title: The effects of bracket removal on enamel.
abstract: BACKGROUND
  Enamel cracks, which may develop during debonding orthodontic brackets, may jeopardise the integrity of the enamel and detract from the appearance of the teeth.
  
  
  OBJECTIVE
  To compare the adhesive remnant scores (ARI), the number, lengths and directions of enamel cracks before bonding and after debonding metal orthodontic brackets with three different methods.
  
  
  METHODS
  Metal brackets were bonded with a self-curing orthodontic adhesive to the buccal surfaces of 75 recently extracted upper and lower premolars. The teeth were randomly divided into three groups, and the brackets removed either with a side-cutter, a single-blade bracket remover or a two-blade bracket remover. The number, directions and lengths of the enamel cracks before bonding and after debonding were compared. The number of 'pronounced' cracks (i.e. cracks that could be identified with the naked eye) and the ARI scores in each group were also compared.
  
  
  RESULTS
  After debonding, the number of enamel cracks and pronounced cracks, and the lengths of the enamel cracks increased in all groups (p < 0.001). There were no statistically significant differences between the groups. The ARI scores and the direction of propagation of the enamel cracks were not influenced by the debonding method used (p = 0.73).
  
  
  CONCLUSIONS
  Concerns about the enamel damage caused by the three methods of debonding justify caution. Despite widespread use of these methods, it would be sensible to search for methods that result in less enamel damage.
authors.affiliation: Department of Orthodontics and Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. heravif@mums.ac.ir
authors.forename: Farzin
authors.initials: F
authors.lastname: Heravi
authors.forename: Roozbeh
authors.initials: R
authors.lastname: Rashed
authors.forename: Leila
authors.initials: L
authors.lastname: Raziee
mesh_terms: D001641:Bicuspid; D017005:Dental Debonding / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D003743:Dental Enamel / Q000293:injuries*; D006801:Humans; D016910:Orthodontic Brackets