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UPDATE OF ORTHODONTICUPDATE OF ORTHODONTIC
starts with blue color and changes to
natural shade after light cure
HELPS TO REMOVE EXCESS FLASH.
Color change compleats complete light
cure and bond strength.
Adhesive contain fluoride
Available in push syrenge and pre
loaded syrenge tips.
ENAMEL BONDING AGENTSENAMEL BONDING AGENTS
Consists of unfilled liquid acrylic monomer
placed on acid etched enamel.
micromechanical retention by resin tag formation
on resin enamel interface.
Micro tags and macro tags are basis for micro
Micro tags are more important because of their
large number and great surface of contact.
On other side bonding agent co-polymerises with
matrix phase of dental composite
DENTIN BONDING AGENTSDENTIN BONDING AGENTS
Unless we understand dentin bonding and certain
terminologies related to it we will not be able to
follow the update of adhesives.
Disadvantages of Dentine Bonding:
Smear Layer .
GENERATIONS OF BONDINGGENERATIONS OF BONDING
Generations are nothing but evolution of bonding
agents from 1955 to 2003.
There are 7 generations.
I - GENERATION Buonocore(1956) introduced.
Resin containing glycerophosphoric acid
Bowen introduced NPhenyl Glycine &
Bonding-is by chelation of bonding agent to calcium
Poor dentine bonding .
Enamel bonding is good
Examples-The first commercial system of
this type (Cervident, SS White).
II - GENERATION (1978)
Bis-GMA (or) HEMA were introduced which are
unfilled resins which causes ionic bonding to the
calcium in dentine.
1. Bonding to smear layerDraw Backs
2.require mechanical preparation
III - GENERATION
Principle: Partially removed (or) modified the
Etching opens dentinal tubules and primer META or
BPDM modifies smear layer and attaches to
Primer, does not penetrate the smear layer
Adhesive retention decreases after some time
Mirage bond, Scotch bond 2
Prisma Universal bond 2 and 3
IV - GENERATION
Complete removal of smear layer was attempted .
Total - etch technique. In the total etch -
technique Orthophosphoric acid was used to etch
enamel and dentin, simultaneously for 15 - 20
Moist - Dentine Concept. However, in order to
avoid collagen collapse, primer solution is applied
which can infiltrate the exposed collagen network
forming hybrid layer. This is called moist dentin
Hybridization: Replacement of hydroxy-
apatite and water in the surface dentin
Hybrid: resin in combination with
remaining collagen fibre
4th generation dentin bonding agents may be again
Etch (phosphoric acid) + Primer (NTG-GMA, N
tolyglycine -glycidyl methacrylate) + Bond (Bis-
All bound-2 (BISCO), Scotch bond
Multipurpose (3M), Prime and bond
v - GENERATION
1. One -Bottle System
Primer and adhesives are combined into one
Show high bond strength values both to the etched
enamel and dentin due to adhesive lateral branches
and hybrid layer formation
2. Self etching primers
This system may be described as, E
(phosphoric acid) + PB (PENTA,
One step (BiSCO), Single bond (3M),
Clearfil SE bond (J MORITA).
Opti bond solo (KERR
VIEtchng was not required at least at the dentinal
They contained dentin conditioning agent as one of
Described as EPB(METHACRYLAED PHOSPHATES)
Drawbacks: Multiple components and multiple steps
VII - GENERATION
Etching, priming, bonding all were
combined into one step.
Shear bond strength not affected-any
type of curing light .
Similar adhesion to prepared and
Desensitizers were added.
