Ahrari Farzaneh, Akbari Majid, Akbari Javad, Dabiri Ghahraman
Assistant Professor of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
J Dent (Tehran). 2013 Jan;10(1):82-93. Epub 2013 Jan 31.
This study aimed to evaluate enamel roughness after adhesive removal using different burs and an Er:YAG laser.
The buccal surfaces of forty human premolars were sealed by two layers of nail varnish, except for a circular area of 3 mm in diameter on the middle third. The enamel surfaces were initially subjected to profilometry analysis and four parameters of surface irregularity (Ra, Rq, Rt and Rz) were recorded. Following bracket bonding and debonding, adhesive remnants were removed by tungsten carbide burs in low- or high- speed handpieces (group 1 and 2, respectively), an ultrafine diamond bur (group 3) or an Er:YAG laser (250 mJ, long pulse, 4 Hz) (group 4), and surface roughness parameters were measured again. Then, the buccal surfaces were polished and the third profilometry measurements were performed.
The specimens that were cleaned with a low speed tungsten carbide bur showed no significant difference in surface irregularity between the different treatment stages (p>0.05). Surface roughness increased significantly after clean-up with the diamond bur and the Er:YAG laser (p<0.01). In comparison between groups, adhesive removal with tungsten carbide burs at slow- or high-speed handpieces produced the lowest, while enamel clean-up with the Er:YAG laser caused the highest values of roughness measurements (P<0.05).
Under the study conditions, application of the ultrafine diamond bur or the Er:YAG laser caused irreversible enamel damage on tooth surface, and thus these methods could not be recommended for removing adhesive remnants after debonding of orthodontic brackets.
本研究旨在评估使用不同车针和铒钇铝石榴石(Er:YAG)激光去除粘结剂后牙釉质的粗糙度。
40颗人前磨牙的颊面用两层指甲油密封,中间三分之一处除外,保留直径3mm的圆形区域。首先对牙釉质表面进行轮廓测量分析,并记录表面不规则性的四个参数(Ra、Rq、Rt和Rz)。在粘结托槽和去除托槽后,分别用低速或高速手机中的碳化钨车针(分别为第1组和第2组)、超细金刚石车针(第3组)或Er:YAG激光(250mJ,长脉冲,4Hz)(第4组)去除粘结剂残留,然后再次测量表面粗糙度参数。接着,对颊面进行抛光并进行第三次轮廓测量。
用低速碳化钨车针清洁的标本在不同治疗阶段的表面不规则性无显著差异(p>0.05)。用金刚石车针和Er:YAG激光清洁后,表面粗糙度显著增加(p<0.01)。各组之间比较,用低速或高速手机中的碳化钨车针去除粘结剂产生的粗糙度最低,而用Er:YAG激光清洁牙釉质产生的粗糙度测量值最高(P<0.05)。
在本研究条件下,使用超细金刚石车针或Er:YAG激光会对牙齿表面造成不可逆的牙釉质损伤,因此不推荐使用这些方法去除正畸托槽粘结剂后的残留粘结剂。