Mousa Mudar Mohammad, Al-Jannan Hiba M G, Sultan Kinda, Ajaj Mowaffak A, Hajeer Mohammad Y, Al-Manadili Ahmad, Ammar Ali Mohsen, Awawdeh Mohammed
Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR.
Department of Oral Histopathology, Damascus University, Damascus, SYR.
Cureus. 2023 Jul 4;15(7):e41372. doi: 10.7759/cureus.41372. eCollection 2023 Jul.
The traditional methods of deboning metal brackets exert excessive force, resulting in enamel scratches, fractures, and patient discomfort. The objective of this study was to evaluate the effectiveness of using two intensity levels of a diode laser for debonding metallic orthodontic brackets as an alternative to the conventional debonding method.
Sixty intact, extracted human premolar teeth were used in this study, and metal orthodontic brackets were bonded to the buccal surface of these teeth. The teeth were divided into three groups for the experiment: (1) the control group, where conventional bracket debonding was performed using a debonding plier, (2) the first experimental group, where a diode laser (2.5W, 980nm) was utilized for laser debonding, and (3) the second experimental group, where a diode laser (5W, 980nm) was used for laser debonding. The laser was applied using a sweeping movement for 5 seconds. After debonding, the adhesive remnant index (ARI), the lengths, and the frequency of enamel cracks were compared among the groups. Additionally, an increase in intra-pulpal temperature was measured.
In all groups, there were no instances of enamel fractures. Laser debonding resulted in a significant reduction in both the frequency and length of newly formed enamel cracks compared to the conventional debonding method. The laser debonding group exhibited increases in intra-pulpal temperature of 2.37°C and 3.60°C in the second and third groups, respectively. These temperature increases were significantly lower than the threshold of 5.5°C. There were no significant differences observed in the ARI scores among the groups.
With all debonding methods, an increase in the length and frequency of enamel cracks should be anticipated. However, laser-assisted debonding of metal brackets offers the advantage of reducing the risk of enamel damage while avoiding thermal damage to the pulp.
传统的去除金属托槽的方法会施加过大的力，导致牙釉质划痕、骨折以及患者不适。本研究的目的是评估使用两种强度水平的二极管激光去除金属正畸托槽作为传统去除方法的替代方法的有效性。
本研究使用了60颗完整的拔除人类前磨牙，将金属正畸托槽粘结在这些牙齿的颊面。将牙齿分为三组进行实验：（1）对照组，使用去粘结钳进行传统的托槽去除；（2）第一实验组，使用二极管激光（2.5W，980nm）进行激光去粘结；（3）第二实验组，使用二极管激光（5W，980nm）进行激光去粘结。激光以扫动的方式照射5秒。去粘结后，比较各组之间的粘结剂残留指数（ARI）、牙釉质裂纹的长度和频率。此外，还测量了牙髓腔内温度的升高。
在所有组中，均未出现牙釉质骨折的情况。与传统去粘结方法相比，激光去粘结导致新形成的牙釉质裂纹的频率和长度均显著降低。激光去粘结组在第二组和第三组中的牙髓腔内温度分别升高了2.37°C和3.60°C。这些温度升高显著低于5.5°C的阈值。各组之间的ARI评分未观察到显著差异。
使用所有去粘结方法时，都应预期牙釉质裂纹的长度和频率会增加。然而，激光辅助去除金属托槽具有降低牙釉质损伤风险的优点，同时避免对牙髓造成热损伤。
