Slides 1-9 are day 1. Slides 10-30 are day 2.The objective of this course if to prepare the student to take and pass the CA OAP exam, and to become a fully functioning orthodontic assistant.

1. Sizing & Fitting
Orthodontic Bands
SOUTHERN CALIFORNIA ORTHODONTIC ASSISTING SCHOOL

2. Types of Bands
Standard band with bracket With headgear tube attachment
Identified with a combination of letters and numbers or charting style:
29LL or 29

3. Bands
In order to place bands, there must be space in front of and behind the tooth
being banded
Separators are used to create space between the two adjacent teeth, and
usually take about a week to create the adequate space needed
You do not want to leave separators in for more than a maximum, of 2 weeks
to avoid the risk of infection or the separator getting lodged into the gums

4. Types of Band Cement
Light Cure Cement:
 Material is light sensitive
 Depending on the curing light
and brand of cement, curing
process is between 5-20
seconds
 Can contain fluoride
 This method allows multiple
bands to be placed without
material curing as long as you
keep it out of direct light
 Usually comes in a syringe
Chemical Cement:
 Comes in part a & b, liquid and
powder form
 When the two components of the
cement are mixed, you have a set
amount of time to position band
before cement hardens on its own
 Usually takes a few hours to fully
harden, advise patient not to eat or
drink for at least 30 minutes
 Two types of chemical cement
 Zinc phosphate: Mixed on a
cold glass slab, the original band
cement
 Glass Ionomer: Higher retentive
strength, can be mixed on
regular mixing pad, most
popular choice

5. Instruments Needed to Fit Bands
Bite Stick Band Remover Band Pusher/Plugger
Used to crimp the band
to fit the anatomy of the
tooth by asking the
patient to bite on the flat
surface of the tip
Used to remove bands,
fitted or cemented
Used to crimp the band to
fit the anatomy of the
tooth with force being
applied from the assistant

6. Proper Band Placement
 Most bands today are anatomically pre-
fabricated to the molars shape
 Usually bands still need crimping to avoid
voids or pockets where plaque and food
can accumulate and later lead to cavities
 When a band is seated, it should be tight
enough for self retention and should not
rock or teater-totter
 Occlusal portion of the band should be
level from mesial to distal
 Ultimately, the band placement is at the
discretion of the doctor
 Bands can be sterilized and retried on new
patient if you do not chose a proper fit the
first time

7. Anatomy of a Band
Bracket
attachment
welded to
bandNumbers &
letters used to
identify band
size and tooth
This occlusal divot
in band can be
used to identify the
bands orientation
Inside of the band
can be meshed or
smooth
depending on
manufacturer

8. Cementing the Band
 Step 1: Prep band
 Ensure the band is not wet with saliva or any other liquid
 Step 2: Mix cement using a spatula and put in band
 Cement is placed on lingual half of band
 Step 3: Dry tooth and surrounding tissue
 Isolation can be achieved by placing cotton rolls between buccal surface of tooth
and the cheek
 Step 4: Place band
 Roll band from distal to mesial, pressing into place with fingers and wiping away
excess cement with additional cotton roll
 Use bite stick and band pusher to seat and contour band to ideal position
 Step 5: Cure adhesive (if necessary)

9. Any Questions?

10. Bonding
SOUTHERN CALIFORNIA ORTHODONTIC ASSISTING SCHOOL

11. Prepare the Tooth's Surface
 Prophylaxis- Clean the tooth surface using pumice and a prophy angle or
brush to ensure there is no plaque or food that could lead to bond failure
by contamination
 Do not use pumice with oils or fluoride

12. Isolation
There are many forms of cheek retractors, above are a few of the most commonly used
NOLA System Standard Cheek Retractor & Saliva Ejector

13. Etch
 Etching the tooth removes the top layer of enamel, allowing for a micro-
mechanical bond between the bracket and the crown of the tooth
 Most common etch contains 37% phosphoric acid
 9.6% Hydrofuoric etch is used on porcelain crowns
 Etch can be applied through a syringe or from a mixing pad using a
microbrush
 Etch can be in liquid or gel form
 Allow 30-60 seconds for etch to be on tooth before rinsing, depending on
manufacturer recommendations

14. Chemistry of Etching
 Etching the tooth's surface strips the enamel on the surface layer, leaving
the tooth microscopically rough or jagged
 The mechanical bond between bracket adhesive and tooth is created by an
interlocking of the cured bonding agent meshing into the imperfections of
the etched enamel surface.

15. Etching
 Apply etch to entire desired area to be bonded
 Avoid etch touching any soft tissue, it may cause irritation and in severe cases,
burns to the tissue
 After leaving etch for 30-60 seconds, rinse thoroughly for at least 10
seconds using the air/water syringe tip. It is critical that there is no etch
residue before moving on. Confirm there is no etch on soft tissue after
rinsing
 Dry the etched teeth with tooth dryer or air/water syringe tip
 The tooth should appear chalky white where etch was placed.

