The influence of dental loupes on the quality of adhesive removal in orthodontic debonding

Objective: Bracket bonding has been a major advance in orthodontic treatment. However, the method of debonding can lead to diverse problems such as enamel fractures, enamel loss and enamel scratching. In this clinical investigation we aimed to evaluate the influence of wearing dental loupes on enamel damage during the debonding procedure. Material and Methods: 22 consecutive patients were randomly assigned in a split-mouth study to evaluate adhesive removal with and without the use of dental loupes (2.5×, LED headlight). Tooth replicas in epoxy resin were made from silicone impressions. Electron microscopic images (50× magnification) of 394 buccal enamel surfaces were evaluated according to an enamel damage index (EDI), line angle grooves (LAG) and composite residues (CR) on anterior teeth, premolars and molars. Results: The EDI revealed highly significant advantages for debonding with dental loupes, with which the EDI was significantly higher for molars, while still less than without dental loupes. We detected no differences between the tooth groups without dental loupes. We found significantly fewer LAG on anterior teeth debonded with dental loupes. CR were fewer in the dental loupes group, and we noted no significant differences between the tooth groups. Conclusions: Dental loupes affect the quality of the debonding procedure, resulting in less enamel damage and composite residue, as well as fewer LAG compared to the control group. We therefore strongly recommend the use of dental loupes in orthodontic debonding procedure