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

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.

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.