Author’s response

We appreciate the letter to the editor from Drs Kamak and Caglaroglu. It allows us to clarify some important aspects of a variable that can influence the efficiency of the indirect bonding technique: the resin excess.

We agree that excess adhesive is removed more easily during direct bonding, and removal is more difficult with the indirect technique. This is especially true when indirect bonding is used with a light-cured adhesive. Since it is impossible to calculate the exact quantity of material, “hard flashes” are unavoidable. In this case, a bur is necessary to remove the excess. We have also found that the degree of light-curing is a variable that can influence the process, because it depends on the operator and is not easy to perform on the posterior teeth, while trying to keep the tray seated.

In our modified technique, the excess adhesive is removed and light-cured on the model. Therefore, the excess is made by the primer and the Sondhi Rapid-Set self-curing resins. At the end of the self-curing process, these resins can be easily removed. The instrument that we use is the scythe of the utility tool, and we proceed manually as follows: (1) we address the occlusal surfaces using the flat surface of the tool; (2) we proceed around the bases also using the flat portion of the instrument; and (3) we proceed to the papilla, the embrasure, and the cervical margins using the tip of the instrument.

With this method, the tooth surfaces should be clean. In addition, a rotor brush with polishing paste could finish the cleaning step. Finally, if some resin remains on the tooth surfaces, it tends to change color to yellow with time. It can be quickly removed by using a small Sof-Lex disc (3M ESPE, Seefeld, Germany). However, the most crucial variable in preventing the resin excess is the quantity of the 2 liquids applied, calculated in a drop of resin A and resin B.

Furthermore, it is well known that demineralization is a side effect of fixed orthodontic appliances. To our knowledge, it is independent of the bonding technique. Hence, the prevention strategy must be used in all orthodontic treatments, direct as well as in indirect. We hope that the development of some new products will help to solve this unwanted side effect.

Finally, we wish to provide a significant technique update regarding the transfer tray. Currently, we use a 0.3-mm thick tray maintaining the same cut, covering the silicone entirely. This change allows for good insertion stability, easier manipulation during the transfer step and no problems in removing the tray.

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Apr 8, 2017 | Posted by in Orthodontics | Comments Off on Author’s response
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