Comparative Efficiency of Adhesive Removal Methods After Orthodontic Treatment: An SEM and AutoCAD-Based Study

Aim: After fixed appliance treatment, it is necessary to remove the brackets and adhesive from the tooth surfaces. Choosing an efficient clean-up procedure for adhesive removal is important, as residual adhesive can lead to plaque accumulation and tooth discoloration. The aim of this study was to compare the efficiency of six different methods for residual adhesive removal, with the Composite Remnant Index (CRI) score improved by using AutoCAD software and scanning electron microscopy. Materials and Methods: After debonding brackets from the surfaces of 210 extracted human premolars, the remaining adhesive was removed using the following methods: round tungsten carbide bur, fissure tungsten carbide bur, composite bur reinforced by zircon-rich glass fiber, medium abrasive disc, ultrasonic dental scaler, and adhesive removing pliers. The CRI score was used to quantify the amount of remaining adhesive on the teeth using SEM images. In order to improve the CRI evaluation procedure, AutoCAD software was used to obtain more accurate results for the clean-up method. Results: The lowest average CRI values were determined in the groups where abrasive discs (0.6) and composite burs (0.68) were used. The maximum residual adhesive surface after the clean-up procedure ranged from 3.71 mm 2 (abrasive disc) to 14.24 mm 2 (adhesive removing pliers). Conclusions: The application of the abrasive disc proved to be the most efficient method for adhesive removal, followed by the composite bur. The use of the fissure tungsten carbide bur proved to be the least efficient method among the tested rotary instruments. Abrasive discs could be considered a part of an optimal clean-up protocol.