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1: Sankin Clear Bracket
(1)Establishing the accurate bonding system
In my practice, the brackets are direct bonded following general bonding procedure (Table 1). About 2 years ago, we held an internal meeting to investigate about gBracket Dislodgement and its Measuresh in order to avoid the bracket dislodgement during treatment. g The Cause of gBracket Dislodgementh (Table 2) were enumerated with the following precautions during bonding procedure:





ŸTable 1: Basic procedures for bonding system
Tooth surface cleaning & simple exclusion of moisture
(Dry area system)
«
Tooth surface conditioning (Xeno Ortho etching gel)
«
Drying (Use of exclusive dryer)
«
Application of Xeno Ortho primer on the bracket
«
Placement of Xeno Ortho paste on the bracket
«
Bracket positioning
«
Removal of excess paste
«
Light cure
«
Wire placement
«
Bonding

The greater the handling steps, the more chance to increase the first cause of dislodgement (contamination).





ŸTable 2: The main cause of bracket dislodgements

Bonding
1: gContaminationh during bonding procedure. (If occurred within 24 to 48 hours means that the bonding was inadequate)
2: Improper bracket positioning.
3: Bonding not successful due to difficulties in decalcifying the tooth.
4: Weakened bonding property due to poor cleaning of the mouth.
Patient management
1: Intake of food as usual or making strong gargles within a few hours after bonding.
2: Chewing of hard food or biting it off the whole.

Wire ligature
1: Ligature for cases of severe rotation, crowding.
2: Inserting the arch wire into the bracket of severe torque.
3: When excessive traction force is applied on the bracket.
Strength of the bracket
(Wing mashed at the ligature)


The check point of gBracket Bondingh
1: As a previous preparation of the bonding tooth
surface, following proper cleaning & polishing
and accurate etching, water rinse thoroughly
and dry with an exclusive dryer.
2: Effective moisture control to avoid
contamination of the tooth surface by saliva or
moisture.
3: Avoid contamination from finger or oil pellicle
to the bonding base surface when handling.
4: Apply the primer thinly on the bonding base
and avoid contamination.
5: Accurate application
of the required
amount of paste
to the bonding base.
6: Accurate positioning of the bracket and
speedy handling (within 2 minutes).
7: Prevention of bracket drifting or
skating when removing excess paste.
8: Accurate polymerization in a short
period of time.


The greater the handling steps, the more chance to increase the first cause of dislodgement (contamination).