Objectives: To conduct a systematic review assessing quantitative enamel loss occurring after orthodontic debonding and clean-up procedures. Materials and Methods: A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was performed on different databases (Embase, Medline, Scopus, Web of Science) for papers investigating volumetric enamel loss due to bracket and clear aligner attachment debonding and/or clean-up procedures. Studies investigating in vivo and in vitro articles published in the English language until 16 July 2022 were included. The study selection was then performed by two authors who screened the abstracts independently. Results: Of 421 screened abstracts, 41 articles were selected for full-text analysis. Finally, nine studies were included in this review. No in vivo papers were retrieved. In vitro papers investigated volumetric loss caused by the removal of metal brackets (n = 7), ceramic brackets (n = 1), and both (n = 1). The clean-up procedure varied among all investigations. Impressions at baseline and after debonding/clean-up were superimposed, and the volumes were subtracted using different 3D digital analysis software. Among all included studies, the volumetric loss of enamel ranged from 0.02 ± 0.01 mm³ to 0.61 ± 0.51 mm³ per tooth. Conclusions: Debonding and clean-up procedures produce enamel loss. The debonding/clean-up procedure that is able to cause the least enamel volume loss has yet to be identified.

Fulfilling a patient’s request for a healthy, functional and esthetic smile represents a daily challenge for dental practitioners

Background: 3D-printed (3DP) resins for permanent restorations are increasing in availability and gaining popularity. Aesthetic stability is an issue of dental resins that may compromise the long-term success of restorations. A staining test has been performed to evaluate gloss, roughness, and color staining of a permanent 3DP resin, and the effects of repolishing. Methods: Squared specimens of one 3DP permanent resin (Crown permanent, Formlabs) have been CAD-designed and 3D-printed. After the roughness, gloss, and color measurements, they were immersed in a coffee staining bath at 44 °C for 24 h and then measured again. Subsequently, they were repolished with three different systems: prophy cup and Nupro prophy paste, HiLuster Plus 2-step, and Opti1Step Polisher 1-step polishing systems. Results: Gloss and Roughness were not significantly affected by the staining procedure. No significant changes were observed for gloss after repolishing, while one of the tested systems (prophy cup and paste) produced a worsening effect on roughness. Color was affected by the staining procedure. After repolishing, b* changes were almost completely recovered, while L* changes were recovered only partially. Conclusions: Color stability still represents a challenge, and 3DP resins for permanent use are affected. Repolishing systems should be further developed and tested.