This presentation is about BONDING in Orthodontics and its reference is "Contemporary Orthodontics by William R. Proffit, Henry W. Fields, and David M. Sarver"

1. By: Dr. Mustafa Batoor
Department of Orthodontics

2.  The method of fixing attachments over the
enamel surface, using adhesive resins.

3. Bonding is based on the mechanical
locking of an adhesive to irregularities in the
enamel surface of the tooth and to mechanical
locks formed in the base of the orthodontic
attachment.

4.  Remove the pellicle and create irregularities
in the enamel surface.
 Gently cleaning and drying the enamel
surface
 Treating with an etching agent, usually 37%
phosphoric acid for 20 – 30 seconds.

6.  The tooth surface must not be contaminated
with saliva, which promotes immediate
remineralization.

7.  The base of the metal bonded bracket or
tube must be manufactured so that a
mechanical interlock b/w the bonding
material and the attachment surface can be
achieved.
 Mechanical Attachment nowadays is
preferred for ceramic as well as metal
brackets.

8.  It must be dimensionally stable
 It must be quite fluid
 It must have excellent inherent strength
 It must be easy to use clinically
 Until recently, light activated filled acrylic
(bis-GMA) resins were preferred bonding
materials.

9.  But new self-adhesive resin cements are
beginning to replace them because they
require less preparation of the tooth surface.
 Modified GICs also can be used as
orthodontic bonding agents.
 Possible advantage is less calcification
around bracket because of F release.
 Great disadvantage; less strength

10.  During direct bonding, bracket position is
determined intra-orally by the clinician during the
bonding procedure.
 This technique can be used quite successfully as a
routine clinical procedure.
 Direct bonding is much more efficient whenever a
single bracket must be repositioned.
 After preparation of the tooth surface, either a
chemically activated or light activated composite
resin can be used.

11.  The major difficulty with direct bonding;
the dentist must be able to judge the proper
position for the attachment and must carry
it to place rapidly and accurately.
 On the other hand, direct bonding is easier,
faster and less expensive.
 Light – cured resins now are used more
frequently than chemically activated resins
because of greater flexibility in working
time and higher bond strengths.

13.  Is done by accurately placing the brackets on
dental casts in a laboratory.
 Then using a template or tray to transfer the
bracket positions to the patients.
 ADVANTAGE; more precise location of
brackets, because the teeth can be examined
from all angles without the limitations of
cheeks and saliva.

15. Steps in Debonding
1. Bracket removal
- Peeling force technique
- Break occur at bracket-adhesive interface
leaving remnant on enamel
2. Residual adhesive cleaning
Fine fluted tungsten carbide burs used with high speed,
with light brush stroke in one direction is most fastest,
least damaging method.