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Abstract：
BACKGROUND: Failure of orthodontic bracket bonds is a common occurrence during orthodontic treatment. This study investigated the impact of Er: YAG laser-based removal of adhesive from the bases of metal and ceramic brackets for re-bonding.
METHODS: A total of 168 extracted premolars were collected from patients. 84 metal brackets were used to be bonded on the buccal surface of the premolars in Groups 1, 2, 3 and 4, while 84 ceramic brackets were applied in Groups I, II, III and IV. Group 1/I represented the initial bonding group, with Group 2/II being the re-bonding group with new brackets, while Groups 3/III and 4/ IV received recycled brackets treated by Er: YAG laser or flaming respectively. Both the first and second de-bonding were performed in all samples using a universal testing machine to determine the shear bond strength (SBS). The adhesive remnant index (ARI) was evaluated using a stereo-microscope. The new and the treated bracket bases were evaluated using scanning electron microscopy (SEM). Differences in initial bonding and re-bonding ability were analyzed through one-way ANOVAs, and differences in ARI were assessed with the Kruskal-Wallis test.
RESULTS: Greater amounts of adhesive residue were observed on ceramic brackets treated by laser. The SBS values for recycled metal brackets in Group 3 (26.13 MPa) were comparable to Group 1 (23.62 MPa) whereas they differed significantly from Group 4 (12.54 MPa). No significant differences in these values were observed when comparing the 4 groups with ceramic brackets. ARI score in Group 4 (2-3 points) differed significantly from the three other groups (P < 0.05). For Group I, II, III and IV, similar ARI scores were observed (P > 0.05). SEM analysis didn\'t show apparent damage of bracket bases consisting of either metal or ceramic material treated by Er: YAG laser.
CONCLUSIONS: Er: YAG laser treatment was superior to flame treatment as a means of removing adhesive without damaging the brackets. SBS values and ARI scores following Er: YAG laser treatment were similar to those for new brackets, offering further support for Er: YAG laser treatment as a viable means of recycling debonded brackets.
METHODS: A total of 168 extracted premolars were collected from patients. 84 metal brackets were used to be bonded on the buccal surface of the premolars in Groups 1, 2, 3 and 4, while 84 ceramic brackets were applied in Groups I, II, III and IV. Group 1/I represented the initial bonding group, with Group 2/II being the re-bonding group with new brackets, while Groups 3/III and 4/ IV received recycled brackets treated by Er: YAG laser or flaming respectively. Both the first and second de-bonding were performed in all samples using a universal testing machine to determine the shear bond strength (SBS). The adhesive remnant index (ARI) was evaluated using a stereo-microscope. The new and the treated bracket bases were evaluated using scanning electron microscopy (SEM). Differences in initial bonding and re-bonding ability were analyzed through one-way ANOVAs, and differences in ARI were assessed with the Kruskal-Wallis test.
RESULTS: Greater amounts of adhesive residue were observed on ceramic brackets treated by laser. The SBS values for recycled metal brackets in Group 3 (26.13 MPa) were comparable to Group 1 (23.62 MPa) whereas they differed significantly from Group 4 (12.54 MPa). No significant differences in these values were observed when comparing the 4 groups with ceramic brackets. ARI score in Group 4 (2-3 points) differed significantly from the three other groups (P < 0.05). For Group I, II, III and IV, similar ARI scores were observed (P > 0.05). SEM analysis didn\'t show apparent damage of bracket bases consisting of either metal or ceramic material treated by Er: YAG laser.
CONCLUSIONS: Er: YAG laser treatment was superior to flame treatment as a means of removing adhesive without damaging the brackets. SBS values and ARI scores following Er: YAG laser treatment were similar to those for new brackets, offering further support for Er: YAG laser treatment as a viable means of recycling debonded brackets.
摘要：
背景：正畸治疗过程中常见的情况是正畸托槽粘结失败。这项研究调查了基于Er：YAG激光从金属和陶瓷支架的底座上去除粘合剂以进行重新粘合的影响。
方法：从患者中收集168颗前磨牙。在第1、2、3和4组中，使用84个金属托槽粘合在前磨牙的颊表面上，而在第1组中应用了84个陶瓷托槽，II,III和IV。组1/I代表初始键合基团，第2/II组是带有新括号的重新结合组，而第3/III组和第4/IV组分别接受Er：YAG激光或火焰处理的回收支架。使用通用试验机在所有样品中进行第一和第二脱粘,以确定剪切粘结强度(SBS)。使用立体显微镜评价粘合剂残留指数(ARI)。使用扫描电子显微镜（SEM）评估新的和处理过的托槽底座。通过单向方差分析了初始键合和重新键合能力的差异，ARI的差异用Kruskal-Wallis检验进行评估.
结果:在激光处理的陶瓷托槽上观察到更大量的粘合剂残留物。第3组（26.13MPa）的回收金属支架的SBS值与第1组（23.62MPa）相当，而与第4组（12.54MPa）则有显着差异。当使用陶瓷托槽比较4组时,没有观察到这些值的显著差异。第4组ARI评分(2～3分)与其他3组比较差异有统计学意义(P<0.05)。对于第一组，II,III和IV，ARI评分相似(P>0.05).SEM分析未显示由Er：YAG激光处理的金属或陶瓷材料组成的支架底座明显损坏。
结论：Er：YAG激光治疗作为一种去除粘合剂而不损坏支架的方法，优于火焰治疗。Er:YAG激光治疗后的SBS值和ARI评分与新支架相似，为Er：YAG激光治疗提供进一步的支持，作为回收脱粘支架的可行手段。
方法：从患者中收集168颗前磨牙。在第1、2、3和4组中，使用84个金属托槽粘合在前磨牙的颊表面上，而在第1组中应用了84个陶瓷托槽，II,III和IV。组1/I代表初始键合基团，第2/II组是带有新括号的重新结合组，而第3/III组和第4/IV组分别接受Er：YAG激光或火焰处理的回收支架。使用通用试验机在所有样品中进行第一和第二脱粘,以确定剪切粘结强度(SBS)。使用立体显微镜评价粘合剂残留指数(ARI)。使用扫描电子显微镜（SEM）评估新的和处理过的托槽底座。通过单向方差分析了初始键合和重新键合能力的差异，ARI的差异用Kruskal-Wallis检验进行评估.
结果:在激光处理的陶瓷托槽上观察到更大量的粘合剂残留物。第3组（26.13MPa）的回收金属支架的SBS值与第1组（23.62MPa）相当，而与第4组（12.54MPa）则有显着差异。当使用陶瓷托槽比较4组时,没有观察到这些值的显著差异。第4组ARI评分(2～3分)与其他3组比较差异有统计学意义(P<0.05)。对于第一组，II,III和IV，ARI评分相似(P>0.05).SEM分析未显示由Er：YAG激光处理的金属或陶瓷材料组成的支架底座明显损坏。
结论：Er：YAG激光治疗作为一种去除粘合剂而不损坏支架的方法，优于火焰治疗。Er:YAG激光治疗后的SBS值和ARI评分与新支架相似，为Er：YAG激光治疗提供进一步的支持，作为回收脱粘支架的可行手段。
