EVALUATION OF THE EFFECTS OF ER-YAG LASER WITH A DIGITAL SCANNING TIP ON DEBONDING OF CERAMIC BRACKETS VS. THE CONVENTIONAL METHOD

Objective: The aim of this study was to evaluate the effect of the Erbium-doped Yttrium Aluminum Garnet (Er-YAG) laser with a digital and homogeneous scanning (X-Runner) tip on the debonding process of ceramic brackets, comparing with conventional methods. Method: 80 extracted teeth were divided equally into four groups regarding the bracket material and the debonding procedure: Polycrystalline+ Laser (PL), Monocrystalline+ Laser (ML), Polycrystalline+ Conventional (PC) and Monocrystalline+ Conventional (MC). Enamel cracks were examined both before and after debonding and the remaining adhesive on the enamel surface was evaluated by using the adhesive reminant index (ARI) with the aid of a stereomicroscope. Additionally, the effect of the Er-YAG laser on pulpal temperature rise and the extent of penetration of Er- YAG laser beams into the adhesive were measured. The nonparametric Kruskal-Wallis statistical test was employed to evaluate remaining adhesive on the tooth surface and enamel cracks, while the Mann-Whitney statistical test was utilized to assess temperature rise. Results: No significant differences in enamel cracks or fractures were observed between the experimental groups concerning both bracket material and debonding procedure (p>0.05). Significant differences were found in ARI scores and pulpal temperature changes between the ML and PL groups. (p<0.05) Additionally, SEM images revealed that the Er: YAG laser beam did not significantly penetrate the adhesive and had no impact on the enamel surface. Conclusion: The Er:YAG laser, especially when used with the X-Runner head, provides precise control and minimal thermal impact, ensuring no damage to the enamel or pulp. Therefore, it can be safely utilized for the removal of ceramic brackets in clinical settings.