Can Bonding Be Removed Without Taking Away Any Tooth Structure? How Should It Be Done?

While it is possible to view enamel and composite bonding and work very carefully to only remove the bonding, SOME tooth structure will be removed.  Even with air abrasion systems, lasers or fine grit sandpaper or burs, SOME enamel is removed (perhaps microscopically).  The question is: is it significant?

The reality is that removal of the enamel is not a big deal.  The teeth are not weaker as a result or more prone to decay.  Your orthodontist should be able to do as you request without any significant issues.

Yes the bonding can be removed without damaging the exosting enamel.  It can be doen with an ultrasonic cleaner that vibrates at a very high frequency, followed by a polish with fine pumice.  It can also be removed with a flame finished carbide burr run on a slow speed handpiece and followed with a fine pumice polish.

Yes and no.  Removing bonding (or composite resin) requires the use of the drill.  Removing it can be done with very little damage to the underlying enamel but to say that NO enamel will be removed would be dishonest.   

In order to maximize tooth structure and not "lose" any more enamel these are the tips that we use.

1. Etch the restoration and tooth and then dry. The restoration will be a different color and the tooth will appear chalky giving the dentist a guide on where to begin

2. The use of an air abrasion unit that uses aluminum oxide powder can selectively remove composite and retain solid enamel

3. You need to determine is the original bonding procedure consisted of any enamel reshaping, because the tooth may be shaped differently and some restorative procedures may be needed to get the correct shape.

4.We also have a microscope to magnify the area by approx 16x and this really helps. A microscope is not a must but some sort of magnification or loupe should be used.

Any time I work with old bonding, I remove it.  We have been doing this for years-You can tell the difference between the plastic and tooth enamel in most instances.  There are carbide burs that can do this safely.  While you always run the risk of removing a little enamel, I have never had a problem with this procedure. 

We also have the KCP(Kinteic Cavity Preparation) air abrasion system that can spray off the last flicks of bonding once we have removed enough of the bonding. 

Talk to your orthodontist and don't worry.  Reshaping is routine.  Taking x-rays and doing an evaluation is important and worth while for planning your treatment.  You will be thrilled with your results!!!