HOME - Clinical cases - Orthodontics
04 December 2019

Clean-up after orthodontic debonding using fluorescent light

Davide Elsido

In the latest issue (November 2019) of the Angle Orthodontist an article was published about a technique developed to help the removal composite during debonding of brackets with respect to time needed, composite remnants, and tooth substance loss. After orthodontic treatment, the enamel surface should be returned to its original condition as close as possible without any composite remnants and without damaging the tooth surface. So far, no consensus exists as to the most efficient technique to remove composite remnants after bracket debonding. Despite many different approaches used in daily practice, the tungsten bur remains the most preferred tool to remove composite remnants. Tungsten carbide burs are effective in removing composite remnants but result in a rough enamel surface.

Therefore, enamel polishing is required to avoid bacterial adhesion. This is recommended to be performed with Sof-Lex discs or similar. Although the ideal procedure for removing composite has been the subject of several investigations, less effort has gone into establishing a technique that facilitates the removal of composite remnants. The fluorescence properties of luminescent chemicals and tooth structures are different under a wavelength of 405 nm.

Therefore, fluorescence can be a good tool to use as a noninvasive method for detecting composites.
Two operators: an experienced orthodontist (A) and an undergraduate student (B) received six models each and were asked to remove the composite remnants by both a conventional light source (CLS), and fluorescent inducing light (FIT). The time taken was recorded, and a postoperative scan was digitally superimposed on the preoperative scan to quantify number of teeth with composite remnants and volume and thickness of enamel loss and composite remnants. Compared to CLS, both operators needed significantly less time when using the FIT method and degree of enamel loss, height, and volume of composite remnants and total remaining composite remnants were significantly reduced. Due to infiltration of composite after etching, complete removal of the remnants is almost never possible without damaging the enamel surface. By conventional light, the primer and sealant agent may still remain on the teeth even though, clinically, the surface might look clean. The resin infiltrated enamel could be responsible for color changes of the enamel in the long term. Due to the FIT method, this infiltrated enamel layer becomes visible, which will then be removed during the clean-up process.

Enamel scratches should be avoided as much as possible since they enhance bacterial adhesion and cannot be eliminated by polishing. Improper handling of the tungsten carbide bur at the line angle and cervical areas can lead to visible grooves and the pressure against the enamel is operator-dependent.

Conclusions: Cleanup after orthodontic debonding with the FIT was superior regarding time needed and removal of composite remnants. Total enamel loss reduction was operator-dependent.

For additional informations:  Evaluation of a Fluorescence-aided Identification Technique (FIT) to assist clean-up after orthodontic bracket debonding.

Related articles

Image Orthodontics recently announced its commitment to providing support and treatment options to patients affected by the closure of Smile Direct Club.

The size of the invisible orthodontics market in China is expected to grow by USD 314.9 million from 2023 to 2028. Moreover, the market is anticipated to progress at a Compound Annual Growth Rate...

Dentsply Sirona is expanding its digital education opportunities with a new DS Campus online. Dental professionals will find a range of on-demand content covering topics in implant dentistry,...

Orthodontic Details said its ordering platform has been adopted by more than 100 orthodontic practices, representing 160 offices across the U.S. and Canada. 

With this new location, Impress – the leader in clear aligners in Europe – now has 11 practices within the U.S. 

Read more

USA     22 February 2024 - 24 February 2024

2024 Chicago Midwinter Meeting

Early-bird rates available through Nov. 30

The 2024 Midwinter Meeting provides exceptional continuing education featuring top dental speakers, an expansive Exhibit Hall with the best vendors in the country and opportunities to meet old and...

USA     22 February 2024 - 23 February 2024

Save the date: A new era for prosthodontics Feb. 2024

95th Annual Meeting of the American Prosthodontic Society

APS Members and colleagues will enjoy relevant education in advanced prosthodontics and implantology, interdisciplinary instruction led by world-renowned experts, and networking and social events...

The U.S. Food and Drug Administration (FDA) has approved Dr. Jonathan An from the UW Department of Oral Health Sciences to lead the first-ever study to evaluate rapamycin in older adults with...

The American Association for Anatomy (AAA) announced its 2024 award recipients, recognizing outstanding contributions to the field. Two UCSF School of Dentistry professors were among the respected...

The National Mobile & Teledentistry Conference (NMTC), the only educational conference geared towards virtual and mobile dental care, is excited to announce our 5-year anniversary at our upcoming...



Most popular