16. Etching a Porcelain Tooth
 Etching a porcelain tooth is almost the same process as a regular tooth,
with these differences:
 Tooth must be micro-etched (sand blasted) with a 50 micron aliminum oxide
and then rinsed thoroughly before bonding
 9.6% Hyrofluoric etch is used, and must rest on desired area usually 3-4
minutes, depending on manufacturers recommendations

17. Primer (Sealant)
 Applied after tooth has achieved the white chalky or frosty look from
etching (may not be as apparent with porcelain tooth
 Apply thin coat using a microbrush
 Gently blow air on tooth to thin layer of primer
 If bonding a porcelain tooth, you will use a special porcelain primer in
conjunction with a porcelain etch

18. Curing
 Original curing lights were a
halogen bulb, which is
recommended 15-20 seconds per
bracket
 Recent advances such as LED’s
(most common) and plasma have
narrowed the wavelength of the
light, allowing cure time as little as 3
seconds per bracket
 Be sure to not accidentally touch the
bracket while curing to prevent
voids or change the doctors final
position. If this does happen, always
let the doctor know, and rebond in
correct position

19. Adhesive &
Placement
1. It is important to press the adhesive
into the mesh pad of the bracket
2. Place bracket in the most idea
position, avoid dragging bracket
around too much
3. Press bracket firmly against tooth the
ensue full torque expression of the
bracket
4. Remove excess “flash” from tooth
and/or bracket
5. Have the doctor place final position

20. Reasons for Bond Failure
 Improper prophy
 Rinsing etch from tooth too soon
 Incomplete rinsing of etch
 Insufficient drying of tooth before or after etching
 Saliva contamination after primer
 Excessive sealant (primer) on tooth
 Moving bracket while curing adhesive
 Hard, acid resistant, fluorosed, hypocalcified or aprismatic enamel
 Paste not pressed into mesh
 Adhesive not cured long enough

21. Instruments Used for Bonding
Bracket Holders
Mouth
Mirror
Cotton
Rolls
Boone Gauge
Explorer
Microbrush

22. Bracket
Placement
Mandibular Arch
Maxillary Arch:
4.0mm
4.0mm
4.0mm
4.0mm
4.0mm
4.0mm
4.0mm
4.5mm
4.5mm
4.5mm
4.5mm
4.5mm
4.0mm
3.5mm

23. Bracket
Characteristics
 Upper central brackets are
widest brackets without
tubes
 Molar brackets have tubes
for archwire placement and
hooks
 Lower anterior laterals and
centrals are interchangable
brackets
 Cuspids and bicuspids may
have hooks attached

24. Indirect Bonding Procedure
 Apply adhesive to pad/mesh of each bracket in the IDB tray
 Make sure to be working in low light and have a protective
barrier to place IDB trays until they are ready to be delivered
 Etch and prime tooth the same as direct bonding procedure
 Using weingardt or cotton plier, hold IDB tray lining up with the
teeth
 Place bracket side of IDB tray onto teeth and roll to other side
 Bonding buccal brackets: from buccal to lingual
 Bonding lingual brackets: from lingual to buccal
 Once IDK tray is firmly seated onto desired teeth, press firmly onto
tooth being bonded as you light cure the adhesive
 Release pressure and cure for another 5-10 seconds depending on
curing light
 Remove IDB tray by using the rolling motion in a C pattern to avoid
breaking brackets while removing
 Remove from side opposite of brackets first

25. Any Questions?

26. Debanding
 When removing full braces & wires (debanding), you do not untie the
patient first. Leave all elastomerics in place so that when the brackets are
dislodged from the tooth, all of the parts of the braces stay together and
make it easier to remove everything all at once
 Always review the condition of teeth to make sure they are healthy enough
to handle slight pressure. Patients with periodontal issues/cavities/bad oral
hygiene are more sensitive.

27. Instruments Used for Debanding
Bond
Remover
Band
Remover
Cement
Remover
Mouth MirrorWeingardt

28. Debanding Techniques
 Removing of all orthodontic
appliances and adhesives or
cements
 Place the deband plier beaks on
the vertical axis of the tooth
 Use “peeling” technique by
torqueing the bracket towards
the incisal edge
 Remove bracket adhesive with
scaler and/or slow speed and 8
round bur combination

29. Removing Cemented Bands
 Using a band remover, apply slight pressure with the silicone top against
the tooth and metal tip against the bracket attachment of the band
 Remove bands from buccal to lingual. Squeeze and pull up towards the
occlusal surface, then over towards the lingual in a rolling motion
 Remove band cement with a cement remover and/or ultrasonic scaler

30. Any Questions?