the orthodontic bracket placement technique...the benefits of indirect bonding. more detailed...

Indirect BondingThe Orthodontic Bracket Placement Technique

423 South 13th St.Terre Haute, IN 47807Toll Free: 800/457-0504Local: 812/232-6026Website: www.johnsdental.com

Your Full Service Dental Laboratory

Johns Dental Laboratories Copyright 2010Excerpts taken from “An update on the indirect-bonding technique” by Dr. Derek Mahony

The indirect bracketing system is the ultimate time saver and there is no inventory to maintain. Typical bracketingtime is 20 minutes or less for both arches.

IntroductionThis technical bulletin from Johns Den-tal is only an introduction to some ofthe benefits of Indirect Bonding. Moredetailed information including prepara-tion of working casts, placement ofbrackets, blocking out bracket under-cuts and chair-side bonding procedurescan be obtained by calling customerservice at 800/457-0504.Indirect bonding has been an

exciting advancement in orthodonticsover the last 10 years. It is a great bene-fit to the clinician as it improves patientcomfort, reduces chair-time, and im-proves the accuracy of bracket place-ment. This technique also reduces thepossibility of moisture contaminationand the need to “beat the clock,” whileworking with self-curing bonding com-posites. The indirect bonding tech-nique utilizes light-cured bondingmaterials and is a time-saver in the busyorthodontic office.

Even skilled cliniciansfind benefits in the indi-rect bonding techniquebecause they simply donot have the visual ac-cess to all the teeth in allplanes of space.

Lab RequirementsSend upper and lowermodels poured in orthostone along with a waxbite. Models must bebubble-free and smooth,so vacuum spatulation ispreferred. Trim modelsto a minimal base and

without perforations. Allow 24 hours formodels to dry, unless using a slow heatreleasing oven.

Doctor needs to request whichbrackets they want to use and which traysystem they are using: one or two. Thetwo tray system, which offers more stability, is what we see most at JohnsDental.

Doctor StepsWhen the doctor receives the traysback, they need to check to make surethe back of the brackets are clean. Ifthere is a residue, it can be removed bythe air/water syringe or the Micro-etchsystem.Prior to setting, the doctor needs to

cut the interproximal areas of the tray.This will make the removal process eas-ier when using the indirect bondingtechnique.This technique requires a dry field.

One way to achieve this is by using theNola dry field cheek retractor-suctionsystem. Follow the steps below.• Pumice or clean the teeth where thebrackets are to be placed.• Etch teeth for at least 30 seconds.• Prime the teeth. (Depending on the

primer, they might also need to be light-cured.)• Place bonding material on each of thebrackets in the matrix.• Place matrix in mouth in a hinged mo-tion. Be sure to keep equal pressure onmatrix to ensure a good bond.• Light cure each bracket (Time will varydepending on what you are bondingwith.)• Remove matrix once all the light cureis finished.• Remove the matrix in sections. Cut ma-trix interproximally and peel downwardfrom incisal to gingival.• Clean up can be done with a scaler ora high speed handpiece using a com-posite finishing bur.

ImpressionsAn excellent alginate impression mustbe taken of “clean” teeth. A bite regis-tration in a centric occlusal relationshipis also required. Extractions and proce-dures such as Air Rotor Stripping shouldbe postponed until after the bonding,but recontouring of restorations of indi-vidual teeth can be done prior to takingthe impressions. The clinician has theoption to band the molars before theworking cast impressions or at thebonding appointment.

If you are mounting brackets one at atime, you are waisting time and money.There is a minimum of 40% less chairtime for bonding when using the In-direct Bonding technique when compared to direct bonding.

Indirect Bonding from Johns Dental

The 2-tray method is shown here.