Efficiency of the Er,Cr:YSGG laser in orthodontic adhesive removal: effects on enamel surface compared with an ultrasonic scaler and a tungsten carbide bur

None of the currently available techniques allows complete and rapid removal of residual adhesive without causing damage to the enamel surface. The aim of the present study was to compare enamel surface characteristics following adhesive removal using an Er,Cr:YSGG laser, an ultrasonic scaler, and a tungsten carbide bur. Material and methods. A total of 105 extracted human teeth were prepared for the experiment. The teeth were randomly divided into three groups (n=35) according to the adhesive removal method used: Er,Cr:YSGG laser, ultrasonic scaler, and tungsten carbide bur. Orthodontic brackets were bonded to the teeth and debonded after 24 hours. The remaining adhesive was removed using the corresponding system and the enamel surfaces were polished with Silicone OneGloss. The following parameters were evaluated: Adhesive Remnant Index (ARI), percentage of adhesive remnant area (ARA%), Enamel Damage Index (EDI), percentage of enamel surface defect area (ESDA%). Results. After treatment with an ultrasonic scaler, the specimens exhibited a relatively smooth enamel surface with fine parallel scratches; however, ARA values were higher compared to the other groups. In the tungsten carbide bur group, the adhesive was almost completely removed (predominance of ARI=0), but the enamel surface showed pronounced roughness, deep grooves, surface irregularities, and microcracks. The Er,Cr:YSGG laser demonstrated ARA values comparable to those of the bur while showing significantly lower ESDA values, thus occupying an intermediate position between removal efficiency and enamel preservation. Intergroup differences were statistically significant (p<0.05). Conclusion. All investigated methods effectively removed orthodontic adhesive; however, they differed in terms of enamel preservation. The tungsten carbide bur ensured maximum removal efficiency at the cost of greater enamel damage, the ultrasonic scaler was more conservative but less effective, while the Er,Cr:YSGG laser provided a favorable balance between efficiency and safety, making it a promising alternative to conventional methods.