Effects of adhesive flash free brackets with different bonding techniques on enamel demineralization and periodontal health

Aim: This study aimed to clinically evaluate the effects of conventional and flash-free brackets applied with direct and digital indirect bonding techniques on enamel demineralization and periodontal health. Methods: In this randomized controlled clinical study, bonding procedure was performed in 20 patients using separate brackets (conventional or flash-free) and techniques (direct or digital indirect bonding) in each quadrant. Demineralization measurements were performed from before and immediately after bonding and one and six months later from four sides of brakets (mesial, distal, incisal/occlusal, gingival). Bleeding on probing, plaque, and gingival indices and were recorded to evaluate periodontal status. Data were statistically analyzed using the Kruskal–Wallis and Mann–Whitney U tests. Results: As a result of flash-free and conventional brackets bonding with different techniques, the highest demineralization value was recorded from the proximal, and the lowest was recorded from the incisal/occlusal sides. The anterior teeth showed a significant increase in the proximal and gingival regions in conventional brackets bonding with digital indirect bonding technique than flash-free brackets (p < 0.05). As a result of flash-free and conventional brackets bonding with different techniques, periodontal parameters increased six months after bonding. However, differences between techniques were found to be statistically insignificant (p > 0.05). Conclusion: Flash-free brackets with digital indirect bonding caused less demineralization than the direct bonding technique. Similar effects were found in terms of flash-free and conventional brackets bonding with different techniques.