BDS [Orthodontics] course

1. PROF (Dr.) SAIBEL FARISHTA

2. HISTORY
• 1955 BUONOCORE used 85% phosphoric acid
• 1965 NEWMAN advent of epoxy resin bonding
• 1966 EASTMAN DENTAL CENTER
Adhesive consisted of a liquid monomer
methyl-2-cynoacrylate & silicate filler
Working time 1 min, setting time 2-4 mins, 50%
phosphoric acid and 7% zinc oxide

3. HISTORY
• 1968 SMITH introduced zinc polyacrylate
[carboxylate cement]
• 1970 ‘BOWENS RESIN OR BISGMA
bisphenol A glycidal dimethacrylate
• 1979 GORELICK survey in US found 93%
orthodontists used bonding for bracket placement
• 1980 Bonding became a routine clinical procedure

4. FIRST GENERATION BONDING AGENTS
1950 BUONOCORE introduced ‘GLYCEROPHOSPHORIC ACID
AND METHACRYLATE TYPE RESIN’
RETENTION RATE 50% AFTER 6 MONTHS

5. SECOND GENERATION BONDING
AGENTS
EARLY 80’S
BASED ON POLY URETHANE BONDING AGENTS
[BIS-GMA] BISPHENOLA GLYCIDAL METHACRYLATE
EG – DENT ADHESIT
IVOCLAR
VIVADENT

6. THIRD GENERATION BONDING
SYSTEMS
THREE COMPONENTS
• CONDITIONER
• PRIMER
• ADHESIVE

7. FOURTH GENERATION
THESE AGENTS FORM STRONG BONDS WITH BASE OR
NOBLE METALS, PORCELAIN AND AMALGAM
ACCORDING TO INSTRUCTIONS THESE PRODUCTS CAN
BE USED SUCCESFULLY FOR BONDING RESIN COMPOSITE
TO FRACTURED PORCELAIN OR BASE METAL CASTINGS
EG- BOND IT
ALL BOND-2 {BISCO DENTAL PRODUCTS}

8. FIFTH GENERATION BONDING
SYSTEMS
•ONE COMPONENT ONE BOTTLE BONDING SYSTEM
•ENTIRE PRIMING AND BONDING SEQUENCE INVOLVES A
SINGLE LIQUID IN SINGLE BOTTLE
•INSTRUCTIONS SIMPLE
•ADHESION ACCOMPLISHED WITHOUT MIXING
•SOME 5TH GEN SYSTEMS CAN BE USED WITHOUT ETHING
AND STILL DEMONSTRATE EXCELLENT BONDING
•FLOURIDE RELEASE AS WELLAS ELASTOMERIC
COMPONENTS TO IMPROVE MARGINAL INTEGRITY ARE REALISED

9. ADVANTAGES OF FIFTH GENERATION
BONDING SYSTEMS
•SIMPLICITY
•SAVE CHAIR TIME
•LESS STRESSFULL FOR DOCTOR AND PATIENT
EXAMPLES
PRIME AND BOND 2:1 - DENTSPLY
SYNTAC SINGLE COMPONENT- IVOCLAR
BOND 1 – PENTRON
ONE STEP—BISCO
TENURE QUIKE - DENT-MAT
SINGLE BOND ADHESIVE -3M DENT
PERMA QUIK- ULTRADENT PRODUCTS

10. ADVANTAGES
• ESTHETICALLY SUPERIOR
• FASTER AND SIMPLER
• LESS DISCOMFORT FOR THE PATIENT
• SAVE ARCH LENGTH SPACE
• PRECISE BRACKET PLACEMENT
• IMPROVED GINGIVAL CONDITION
• BETTER ACCESS FOR CLEANING
• PARTIALLY ERUPTED OR FRACTURED TEETH
CAN BE CONTROLED
• PROXIMAL SLICING IS POSSIBLE DURING
TREATMENT

11. ADVANTAGES OF BONDING
• CARIES RISK UNDER LOOSE BANDS IS
ELIMINATED
• BRACKETS CAN BE RECYCLED
• LINGUAL BRACKETS ‘INVISIBLE BRACES’
FOR ESTHETICS

12. • CLEANING
• ENAMEL PRETREATMENT [ETCHING]
• PRIMER
• BONDING
BONDING PROCEDURE

13. SUCCESSFUL BRACKET BONDING
REQUIRES
• TOOTH SURFACE AND ITS
PREPARATION
• THE DESIGN OF ITS ATTACHMENT
BASE
• THE BONDING MATERIAL

