Sabit ortodontik tedavinin temel parçası olan braketler tedavi sırasında çeşitli nedenlerle dişten ayrılabilmektedir. Hastaya veya ortodontiste bağlı çok sayıda faktör braket kopmasını etkileyebilir. Hastayla ilişkili faktörler olarak mine defektleri, kooperasyon, ağız hijyeni gibi nedenler sayılabilirken, ortodontiste bağlı faktörler mine pürüzlendirme yöntemi, primer, kompozit rezin türü, ışık cihazı, polimerizasyon süresi ve kullanılan braket tipi olarak sayılabilir. Ortodontist tedavi sırasında zaman kaybını önlemek veya ekonomik tasarruf sağlamak amacıyla aynı braketi tekrar kullanmayı isteyebilir. Bu amaçla çeşitli geri dönüşüm yöntemleri braketlerin kullanılmasına olanak sağlamaktadır. Ortodontik braketlerin geri dönüşümü için birçok yöntem mevcuttur; geri dönüşüm için seçenekler yakma, freze etme yöntemi, kumlama ve lazer olarak sayılabilirken, bu yöntemler kombine olarak da uygulanabilmektedir. Braketlerin geri dönüşümünün braketlerin mine yüzeyine bağlanma dayanımına ve braketlerin fiziksel özelliklerine etkisi araştırma konusu olmuştur. Braketlerin geri dönüşümüyle birlikte slot boyutlarında değişiklik olup olmaması, sürtünme ve korozyon miktarları araştırılmıştır. Geri dönüştürülerek kullanılan braketlerin fiziksel özelliklerinde oluşan değişikliğin klinik açıdan etkisi üzerinde durulmuştur. Ayrıca uygulanan geri dönüşüm yönteminin braket materyali tipine (paslanmaz çelik, seramik) bağlı olarak da etkisi değişebilmektedir. Her geri dönüşüm yöntemi kendine özgüdür ve etkileri de farklı olabilmektedir. Kullanılan geri dönüşüm yöntemlerinin birbirlerine göre avantajları ve dezavantajları olduğu için ortodontist braketleri tekrar kullanmak istediğinde braket tabanındaki artık adezivi temizlemek için kullanacağı uygun yöntemi seçmelidir. Bu derlemenin amacı ortodontik braketlerin geri dönüşüm yöntemlerini tanımlamak, bu konuda yapılmış çalışmaları incelemek ve geri dönüşüm yöntemlerinin braketler üzerine etkilerini açıklayarak klinik açıdan öngörü sağlamaktır.
Anahtar Kelimeler: Sabit ortodontik tedavi; ortodontik braketler; sıyırma bağlanma dayanımı; bakteri tutulumu; sürtünme
Brackets, which are the basic part of fixed orthodontic treatment, can be separated from the teeth for various reasons during treatment. Many factors related to the patient or the orthodontist can affect bracket failure. While patient related factors can be enamel defects, cooperation, and oral hygiene, factors related to the orthodontist can be as enamel roughening method, primer, composite resin type, light device, polymerization time, and type of bracket. The orthodontist may want to reuse the same bracket in order to prevent time loss or to save money during treatment. Thereby, various recycling methods allow the use of brackets. There are many methods for recycling orthodontic brackets; options for recycling are burning, milling method, sandblasting, laser, and combination of these methods. The effects of the recycling brackets on the bond strength of the brackets to the enamel surface and the physical properties of the brackets have been investigated. By recycling the brackets, changes in slot dimensions, the amount of friction and corrosion were assessed. The clinical effects of the change in the physical properties of the recycled brackets have beed emphasized. In addition, the effects of the recycling method may vary depending on the bracket material type (stainless steel, ceramic). Each recycling method is unique and its' effects can be different. Since the recycling methods used have advantages and disadvantages compared to each other, when the orthodontist wants to reuse the brackets, he should choose the appropriate method to clean the residual adhesive on the bracket base. The aim of this review is to describe the recycling methods of orthodontic brackets, examine the studies on this subject and provide clinical foresight by explaining the effects of recycling methods on brackets.
Keywords: Fixed orthodontic appliances; orthodontic brackets; shear bond strength; bacterial adhesion; orthodontic friction
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