|Year : 2014 | Volume
| Issue : 4 | Page : 103-106
A simplified indirect bonding technique
Radha Katiyar1, Ravi K Goyal2, Ajit V Parihar1
1 Department of Dental Science Division of Orthodontics IMS, BHU, Varanasi, Uttar Pradesh, India
2 Private Practitioner, Raipur, Chhattisgarh, India
|Date of Web Publication||1-Jul-2014|
Faculty of Dental Sciences, Division of Orthodontics, IMS, BHU, Varanasi - 221 005, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
With the advent of lingual orthodontics, indirect bonding technique has become an integral part of practice. It involves placement of brackets initially on the models and then their transfer to teeth with the help of transfer trays. Problems encountered with current indirect bonding techniques used are (1) the possibility of adhesive flash remaining around the base of the brackets which requires removal (2) longer time required for the adhesive to gain enough bond strength for secure tray removal. The new simplified indirect bonding technique presented here overcomes both these problems.
Keywords: Indirect bonding, simplified, technique
|How to cite this article:|
Katiyar R, Goyal RK, Parihar AV. A simplified indirect bonding technique. APOS Trends Orthod 2014;4:103-6
| Introduction|| |
During recent years, there has been an increasing interest in indirect bonding as a routine clinical procedure.  Indirect bonding was developed by Silverman et al.  This technique involves a two-stage process:
- Bracket placement in the laboratory on a plaster model and
- Transfer of these attachments to the patient's mouth by means of a tray, where they are bonded to the etched enamel surface.
Over the years, many refined variations of this technique have been described as "newer techniques" due to the better-quality materials available. ,,,,, Laboratory bond strengths and clinical bond failure rates of indirectly bonded brackets are comparable to those of directly bonded brackets. ,
Problems encountered with present techniques involve:
- Possibility of excess adhesive flash remaining around the base of the brackets, which later on requires removal with a round bur and a hand piece,
- Difficult to use in crowded dentitions,
- Inaccurate curing,
- Sometimes poses difficulty in removal of tray,
- Is not cost-effective.
Present article describes a simplified indirect bonding technique:
| Technique: Steps|| |
Special type of jigs are made with 0.021˝ × 0.025˝ inch stainless steel wire for each bracket, one of the end of jig is bent labially to engage the slot and a second bend is given perpendicular to the wire just close to bracket wing. Wire is then bent from over the occlusal surface to palatal or lingual surface ensuring sufficient flow of tray material for better stabilization. This jig is engaged in bracket with help of elastic module. (Ortho Organizers, Inc., 1619 S. Rancho Santa Fe Road, San Marcos, CA 92069; www.orthoorganizers.com) [Figure 1].
Reference lines on models
Markings on the labial and buccal surface of teeth are made with the help of Boone bracket gauge (Ortho-pli, 10061 Sandmeyer Lane • Philadelphia, PA) so as to decide the precise position of the bracket over the tooth surface of study model [Figure 2].
Precise bracket positioning in model
Jig fitted brackets are secured to the teeth over the model with the help of caramel candy [Figure 3] and [Figure 4].
Formation of transfer tray
Condensation silicone material ("Orthogum" Zhermack SpA, Italy;email@example.com) is used for making transfer trays. First each wire tag is stabilized using sticky wax and then silicone material is placed on occlusal, incisal, lingual and palatal surfaces of teeth, leaving only the facial surfaces free. When material sets, impression tray is removed from the model [Figure 5], [Figure 6], [Figure 7]. Appropriate cleaning of the mesh surface of each bracket is then done.
After the preparation of the teeth, light cure composite (Transbond XT TM 3M Unitek, Orthodontic Products 2724 South Peck Road Monrovia, CA 91016 USA, www.3MUnitek.com) adhesive material is applied on the lingual sides of the bonding bases and the silicone tray is transferred to the mouth [Figure 8] and [Figure 9]. Excess bonding material is removed using an explorer [Figure 10]. A self-cure bonding agent can also be used.
Removal of tray
After the completion of curing, elastic module is removed from each bracket freeing the transfer tray with jigs. These jigs are removed from the silicone tray and can be reused with proper sterilization [Figure 11], [Figure 12], [Figure 13].
The advantages of this technique over existing techniques are easy removal of excess resin flash, better curing accessibility and easy removal of transfer tray. The whole procedure takes 10-15 min of chairside time. Thus, it is a very simple and cost-effective method for indirect bonding.
| References|| |
|1.||Sheridan JJ. The Readers' Corner. 1. Do you use indirect bonding? J Clin Orthod 2004;38:543-4. |
|2.||Silverman E, Cohen M, Gianelly AA, Dietz VS. A universal direct bonding system for both metal and plastic brackets. Am J Orthod 1972;62:236-44. |
|3.||Thomas RG. Indirect bonding: Simplicity in action. J Clin Orthod 1979;13:93-106. |
|4.||Read MJ, O'Brien KD. A clinical trial of an indirect bonding technique with a visible light-cured adhesive. Am J Orthod Dentofacial Orthop 1990;98:259-62. |
|5.||Sinha PK, Nanda RS, Ghosh J. A thermal-cured, fluoride-releasing indirect bonding system. J Clin Orthod 1995;29:97-100. |
|6.||Cooper RB, Sorenson NA. Indirect bonding with adhesive precoated brackets. J Clin Orthod 1993;27:164-7. |
|7.||Hickham JH. Predictable indirect bonding. J Clin Orthod 1993;27:215-7. |
|8.||Sondhi A. Efficient and effective indirect bonding. Am J Orthod Dentofacial Orthop 1999;115:352-9. |
|9.||Klocke A, Shi J, Kahl-Nieke B, Bismayer U. Bond strength with custom base indirect bonding techniques. Angle Orthod 2003;73:176-80. |
|10.||Polat O, Karaman AI, Buyukyilmaz T. In vitro evaluation of shear bond strengths and in vivo analysis of bond survival of indirect-bonding resins. Angle Orthod 2004;74:405-9. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13]