Iatrogenic effects of orthodontic procedures on enamel: A review

Orthodontic treatment has the potential to cause some damage to dental enamel during cleaning with abrasives before bonding of brackets, the acid etching process itself, enamel fractures caused by forcibly removing brackets or debonding procedures, mechanical removal of composite remnants with rotary instruments or in the rebonding of failed brackets. In addition the enamel surface may be demineralised as the result of bacterial biofilm around orthodontic attachments and also may get worn or eroded due to contact more commonly with ceramic brackets. Structural damage may also be caused intentionally by clinicians when reducing enamel by interproximal enamel stripping. Clinicians should make every effort to minimize damage to tooth enamel.