banding and bonding

BANDING ANDBANDING AND
BONDINGBONDING
Saturday, February 11, 2017 1www.drdentiste.com

CONTENTSCONTENTS
BANDING
Introduction
History
Indications
Requisites
Technique

BONDING
History
Advantage
Disadvantage
Technique
Recycling
Other applications of bonding
Recent advances in bonding system
Conclusion
References

INTRODUCTIONINTRODUCTION
BANDING
 The chief parts of modern fixed appliances are tooth
bands and arch wires
 Tooth bands are made up of metals and cemented to the
teeth and provides place for attachment of other auxiliaries
like brackets, buccal tubes, lingual buttons etc.
 These auxiliaries can be either welded or soldered to the
bands. The tooth moving forces derived from the arch
wires are transmitted to the teeth through the bracket.

INDICATIONS FOR BANDINGINDICATIONS FOR BANDING
 Teeth that will receive heavy intermittent forces against the
attachments. E.g.: upper I molars
 Teeth that will need both labial and lingual attachments
 Teeth with short clinical crowns
 Tooth surfaces that are incompatible with successful bonding

RequisitesRequisites
 Must fit the contours of the tooth as closely as possible,
there by enhancing the attachment to the teeth
 Should not extend subgingivally any more than is
necessary for adequate retention on the teeth
 Resistant to deformation under stresses in the mouth
 Material should have enough springiness that it can be
forced over the height of contours of the teeth and spring
back slightly into undercut areas
 As high polish as possible is placed on the surfaces to
reduce the adhesion of food debris

TechniqueTechnique
Procedure : Separation
Selection of band material
Fabrication and fitting
Cementation

Separating springsSeparating springs ::

Elastomeric separators;
which surrounds the contact point and
squeeze the teeth apart over period of few
days

Selection of band materialSelection of band material
 Incisor bands:
Band material is usually thinner. It varies from from
0.12 inch in width and 0.003-0.004 inch in thickness
 Premolar bands :
0.004 thickness and 0.15 inch wide
 Molar bands:
0.005-0.006 inch thickness and 0.18-0.20 inch wide
 Preformed bands: Various sizes are available for different
teeth commercially with prewelded attachments

FABRICATING AND FITTINGFABRICATING AND FITTING
BANDSBANDS
 Upper molar band is designed to be placed initially by hand
pressure on the mesial and distal surfaces bringing the band
down close to the height of the marginal ridges.
 Then it is driven to place by pressure on the mesiobuccal and
distolingual corners.
 Final seating is with heavy biting force on the distolingual
surface.

 Lower molar bands are designed to be seated
initially with hand pressure on the proximal
surface and then heavy biting force along the
buccal but not the lingual margins.

 Upper premolar bands are usually seated with
alternate pressure on the buccal and lingual
surfaces.
 Lower premolar bands are designed for heavy
pressure on the buccal surface only.

CementationCementation
 The most commonly used cements are zinc phosphate and
glass ionomer
 A thick cement mix is loaded into the band in such a way that
all the interior surfaces are totally covered with cement, so
that there is no bare metal.
 Now the upper aspect of the band is covered with gloved
finger and the band is pushed from above further apically
using digital pressure.
 Patient is instructed to bite firmly but gently over the band.

BONDINGBONDING
For the patient to whom esthetics being the prime
consideration even during the treatment, the metallic look
of the orthodontic appliance has always been the bone of
contention.

..
Advantages
 It is esthetically superior.
 It is faster and simple.
 There is less discomfort for the patient
 Arch length is not increased by band material.

 It allows more precise bracket placement.
 Bonds are more hygienic than bands Partially erupted teeth
can be controlled.
 Mesiodistal enamel reduction ( proximal reduction) is
possible during treatment.
 Attachments may be bonded to artificial tooth surfaces
(eg., amalgam, porcelain, gold) and to fixed bridge work.

 Interproximal areas are accessible for composite
buildups.
 Caries risk under loose bands is eliminated and
interproximal caries can be detected and treated.
 No band spaces are present to close at the end of
treatment.
 Brackets may be recycled, further reducing the cost.
 Lingual brackets, invisible braces, can be used when
patient rejects visible orthodontic appliance.

 Disadvantages of Bonding:
 A bonded bracket has a weaker attachment than a cemented
band.
 Some bonding adhesives are not sufficiently strong.
 Better access for cleaning does not necessarily guarantee
better oral hygiene and improved gingival condition, especially
if excess adhesive extend beyond the bracket base.

 The protection against the inter proximal caries of well
contoured cemented band is absent.
 Bonding is more complicated when lingual auxiliaries
are required or where headgears are attached.
 Rebonding a loose bracket requires more preparation
than rebanding a loose band.
 Debonding is more time consuming than debanding,
since removal of adhesive is more difficult than removal
of cement

 Bonding procedures can be performed in 2 ways
Direct bonding
Indirect bonding
Direct bonding:
This procedure is quite simple and involves following
steps
CLEANING
ENAMEL CONDITIONING
SEALING
BONDING

Cleaning
 This requires rotary instruments, either
a rubber cup or a polishing brush.

