Diastema Closure Following Detection and Removal of Residual Resins After Orthodontic Treatment - Case Report with 1-year follow-up
At a Glance
Section titled âAt a Glanceâ| Metadata | Details |
|---|---|
| Publication Date | 2025-09-29 |
| Journal | Clinical and Experimental Health Sciences |
| Authors | BengĂŒ DoÄu Kaya, Pınar Yılmaz Atalı, Deniz Meltem Sever, Dilek TaÄtekin |
| Institutions | Ăanakkale Onsekiz Mart Ăniversitesi, Marmara University |
| Analysis | Full AI Review Included |
Executive Summary
Section titled âExecutive SummaryâThis case report details the successful methodology and 1-year performance evaluation of direct resin composite restorations used for diastema closure following orthodontic treatment.
- Detection Efficacy: Residual orthodontic adhesive resin was most accurately identified using a combination of cross-polarized Mobile Dental Photography (MDP) and a plaque disclosing agent, proving superior to UV light imaging for non-fluorescent materials.
- Material Selection: The restoration utilized a single-shade composite (Charisma Diamond One) and a universal adhesive (Gluma Bond Universal), simplifying the layering process while maintaining high esthetic standards.
- Processing Parameters: Composite was applied in 2 mm increments and polymerized using a polywave LED light curing device at a high intensity of 1000 mW/cm2 for 20 seconds per layer.
- Surface Engineering: A rigorous finishing protocol involving multi-step discs (OptiDisc, 10,000 rpm) and diamond spiral rubbers was essential to achieve optimal surface luster and texture, crucial for minimizing plaque accumulation.
- Performance Metrics: At 12 months, the restorations achieved âclinically very goodâ (Score 1) or âclinically goodâ (Score 2) ratings across esthetic, functional, and biological subcategories according to the revised FDI criteria.
- Failure Analysis: A single cohesive fracture occurred at 6 months due to external trauma (hazelnut consumption), confirming the integrity of the adhesive bond at the cervical margin, and was easily repairable.
Technical Specifications
Section titled âTechnical Specificationsâ| Parameter | Value | Unit | Context |
|---|---|---|---|
| Curing Light Intensity | 1000 | mW/cm2 | Polywave LED device (Valo Cordless) |
| Curing Time | 20 | seconds | Per composite increment |
| Composite Layer Thickness | 2 | mm | Incremental layering technique |
| Polishing Disc Speed | 10,000 | rpm | OptiDisc use during resin removal |
| Final Polishing Duration | 10 | seconds | Opti1step diamond rubber point |
| Etching Acid Concentration | 37 | % | Orthophosphoric acid |
| Restoration Material | Charisma Diamond One | N/A | Single shade resin composite |
| Adhesive System | Gluma Bond Universal | N/A | Universal adhesive agent |
| 12-Month Esthetic Score | 1 (Very Good) | FDI Criteria | Surface luster, color match, marginal staining |
| 12-Month Functional Score | 2 (Good) | FDI Criteria | Proximal contact point, form & contour |
Key Methodologies
Section titled âKey MethodologiesâThe procedure involved a highly controlled sequence of detection, removal, and restoration steps, emphasizing surface integrity and material handling:
- Residual Resin Detection: Initial screening utilized cross-polarized Mobile Dental Photography (MDP) combined with a plaque disclosing agent to visually demarcate non-fluorescent residual adhesive boundaries on the enamel surface.
- Resin Removal Protocol: Multi-step discs (OptiDisc) were employed at 10,000 rpm. The tactile Sond marking technique was used concurrently to confirm complete removal of the resin layer.
- Enamel Surface Finishing: The final step of the removal phase involved polishing the buccal surfaces for 10 seconds using an Opti1step diamond rubber point to minimize surface roughness.
- Isolation and Etching: Rubber dam isolation was established. The tooth surfaces were etched with 37% orthophosphoric acid (Etching Gel).
- Adhesion and Layering: A universal adhesive agent (Gluma Bond Universal) was applied. Single-shade composite (Charisma Diamond One) was placed using a layering technique in 2 mm increments.
- Polymerization: Each composite increment was cured using a polywave LED light device (Valo Cordless) at a standardized intensity of 1000 mW/cm2 for 20 seconds.
- Final Finishing: The restorations were contoured and polished using OptiDisc discs and 2-step diamond spiral rubbers (Diacomp Twist Plus) to achieve a smooth, high-luster surface finish.
- Longitudinal Assessment: Restorations were evaluated at 3, 6, and 12 months using the revised FDI criteria to monitor esthetic, functional, and biological performance.
Commercial Applications
Section titled âCommercial ApplicationsâThe findings provide critical data for the development and clinical validation of materials and diagnostic tools in restorative dentistry and orthodontics.
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Restorative Material Development:
- Validates the long-term clinical performance (1-year Score 1/2) of single-shade composite systems for high-visibility anterior restorations, supporting their market viability as a simplified alternative to multi-layer systems.
- Provides performance data on universal adhesives under conditions of prior enamel manipulation (resin removal).
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Diagnostic and Imaging Technology:
- Drives the integration of cross-polarization filters and plaque disclosing agents into clinical photography systems (MDP) for enhanced material detection, especially where adhesives lack fluorescent dyes.
- Informs manufacturers that UV/fluorescence-based detection systems may be insufficient for common, non-fluorescent orthodontic adhesives.
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Finishing and Polishing Systems:
- Reinforces the necessity of high-quality, multi-step finishing kits (e.g., OptiDisc, diamond rubbers) to achieve the surface smoothness required for FDI Score 1/2 outcomes, directly impacting product marketing related to plaque resistance and longevity.
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Clinical Protocol Standardization:
- Establishes a benchmark protocol for post-orthodontic restorative procedures, minimizing clinical variability and improving outcomes related to residual resin removal and subsequent composite placement.
View Original Abstract
This case report aimed to determine and remove the residual resins after debonding, to restore the upper lateral teeth with a single shade composite to evaluate with follow-ups. An 18-year-old female patient applied to our clinic with the complaint of the presence of diastemas. Following the sond marking technique, MDP (Smile Lite, Smile Line) and mobile phone (iPhone 11, Apple); DSLR camera (Nikon), macro lens and D-Light caries detection mode (GC) before and after the application of plaque staining gel (Tri Plaque ID, GC) to detect resin residues on tooth surfaces after bracket removal. The residual resins were removed with finishing and polishing discs (last 3 stages) (OptiDisc, Kerr). One week later, the selective-etch technique, universal adhesive (Gluma Bond Universal, Kulzer), and single shade composite (Charisma Diamond One, Kulzer) were used for diastema closure. The patient was called for follow-up at 3, 6, and 12-months evaluated FDI criteria. Residual resins were best determined by using a combination of plaque coloring agent and MDP since the composite used was not a fluorescent light-emitting material. For restorations, FDI 1 and 2 scores were observed in the esthetic, functional, and biological evaluations.