Evaluation of pain perception and enamel loss by two different techniques of debonding: a randomized controlled trial

Lakshmi Niharika Ubbarapu; Gowri Sankar Singaraju; Ganugapanta Vivek Reddy; Perala Johnson; Kiran. K. Kumari; Prasad Mandava

doi:10.17126/joralres.2024.021

Lakshmi Niharika Ubbarapu Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0009-0007-5360-1837
Gowri Sankar Singaraju Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0000-0002-7666-7392
Ganugapanta Vivek Reddy Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0000-0002-7513-1502
Perala Johnson Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0000-0002-4739-1585
Kiran. K. Kumari Department of Orthodontics, CKS Teja Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0009-0000-7827-9484
Prasad Mandava Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India. http://orcid.org/0000-0003-3024-544X

DOI: https://doi.org/10.17126/joralres.2024.021

Keywords: Pain, Adhesives, Orthodontic Brackets, Dental debonding, Dental instruments, Orthodontics

Abstract

Objective: To assess the level of discomfort experienced by patients during the debonding procedure using two different debonding instruments, as well quantify the iatrogenic enamel loss following debonding.
Materials and Methods: A total of 50 patients who were due for debonding were randomly allocated into two equal groups of 25 each by SNOSE method. The group-A (GDC Bracket Remover # Straight Plier (3000/83)) and group- B (#095-S - Bracket and Adhesive Removing Plier. Orthopli, Philadelphia, Pa) were utilized for debonding by a standard procedure. Patients were given a pain-perception worksheet with a visual analogue scale (VAS) to note the pain/discomfort experienced. The amount of residual enamel attached to the bracket base pad was evaluated by elemental mapping using backscattered scanning electron microscopy technique. Mann Whitney U test and Kruskal-Wallis test were utilized for analysing pain perception. The bracket adhesive remnant index (BARI) and adhesive remnant index (ARI) scores were analysed using Chi-Square Test.
Results: The pain perception with ORTHOPLI adhesive and bracket debonding plier (22.5) was less compared to that of GDC plier (30) and statistically significant. BARI scores showed 39% more enamel loss in Group B compared to Group A. ARI scores showed less amount of adhesive attached to tooth surface in Group B (58%) compared to group A. Whereas, the percentage of enamel attached to the bracket base of both the groups showed no significant difference.
Conclusion: ORTHOPLI adhesive and bracket debonding plier is more effective in debonding as it causes comparatively less pain and adhesive attached to the tooth surface.

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