Precautions for ceramic brackets

1. Bracket removal technology and the risk of enamel damage

Since the performance of ceramic brackets is significantly different from that of metal brackets, the technology of removing metal brackets is not very effective for removing ceramic brackets. Compared with metal brackets, ceramic brackets are more likely to cause enamel damage when removed, while single crystal alumina ceramic brackets with more crystalline alumina brackets will cause more enamel loss. Chemical bonding is better than mechanical bonding. It will also cause greater enamel damage. Many clinical studies have reported enamel damage during mechanical de-bracketing. If there are factors that affect tooth structure such as enamel hypoplasia, enamel cracks, large-area restorations, dead pulp teeth, etc., the possibility of enamel damage caused by mechanical de-bracketing methods will be higher. In addition, the mechanical force of removing the bracket may cause discomfort to the patient. Electric heating is another technique for removing brackets. The method is to use a rechargeable heat gun to heat the bracket when pulling force is applied to the bracket. When enough heat passes through the bracket-adhesive layer, the bracket will fall off immediately.

1) The amount of enamel loss during the debonding process: It is related to the type of equipment and resin used. From a clinical point of view, the amount of enamel loss during the conventional bonding and debonding process is not significant compared to the entire enamel thickness, but the use of manual instruments and improper drill bits caused by deeper enamel creases or grooves should be avoided.

2) Enamel avulsion and enamel cracking: enamel damage is more likely to occur when removing ceramic brackets than removing metal brackets. Single crystal brackets cause more damage than multi-pin brackets. Chemical bonding causes more damage to enamel than mechanical bonding. Big. If the tooth structure itself has developmental defects, enamel cracks, large-area restorations or dead teeth, the tooth structure is more likely to be destroyed.

2. Repeated use of ceramic brackets

1) Ceramic brackets are easier to break than metal brackets but are not easily deformed. Therefore, the ceramic brackets after debonding can still maintain their precise groove and base shape, and are more likely to be reused.

2) The method of repeated use: heat to clean the residual adhesive of the ceramic bracket substrate, scrub thoroughly, sterilize in a high-temperature oven, and then soak in 75% alcohol for use. After air-drying before use, it can be reused as usual.

3) The newer ceramic brackets have weakened bonding strength but still meet clinical needs. The weakened bonding strength can significantly reduce the possibility of enamel damage during debonding.