Analysis of enamel surface roughness after different adhesive removal techniques for orthodontic bracket debonding

Background: The objectives of this study were to explore traditional resin removal procedures in the debonding process and evaluate the Er:YAG laser as a plausible option. Methods: Sixty premolar teeth were bonded with brackets. Then, brackets were removed and five adhesive clean-up methods were tested against control teeth: (a) Er:YAG laser at 200 mJ and 20 Hz; (b) Er:YAG laser at 305 mJ and 10 Hz; (c) 20-fluted flame-shaped tungsten carbide bur at high-speed; (d) #8-fluted round tungsten carbide bur at low-speed; and (e) #5 round end tapered fine diamond bur at high speed. Quantitative measurements including average (Avg) profile height, total indicator run-out (TIR), arithmetic average roughness (R_a), and time were made using profilometry. Qualitative evaluation of tooth surfaces was done using SEM. Results: The two laser settings produced a statistically higher TIR, R_a, and time compared to the controls (P < 0.001). There was no statistical difference between the three bur techniques in regards to surface texture or time. Qualitatively, the 20-fluted carbide bur left the smoothest surface. Conclusion: The Er:YAG laser at the tested settings would not be appropriate for adhesive removal. The interaction of the Er:YAG wavelength under these conditions was not comparable to the 20-fluted flame-shaped tungsten carbide bur at high speed for orthodontic adhesive removal leaving a smoother enamel surface.