Case-control Study, Debonding, Orthodontic Appliance
Conditions
Keywords
orthodontic clean-up, orthodontic debonding, enamel preservation, minimally invasive dentistry, case-control study
Brief summary
Orthodontic clean-up following debonding remains a technically demanding procedure, with documented risks of enamel roughening, microdefects, discoloration, and increased plaque retention. Minimally invasive technologies have recently been introduced to improve adhesive removal while limiting damage to the outer enamel layer, but comparative clinical evidence remains limited. This aim of this case-control study was to compare the effectiveness and the safety of two different minimally invasive clean-up systems: two-step ultrasonic inserts (Combi Touch, Mectron) and a one-step polishing bur (One Gloss®, Shofu). A total of 142 patients presenting residual orthodontic adhesive after debonding were included. They were randomly allocated to: (1) Case group (n = 71): two-step ultrasonic system (Combi Touch, Mectron) equipped with 30-µm diamond-coated and PEEK-coated inserts; (2) Control group (n= 71): one-step tungsten carbide/abrasive polisher (One Gloss®, Shofu). For each patient the following clinical indices were recorded at baseline (T0) and 30-day follow-up (T1): Plaque Control Record (PCR), Bleeding on Probing (BoP), Adhesive Remnant Index (ARI), International Caries Detection and Assessment System (ICDAS-II), and dentinal sensitivity (Schiff Air Index). Orthodontic treatment modality (clear aligners vs fixed appliances) was documented as a covariate and tested for potential interactions with clinical outcomes.
Interventions
DEVICETwo-step ultrasonic protocol
Diamond- and PEEK-coated inserts
DEVICEOne-step clean-up protocol
One-step tungsten carbide/abrasive polisher
Sponsors
IRCCS San Raffaele
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients undergone either fixed vestibular orthodontic treatment or clear aligner therapy * Debonding procedure must not have occurred more than 24 months prior to evaluation * ICDAS-II index ≤ 2
Exclusion criteria
* Patients treated with removable orthodontic appliances * Patients whose debonding exceeded 24 months * ICDAS-II score \> 2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plaque Control Record (PCR) | Baseline, after 30 days | The PCR is scored as the percentage of tooth surfaces with visible plaque (0-100%). Higher scores indicate worse oral hygiene. |
| Bleeding on Probing (BoP) | Baseline, after 30 days | BoP is expressed as the percentage of bleeding sites (0-100%). Higher scores indicate worse gingival health. |
| Adhesive Remnant Index (ARI) | Baseline, after 30 days | The ARI is scored 0-3, where 0 = no adhesive left on tooth surface and 3 = all adhesive remaining. Higher scores indicate more adhesive remaining on the enamel. |
| International Caries Detection and Assessment System (ICDAS-II) | Baseline, after 30 days | The ICDAS-II is scored from 0 to 6, where 0 = sound tooth surface and 6 = extensive cavitated lesion. Higher scores indicate worse caries status. |
| Schiff Air Index | Baseline, after 30 days | The Schiff Air Index scored from 0 to 3, where 0 = no response to air stimulus and 3 = strong painful response. Higher scores indicate greater dentinal hypersensitivity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Orthodontic treatment modality | Baseline | Orthodontic treatment modality was recorded as a categorical variable at baseline (T0), distinguishing between the use of clear aligners and fixed appliances. This variable does not follow a numerical scale; instead, it consists of two categories. No minimum or maximum values apply, and higher values do not correspond to better or worse outcomes. |
Countries
Italy
Outcome results
None listed