The Effectiveness and Reliability of Disclosing Solution in Adhesive Remnant Index: A Pilot Study

In clinical investigation, scoring the adhesive remnant index (ARI) from tooth surface was difficult due to a lack of a contrasting color in the orthodontic adhesive. Adhesive remnant on the tooth surface is more visible if disclosing solution is applied after debonding. To date, no studies have assessed ARI using a disclosing solution. Objectives: To compare the effectiveness of visual inspection and digital photography in ARI assessment using disclosing solution and to investigate the reliability of two examiners in scoring ARI on the tooth surface. Material and Method : Brackets of MBT prescription were bonded to the 10 extracted teeth using self-etching primer and light cure adhesive. All brackets from the samples were mechanically debonded using selected pliers. After debonding, disclosing solution was applied on the adhesive remnant and ARI score were visually recorded. The ARI were also scored from photographs of the samples which were taken with the macro lens of DSLR Camera. Comparison of ARI score between visual and photographic inspection were analyzed using Fisher Exact test. Intra-operator and Inter-operator reliability of ARI score were calibrated using Kappa test. Result : The Fisher Exact test revealed no statistically significance difference of ARI assessment between visual and photographic inspection (p > 0.95). ARI score of 3 were found 70% in both techniques. These findings indicated that the bond failure frequently occur between bracket and adhesive. Calibration was carried out and the result showed photographic inspection had a better agreement (K > 0.62) than visual inspection (K > 0.57) for both calibrations Conclusion: Disclosing solution application is a viable new approach for further clinical study of adhesive remnant on the tooth surface either by visual inspection or photography.