GLASS IONOMER CEMENTS
Invented -1969 reported in 1971 by WILSON AND
POWDER ; Flouroalumino silicate glass
Liquid: Poly alkenoic acid (Carboxyl containing acid )
Setting Reaction: The hydrogen ions of the acid
attack the glass particles in the presence of
water releasing calcium, strontium, and aluminium
The metal ions combine with the carboxylic group
of the polyacid to form the polyacid salts matrix
and the glass surface is changed to a silica
Bond strength less than that of composite
Hydrogel phase: Responsible for the uptake and
release of added environmental fluoride from topical
gels, rinses & dentifrices
Gic's used for bonding toGic's used for bonding to
ceramic bracketsceramic brackets
Cacciafesta et al (1998) (European journal of
The lower bond strength of glass ionomer
cements might be advantageous with ceramic
brackets where high bond strengths have
been associated with enamel damage
Orthodontic use of GIC increased
with development of resin modified
+10-20% resin monomers
LIGHT OR CHEMICAL
Improved physical properties especially fracture
Stable hydrogels when compared with GIC.
Capsulation helps in mixing with a trichurator.
Polymerization proceeds faster than acid-base
RMGIC-tolerates moisture similar to GIC's
Sustained fluoride release and caries inhibition
Effect of brushing on fluoride
release from 3 bracket adhesives-
AJO DO Staley e tal.
Resin modified GIC bracketed
groups released morefluoride han the
other groups over the 93 days of
Silver et al AJO (1995) Found excellent long
term adhesion with such materials in the
absence of enamel etching .
Bishata et al: AJO (1999) Advised etching of
enamel for sufficient bond strength.
Multicure GICMulticure GIC
Manufactured by –3M- UNITEK
Features-slight blue tint of the cement for
easy clean up
Cherry flavour for pt acceptance
Adequate strength with in 40 sec of curing
with ortholux -XT .
Advantages-adhers to regular etched or
Minimizing wash out by filling voids.
Sustained fluoride release.www.indiandentalacademy.com
CURRENT CATEGORIES OF ADHESIVECURRENT CATEGORIES OF ADHESIVE
1. Total etch adhesive bonding
2. Self - etch adhesive bonding
Total- etch Adhesive bondingTotal- etch Adhesive bonding
Bonding or adhesion to the enamel is
done in the following procedure:
2) Enamel conditioning or acid etching
To remove saliva,acquired pellicle,
different organic and inorganic
components of enamel and dentin.
Also improves wetting.
Etching in fluoridated teeth
Fluoride ion is incorporated into hydroxy-
apatite crystals and is resistant to acid-
dissolution which aids in prevention of
Hence fluoridated teeth requires longer etching time
Primers: Primers were invented to deal
with moist dentine problem.
They are difunctional .
one end has affinity for hydrophilic
dentine and the other for hydrophobic
e. g HEM A (Hydroxy ethyl methacrylate)
A Self etching primerA Self etching primer
A Self etching primer combines etchant
and primer in one chemical compound
Contains bifunctional methacrylate base .
Primers - penetrates into the exposed
Less evoparation,more stable viscosity,and
wetting capability due o unit dose package.
Trans plus SEPTrans plus SEP
Trans bond plus SEP CONSISTS OF 3
Second compartment:water & soluble
Third compart ment:Applicator microbrush.
Chemical comparison of phosphoric acidChemical comparison of phosphoric acid
to self-etching primerto self-etching primer
Scanning electron microscopeScanning electron microscope
Irregular but smooth hybrid layer,3-
4 mm thick irregular tag formation
with no apparent in dentations of
Minimal etching with SEP indicates
majority of bond may be more of a
chemical bond with calcium in the
enamel than mechanical bond.
Scanning electron microscopeScanning electron microscope
Phosphoric acid etch Transbond plus
Effects of blood contamination on the
shear bond strenghs of conventional and
hydro philic primers-AJO DO-2004
Vittorioo cacaiafesta e tal
Blood contamination of enamel during he
bonding procedure of conventional and
hydrophilic primers significantly lowers
their bond strength values and mig produce
a bond strength that not clinically adequate
MIP,s - MOISTUREMIP,s - MOISTURE
INSENSITIVE PRIMERINSENSITIVE PRIMER
Arndt kloche et. al. Angle
orthodontist 2003 August.)
