Area and Volume of Remaining Cement and Enamel after Removal and Polishing of Buccal or Lingual Multibracket Appliances  
[PERSON]  
1 Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; [EMAIL_ADDRESS] (A.B.M.); [EMAIL_ADDRESS] (A.A.M.)  
[PERSON]  
1 Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; 32 Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; 33 Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; 34 Department of Orthodontics, Faculty of Medicine and Health Sciences, Catholic University of Valencia, 46001 Valencia, Spain 47001-95  
multibracket appliance therapy has shown a higher risk of developing white spot lesions related to biofilm associated with poor hygiene. However, there are some strategies for their prevention, such as the application of acidulated phosphate fluoride, diffusoliane varnish, and high-concentration fluoride toothpastes [2,3]. Furthermore, lingual multibracket appliance therapy has shown some disadvantages, such as worse accessibility concerning the lingual/palatal surfaces, irregularities in the anatomy of lingual surfaces [4], and the worst dissolution of enamel prisms during enamel conditioning with etching agents [5]. Finally, the success of orthodontic treatment depends on obtaining ideal shear bond strength (SBS) between the fixed multibracket appliances and the enamel surfaces, which depends on the inner surface design of the fixed multibracket appliances, the type of mesh of the inner surface design of the fixed multibracket appliances, the size and shape of the fixed multibracket appliances, and the preconditioning of the enamel surfaces [6]. In addition, the development of the adhesion technique of orthodontic materials has improved the SBS values of fixed multibracket appliances [7], especially the acid etching technique, which decreases the amount of bond failures in fixed lingual multibracket appliance brackets [8]. However, after fixed multibracket appliance therapy debonding and polishing, it seems that there is an inevitable increase in enamel roughness (ASa) in both lingual and buccal multibracket appliance therapies [9], with significant differences in the degree of enamel damage regarding the type and material of the bur used [10], and with there being lower \(\Delta\)Sa values with composite and fiber glass burs [10]. Therefore, sandblasting procedures have been recommended in order to increase the SBS values of the preconditioned enamel surfaces, which not only increases the SBS values of fixed lingual multibracket appliances but also increases the amount of cement remnants over the lingual enamel surfaces [11]. Moreover, significant differences have been found between the SBS values of lingual multibracket appliance and buccal multibracket appliance therapies. This could influence the \(\Delta\)Sa and also the amount of cement remnants after multibracket appliance therapy debonding [5].  
The aim of this study was to compare the area and volume of remaining cement after lingual and buccal multibracket appliance debonding, the area and volume of remaining cement after cement polishing, and the area and volume of enamel removed after cement polishing using a morphometric digital measurement technique, with a null hypothesis (H\({}_{0}\)) stating that no difference exists between the area and volume of remaining cement after lingual and buccal multibracket appliance debonding, the area and volume of remaining cement after cement polishing, and the area and volume of enamel removed after cement polishing using a morphometric digital measurement technique.