**6.3. Adjunctive methods proposed for mechanical debracketing**

Larmour and Chadwick [57] evaluated the ability of a commercial debonding agent, postdebonding agent (P-de-A) (Oradent Ltd., Eton, Berks, UK). This green gel, containing a derivative of peppermint oil, was claimed to facilitate ceramic bracket debracketing and adhesive residue removal. The manufacturer of P-de-A advised an application time of 1–2 min to soften the resin. Nevertheless, the P-de-A research results did not support these claims [57, 58].

In 1997, Arici et al. [59, 60] proposed the use of a crushable porous ceramic lamella as a means of facilitating debracketing. These porous lamellae were attached to the bracket base with adhesive resin. Subsequently, these bracket/lamella assemblies were bonded to the enamel of the experimental teeth (bovine incisor teeth). The authors [60] of this in vitro study reported the safe removal of these ceramic bracket/lamella assemblies, i.e., no fractures of the ceramic bracket or any evidence of enamel damage was observed. Commercial production of this type of ceramic bracket/lamella assembly was not undertaken.

In 1998, Larmour et al. [61] evaluated the possibility of reducing the complications of ceramic bracket debracketing by introducing a notch in the composite bond layer. A section of Mylar® matrix strip (0.01 mm thick and 0.75 mm wide) was placed within the bonding agent in this ex vivo investigation. After the bonding agent had set, the matrix strip was removed creating a "notched" bond layer. Larmour et al. [61] concluded that notching the bonding agent does facilitate ceramic bracket removal. Nevertheless, they emphasized that this modification is not feasible in a clinical setting due to the time needed and the technical difficulty of creating a "notched" bond layer. Furthermore, they cautioned that such a "notched" adhesive layer may lead to plaque accumulation.

In 2003, Carter [62] suggested that a hot-water bath might facilitate ceramic bracket debracketing. Patients were given a cup of hot water, supplied from a coffeemaker, and were asked to hold this water in their mouths for 1 min without swallowing. Subsequently, debracketing with suitable pliers was performed. Carter [62] emphasized that since 1986 no enamel fracture or any other iatrogenic damage occurred with this application in his clinic. Unfortunately, the exact temperature of this "hot-water bath" was not stated.
