Abstract
Introduction: The removal of residual orthodontic adhesive after debonding fixed appliances is a critical step in orthodontic treatment. Although numerous methods are available, there is no consensus on which is the most appropriate to use with respect to their impact on enamel.
Objective: This scoping review aimed to systematically map primary studies on debonding methods for residual orthodontic adhesive, assess their effects on the enamel, and highlight knowledge gaps to inform future research.
Methods: Three databases (PubMed, Scopus, and the Cochrane library databases) were searched up to April 2025. Studies were included if they investigated at least one debonding method and its effects on human enamel. The findings were narratively synthesised.
Results: A total 747 studies were screened and 85 were included. Of the 85 studies, the vast majority (81) were in vitro investigations, which limits their clinical relevance. A total of 105 methods to remove residual orthodontic adhesive were evaluated, and 46 debonding methods were recommended. Extracted human premolars were most frequently studied in the in vitro investigations. The included studies examined three parameters, which were 1) enamel surface topography/roughness, 2) enamel volume loss, and 3) enamel colour change. The impact on enamel varied between different debonding methods. The findings indicate that, although numerous methods exist, no current technique can be regarded as optimal, leaving clinicians without definitive evidence-based guidance for adhesive removal. However low-speed tungsten carbide burs (alone or in combination with aluminium-oxide coated discs) and fibreglass burs were the most frequently recommended approaches across studies.
Conclusion: This scoping review synthesised the evidence on the effects of orthodontic debonding methods on enamel surface topography, volume, and colour. Surface topography was frequently assessed; enamel volume loss and long-term colour changes were explored less often. No consensus exists on the optimal adhesive removal method and the findings highlighted key knowledge gaps and priorities for future research.
Registration: This scoping review was registered in the Open Science Framework (OSF) database (https://doi.org/10.17605/OSF.IO/A57YU).