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adhesive: Maxcem Elite™ CLEAR SHADE by Kerr™ (self-adhesive resin cement) or Geristore® by DenMat®
Primer: Assure™ by Reliance™ (bracket and enamel) or Transbond® MIP by Unitek™ (enamel option, if not using Assure)abrasive: Chairside Microetcher with 50 Micron Aluminum Oxideetch: Acid Etch Gel (AO part #001-913), Acid Etching Liquid (AO part #001-912), Porcelain Conditioner (AO part #001-966)instruments: NOLA Dry field system, Cotton rolls, Light cure lamp min. 3000 mW/cm2 (AO Blue Ray 3), Interproximal stripping bur, Open/Close Instrument (AO part#010-300), Debonding instruments (Anterior: AO part #001-302, Posterior: AO part #001-E345RT)
Recommended mateRials
geRistoRe PRePaRation
BRacKet: Before bonding , apply two thin layers of Reliance Assure to the brackets in the transfer tray, use the brush to stroke the surface of the bracket.
tootH suRFace: Apply two thin layersof Reliance Assure or a thin layer ofTransbond MIP to the lingual surfaceof the tooth after step 6 above.
Bonding to enamel
1. Sandblast 3-4 seconds per tooth. Direct nozzle away from the gingival margin to avoid initiating bleeding.
2. Rinse thoroughly to remove all residue.
3. Insert NOLA. Center the tongue cage with two cotton rolls.
4. Etch the tooth with 37% phosphoric acid gel for 60 seconds.
5. Rinse and suction for minimum 10 seconds per tooth.
6. Thoroughly dry tooth surfaces to reveal chalky-white bonding surface.
7. Apply thin layer of Maxcem Elite to bracket bases in the transfer tray. Note: Application time should be less than 40 seconds, reduce lighting.
8. Insert transfer tray. Once seated, apply constant pressure to the occlusal surface of the tray and a short pressure with the tip of the curing light to push each bracket toward the tooth. Light cure to your light specifications. Let the adhesive cure 3-5 minutes prior to removing tray.
9. Remove the NOLA and the cotton rolls. To remove the tray, roll from the labial to occlusal surface, tray will break apart easily.
10. Remove any excess adhesive with a scaler and dental floss. Use explorer to remove tray material from slots and gingival wings.
11. Check occlusal contacts with articulating paper. Note: There should be NO contact on anterior brackets.
12. Place shims for any interferences. Katec-Cem® shown here.
Bonding to PoRcelain, comPosite, Resin and ReBonding
Preparation - all surfaces1. Sandblast 3-4 seconds per tooth away from the gingival margin to avoid bleeding.2. Rinse thoroughly to remove residue.3. Insert NOLA. Center the tongue cage with two cotton rolls.
additional Preparation - Porcelain surface1. Coat the surface of the porcelain with a thin layer of LIQUID etch 37% phosphoric acid. DO NOT RINSE.2. Leaving the layer of acid etch on the porcelain, apply a layer of porcelain conditioner on top of the phosphoric acid. Apply a second layer and let sit for 60 seconds.3. Thoroughly rinse. Lightly dry.
additional Preparation - metal and composite surface1. Thoroughly dry tooth surfaces to reveal the sandblasted surface.2. If using Maxcem, surface is ready for adhesive application.3. If using Geristore, apply a thin layer of primer (Assure or MIP) leave for 5 seconds and dry with air stream for 3 seconds RePeat.
additional Preparation - Resin surface (temporary crowns)1. Make 5 to 10 little holes with an interproximal stripping diamond bur on the lingual side of the tooth.2. Directly fill the holes with Maxcem.
Bonding1. Apply small amount of Maxcem (if using Geristore see “Geristore Preparation” on the reverse side) to bracket bases in the transfer tray. NOTE: Application time should be less than 40 seconds, reduce lighting.2. Insert transfer tray. Once seated, apply constant pressure to the occlusal surface of the tray and short pressure with the tip of the curing light to push each bracket toward the tooth. Light cure to your light specifications. Let the tray set 3-5 minutes prior to removing tray.3. Remove the NOLA and the cotton rolls. To remove the tray, roll from the labial to occlusal surface, tray will break apart easily.4. Remove any excess adhesive with scaler and dental floss. Use explorer to remove tray material from slots and gingival wings.
Rebonding1. Carefully remove the remaining bonding material on the tooth with a composite bur.2. Prepare the tooth surface as for the initial bonding.3. Totally sandblast the bracket base.4. Apply small amount of Maxcem to bracket base and bond without any primer. NOTE: In case of using Geristore, see “Geristore Preparation” steps that must be followed prior to applying adhesive.
cHaiRside deBonding
Anterior debonding: one edge of the pliers on the base and the other edge of the bracket.
Posterior debonding: grab the occlusal edge of the bracket base and any edge on the bracket.
tiPs FoR BRacKet Removal
The bases have a“debonding edge” all around.
1. Use an interproximal stripping diamond bur (see below) to remove the glue inside the edge.
2. Insert an Open/Close instrument. Twist toward lingual.
LITSL-65 REV2Geristore is a registered trademark of DenMat Corporation. DenMat is a registered trademark of Den-Mat Holdings.Assure is a registered trademark of Reliance Orthodontic Products, Inc. Transbond is a registered trademark of 3M Company Corporation.
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