Enamel loss at bond-up, debond and clean-up following the use of a conventional light-cured composite and a resin-modified glass polyalkenoate cement

The aim of this study was to determine whether there was any difference in the degree of enamel loss at bond-up, debond and enamel clean-up when two different adhesive systems were tested and with four different methods of enamel clean-up. The adhesive systems were 37 per cent o-phosphoric acid with Transbond XT (group 1) and 10 per cent poly(acrylic acid) conditioner with Fuji Ortho LC (group 2). Using flattened enamel specimens, enamel loss at each stage was determined using a planer surfometer. These stages were: prior to treatment, at pumice prophylaxis, following enamel etching or conditioning and following enamel clean-up. The four clean-up methods were a high-speed tungsten carbide bur, a slow-speed tungsten carbide bur, an ultrasonic scaler and debanding pliers. The results, analysed using non-parametric tests, demonstrated that significantly more enamel loss occurred following the use of 37 per cent o-phosphoric acid than poly(acrylic acid) conditioner (P = 0.001). At debond and prior to clean-up, more adhesive remained on the enamel surface in group 1 than in group 2 (P = 0.005). During the subsequent enamel clean-up and with both adhesive systems, the least enamel loss occurred following the use of the slow-speed tungsten carbide bur and the greatest loss was seen with the ultrasonic scaler or high-speed tungsten carbide bur. Overall, the lowest enamel loss was observed with the poly(acrylic acid) conditioner and Fuji Ortho LC system (group 2) and where enamel clean-up was performed using the slow-speed tungsten carbide bur.