Effects of Orthodontic Mechanics on Tooth Enamel: A Review
Section snippets
Potential Damages During Bonding
Advances in adhesive technology and the introduction of new materials and bonding techniques have greatly influenced and revolutionized orthodontic practice. Contemporary adhesives can be divided into two systems: etch and rinse (E&R) and self-etch adhesives/primers (SEP).2 The first system (E&R) uses phosphoric acid etching and primer/adhesive resin application as two separate phases, while the latter (SEP) combines etching and priming together in a single phase and the adhesive resin in
Enamel Damage During Debonding Procedures
The objectives of debonding are to remove the attachment and all the adhesive resin from the tooth and to restore the surface as closely as possible to its pretreatment condition. To achieve these objectives, correct bonding and debonding are of fundamental importance. There are several factors involved in debonding, the most important of which are the type of bracket and adhesive used, instruments used for bracket removal, and the armamentarium for resin removal.25 The ideal orthodontic
Interdental Stripping: Intentional Damage
Interdental stripping, also called as interproximal enamel reduction, enamel reproximation, or slenderization, is a common clinical procedure in orthodontic therapy. Among various techniques available today, the most commonly used ones are handheld or motor-driven abrasive strips, and tungsten carbide or diamond burs.48 The main indications for this technique include reshaping the approximal contacts, managing Bolton discrepancy problems, treating mild or moderate crowding, and stabilizing the
Enamel Wear
Abrasion of enamel surfaces can occur when teeth make contact with either metal or ceramic brackets. The latter is common on upper canine tips, as the cusp tip hits the lower canine brackets during retraction. It may also be seen on the incisal edges of upper anterior teeth where ceramic brackets are placed on lower incisors of a patient who has an increased overbite. The clinician should always ensure that no enamel damage is occurring due to bracket placement. One method to achieve the latter
Susceptibility to Caries and White Spot Formation
Demineralization is a common side effect associated with fixed appliance orthodontic treatment. The development of white spot lesions (WSL) is almost inevitable when oral hygiene is poor (Fig 1A and B). The components of the appliance and the bonding materials promote plaque accumulation and bacterial colonization, especially Streptococcus mutans and Lactobacillus,55 with subsequent acid production leading to decalcification. This might produce an alteration in the appearance of the enamel
Enamel Damage During Adhesive Removal and Rebonding Failed Brackets
Although the primary orthodontic goal lies in returning the enamel surface to its original state following removal of orthodontic attachments, the adhesive removal procedures after debonding may remove up to 55.6 μm of surface enamel.81 The failure at the bracket-adhesive interface decreases the probability of enamel damage, but has the disadvantage of requiring the mechanical removal of the residual adhesive after debonding.
The search for an efficient and safe method of adhesive resin removal
Conclusion
Enamel damage can be considered as an inevitable sequela to orthodontic treatment, with various procedures producing varied effects. The aim of every orthodontic practitioner should be to minimize damages to enamel, helping improve the longevity of teeth as well as dentition as a whole. This can be done by keeping abreast with the recent technologies and using them in a proper manner. This brings in the necessity to have a fundamental knowledge of preventive dentistry principles and the
References (92)
- et al.
Enamel loss due to prophylaxis and multiple bonding/debonding of a orthodontic attachment
Am J Orthod
(1981) - et al.
Evaluation of Scotchbond Multi Purpose and maleic acid as alternative methods of bonding orthodontic brackets
Am J Orthod Dentofacial Orthop
(1997) - et al.
Tensile bond strength to and SEM evaluation of ground and intact enamel surfaces
J Dent
(1999) - et al.
An evaluation and comparison of orthodontic bracket bond strengths achieved with self etching primer
Am J Orthod Dentofacial Orthop
(2004) - et al.
Effect of a self etch primer/adhesive on the shear bond strength of orthodontic brackets
Am J Orthod Dentofacial Orthop
(2001) - et al.
Influence of self etching primer drying time on enamel bond strength of resin composites
J Dent
(1999) - et al.
Shear bond strength of orthodontic brackets bonded with a modified 1-step etchant-and-primer technique
Am J Orthod Dentofacial Orthop
(2003) - et al.
Shear bond strength of orthodontic brackets with 3 self-etch adhesives
Am J Orthod Dentofacial Orthop
(2006) - et al.
