Effects of different debonding techniques on the debonding forces and failure modes of ceramic brackets in simulated clinical set-ups.

INTRODUCTION: The objectives of this study were to evaluate the effects of different debonding techniques on the in-vitro mean debonding forces and failure modes of ceramic brackets bonded to enamel with clinically simulated setups. METHODS: Three kinds of ceramic brackets (Clarity; 3M Unitek, Monrovia, Calif; Inspire and Inspire Ice; Ormco, Orange, Calif) were bonded to extracted premolars with the same bonding system. Thirty ceramic brackets, 10 of each type, were removed by hand; 60 ceramic brackets, 20 of each type, were tested on a universal testing machine with the pliers according to the manufacturers' recommendations. To simulate clinical debonding conditions, specially designed setups were used to debond the ceramic brackets. Debonding forces and failure modes were investigated. Fractographic evaluations were performed by using scanning electron microscopy. RESULTS: Most brackets failed at the bracket-adhesive interface. Cohesive bracket fractures were noted in all 3 types of ceramic brackets (debonded by hand: 70% of Inspire, 20% of Inspire Ice, and 10% of Clarity; debonded by machine: 75% of Inspire, 30% of Inspire Ice, and 25% of Clarity). The cohesive ceramic fractures of the Clarity brackets were located at the junction between the wings and the body, and at the slot. However, for the Inspire and the Inspire Ice brackets, the cohesive ceramic fractures were located at the occlusal aspect of the base. The mean debonding forces of Inspire, Inspire Ice, and Clarity brackets were 25.72 +/- 11.98, 17.92 +/- 5.03, and 76.89 +/- 23.47 N, respectively. No enamel damage was found after the brackets were removed. CONCLUSIONS: The results of the failure modes showed that the new designs with a ball reduction band in the Inspire Ice bracket and the vertical debonding slot in the Clarity bracket significantly reduced the risk of ceramic bracket fracture during debonding. The force required to debond the Inspire Ice bracket was significantly lower than that of the Inspire bracket.

Intrusion of the overerupted upper left first and second molars by mini-implants with partial-fixed orthodontic appliances: a case report.

Overeruption of maxillary molar(s) because of loss of the opposing teeth creates occlusal interference and functional disturbances. To restore proper occlusion, intrusion of the overerupted molars becomes essential before reconstruction can be initiated. A plausible procedure is orthodontic intrusion, which demands calibrated anchorage support from intraoral multiunit teeth and from headgear wear. In this report, we present a simplified and localized version of the orthodontic appliances in conjunction with mini-implants to intrude the overerupted molars. The purpose of using implants as skeletal anchorage was to eliminate the need for patient compliance for headgear wear and to overcome the difficulty resulting from the shortage of anchor teeth. The results showed that the biological responses of the teeth and the surrounding bony structures to the intrusion appeared normal and acceptable. Furthermore, the periodontal health and vitality of the teeth were well maintained even after a one-year follow-up.