Comparative analysis of enamel surface integrity and pulpal temperature in debonding metallic brackets: a study of two intensity levels of diode laser versus conventional method

The process of removing metallic orthodontic brackets creates difficulties which affect the enamel surface condition along with excessive temperature rise in the pulp. Traditional ethnomethodological debonding methods lead to enamel destruction yet the advent of diode lasers promises to decrease adverse side effects. Speakers evaluate the impact of using two different laser intensity settings during diode laser-assisted bracket debonding on enamel surface preservation andclarations of intrapulpal temperature changes.A test involved sixty human premolars bonded with metallic brackets by means of a standardized adhesive system that was then randomly distributed into three groups where each group consisted of twenty premolars (Group A – conventional debonding by pliers, Group B – laser debonding at 2.5 W, and Group C – laser debonding at 3.5 W). The research used thermocouple technology to monitor pulpal temperature changes while Scanning Electron Microscopy (SEM) together with modified Adhesive Remnant Index (ARI) evaluated the condition of enamel surfaces. A statistical Analysis was performed by using ANOVA and post hoc tests in which the p value was set below 0.05.The debonding technique by conventional means (Group A) generated a mean temperature elevation of 2.1 ± 0.5°C in the pulpal area while Group B with 2.5 W laser power and Group C with 3.5 W laser power led to temperature rises of 4.5 ± 0.8°C and 6.2 ± 1.1°C respectively. Quantitative evaluation through SEM revealed Group A had the highest rates of enamel damage whereas Group C registered the lowest amount of enamel modification. The ARI results confirmed that Group A experienced more adhesive residual on enamel surfaces whereas both Groups B and C maintained more adhesive material on their bracket bases during the debonding process.Diode laser-assisted brackets debonding conducted at low and high intensity settings produced better enamel preservation results than standard debonding methods. The pulpal temperature generated at the 3.5 W setting exceeded other measurements which justifies careful use of this method. A diode laser at 2.5 W offers a suitable tradeoff between enamel protection and pulpal thermal safety.

Medicina Oral S.L.
Universitat de València