Chapter 17
Debonding
When the active phase of fixed appliance treatment is complete, the bonds and bands need to be removed. This process in known as ‘debonding’. A long appointment should be scheduled for this much-welcome and long-awaited procedure.
The appointment for the removal of the fixed appliance may be anything from 1 to 2 years after the start of treatment, more if it has been part of a multi-disciplinary treatment. For teenage patients, this represents a significant percentage of their lives. For them, and for the whole team, this appointment is eagerly anticipated!
Occasionally, one dental arch is braced before the other, e.g. if the bite needs to be opened. However, it is uncommon for the two arches to be debonded on separate occasions and as a general rule both upper and lower appliances are removed at the same appointment.
Just as the fitting of the fixed appliance takes longer than the average appointment, so the removal of the appliance needs more time.
The nurse will need to prepare (Figures 17.1 and 17.7):
- the patient’s clinical notes
- the patient’s model box
- mouth mirror, probe and College tweezers
- anterior bracket removing pliers (Figure 17.2)
- anterior ceramic bracket removing pliers, if needed
- band-removing pliers (Figure 17.3)
- band-slitting pliers (Figure 17.4)
- Mitchell trimmer
- adhesive-removing pliers (Figure 17.5)
- contra-angled (CA) handpiece and debonding bur (Figure 17.6)
- prophylactic paste and rubber cup
- sharps container for wire, brackets, etc.
- 3-in-1 syringe
- suction
- floss
- hand mirror
Figure 17.1 Tray for deband.
Figure 17.2 Anterior bracket removing pliers.
Figure 17.3 Band-removing pliers.
Figure 17.4 Band-slitting pliers.
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