Orthotown July/August 2020 - 42
REBONDING WITH RESIDUAL COMPOSITE ON ENAMEL
Option A:
Least aerosols
Step
Option B:
Increased aerosols
Option C:
Traditional method
1. Composite
removal
Remove as much composite as possible with
composite-removing pliers without crazing
enamel.
Using a slow-speed
handpiece, remove
residual composite
with an operative latch
carbide bur.
Using a high-speed
handpiece, remove
residual composite.
2. Mechanical
retention
Manually roughen the composite on the
enamel with a paper disc by placing pointer
finger on lingual surface of tooth and disc
on facial side of tooth, pinching the disc with
your thumb and agitating back and forth to
mechanically prepare the tooth surface.
Using a diamond bur,
roughen the tooth
surface.
Using a sandblaster,
micro-etch the tooth
surface.
3. Rinse
Rinse each tooth for 10 seconds with a
disposable-tip squeeze bottle filled with
water.
Rinse each tooth for 10
seconds using chairside
water syringe; press
very lightly on the water
button to reduce water
splash.
4. Dry
Blot teeth dry thoroughly with cotton roll or
2x2. Note: Be light-handed and gently press
the cotton roll to the tooth surface. Wiping or
scrubbing will significantly increase enamel
rod fracture.
Dry thoroughly with a
tooth dryer.
Dry thoroughly with
chairside air syringe.
5. Prime and dry
Apply one coat of a composite primer (e.g.,
Assure Plus, Plastic Conditioner, OrthoSolo)
with a bristle brush, stroke over five times.
With a new, dry brush, stroke over each tooth
surface five times to evaporate solvent. This
dry brush may be used for three teeth until
needing to be discarded. Light-cure tooth for
10 seconds.
Apply one coat of a
composite primer; airdry with a tooth dryer for
3 seconds per tooth.
Apply 1 coat of a
composite; air-dry with
chairside air syringe.
6. Bracket
placement
Firmly smear adhesive into bracket base with
a spatula; place on tooth and light-cure.
Before the COVID era, self-etch
techniques were traditionally producing a
10-20% reduction in strength, compared
with phosphoric acid etching. If clinicians
are focused on the least amount of aerosol
production (utilizing "A" steps), it should be
42
noted that the same reduction in strength is
maintained when utilizing a self-etch versus
traditional etch process with these steps.
These procedures were developed as a
response to the concerns about forced air and
water spray. Every step in these protocols is
intentional and vital to a successful bond.
Because of the slight (10-15%) decrease in
strength and extreme technique sensitivity,
these protocols should not be utilized when
we are past the COVID-19 crisis. ■
JULY/AUGUST 2020 // orthotown.com
OT0720_Gange_COVID_Bonds_MM.indd 42
7/14/20 9:56 AM
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Orthotown July/August 2020
Table of Contents for the Digital Edition of Orthotown July/August 2020
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