An in vitro atomic force microscopic study: comparative evaluation of enamel surface damage during clean up procedures after debonding with and without dental loupes under varying light intensities

Introduction: A smooth enamel surface after the removal of bracket from a tooth is essential for both aesthetic demands and the prevention of plaque accumulation. The significance of preserving the parent structure has revolutionized the treatment protocols towards the use of magnified fields like loupes, microscopes. Presently, dental chairs are supplied with lights of varying intensities ranging from 20,000 lux to 40,000 lux units. So, it’s worthy a point to note as to what light intensity gives us the best visual experience and minutest detail of the adhesive resin on the tooth surface after debonding so as to minimize the enamel loss.
Aims & objectives: To compare and evaluate enamel surface damage during clean up procedures after debonding using different light intensities with & without dental loupes observed under atomic force microscope (AFM).
Methodology: A total of sixty freshly extracted pre molar teeth were randomly divided into two groups with Group 1 being the control group with 12 sample teeth and the other was test group with 48 sample teeth. All the sample teeth in the test group were bonded with MBT pre-molar brackets and were debonded using a debonding plier. After the debonding procedure was done, the samples were divided equally into 4 groups namely, Group 2, Group 3, Group 4, Group 5. Clean up procedure for the residual resin of all the samples in Group 2 and Group 3 was done under halogen chair light of 20,000 lux without & with magnification respectively and for Group 4 & Group 5 clean up procedure for the residual resin of all the samples was done under LED chair light of 40,000 lux without & with magnification respectively. After the clean up procedure, the buccal surfaces of all the sample teeth in Group 1,2,3,4,5 were scanned by Atomic Force Microscope and the parameters Average Roughness (Ra) & Root Mean Square Roughness (Rq) were duly recorded and sent for statistical analysis.
Results: Descriptive statistics for average roughness value (Ra) and root mean square roughness (Rq) showed least roughness in control group followed by group 5, 4, 3, 2 respectively.
Conclusion: From our study it was concluded that due to better visualization under increased light intensity and magnification, the ability to remove the adhesive remnant with least damage to the enamel surface was achieved.