salehi P, Pakshir H, Naseri N, Baherimoghaddam T. The effects of composite resin types and debonding pliers on the amount of adhesive remnants and enamel damages: A stereomicroscopic evaluation. J Dent Res Dent Clin Dent Prospects. 2013;7(4):199-205.
20. Zarrinnia K, Eid NM, Kehoe MJ. The effect of different debonding techniques on the enamel surface: An in vitro qualitative study. Am J Orthod Dentofacial Orthop. 1995;108(3):284-93.
21. Miksic M, Slaj M, Mestrovic S. Stereomicroscope analysis of enamel surface after orthodontic bracket debonding. Coll Antropol. 2003;27 Suppl 2:83-9.
22. Kim SS, Park WK, Son WS, Ahn HS, Ro JH, Kim YD. Enamel surface evaluation after removal of orthodontic composite remnants by intraoral sandblasting: A 3-dimensional surface profilometry study. Am J Orthod Dentofacial Orthop. 2007;132(1):71-6.
23. Claudino D, Kuga MC, Belizario L, Pereira JR. Enamel evaluation by scanning electron microscopy after debonding brackets and removal of adhesive remnants. J Clin Exp Dent. 2018:10(3):248-51.
24. Zachrisson BU, Årtun J. Enamel surface appearance after various debonding techniques. Am J Orthod. 1979;75(2):121-7.
25. Waes H, Matter T, Krejci I. Three-dimensional measurement of enamel loss caused by bonding and debonding of orthodontic brackets. Am J Orthod Dentofac Orthop. 1997;112(6):666-9.
26. Ireland AJ, Hosein I, Sherriff M. Enamel loss at bond and clean-up following the use of a conventional light-cured composite and a resin- modified glass polyalkenoate cement. Eur J Orthod. 2005;27(4):413-9.
27. Zarrinia K, Eid NM, Kehoe MJ. The effect of different debonding techniques on the enamel surface: an in vitro qualitative study. Am J Orthod Dentofac Orthop. 1995;108(3):284-93.
28. Rouleau BD, Grayson WM, Cooley RO. Enamel surface evaluations after clinical treatment and removal of orthodontic brackets. Am J Orthod. 1982;81(5):423-6.
29. Nazir S, Cheema JA, Ahmed F, Khan UQ, Alam MA, Rehman ST. Comparison of enamel surface roughness parameters for resin removal following debonding using tungsten carbide bur and soflex discs with high speed and low speed hand pieces. Pak Oral Dent J. 2020;40(1):20-3.
30. Eminkahyagil N, Arman A, Çetinsahin A, Karabulut E. Effect of resin-removal methods on enamel and shear bond strength of rebounded brackets. Angle Orthod. 2006;76(2):314-21.
31. Ferreira JTL, Borsatto MC, Saraiva MCP, Matsumoto MAN, Torres CP, Romano FL. Evaluation of Enamel Roughness in Vitro After Orthodontic Bracket Debonding Using Different Methods of Residual Adhesive Removal. Turk J Orthod. 2020;33(1):43-51.
32. Cardoso LA, Valdrighi HC, Vedovello Filho M, Correr AB. Effect of adhesive remnant removal on enamel topography after bracket debonding. Dental Press J Orthod. 2014;19(6):105-12.
33. Pus MD, Way DC. Enamel loss due to orthodontic bonding with filled and unfilled resins using various clean-up techniques. Am J Orthod. 1980;77(3):269-83.
34. Brown CRL, Way DC. Enamel loss during orthodontic bonding and subsequent loss during removal of filled and unfilled adhesives. Am J Orthod. 1978;74(6):663-71.

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