Journal Article

A comparative study of qualitative and quantitative methods for the assessment of adhesive remnant after bracket debonding

S. Burcak Cehreli, Omur Polat-Ozsoy, Cagla Sar, H. Evren Cubukcu and Zafer C. Cehreli

in The European Journal of Orthodontics

Published on behalf of European Orthodontics Society

Volume 34, issue 2, pages 188-192
Published in print April 2012 | ISSN: 0141-5387
Published online January 2011 | e-ISSN: 1460-2210 | DOI:
A comparative study of qualitative and quantitative methods for the assessment of adhesive remnant after bracket debonding

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  • Restorative Dentistry and Orthodontics


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The amount of the residual adhesive after bracket debonding is frequently assessed in a qualitative manner, utilizing the adhesive remnant index (ARI). This study aimed to investigate whether quantitative assessment of the adhesive remnant yields more precise results compared to qualitative methods utilizing the 4- and 5-point ARI scales.

Twenty debonded brackets were selected. Evaluation and scoring of the adhesive remnant on bracket bases were made consecutively using: 1. qualitative assessment (visual scoring) and 2. quantitative measurement (image analysis) on digital photographs. Image analysis was made on scanning electron micrographs (SEM) and high-precision elemental maps of the adhesive remnant as determined by energy dispersed X-ray spectrometry. Evaluations were made in accordance with the original 4-point and the modified 5-point ARI scales. Intra-class correlation coefficients (ICCs) were calculated, and the data were evaluated using Friedman test followed by Wilcoxon signed ranks test with Bonferroni correction.

ICC statistics indicated high levels of agreement for qualitative visual scoring among examiners. The 4-point ARI scale was compliant with the SEM assessments but indicated significantly less adhesive remnant compared to the results of quantitative elemental mapping. When the 5-point scale was used, both quantitative techniques yielded similar results with those obtained qualitatively.

These results indicate that qualitative visual scoring using the ARI is capable of generating similar results with those assessed by quantitative image analysis techniques. In particular, visual scoring with the 5-point ARI scale can yield similar results with both the SEM analysis and elemental mapping.

Journal Article.  2453 words.  Illustrated.

Subjects: Restorative Dentistry and Orthodontics

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