Investigation of the enamel surface changes in teeth with artificially produced white spot lesions and healthy ones after debonding: An in vitro study

Aim: The aim of this study is to compare the surface changes after debonding in the ceramic and metal bracket groups in healthy teeth with and teeth with caries lesion created after bonding. Materiel and Method: In the study, 60 healthy premolar teeth were separated to two groups for application of metal and ceramic brackets. Mild lesion (n = 10), advanced lesion (n = 10) and non lesion control group (n = 10) were established in order to examine the effect of white spot lesions on enamel damage as well as bracket species. All teeth underwent the same bonding protocol. Enamel surface changes were examined by steromicroscopic examination before application (T0), after debonding (T1) and after surface cleaning (T2). Results: The amount of adhesive adhered on the tooth surface as a result of debonding in the ceramic bracket group was significantly higher than the metal bracket group. In the metal bracket group, it was determined that the difference between the total crack length average at T0 and T2 was statistically insignificant. In the ceramic bracket group, it was determined that the difference between the total crack length average at T0 and T2 was statistically significant. When the caries level is mild, the difference between the total cavitation area average at T1 and T2 is statistically insignificant in both the metal and ceramic bracket groups. When the caries level is advanced, the difference between the total cavitation area average at T1 and T2 is statistically significant in both the metal and ceramic bracket groups. Conclusion: Debonding of ceramic brackets increased the average crack size. The white point lesion surrounding the entire surface of the bracket carries the risk of cavitation during debonding. Cavities come into play especially during the cleaning of adhesive residues. Key Words: Debonding, enamel crack, white spot lesion.