Hydrophilic primer - from 3rd
Bonding can be
Requires moisture for the initiation
Adhesion promoters forAdhesion promoters for
orthodontic bondinqorthodontic bondinq
Adhesion promoters-are chemical
substances introduced to enhance the
bond with resin.
Used for increasing bond streangths.
Adhesion promotors used in case of
porcelain or gold resoratins.
Adhesion promoors are teremed as
MEGABOND 1,2,and 3(M-1,M-2,M-3)
Adhesion promotorsAdhesion promotors
M-1:NTG – GMA -Magnesium Salt of N -
Tolylglycineglycidyl Methacrylate in acetone
M-2:PMGDM -Adiadduct of Glyercol
Dimethacrylate and pyrromellitic anhydride
M-3:Dimethyl paratoluidine in acetone.
M-1 & M-2 are used primarily for tooth
enamel surface where as M-3 & M-4 are used
for coaing mesh meal brackets
The shear bond streangth was
increased from 9.0Mpa for the
control to 13.3Mpa(an increase of
48%) when adhesion promotors used.
Adhesion promoters ,their
effect on the bond strength of metal
BONDING TO GOLDBONDING TO GOLD
Until recently, bonding to gold and other
metals was considered difficult.
In the 1980's some adhesives - (Enamelite
500, Goldlink) etc and primers (fusion) -
were designed to allow such bonding.
However, published reports and clinical
experience do not support their
There are 2 types of AdhesionThere are 2 types of Adhesion
promoters for goldpromoters for gold
Resins with adhesive promotors .
eg-super bond c and b
Super bond C & B is a metal bonding
adhesive and contains 4 – META 10-
eg. All bond 2 (Primers A & B)
and scotch bond multipurpose adhesive
All bond 2 contains an organosilane agent -
BPDBM - Biphenyl dimethacrylate and NTC -
GMA bond accelerator
Bonding to porcelainBonding to porcelain
Bonding to porcelain is also enhanced by the
use of adhesion promotors, principally organo
One difference from Gold is that an etching
process is used similar to conventional
The etchant used is 2.5% Hydrofluoric acid
The etching time in 90 secs.
Hf acid dissolves the crystalline and glassy
phases of porcelain thus enhancing the
surface area and energy.www.indiandentalacademy.com
Chemistry of silane couplinqChemistry of silane couplinq
Chemistry of silane couplinqChemistry of silane couplinq
Stage 1 Stage 2
Stage 3 www.indiandentalacademy.com
COMERCIALLY AVAILABLE ORGANOCOMERCIALLY AVAILABLE ORGANO
Supplied in prehydrolysed form& hydrolysed
Pre hydrolysed form:eg scotch prime
hydrolysed form:eg ormo porcelain primer.
The pre hydrolysed form is unstable and has
a very short shelf life
Bonding to amalgam restorationsBonding to amalgam restorations
Micro-etching is essential for bonding to
amalgam and other nonprecious metals.
Small amalgam restorations no sand
blasting to be done
Large amalgams should be sandblasted for
about 3 sec to provide an improved surface
Bonding to acrylic and compositeBonding to acrylic and composite
An acrylic adhesive resin is preferred for
bonding Metal, plastic or ceramic brackets to
The bond strength obtained, with the
addition of new composite to Mature
composite, is substantially less than the
cohesive strength of the Material.
Fluoride releasing adhesivesFluoride releasing adhesives
Fluoride releasing adhesives is a relatively
recent advancement.Fluoride release:
Wiltshire et al have reported on the fluoride
release characteristics of various resins.
Most resins show an immediate release of
fluoride following bonding and thereafter
the levels of release decreases sharply and
levels of off
Clinical comparision of the bond failure
rates between the fluoride releasing and
non- fluoride releasing composite resins-
JCO 2000 CHUN-HIS CHUNG,DMD,MS
This study demonstrates that a
fluoride –exchanging composite resin
such as phase II is clinically enough for
use as an orthodontic bonding.