14. ENAMEL PRETREATMENT
• ETCHING GELS OR SOLUTIONS USED
Gel provides better control for restricting
the etched area but requires more thorough
rinsing afterward
• OPTIMUM ETCHING TIME
15 secs for young permanent teeth
60 secs for adult teeth

15. Enamel pretreatment
• Longer periods of etching provide not more
but actually less retention due to loss of
surface structure
• Caution should be excercised when etching
damaged teeth with exposed dentin, deep
enamel cracks, external or internal
demineralization

17. •How much enamel is removed?
Routine etching removes 3 to 10 µm
Histologic alterations occur at 25 µm
Normal enamel is 1000 to 2000 µm thick

18. PRIMER
ALSO KNOWN AS ADHESION PROMOTERS OR
ADHESION ENHANCERS
PRIMERS CONSIST OF A BIFUNCTIONAL
MONOMER IN A SOLVENT SUCH AS WATER,
ACETONE OR ETHANOL ON A BIFUNCTIONAL
MONOMER, HYDROFILLIC AND HYDROPHOBIC
GROUPS ARE ALSO PRESENT

19. • THE PRIMER WETS AND PENETRATES THE COLLAGEN
MESHWORK RAISING IT ALMOST TO ITS ORIGINAL LEVEL
• THE PRIMER ALSO INCREASES THE SURFACE ENERGY
HENCE THE WETTABILITY OF THE TOOTH SURFACE
• THEY PROMOTE INFILTRATION OF UNFILLED RESIN INTO
THE DEMINERALIZED TOOTH SURFACE AND EXPOSED
COLLAGEN FIBRILS HENCE IMPROVES THE CONTACT
BETWEEN THE TOOTH SURFACE AND THE ADHESIVE
HOW PRIMERS PROMOTE OR ENHANCE
ADHESION?

20. TYPES OF ADHESIVES
• NON MIX ADHESIVES
EG; UNIQUE, RIGHT ON, SYSTEM 1, UNITE
• VISIBLE LIGHT POLYMERISED ADHESIVES
EG ; FOTOFIL, DURAFIL

21. BONDING TO CROWNS AND
RESTORATIONS
SELECTED ADHESIVES USED
PRIOR TO BONDING THE SURFACE SHOULD BE ROUGHNED
WITH SAND PAPER DISKS
SPECIFIC PRIMERS EG; FUSION, ORMCO PRIMER
RESIN USED - ACRYLIC ADHESIVES

22. INDIRECT BONDING
-- SILVERMAN
--COHEN
BRACKETS ARE ATTACHED TO TEETH ON THE PATIENTS
MODELS AND TRANSFERRED TO THE MOUTH WITH A
SILICON TRANSFER TRAY INTO WHICH BRACKETS BECOME
INCORPORATEDAND THEN BONDED SIMULTANEOUSLY
ADVANTAGES;- ACCURATE POSITIONING
-CHAIR SIDE TIME DECREASED
DIS ADVANTAGES:-REMOVAL OF EXCESS ADHESIVE IS
MORE DIFFICULT AND TIME
CONSUMING

23. RECYCLING
THE ADHESIVE IS REMOVED FROM THE BRACKET
COMPLETELY WITHOUT DAMAGING OR WEAKNING THE
DELICATE FOIL MESH. THE DIMENSIONS OF THE BRACKET
SLOT SHOULD NOT BE DISTORTED
HEATING - 450˚C
- ELECTROPOLISHING TO REMOVE THE
OXIDE BUILD UP OR TARNISH

24. RECYCLING
RECENT INVITRO TESTS SHOW :- SIGNIFICANT REDUCTION
IN RETENTIVE STRENGTH AFTER RECYCLING OF BOTH MESH
BACKED AND PHOTO ETCTHE BACKINGS

25. ADVANTAGES :
• ESTHETICS
•ENAMEL DEMINERALIZATION IS BETTER CONTROLLED AND
HAS LESS CONSEQUENCE ON THE LINGUALTOOTH SURFACES
•LIP POSTURE SEEN CORRECTLY
LINGUAL BRACKET
BONDING [Invisible braces]
COMMERCIAL LINGUAL SYSTEMS
PIONERED IN JAPAN BY FUJITA

26. DIS – ADVANTAGES
OF LINGUAL ORTHODONTICS
1. TECHNIQUE DIFFICULT
2. TIME CONSUMING
3. AWKWARD WORKING POSITION
4. GOOD LIGATION DIFFICULT
5. UNCOMFORTBLE FOR THE TONGUE

27. THANK YOU