Reconditioning of ceramic orthodontic brackets with an Er,Cr:YSGG laser

It is now known that erbium lasers are effective in composite removal, but there is minimal information about their efficacy on recycling of ceramic brackets. This study, therefore, aimed to determine the percentage of remaining adhesive on the base and the shear bond strength of debonded ceramic brackets after being reconditioned by an Er,Cr:YSGG (erbium, chromium: yttrium–scandium–gallium–garnet) laser. Thirty premolars were divided into three groups, then bonded with mechanical retention ceramic brackets according to the bracket base conditions: (1) new brackets; (2) debonded brackets cleaned of adhesive with the Er,Cr:YSGG laser at 3.5 W; and (3) debonded brackets cleaned of adhesive with the Er,Cr:YSGG laser at 4 W. Before bonding, the percentage of remaining adhesive on the bases of reconditioned brackets was calculated by using stereomicroscopic images through an image processing software. The brackets were then tested in shear mode in a universal testing machine and the adhesive remnant index scores were determined. The percentage of remaining adhesive on the bases of brackets that were cleaned by the Er,Cr:YSGG laser at 4 W (3.1 %) was significantly lower than that of the 3.5-W laser group (5.9 %) (p = 0.03). No significant difference was found in bond strengths between the new and the reconditioned brackets (p = 0.19). The frequency of bond failure at the enamel-adhesive interface was lower in the laser-reconditioned brackets when compared to the new brackets. The application of Er,Cr:YSGG laser was efficient in removing adhesive from bases of debonded ceramic brackets because it produced comparable bond strengths to new brackets while reducing the risk of enamel damage during debonding.