Original article
Surface roughness of the restored enamel after orthodontic treatment

https://doi.org/10.1016/j.ajodo.2008.02.025Get rights and content

Introduction

After fixed appliance treatment, one concern is to restore the enamel surface as closely to its original state as possible. A variety of cleanup processes are available, but all are time-consuming and carry some risk of enamel damage. The purpose of this study was to examine tooth surfaces restored with different cleanup protocols.

Methods

Ninety-nine premolars extracted for orthodontic purposes were used. The 2 materials tested were Sof-Lex disks (3 M ESPE AG, Seefeld, Germany) and fiberglass burs (Stain Buster, Carbotech, Ganges, France). These were used alone and in combination with high- and low-speed handpieces, with which they were also compared. Eight groups were ultimately tested. All groups were compared with intact enamel, which served as the control group. From each group, 10 samples were examined with profilometry and 1 with scanning electron microscopy. Adhesive remnant index scores were recorded to ensure equal distributions for the groups. The time required for the cleanup processes and profilometry test results were also recorded.

Results

The fastest procedure was performed with high-speed handpieces, followed by low-speed handpieces. Sof-Lex disks and fiberglass burs required more time than carbide burs but did not result in significantly longer times for the cleanup procedure when combined with tungsten carbide-driven low- or high-speed handpieces or when used alone with low-speed handpieces. Although Sof-Lex disks were the most successful for restoring the enamel, it was not necessary to restore the enamel to its original surface condition. Generally, all enamel surface-roughness parameters were increased when compared with the values of intact enamel. The average roughness and maximum roughness depth measurements with Sof-Lex disks were statistically similar to measurements of intact enamel.

Conclusions

No cleanup procedure used in this study restored the enamel to its original roughness. The most successful was Sof-Lex disks, which restored the enamel closer to its original roughness.

Section snippets

Material and methods

Ninety-nine premolars extracted for orthodontic purposes, with a maximum storage period of 1 month, were used. They had no carious lesions or microcracks and were kept in distilled water that was changed weekly to prevent bacterial growth.14 The teeth were embedded horizontally in self-cure acrylic resin so that at least 2 mm of buccal enamel was exposed. The buccal enamel surfaces of the teeth were pumiced, washed for 30 seconds, and dried for 10 seconds with a moisture-free air spray. The 90

Results

Table I shows the distribution of the ARI scores of the groups. No statistically significant difference was found between the groups. The distributions were similar; this is essential for accurate comparison.

Table II shows the times required for cleanup. Because the micromotor is a lower-speed handpiece than the aerator, the procedures involving the micromotor took longer. The fastest procedure was performed by using ATC. Sof-Lex disks and fiberglass burs took significantly longer for the

Discussion

The concern over debonding and inducing enamel surface alterations arises from the importance of the uppermost layer of the enamel, the hardness and higher mineral and fluoride content of which are particularly important. The loss of surface enamel and associated exposure of enamel prism endings to the oral environment can result in decreased resistance of the enamel to the organic acids in plaque and make it more prone to decalcification.16 The microscopic appearance showed enamel scarring.

Conclusions

Our goal was to restore the enamel to its original state after orthodontic treatment. The methods tested in this study could not restore the original enamel surface, but they were close to the values of intact enamel. Sof-Lex disk performance was superior to that of other combined protocols or fiberglass burs. Sof-Lex disks restored the enamel the closest to the original enamel surface.

References (22)

Cited by (54)

  • Effect of alumina particle morphology used for air abrasion on loss of enamel and luting composite resin

    2021, Dental Materials
    Citation Excerpt :

    This surface appeared rough and sharp edged as the powder. Although many clinicians have created different methods of resin removal and enamel polishing no gold standard or consensus exists regarding the best resin removal technique with no or less damage to enamel surface [7,20,21]. This study aimed to assess the enamel loss resulting from air abrasion with two different air abrasion powders with differences in morphology and particle size.

  • A comparison of traditional orthodontic polishing systems with composite polishing systems following orthodontic debonding

    2021, Saudi Dental Journal
    Citation Excerpt :

    This is in contrast to previous studies that concluded there was a significant difference in enamel surface roughness change pretreatment and post-treatment when using a tungsten carbide bur to remove residual adhesive (Garg et al. 2018; Goel et al., 2017; Vidor et al., 2015). An additional study found that after debonding, Sof-Lex disks most successfully returned enamel to its original surface roughness (Özer et al., 2010). Osorio et al. (1998) found that Sof-Lex disks produced an enamel surface that was second to the Enhance system with the gloss polishing paste or superior to the Enhance system without the polishing paste.

  • Comparison of enamel surface roughness and color alteration after bracket debonding and polishing with 2 systems: A split-mouth clinical trial

    2021, American Journal of Orthodontics and Dentofacial Orthopedics
    Citation Excerpt :

    In this double-blind, split-mouth randomized clinical trial, the effects of 2 polishing systems on enamel SR and color were compared, providing clinically useful information. Despite previous qualitative and quantitative studies evaluating the enamel SR2-5 and color change6-11 after bracket removal, no previous clinical study evaluated the use of Sof-Lex Spiral Wheels for enamel polishing. Split-mouth studies offer the advantages of concurrent experimental and control assignment, limiting sample size requirements, and increasing precision.35

View all citing articles on Scopus

The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

View full text