Cement Remnants Thickness After Polishing With Tungsten, Diamond, and Arkansas Bur Using Composite Customized Lingual Brackets

INTRODUCTION: There is no current evidence in the literature that clearly guides clinicians in selecting the most effective polishing protocol in lingual orthodontics. This study aimed to compare the reduction of adhesive remnants after polishing customized lingual composite brackets using tungsten carbide, fine diamond, and Arkansas burs. METHODS: A total of 504 extracted teeth were included and randomly assigned to three groups according to bur type (n = 168). Brackets were bonded and debonded following a standardized protocol, and digital scans were obtained before and after polishing. Each bur was tested at both low speed (contra-angle) and high speed (turbine). RESULTS: Tungsten carbide burs produced the greatest reduction in cement thickness under both rotary conditions. At low speed, the mean Pre-Post thickness differences were 0.64 mm (TUN), 0.31 mm (ARK), and 0.37 mm (DIA). At high speed, differences were 0.45 mm (TUN), 0.39 mm (ARK), and 0.41 mm (DIA). Statistically significant differences were found between the tungsten carbide group and both the Arkansas and diamond groups (p < 0.005), with no differences between the latter two. CONCLUSION: Tungsten carbide burs removed significantly more adhesive than Arkansas and diamond burs, regardless of rotary speed. These findings support clinical decision-making by helping optimize polishing protocols in lingual orthodontics.