Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (32): 8358-8363.doi: 10.12307/2025.875

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Effects of different methods for removing invisible orthodontic resin attachments on the enamel surface

Yu Yongyue1, Liu Mingxin1, Lu Yun1, Gao Lu1, Wu Dalei1, 2   

  1. 1School of Stomatology, Dalian Medical University, Dalian 116044, Liaoning Province, China; 2Department of Stomatology, Second Affiliated Hospital of Dalian Medical University, Dalian 116028, Liaoning Province, China
  • Accepted:2026-02-03 Online:2026-11-18 Published:2026-04-23
  • Contact: Gao Lu, MD, Associated professor, Master’s supervisor, School of Stomatology, Dalian Medical University, Dalian 116044, Liaoning Province, China Wu Dalei, MS, Associate chief physician, School of Stomatology, Dalian Medical University, Dalian 116044, Liaoning Province, China; Department of Stomatology, Second Affiliated Hospital of Dalian Medical University, Dalian 116028, Liaoning Province, China
  • About author:Yu Yongyue, MS candidate, School of Stomatology, Dalian Medical University, Dalian 116044, Liaoning Province, China Liu Mingxin, MS candidate, School of Stomatology, Dalian Medical University, Dalian 116044, Liaoning Province, China
  • Supported by:
    National Natural Science Foundation of China (Youth Project), No. 81801016 (to LY)

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Abstract: BACKGROUND: In recent years, invisible orthodontic technology has been widely adopted by most orthodontic patients. However, improper removal of invisible orthodontic resin attachments may lead to permanent enamel damage and increased susceptibility to caries. Therefore, maintaining enamel integrity during the removal of resin attachments is of great importance.
OBJECTIVE: To investigate the effects of four methods for removing resin attachments on enamel surface morphology, roughness, and resistance to caries.
METHODS: Sixty-nine healthy premolars requiring extraction for orthodontic treatment were collected, and the crowns were preserved. (1) 60 teeth were randomly selected; the surface of each tooth was divided into five zones, and assigned to one control group (untreated tooth surface) and groups A, B, C, and D. Groups A–D received resin attachments bonded to the tooth surfaces. Group A first removed the resin attachments using a yellow-labeled diamond bur, then polished the tooth surface with Silicone One Gloss silica particles; group B first removed the resin attachments using a tungsten carbide bur, then polished the tooth surface with Silicone One Gloss silica particles; group C first removed the resin attachments using tungsten carbide burrs, then polished the tooth surfaces using EVE Twist cyclone wheels; group D first removed the resin attachments using yellow-labeled diamond bur, then polished the tooth surfaces using EVE Twist cyclone wheels. Tooth surface roughness values were measured before resin attachment bonding (T0), after debonding (T1), and after resin attachment removal and polishing (T2). Scanning electron microscopy was used to observe the enamel surface morphology after polishing. (2) Nine tooth crown samples were selected, and each tooth surface was divided into four sections, corresponding to the control group (untreated tooth surface), and groups A, B, and C. The treatment methods were the same as above. A caries resistance experiment was then conducted for 20 days. After the experiment, scanning electron microscopy was used to observe the demineralization morphology of the enamel surface.
RESULTS AND CONCLUSION: (1) Intra-group comparison: The tooth surface roughness values of samples in groups A, B, C, and D at T1 were greater than at T0. The tooth surface roughness values of samples in all four groups at T2 were less than at T1. The tooth surface roughness values of samples in groups A, B, and D at T2 were greater than at T0. Intergroup comparison: Comparing the difference in tooth surface roughness between T1 and T0, groups B and C showed smaller differences than groups A and D. Comparing the difference in tooth surface roughness between T2 and T0, group C showed smaller differences than groups A, B, and D. Based on the tooth surface roughness measurements, group D showed significant enamel scratches and was not subjected to scanning electron microscopy observation. Scanning electron microscopy showed that group A had rough scratches and wide grooves on the enamel surface; group B had a rough enamel surface with numerous rough scratches; group C had fine, scattered scratches on the enamel surface. (2) After the anti-caries experiment, scanning electron microscopy showed that the enamel surface of group A was rough and uneven, with demineralization pores visible between calcified clusters; the enamel surface of group B was relatively smooth, and the demineralization pores were significantly smaller than those in group A; the enamel surface of group C was the smoothest, with fine demineralization pores, closer to the enamel surface of the control group. (3) The results show that during the resin attachment removal stage, using tungsten carbide burs caused less damage to the tooth surface and resulted in a smaller decrease in anti-caries ability compared to using diamond burs. During the polishing stage after resin attachment removal, using EVE Twist cyclone wheels caused less damage to the tooth surface and resulted in a smaller decrease in anti-caries ability compared to using silicon particle polishing. 

Key words: invisible orthodontics, resin attachment removal method, tungsten carbide bur, EVE Twist cyclone wheels, roughness, enamel surface morphology, caries resistance 

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