Effect of Different Adhesive Removal Techniques After Orthodontic Bracket Debonding on Postoperative Hypersensitivity: A Randomized Clinical Trial

November 9, 2026 updated by: Asmaa Badr Abdelfatah

The objective of this randomized clinical trial is to evaluate and compare the effect of four different residual adhesive removal techniques following orthodontic bracket debonding on postoperative tooth hypersensitivity. The study compares low-speed tungsten carbide burs against fiberglass burs, white stone burs, and rubber-impregnated polishing points. Postoperative hypersensitivity will be evaluated using a Visual Analogue Scale (VAS) with an air-blast stimulus test immediately after debonding, at 24 hours, and at 7 days follow-up.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

15

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • Cairo, Egypt
        • Faculty of Dentistry, Cairo University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

15 years to 45 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients of any gender aged 15 to 45 years undergoing routine fixed labial orthodontic bracket removal across anterior and premolar teeth in both jaws.
  • Systemically healthy patients.
  • Good oral hygiene with a healthy, intact periodontium without clinical attachment loss or gingival recession.
  • Patients capable of reliably recording subjective discomfort on a Visual Analogue Scale (VAS) and willing to attend follow-up visits.
  • Sound fully erupted permanent incisors, canines, and premolars bonded with conventional stainless steel labial brackets.
  • Labial enamel surfaces free of visible pre-existing enamel defects, structural hypoplasia, severe fluorosis, or restorations.

Exclusion Criteria:

  • Active use of systemic analgesics, NSAIDs, corticosteroids, or centrally acting pain medications within 14 days prior to debonding.
  • Use of desensitizing toothpastes, mouthwashes, or topical fluoride varnishes within 30 days prior to the trial.
  • Heavy bruxism, clenching habits, or pathological wear/erosion extending into dentin.
  • Pregnant or lactating female patients.
  • Teeth with irreversible pulpitis, pulpal necrosis, history of endodontic treatment, or periapical pathology.
  • Teeth with active carious lesions or exposed cervical dentin/cementum.
  • Teeth with severe, deep enamel microcracks identified at baseline examination.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Active Comparator: Low-Speed Tungsten Carbide Bur

Residual composite adhesive remnants on eligible teeth are cleaned using a 12-fluted low-speed tungsten carbide bur operated at 15,000-20,000 rpm under continuous water cooling.

Composite resin is removed using a 12-fluted tapered low-speed tungsten carbide bur operated at 15,000-20,000 rpm under continuous air-water spray irrigation until all visible adhesive remnant is completely eliminated.

Experimental: Fiberglass Bur

Residual composite adhesive remnants on eligible teeth are cleaned using a fiberglass bur operated at 15,000-20,000 rpm under continuous water cooling

Composite resin remnants are eliminated using a fiberglass resin-removal bur operated at 15,000-20,000 rpm under continuous air-water spray irrigation until all visible material is completely removed.

Experimental: White Stone Bur

Residual composite adhesive remnants on eligible teeth are cleaned using a fine-grit white stone bur (aluminum oxide) operated at 10,000-15,000 rpm under continuous water cooling.

Composite resin remnants are removed using a fine-grit Arkansas white stone bur (aluminum oxide) operated at 10,000-15,000 rpm under continuous air-water spray irrigation until the enamel surface is clear.

Experimental: Rubber-Impregnated Polishing Point

Residual composite adhesive remnants on eligible teeth are cleaned using a rubber-impregnated polishing point operated at 10,000-15,000 rpm under continuous water cooling

Residual adhesive tags are removed and polished using a rubber-impregnated composite polishing point operated at 10,000-15,000 rpm under continuous air-water spray irrigation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Hypersensitivity
Time Frame: Baseline (immediately post-debonding, before clean-up), 24 hours, and 7 days post-adhesive removal.

Patient-reported pain and hypersensitivity evaluated using a Visual Analogue Scale (VAS) score ranging from 0 (No pain) to 10 (Unbearable severe pain) in response to a 2-second dental syringe air-blast stimulus test.

Baseline (immediately post-debonding, before clean-up), 24 hours, and 7 days post-adhesive removal.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Procedure Time
Time Frame: Immediately during the clean-up procedure.

Time taken to perform complete residual adhesive removal per tooth, measured using a stopwatch

Immediately during the clean-up procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Director: Heba El-Deeb, PhD, Cairo to Department of Conservative Dentistry, Faculty of Dentistry, Cairo University .

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

October 1, 2027

Study Registration Dates

First Submitted

November 9, 2026

First Submitted That Met QC Criteria

November 9, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 9, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • CONS 3-4-1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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