Braces treatment involves several steps, starting with the placement of the brackets. Here, our orthodontists in Surrey explore orthodontic bonding, explaining what it is and how it works.
What is orthodontic bonding?
Orthodontic bonding is the process of placing braces on your teeth during orthodontic treatment. Bonding brackets to your teeth essentially means gluing brackets to your teeth. The substance used in orthodontic bonding is an adhesive for braces brackets, often called dental cement or braces cement.
The Importance of Orthodontic Bonding
As mentioned, the main function of orthodontic adhesive is to create a strong bond between the adhesive, the bracket and the tooth enamel. This bond offers a strong grip, which is needed as it has to hold up to the environment of the mouth (moisture) and the pressures of eating and oral hygiene. If the bond isn't strong enough, then it runs the risk of brackets becoming detached, which can negatively impact the success and duration of the orthodontic treatment.
Along with being strong, these adhesives must also allow the bracket to come off without causing damage to the enamel and without leaving residue.
Types of Orthodontic Bonding Adhesives
Bonding adhesives are the substances used to attach appliances to teeth. Different types of adhesives can be used, including:
- Conventional composite (composite)
- Conventional glass ionomer cement (GIC)
- Polyacid‐modified composites (compomers)
- Resin‐modified glass ionomer cement
Orthodontic Bonding Techniques
Orthodontic bonding techniques attach brackets and wires to teeth in treatments, ensuring braces stay securely in place. The methods used in orthodontic bonding are categorized into direct and indirect bonding, each offering advantages based on the clinical situation and treatment goals.
Direct Bonding
Direct bonding is the main technique used in orthodontics, involving the direct application of brackets onto teeth. This process includes applying the orthodontic bonding agent to the tooth surface, placing the bracket, and then curing the adhesive material with a dental light. Direct bonding is fast and efficient, providing the benefit of immediate bracket placement.
Indirect Bonding
Indirect bonding is a more involved process where brackets are initially placed on a model of the patient's teeth, and later transferred to the patient’s mouth. This method is often chosen for its precision. It is particularly suitable for patients with complex dental cases, facilitating accurate placement and better results.
Enamel Pretreatment Methods
Enamel pretreatment methods ensure a strong bond between the tooth and orthodontic adhesive. Treatments like acid etching and self-etching primers remove the smear layer (layer of debris on tooth surfaces) and create a rough surface for stronger adhesion, essential for the longevity of orthodontic appliances.
Acid Etching
Acid etching is a classic enamel pretreatment technique that creates microscopic roughness on the tooth surface. Applying a phosphoric acid gel or solution etches the enamel, enhancing the surface area for improved bonding of orthodontic adhesives. This method has been fundamental in orthodontic bonding because of its proven effectiveness in securing a robust adhesive bond.
Self-Etching Primers
Self-etching primers are an alternative to acid etching. These primers work by integrating both etching and priming into one step. Generally, they are less acidic compared to conventional acid etching, which minimizes the potential for enamel harm while still ensuring strong bond strength, especially when convenience and efficiency are key considerations.
Factors Affecting Bond Strength
The strength of an orthodontic bond relies on factors such as enamel surface preparation, adhesive type, and curing method. Moisture presence, bonding material, and clinical technique also matter. Taking these factors into consideration can help achieve a durable bond against orthodontic forces.
Surface Texture & Preparation
The texture and preparation of the surface are crucial for effective orthodontic bonding. The tooth's surface roughness, which can be created using techniques like acid etching or self-etching primers, influences how well the adhesive attaches. Adequate preparation guarantees a bond strong enough to endure daily use without breaking.
Moisture Control During Bonding
Controlling moisture during bonding is crucial for achieving the best adhesive strength. Too much moisture on the tooth surface can impact the bonding process, weakening the adhesive. Techniques like using rubber dams or cotton rolls are often used to create a dry working area, allowing the adhesive to bond effectively to the tooth surface.