An In Vitro Study Comparing Debonding of Orthodontic Ceramic and Metal Brackets Using Er:YAG Laser and Conventional Pliers

Removing orthodontic brackets often presents clinical challenges, as it may cause patient discomfort, bracket fracture, or enamel damage resulting from strong adhesive bonds. Various techniques have been proposed to facilitate safer and more efficient debonding. Among them, laser-assisted methods have gained attention for their potential to minimize mechanical stress and improve patient comfort. The main objective of this study was to evaluate the effect of an erbium-doped yttrium–aluminum–garnet (Er:YAG) laser as an alternative to traditional mechanical methods for removing metal and ceramic orthodontic brackets. Materials and Methods: Thirty-six extracted premolars were prepared for bonding metal or ceramic brackets using a light-cure adhesive system. The control group consisted of six ceramic and six metal brackets removed with conventional orthodontic pliers. In the experimental groups, brackets were debonded using the Er:YAG laser (2940 nm, 0.6 mm spot size, 150 mJ; 15 Hz; (2.25 W) with an H14 handpiece. Irradiation time was recorded for each method, and teeth were rescanned to measure the surface area and volume of the crowns before and after bracket removal. Data were analyzed using one-way ANOVA and Tukey’s HSD test (p < 0.05). Scanning electron microscopy (SEM) was used for surface analysis. Results: A significant difference in debonding time (p = 0.001) was observed between the laser and traditional methods. The laser group took 52.5 s for metal and 56.25 s for ceramic brackets, compared to 1.05 s (metal) and 0.64 s (ceramic) in the traditional group. A significant difference in remaining cement volume was noted (p = 0.0002), but no differences were found between metal and ceramic brackets with laser removal. Conclusions: Er:YAG laser-assisted debonding is safe and minimally invasive but more time-consuming and costly than conventional methods, showing no improvement in clinical efficiency under current parameters.