Evaluation of enamel discoloration associatedwith different bracket systems and finishing procedures

Introduction and Aim: Different bracket systems can be used according to the planning of the fixed orthodontic treatment or to the clinician's preference. The brackets on the tooth surface during treatment may cause enamel discoloration problems. Enamel discoloration after orthodontic treatment is an important criterion in terms of the quality of treatment and the patient satisfaction. The aim of this study is to compare the effects of two different bracket systems and finishing techniques on enamel discoloration Material and Method: For this study, 40 human premolar teeth were used. Teeth were randomly divided into four groups and each group had 10 teeth. Gemini bracket - tungsten carbide burr (Group 1), Gemini braces - tungsten carbide burr - Sof-lex disk group (Group 2), Flash free braces - tungsten carbide burr (Group 3), Flash Free braces - tungsten carbide burr - Sof-lex disk group (Group 4) were experimental groups. Vita Easyshade spectrophotometer color measurement device was used to measure the initial and final color measurements of the total 40 teeth in four groups. Adhesive coated and 3M Gemini conventional bracket systems were bonded to the tooth surfaces with 3M Transbond XT adhesive agent. After debonding the braces, the adhesive residues on the teeth surface were cleaned with tungsten carbide or tungsten carbide-Sof-lex finishing techniques. The clinical color change of teeth was calculated using ∆E = [(∆L)2 + (∆a)2 + (∆b)2]1/2= [(Ls-Lö)2 + (as-aö)2 + (bs-bö)2]1/2 formula, Kolmogorov Smirnov test was used to determine the data normality. A two-way analysis of variance was used to evaluate the factors effecting the enamel discoloration (p˂0,05). Comparison of the color difference values (ΔE) between groups were determined with using the Tukey multiple comparison test (p˂0,05). Results: It was found that the color change of enamel surface in the Flash Free bracket system groups was significantly less than the Gemini bracket system groups (p;0,003 p˂0,05). The mean ΔE values obtained from the Sof-lex groups were lower than groups without sof-lex, but these results were not statistically significant (p;0,280 p>0,05). Conclusion: As a result of this in vitro study, it was found that using these two types of the braces and finishing techniques resulted in coloration on the enamel surface. Debonding with tungsten carbide burr caused more color changes than the finishing protocol with using both of the tungsten carbide burr and Sof-lex disc. It was observed that using Sof-lex disc leads to less color change in all groups. Regardless of the finishing protocols, it was found that the Flash Free bracket system caused less color change on the teeth than the Gemini bracket system.