Pacific Coast Society of Orthodontists Bulletin Winter 2012 - (Page 43)

ANNUAL SESSION The original ProSeal was cured by a halogen light source, while L.E.D. ProSeal can be cured by any dental curing light. When applying to the labial surface, place the first stroke at the middle of the crown and paint incisally; then, go back to the cervical one-third of the tooth. This helps to reduce excessive pooling of the ProSeal liquid in the region of the gingival margin. At debonding, be sure to go over the whole labial surface of the tooth to clear away the ProSeal. A 2010 study at the University of Iowa showed that ProSeal can withstand brushing for a twoyear period; a 2011 study at UT San Antonio showed that ProSeal resisted decalcification. BONDING TO COMPOSITE RESTORATION AND METALSURFACES For composite surfaces, after prophying, roughen the surface with a fine diamond bur (not a carbide or green stone). Etch (only if also bonding to enamel), rinse, dry, place Assure, and bond your bracket with any desired paste. Metal surfaces such as gold or amalgam must be sandblasted, as the ultimate bond strength will be nearly doubled in comparison to simply roughening the surface with a bur. After sandblasting, rinse, dry, paint on Assure, and apply your bracket to the metal surface with your preferred bonding agent. If using a light cure paste, cure for twice the usual time in order to ensure adequate polymerization. PORCELAIN CROWNS For porcelain, we need to sandblast, as this is less damaging to the porcelain surface and provides a better bond than roughening with a coarse bur. After sandblasting, etch with hydrofluoric acid (Porc-Etch™). If there is any chance of the acid coming into contact with the gingival margin, you can use a barrier gel adjacent to the gingiva. Etch for a minimum of 4 minutes, and then wipe off the porcelain surface. Now apply one thin coat of porcelain conditioner, dry, apply a coat of Assure Universal Bonding Resin, and bracket with the paste of your choice. For bonding to known Cerec crowns, check with the dentist who fabricated the crown to determine if it is porcelain or composite. Zirconia crowns are the next challenge, and are most likely to be found in the posterior regions. At present, we cannot bond successfully to zirconia, but Reliance plans to come out with a second generation of Assure in 2013; this formulation will bond to all surfaces, including Zirconia. At debond for porcelain, go over the porcelain surface with a polishing point; then, follow with a diamond polishing paste with a rubber cup. W I N T E R 2 0 1 2 • P C S O B U L L E T I N LINGUAL RETAINERS The lingual retainer must fit flush on each tooth. Each tooth to be bonded should be sandblasted following the initial prophy, with 50 micron-size aluminum oxide particles. Etch, rinse, dry, apply a coat of Assure, dry and apply a paste such as FlowTain™, and then light cure. Dental floss can be used to pull the lingual bar in a labial direction by having the inferior aspect of the floss below the tooth contact in the dental midline (for bonding bars to lower canines only). OTHER BONDING APPLICATIONS For occlusal bonding or bite turbos, the paste requirement is that the paste must have the same wear rate as enamel, not harder. For crown appliance cementation, Fuji® Ortho LC (GC Corporation) is used following a regular acid etch. Remember that Fuji will not adhere to metal surfaces. An alternative cement would be Crown Lok™, which will bond chemically to the inside of the crown, but is not hydrophilic like the Fuji material. When bonding large acrylic appliances, use Band Lok® or Ultra Band Lok®. Etch the buccal and lingual surfaces only—not the occlusal surfaces. The mesial of the most anterior tooth and distal of the terminal tooth can also be etched. Always condition the acrylic with Plastic Conditioner. A great combination for placing aligner attachments is the use of a self-etching primer to condition and the FlowTain paste for the attachment, due to its smoothness when cured. For constructing a temporary veneer, such as for a pegshaped maxillary lateral incisor, the Reliance Orthodontic Veneer System (OVS™) kit can be utilized. For a recently exposed tooth, the C&C™ extrusion kit allows you to fabricate a composite pad with a chain to the tooth, thereby reducing patient trauma after alignment (by being ground off the enamel, not crimped). An aligner adhesive that will allow bonding attachments to clear orthodontic aligners and a Pontic Paint for aesthetic masking of aligners will be introduced by Reliance in 2013. Get more detail on bonding protocol by downloading Mr. Gange’s pdf, “Chairside Bonding Technique” at www.glao.org/meetings/upload/gange-handout.pdf, or by ordering his more recent DVD, “The Complete Orthodontic Bonding Reference Guide” on the Reliance Web site, www.relianceorthodontics.com/store/product. php?productid=41 S 43 SUMMARIES http://www.glao.org/meetings/upload/gange-handout.pdf http://www.relianceorthodontics.com/store/product.php?productid=41 http://www.relianceorthodontics.com/store/product.php?productid=41

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Winter 2012

Incremental Change
What a Time it Was!
Invisalign
AAO Trustee's Report
A need, A dream, A reality: A team approach produces an extraordinary outcome
PRECEDENT Orthodontists on Devices
The Complexities of Successful Herbst Treatment
Dr. Bryan Williams
Presentation Software
Treatment Planning: The Magic Step
Comprehensive Mixed Dentition Approach
Social Media 101 for Orthodontists
Update on Bonding 2012
Create the Future by Looking Back: 100 Years of PCSO
PCSO Business
Component Reports
AAOF Report
PCSO at a Glance
Case Report Pre-Treatment
Case Report Post-Treatment
In Memory

Pacific Coast Society of Orthodontists Bulletin Winter 2012

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