{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:41:40Z","timestamp":1788370900072,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Scientific World Journal"],"published-print":{"date-parts":[[2021,5,6]]},"abstract":"<jats:p>Background and Objective. The primary responsibility of an orthodontist is to preserve the dental enamel structure during debonding ceramic brackets. The enamel injury caused at the time of bracket removal causes inconvenience to the patient and disturbs the treating orthodontist. This paper aims for an effective evidence-based debonding protocol to keep the enamel surface intact. Methods. The current study includes 80 extracted premolars of human from the patient visiting for orthodontic treatment of Coorg Institute of Dental Sciences, Karnataka, India. The brackets were debonded using four different methods. The enamel surface damage after the procedure was assessed with the Enamel Surface Index (ESI); similarly, the Adhesive Remnant Index (ARI) score was used to determine the adhesive residual deposit. Scanning electron microscopy (SEM) was used to visualize better microporosities and micromechanical retention of adhesive remnants on the enamel surface. The normality of the data was tested using the Kolmogorov\u2013Smirnov test. Depending upon the normality test result, the one-way ANOVA test or Kruskal\u2013Wallis test was used to test the mean ESI and mean ARI differences among different debonding methods along with the appropriate post hoc tests. The necessary ethical clearance was obtained from the Ethics Committee of the institute. Results. The ultrasonic scaler (US) technique led to more significant enamel surface damage, with 13 (65%) samples in the ESI scores III and IV against the satisfactory surface in 2 (10%) samples with the ligature cutter (LC) technique (ESI-I) reflecting LC as a better technique. The ESI scores (III and IV) for debonding plier (DP) and thermal method (TM) reflected a higher value in 12 (60%) and 10 (50%) samples and caused more damage to the enamel surface as compared to the LC technique. The ARI score was highest (ARI-1\u2009=\u200940%) with the LC technique, followed by the US (ARI-1\u2009=\u200920%), TM (ARI-1\u2009=\u200915%), and DP (ARI-1\u2009=\u20095%) methods. We have observed a significant association (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                     <\/a:math>\n                  <\/jats:inline-formula> value &lt;0.05) of the ARI score among four different debonding ways in terms of each tooth\u2019s residual adhesive after the bracket removal. Conclusion. The result establishes the LC technique as a more acceptable one as it causes minimal harm to the debonded surface. The adhesive left on the debonded area is also minimum as compared to the other three methods tested. Therefore, it can be suggested as an ideal method.<\/jats:p>","DOI":"10.1155\/2021\/5561040","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T21:36:39Z","timestamp":1620509799000},"page":"1-8","source":"Crossref","is-referenced-by-count":11,"title":["Enamel Surface Damage following Debonding of Ceramic Brackets: A Hospital-Based Study"],"prefix":"10.1155","volume":"2021","author":[{"given":"Neelutpal","family":"Bora","sequence":"first","affiliation":[{"name":"Dentistry, Assam Medical College and Hospital, Dibrugarh 786002, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-4879","authenticated-orcid":true,"given":"Putul","family":"Mahanta","sequence":"additional","affiliation":[{"name":"Forensic Medicine and Toxicology, Assam Medical College and Hospital, Dibrugarh 786002, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5609-7492","authenticated-orcid":true,"given":"Deepjyoti","family":"Kalita","sequence":"additional","affiliation":[{"name":"Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta","family":"Deka","sequence":"additional","affiliation":[{"name":"Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjumoni","family":"Konwar","sequence":"additional","affiliation":[{"name":"Radiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiranjita","family":"Phukan","sequence":"additional","affiliation":[{"name":"Medicine, Tezpur Medical College and Hospital, Tezpur, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","first-page":"35","article-title":"Bond strength of ceramic brackets with various bonding systems","volume":"61","author":"S. 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