Pulpal response in electrothermal debonding.
An alternative method to conventional bracket removal that minimizes the potential for ceramic bracket failure as well as trauma to the enamel surface is electrothermal debonding (ETD). However, the potential for pulpal damage using ETD on ceramic brackets still needs assessment. The purpose of this research is to investigate and assess any pulpal damage caused by ETD. Ten patients requiring four premolar extractions each were randomly selected (5 boys and 5 girls). Ceramic brackets were bonded to experimental and control teeth. A total of 30 teeth were used to provide histologic material of the human pulp. Fifteen teeth were extracted 24 hours after ETD, seven were extracted 28 to 32 days after ETD, and eight were the control teeth and debonded by a conventional method, with pliers. The pulp was normal in most cases in the control group. There was significant hyperemia seen 24 hours after debonding in teeth debonded by ETD. Teeth extracted 30 days afer ETD showed varied responses, ranging from complete recovery in some cases to persistence of inflammation and pulpal fibrosis. Teeth subjected to the conventional debonding were normal histologically. The teeth in our research were healthy teeth with a rich blood supply and were from a younger age group. Patients with compromised teeth that have large restorations or a questionable pulpal status could behave more adversely to this significant amount of heat applied. In compromised cases and on older patients, performing pulp vitality tests before ETD may inform the operator about the status of the pulp and thereby prevent the potential for pulpal damage.(ABSTRACT TRUNCATED AT 250 WORDS)
Takla
P M
PM
University of Detroit Mercy, Mich, USA.
Shivapuja
P K
PK
D000293:Adolescent; D001641:Bicuspid; D002516:Ceramics; D002648:Child; D017005:Dental Debonding / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003782:Dental Pulp / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D003791:Dental Pulp Test; D004560:Electricity; D004912:Erythrocytes / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006358:Hot Temperature; D006801:Humans; D006940:Hyperemia / Q000473:pathology; D008297:Male; D016910:Orthodontic Brackets; D011671:Pulpitis / Q000473:pathology; D013997:Time Factors