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 Table of Contents  
Year : 2014  |  Volume : 4  |  Issue : 4  |  Page : 103-106

A simplified indirect bonding technique

1 Department of Dental Science Division of Orthodontics IMS, BHU, Varanasi, Uttar Pradesh, India
2 Private Practitioner, Raipur, Chhattisgarh, India

Date of Web Publication1-Jul-2014

Correspondence Address:
Radha Katiyar
Faculty of Dental Sciences, Division of Orthodontics, IMS, BHU, Varanasi - 221 005, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-1407.135808

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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

How to cite this URL:
Katiyar R, Goyal RK, Parihar AV. A simplified indirect bonding technique. APOS Trends Orthod [serial online] 2014 [cited 2019 Mar 26];4:103-6. Available from: http://www.apospublications.com/text.asp?2014/4/4/103/135808

  Introduction Top

During recent years, there has been an increasing interest in indirect bonding as a routine clinical procedure. [1] Indirect bonding was developed by Silverman et al. [2] This technique involves a two-stage process:

  1. Bracket placement in the laboratory on a plaster model and
  2. 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. [3],[4],[5],[6],[7],[8] Laboratory bond strengths and clinical bond failure rates of indirectly bonded brackets are comparable to those of directly bonded brackets. [9],[10]

Problems encountered with present techniques involve:

  1. 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,
  2. Difficult to use in crowded dentitions,
  3. Inaccurate curing,
  4. Sometimes poses difficulty in removal of tray,
  5. Is not cost-effective.

Present article describes a simplified indirect bonding technique:

  Technique: Steps Top

Jig preparation

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].
Figure 1: Jig engaged in bracket with help of elastic module

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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].
Figure 2: Reference Lines on Models

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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].
Figure 3: Bracket positioning in modelfrontal view

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Figure 4: Bracket positioning in mode occlusal viewl

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Formation of transfer tray

Condensation silicone material ("Orthogum" Zhermack SpA, Italy;web@zhermack.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.
Figure 5: Condensation silicone transfer tray lateral view

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Figure 6: Condensation silicone transfer tray occlusal view

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Figure 7: Condensation silicone transfer tray separated from model

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Bonding procedure

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.
Figure 8: Placement of impression tray in mouth frontal view

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Figure 9: Placement of impression tray in mouth occlusal view

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Figure 10: Removal of excess composite

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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].
Figure 11: Removal of elastic module from the brackets

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Figure 12: Removal of Jig from the brackets

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Figure 13: After completion of indirect bonding

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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 Top

1.Sheridan JJ. The Readers' Corner. 1. Do you use indirect bonding? J Clin Orthod 2004;38:543-4.  Back to cited text no. 1
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.  Back to cited text no. 2
3.Thomas RG. Indirect bonding: Simplicity in action. J Clin Orthod 1979;13:93-106.  Back to cited text no. 3
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.  Back to cited text no. 4
5.Sinha PK, Nanda RS, Ghosh J. A thermal-cured, fluoride-releasing indirect bonding system. J Clin Orthod 1995;29:97-100.  Back to cited text no. 5
6.Cooper RB, Sorenson NA. Indirect bonding with adhesive precoated brackets. J Clin Orthod 1993;27:164-7.  Back to cited text no. 6
7.Hickham JH. Predictable indirect bonding. J Clin Orthod 1993;27:215-7.  Back to cited text no. 7
8.Sondhi A. Efficient and effective indirect bonding. Am J Orthod Dentofacial Orthop 1999;115:352-9.  Back to cited text no. 8
9.Klocke A, Shi J, Kahl-Nieke B, Bismayer U. Bond strength with custom base indirect bonding techniques. Angle Orthod 2003;73:176-80.  Back to cited text no. 9
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.  Back to cited text no. 10


  [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]


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