Update and Overview
for Indirect Bonding

Indirect Bonding has been used throughout the profession for more than 25 years. While many practices were initially successful with Indirect, problems arose that prevented the technique from becoming an industry standard. Over the years, however, advances such as customized bracket placement, specialized adhesive systems and transparent transfer trays have helped Indirect Bonding become a highly accurate and dependable system that doctors now rely on with the highest of confidence.

You Need Quality Indirect Bonding Services...We Deliver

At Specialty Appliances

The Custom-Base Laboratory Technique In our custom-base Indirect system, brackets are placed on the working models using a direct bonding adhesive such as Phase II from Reliance Orthodontic Products. Only a thin film of bonding material (light cure or auto cure) is required to bond the brackets to the teeth because of the precise fit of the bases to each tooth. This view of the custom-base technique with the final base against the laboratory model highlights the exact fit of the adhesive to the dental surfaces.
Bracket Placement at Specialty Appliances When we receive a case, we first perform a quality-control process on the construction models. After we have verified the accuracy of the models, we place reference lines on the cast for bracket placement. We mark the incisal and occlusal edges of the teeth, followed by long axis lines and vertical height reference indicators. Many practices have provided us with standard guidelines for average vertical heights. We also gauge the vertical height of the teeth for bracket placement with attention to the overall size of the dentition.
The Two-Tray System At Specialty, we have refined a system using a time-proven "two tray" system. First, a flexible "inner tray" made from pressure-formed vinyl covers the brackets. Next, a hard acrylic is processed directly over the soft tray to act as a "carrying and simultaneous seating tray," exerting positive pressure to help set the brackets. This system also lets the clinician easily position and seat the trays while maintaining a clear field of view. In some instances, the inner tray may be separated from the outer tray and seated first with a slight "flexing" as needed due to crowding or rotation of the teeth. The outer tray is then seated immediately over the inner tray. All transfer trays are sectioned according to the doctor’s preference.

In Your Practice

Preparing the Teeth for Bonding The most predictable adhesives used in Indirect Bonding are employed with a completely dry field – we recommend the NOLA cheek retractor and moisture-control system. Beginning with the lower, one arch at a time is prepared and bonded to avoid contamination. Pumicing the teeth with a rubber wheel is recommended, while some practices also micro-etch the posterior teeth. The recommended etch from Reliance is the 37% acid solution, followed by a thorough rinsing of each tooth for at least ten seconds.
Applying the Adhesive Components The custom bases in the trays are first prepared by painting Reliance Adhesion Booster on each pad. Adhesion Booster is specially formulated to enhance bonding strength. The bonding adhesive (either light or auto cure) is then applied to the composite pads and the companion sealant is brushed on the etched teeth. It’s important to note that, in addition to the thin sealant on the custom pads, a small bead of adhesive may be used to ensure that any micro-gaps between the custom composite bases and tooth surfaces are filled.
Delivering the Brackets Keeping the inner and outer trays together as one unit, seat the tray from the posterior to the anterior in one motion. The trays have a snap fit, which helps establish the seating. Since the material is transparent, it is easy to visually confirm that the tray is seated completely. Once the adhesive is set, the hard outer tray is removed and the flexible inner tray is then easily peeled away from the brackets with a scaler. The block-out material used around the gingival portion of the brackets facilitates tray removal without dislodging the brackets.