APC PLUS ADHESIVE SYSTEMAPC PLUS ADHESIVE SYSTEM
APC plus adhesive systemAPC plus adhesive system
REDUCE BONDING STEPS.
COLOR CODED TO REMOVE EXCESS
MOISTURE TOLERENCE AND
MORE STABILITY AND SHELF LIFE
CUTING BY ORTHOLUX.
The future of adhesive dentistry is bright.The
scope for deepening in this pool is still
tremendous.This will require for more collabaration
between molecular biologists and polymer chemists
that has previously occurred
Commercialization of such technology can only
be done by large corporations that have both type
of scientists in their research and development
Transbond XTTransbond XT
AdhesivKit in Syringes AdhesivKit in capsules
Transbond™ XT Light CureTransbond™ XT Light Cure
Bonds metal and ceramic brackets to tooth
Available in both syringes and capsules,
uses light cure adhesive technology.
The viscosity of adhesive prevent adhesive run-on
and bracket skating that saves you money .
reduces adhesive waste.
easy application, increased control and convenience.
A syringe delivery system is available too.
Immediate archwire tie-inwww.indiandentalacademy.com
Transbond LR AdhesiveAdhesive
Transbond™ LR AdhesiveTransbond™ LR Adhesive
Developed specifically for bonding lingual
Easy to apply,
optimal handling characteristics .
working time is extended so accurate
placement is enhanced
product waste is minimized
Indirect Bonding AdhesiveIndirect Bonding Adhesive
The Sondhi™ Rapid-Set Indirect
Bonding Adhesive is revolutionary
from every angle. This lightly filled
resin cures in half the time (2
minutes vs. 4 minutes) of other
indirect adhesives, while achieving
two thirds of its bond strength within
the first five minutes
Designed to complement our APC™
Adhesive Coated Appliances, the Sondhi
Rapid-Set Indirect Bonding Adhesive
allows you to take full advantage of the
benefits of indirect bonding. More
accurate bracket placement; less bracket
repositioning; maximization of doctor time;
and compared to direct bonding, decreased
chair time and patient discomfort from
simultaneous bonding of all brackets
From the doctor's angle, it means
less wasted time per patient and less
stress. It also means more control
over bracket placement second molar
to second molar, and a higher level of
precision, accuracy and strength. This
instills added confidence that the
doctor's goal, straight teeth, will be
From the patient's angle, it means a
faster, more comfortable, more
confident bonding experience. From the
business angle, it means more cost
effective use of doctor time.
Any way you look at it, indirect bonding
is superior with the Sondhi Rapid-Set
Indirect Bonding Adhesive
For fast orthodontic curing times andthe
convenience of untethered portability, your
best choice today is the Ortholux™ LED
Curing Light from 3M Unitek.
With the Ortholux LED light, there’s no
cord connecting the handpiece to a light
source. There’s no bulky equipment to get
in the way or impede chairside mobility.
And yet, with a small handheld unit, you
have curing times for orthodontic bonds
that are typically twice as fast aswww.indiandentalacademy.com
Advanced LED Technology is the Key
The Ortholux LED curing light uses one
blue LED (Light Emitting Diode) that emits
light in the 430-480 nm range at an
intensity of 1000 mW/cm2
. The light is
optimized specifically for the
polymerization of materials used in
orthodontic bonding. With LED technology,
there is no bulb to lose intensity or wear
out. Heat build-up is minimal, so there is no
need for a fan which uses battery power
and adds weight. Microprocessor-basedwww.indiandentalacademy.com
Convenience for You and the Patient
The Ortholux LED light is remarkably easy
to handle and use. The handpiece is
compact, sleek and weighs less than eight
ounces. The light guide rotates 360
degrees, making positioning easy for you,
and quick curing times enhance patient
comfort and shorten chair time.