Thermal debonding of ceramic brackets: an in vitro study.

Thermal debonding has been developed to overcome the problems of enamel damage and high forces when debonding ceramic orthodontic brackets. However, the temperature changes with thermal debonding have the potential to damage the tooth tissues. The principal aims of this study are, first, to investigate the effects of resin type, resin thickness, and debonding force on the temperature changes in human premolars during thermal debonding of ceramic brackets and, second, to record the sites of bond failure and damage to the tooth surface. Ceramic brackets were attached to each specimen by using one of four types of bonding resin in a controlled thick or thin resin layer. The ceramic debonding unit (Dentaurum, Pforzheim, Germany) was used to thermally debond the brackets with either a 40 or 80 Nmm torsional force. Higher temperature changes at the pulpal wall (> 10 degrees C in some 40 Nmm torsional force specimens) always occurred with Concise (3M Dental Products, St. Paul, Minn.) and Transbond (Unitek/3M Dental Products, Monrovia, Calif.) resins, and lower temperature changes (< 5 degrees C) with Quasar (Rocky Mountain Orthodontics, Denver, Colo.) and Ortho. B.S. (Dentaurum, Pforzheim, Germany) resins. In general, resin thickness was not significantly associated with buccal surface or pulpal wall temperature changes. However, temperature changes at the pulpal wall were significantly associated with the temperature changes at the buccal surface (r = 0.76), with the temperature of the thermal debonder blade for thin resin layer specimens (r = 0.50), and the time required to debond the bracket for both thick (r = 0.74) and thin (r = 0.63) resin layer specimens. In most specimens, the site of bond failure occurred at the bracket-resin interface. There was no evidence of enamel damage after bracket removal.