Er:YAG laser vs. ultrasonic debonding in orthodontics: Impact on pain and enamel condition

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Created On: 14/12/2023

A randomized clinical trial was conducted to assess the efficacy of laser and ultrasound in alleviating pain during the process of orthodontic debonding and to examine their impact on the enamel surface.

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Key take away

Using an Er:YAG laser for orthodontic bracket debonding has the potential to decrease pain and discomfort, offering an alternative approach to minimize any adhesive residue remaining on the tooth surface.

Background

Method

A total of 42 volunteers who were undergoing orthodontic therapy were enrolled. Upon completing their intervention, a randomized debonding procedure was performed using one of 3 methods: Group 1 (control group) utilized a bracket-removing plier (KP-013-135-PMK, CHIFA, Germany); Group 2 employed an erbium-doped yttrium aluminium garnet (Er:YAG) laser (Pluser, Doctor Smile, Italy); and Group 3 used an ultrasonic scalar (Woodpecker, UDS-J, China) with 14 subjects in each group.

Assessment of pain levels was done with the utilization of a numeric rating scale (NRS), and the amount of adhesive left on the teeth was determined using the Adhesive Remnant Index (ARI). For statistical assessment, the assembled data were subjected to the Bonferroni test and analysis of variance (ANOVA).

Result

Group 1 had the highest NRS values, Group 2 had the lowest values, and Group 3 had intermediate values (Figure 1).

When it comes to debonding brackets, the Er:YAG laser method resulted in significantly reduced pain intensity in comparison with the plier and ultrasonic scalar methods. Regarding the ARI values, Group 1 exhibited substantially greater values than the other two groups, whereas there were no clinically meaningful differences between Group 2 and Group 3 (Figure 2).