Three-dimensional measurement of enamel loss caused by bonding and debonding orthodontic brackets
Am J Orthod Dentofacial Orthop
(1997) Retentive shear strengths of various bonding attachment bases
Am J Orthod Dentofacial Orthop
(1980)
Tensile strength and modulud of elasticity of tooth structure and several restorative materials
J Am Dent Assoc
Ceramic brackets, something old, something new, a review
Semin Orthod
Effect of altering the type of enamel conditioner on the shear bond strength of a resin-reinforced glass ionomer adhesive
Am J Orthod Dentofacial Orthop
Shear bond strength of orthodontic brackets cemented with a zinc oxide-polyvinyl cement
Am J Orthod Dentofacial Orthop
Clinical trials with crystal growth conditioning as an alternative to acid etch enamel pretreatment
Am J Orthod
The shear bond strengths of stainless steel and ceramic brackets used with chemically and light activated composite resins
Am J Orthod Dentofacial Orthop
Bond strength of ceramic brackets under shear stress: an in vitro report
Am J Orthod Dentofacial Orthop
Comparisons of different debonding techniques for ceramic brackets: an in vitro study
Am J Orthod Dentofacial Orthop
Comparison of bond strength between simple foil and laser structured base retention brackets
Am J Orthod Dentofacial Orthop
Improvements in bracket base design
Am J Orthod
The relationship between bond strength and orthodontic bracket base
Am J Orthod Dentofacial Orthop
Shear, tortional and tensile bond strengths of ceramic brackets using three adhesive filler concentrations
Am J Orthod Dentofacial Orthop
Anterior interocclusal relationsPart 1
Am J Orthod
Air-rotor stripping and enamel demineralization in vitro
Am J Orthod Dentofacial Orthop
Orthodontic microabrasive reproximation
Am J Orthod Dentofacial Orthop
Qualitative and quantitative evaluation of enamel after various stripping methods
Am J Orthod Dentofacial Orthop
Adherence of Streptococcus mutans to orthodontic brackets
Am J Orthod Dentofacial Orthop
Demineralization and remineralization around orthodontic appliances: an in vitro study
Am J Orthod Dentofacial Orthop
Quantitative measurements of remineralization of incipient caries
Am J Orthod Dentofacial Orthop
The effect of a fluoride program on white spot formation during orthodontic treatment
Am J Orthod Dentofacial Orthop
Incidence of white spot formation after bonding and banding
Am J Orthod
An in vivo study on the merits of two glass ionomers for the cementation of orthodontic bands
Am J Orthod Dentofacial Orthop
Antibacterial activity and bonding characteristics of an adhesive resin containing antibacterial monomer MDPB
Dent Mater
Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment
Am J Orthod
Effects of high speed curing devices on shear bond strength and microleakage of orthodontic brackets
Am J Orthod Dentofacial Orthop
Enamel surface evaluations after clinical treatment and removal of orthodontic brackets
Am J Orthod
Enamel surface characteristics on removal of bonded orthodontic brackets
Am J Orthod
Quality control in orthodontics: risk/benefit considerations
Br Dent J
Micro tensile bond strengths of an etch&rinse and self-etch adhesive to enamel and dentin as a function of surface treatment
Oper Dent
Effect of active pretreatment of self etching primers on the ultramorphology of intact primary and permanent tooth enamel
J Dent Child
Effects of 15 vs 60 second enamel acid conditioning on adhesion and morphology
Oper Dent
Bracket bonding with 15-60 second etching and adhesive remaining on enamel after debonding
Angle Orthod
Clinical applications of enamel adhesives
Oper Dent
Effect of using self etching primer for bonding orthodontic brackets
Angle Orthod
Recent developments in dentin bonding
Am J Dent
Effect of self etching primers on bond strength—are they reliable?
Angle Orthod
Cited by (29)
In vivo examination of enamel microcracks after orthodontic debonding: Is there a need for detailed analysis?
2021, American Journal of Orthodontics and Dentofacial OrthopedicsExperimental study of brackets adhesion with a novel enamel-protective material compared with conventional etching
2020, Saudi Dental JournalCitation Excerpt :Dental enamel is a highly mineralized tissue characterized by its years-long slow formation, limited quantity and its loss irreversibility (Fukae, 2009; Dorozhkin, 2013). Adhesion preparation is associated with several procedures such as damages related to abrasive cleaning, enamel structure defacing caused by etching, enamel loss when mechanically removing resin remnants or when failure and fractures at bracket removal are generated (Arhun and Arman, 2007). A 37% aqueous solution of phosphoric acid when applied for a brief lapse (15 to 30 s) dissolves enamel minerals creating roughness with a wide extent of coverage that is microscopically visible from 3, 10 and even 170 µm (Øgaard and Fjeld, 2010).
Development, characterization and comparison of two strontium doped nano hydroxyapatite molecules for enamel repair/regeneration
2016, Dental MaterialsCitation Excerpt :In severe cases, frank cavitations are seen which even require restorative intervention. It is reported that any tooth in the mouth can be affected by the process with most common ones being the anteriors comprising of maxillary lateral incisors and canines [4]. The second most common problem faced by orthodontic clinicians is the loss of surface enamel while debonding/removing orthodontic brackets.
In-vitro study of the effect of casein phosphopeptide amorphous calcium fluoride phosphate on iatrogenic damage to enamel during orthodontic adhesive removal
2011, American Journal of Orthodontics and Dentofacial OrthopedicsCitation Excerpt :However, most residual adhesive requires subsequent removal, posing its own complications. The ideal adhesive should possess clinically relevant bond strength and fail consistently at the enamel-adhesive interface to facilitate adhesive cleanup.6,44 Thus, the use of a conservative debonding technique might not be as critical as the choice of the adhesive-removal instrument.