What is the safest method of orthodontic debonding - a systematic review of the literature.

The objective of this study was to review the current knowledge based on in vitro and in vivo studies, that evaluated the enamel damage connected with removal of metal and ceramic orthodontic brackets taking into account different debonding methods. Brackets fracture was also assessed. The protocol for this study was constructed according to the PRISMA statement. The literature review was performed in MEDLINE via PubMed, Cochrane and Scopus databases in May 2021. The searching was repeated in Journal of Stomatology, Orthodontic Forum and grey literature was screened using Google Scholar. Out of eligible studies 207 were screened by title and abstract, 85 subjected to full-text analysis and 30 were qualified for the research. The prevalence of enamel fracture ranged from 0 to 94.4%. The results of our review do not allow to identify the manual method of debonding that minimizes the risk of enamel damage. Thermal method and laser irradiation reduce the risk of enamel fracture.