MOISTURE CONTROL:
After the rinse, salivary control and
maintenance of a completely dry working
field is absolutely essential.
Its presence may prevent the good bond
between the sealant and bonding agent

 Lip expanders and / or cheek retractors
 Saliva ejectors
 Tongue guard with bite blocks
 Salivary duct obstructors
 Gadgets that combine several of these (saliva ejector,
tongue holder, and bite block).
 Cotton or gauze rolls
 Antisialagogues

 Enamel pretreatment
 The conditioning solution or gel (usually 37%
phosphoric acid ) is then lightly applied over the
enamel surface with a foam pellet or brush for 15 to
30 sec.
 When etching solutions are used, the surface must
be kept moist by repeated applications. To avoid
damaging delicate enamel rods, care must be taken
not to rub the liquid on to the teeth.

 At the end of the etching period the etchant is rinsed off
the teeth with abundant water spray.
 Salivary contamination of the etched surface must not be
allowed. ( If it occurs rinse with water spray or re - etch for
a few seconds; the patient must not rinse.)

 Should the etch cover the entire facial enamel or only
a small portion outside the bracket pad?
Clinical experience indicates that etching the
entire facial enamel with solution is harmless at least when
a fluoride mouth rinse is used regularly.

 Studies and clinical experience indicate that 15-30 secs
adequate for etching most young permanent teeth.
 However important individual variation exists in enamel
solubility between patients, between teeth and within the
same tooth

 Bond strength varied from 29.3Kg/cm2for the 15 sec etch
to 92.3 Kg/cm2 for 60sec
 Based upon the established requirement of 60-80Kg /cm2
to meet clinical needs 30sec etch procedure is suggested
for clinical trail

 Is etching time is different for young and old teeth?
 For deciduous teeth, no difference was found in effect
between the etching periods.
 For young permanent teeth, 15 seconds of etching created
more retentive conditions than 60 seconds.
 For old permanent teeth, the reverse was found. The most
retentive conditions were found for the deciduous teeth,
regardless of etching time.

 Is prolonged etching necessary when teeth are pretreated
with fluoride?
 extra etching time is not necessary when teeth have been
pretreated with fluoride.
 When in doubt, check that the enamel looks uniformly dull
and frosty white after etch. If it does, surface retention is
adequate for bonding.
 Teeth with higher concentration fluoride are generally
considered resistant to etching than normal teeth and may
require extended etching time

 Is etching permissible on teeth with internal white
spots?
 Caution should be exercised when etching over acquired
and developmental demineralization's.
 It is best to avoid it.
 If this is impossible, a short etching time, the application of
sealant, and the use of direct bonding with extra attention
to not having areas of adhesive deficiency are important.
 The presence of voids, together with poor hygiene, can
lead to metal corrosion and staining of underlying
developmental white spots.

Possible iatrogenic effects of acidPossible iatrogenic effects of acid
etching of enameletching of enamel
 Fracture and cracking of enamel upon debonding
 Increased surface porosity – possible staining.
 Loss of acquired fluoride in outer 10µm of enamel surface.
 Loss of enamel during etching.
 Resin tags retained in enamel – possible discoloration of
resin.
 Rougher surface if over-etched.

 SELF ETCHING PRIMER
 Developed by Watanabe and Nakabayashi. It is a aqueous
solution of 20% phenyl – P in 30% HEMA.
 An acidic primer combines the etchant with the primer in
one application, Contains both acid (Phenyl – p) and the
primer ( HEMA and dimethacrylate).
Clearfil liner bond V (Kuraray)Clearfil liner bond V (Kuraray)
Mega bond (Kuraray)Mega bond (Kuraray)
Prompt – L – Pop ( 3M UniteK )Prompt – L – Pop ( 3M UniteK )
First step (Reliance)First step (Reliance)
Transbond Plus ( Unitek 3m )Transbond Plus ( Unitek 3m )
Ideal 1 (GAC )Ideal 1 (GAC )
One up Bond F ( TokuyamaOne up Bond F ( Tokuyama

Bond strength
 Adequate and acceptable bond strength.
 No statistical difference with conventional composite resin
adhesive system.
 Varies from 8 – 20 MPa.
 A delay in bonding after SEP application further increases
the bond strength.

Sealing
 The sealant coating should be thin and even, because
excess sealant may induce bracket drift and unnatural
enamel topography when polymerized.
 Sealants provide enamel cover in the areas of adhesive
voids especially valuable with indirect bonding

 Moisture insensitive primers (MIP)
 Hydrophilic primers that can bond in the wet fields
 Bond strengths are significantly lower under wet field than
in dry conditions
 For optimal results MIP should be used with their respective
adhesive resins

POSITIONING

FITTING

REMOVAL OF EXCESS
Excess must be removed with the scaler
before the adhesive has set or it must be
removed with bur after setting.

INDIRECT BONDING

Indirect bonding withIndirect bonding with
silicone impression traysilicone impression tray
 Take an impression and pour up a stone model
 Select brackets for each tooth
 Apply a small portion of water soluble adhesive on each tooth
 Position the brackets on the model, check all the
measurements and allignments, reposition if needed

 Press the putty on to the bonded brackets
 Form the tray , allowing sufficient thickness for
strength.
 After silicone tray has set, immerse the model and tray
in hot water to release the brackets from the stone
 Remove any remaining adhesive under running water
 Trim the silicone and mark the midline

 For silicone tray fabrication, mix material according to
manufacturers instructions
 Prepare the patients teeth as for a direct application
 Mix adhesive, load it in a syringe apply a sufficient portion to
the bonding bases
 Seat the tray on prepared arch and hold with firm and steady
pressure for 3 min
 Remove the tray after 10 min
 Complete the bonding by careful removal of excessive flash

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