ORTHODONTIC BANDING AND CEMENTATION Materials Required Materials for fitting bands: 1. Selection of bands of different sizes for the teeth to which you are fitting bands 2. Tweezers to take the bands out of the band selection 3. A mouth mirror for indirect vision. 4. A plugger to push the band down on the tooth. Serrations on the edge of the plugger or a groove in the end of it will grip the edge of the band as you are using the plugger to push the band onto the tooth. Some operators place a groove in the end of the plugger using a diamond disk or a separating disk on a slowspeed handpiece. 5. A burnisher, or instrument to rub or adapt the edges of the band to the contours of the tooth. 6. A bite stick for the patient to bite down the band to thoroughly seat it. 7. A rotating heatless stone mounted on a mandrel in a slowspeed handpiece to place a collar. 8. A band removing plier to take the band off of the tooth after it is fitted and adapted before you cement the band. 9. The Treatment plan 10. A panorex to know how to position the wire slot for the best root parallelism. Required Materials for cementing bands: 1. The fitted bands 2. A mouth mirror for indirect vision 3. A band removing plier 4. A cement spatula 5. A sharp scaler to remove the excess cement 6. Wax or Chap Stick to block out the wire slot and any other tubes that could become blocked by the cement 7. Floss to use between the teeth after the bands are cemented 8. An air/water syringe to rinse and dry the teeth 9. A heatless round stone mounted on a mandrel in a slowspeed handpiece for placing a collar on the occlusal edge of the band 10. Prophy materials to clean the teeth prior to cementation. 11. A band bite stick 12. A plugger that you can use to push on the edge of the band to push it onto the tooth 13. Band cement 14. A pad on which to mix the band cement and/or a frozen slab 15. Cotton rolls to isolate the teeth and or the Great Lakes Dry Field System 16. Highspeed evacuation for rinsing the teeth and low speed suction from a saliva ejector to keep the teeth isolated and dry 17. Liquid flavoring on a cotton roll to wipe the excess cement from the teeth 18. If you are using band cement that is light cured you will need a curing light 19. If your bands do not come with the inside surface microetched, you will also need a microetcher to do this to make them adhere better. International Training Institute 2009 www.iticourses.com Page 1 of 7
Shapes Of Orthodontic Bands BACL-04 Shapes of Bands Page 1 of 1 Page 2 of 7
Identification Of Orthodontic Bands MAXILLARY Bicuspids First Molar Second Molar Example Overall Shape Square oval Rhomboid Parallelogram Rhomboid Parallelogram Bracket Size small large small rounded Bracket Shape square rectangular offset angle rectangular offset angle Hook Direction On distal wing Directed distal Directed distal # of tubes, slots 1 1 wire slot 1 headgear tube 2 wire slots 1 Convertible N/A yes no Laser, Ink Id. marks 4 ink color, size, label 6 6 7 7 MANDIBULAR Bicuspids First Molar Second Molar Example Overall Shape Triangular Trapezoid Square trapezoid Bracket Size small medium Small rounded Bracket Shape offset square rectangular rectangular Hook Direction On distal wing? Directed distal Directed distal # of tubes, slots 1 1 or 2 wire slots 1 Convertible n/a yes No Laser, Ink Id. lines 6 6 7 7 BACL-05 Band Identification Page 1 of 1 Page 3 of 7
TORQUE SUMMARY MAXILLARY ARCH DEGREES TOOTH Minimum Average Maximum central incisors +7 +15 +22 lateral incisors +3 +9 +14 cuspids -3 +3 +7 premolars -7 molars -10 MANDIBULAR ARCH DEGREES TOOTH Minimum Average Maximum incisors -6-5 +3 cuspids -11-7 0 first bicuspids -17-11 -7 second bicuspids -22-17 -9 first molars -30-10 second molars -27-10 International Training Institute 2009 www.iticourses.com
BACL-02A: Fitting A Band Steps Checklist Student Name: Patient Name: 14 Possible Your Score: 1. Remove the separators. Double check for missing separators that may have slipped under the gingiva. Take a PA if necessary to see radiopaque separators. 2. Floss interproximally to check that contact is fully open. 3. Examine the size of the tooth and estimate the band size. Often the size will be similar for the same teeth on the right and left. 4. Select a band. The hook is toward gingiva and directed distally. A headgear tube is positioned occlusally. Any lingual cleat, button, PHA or LLA tube should be added after the band is fitted if indicated on the treatment plan. 5. Seat the band on distal first and stretch band over onto mesial and down into contact area. If band won t stretch enough, get a bigger band. 6. Lay the plugger on its side, press a finger down on top of the plugger, and seat the band. It should go at least half way down with heavy finger pressure, but not more than three-quarters with just finger pressure. Otherwise it is too big, too loose, and will loosen later after cementation. Preplan slot position 7. Check the panorex for the tooth s root direction and preplan seating of the band down more on the mesial or the distal to facilitate root alignment. 8. Look at the cusp tip heights of the adjacent teeth and preplan seating the wire slot height to align cusp tips evenly for the best occlusion. 9. Check the torque of adjacent teeth and preplan slot height and torque to facilitate proper tooth torque using a straight wire. 10. Check inset/offset of the bracket for ideal facial-lingual positioning of the tooth to align the functional cusp tips. Seat the band the rest of the way with the bite stick 11. Position the bite stick on the seating lug, on the edge of the bracket pad, or on the occlusal edge of the band and ask the patient to bite together gently. Watch how the band moves. If the band slips down on the tooth a lot, then the band may be too big. If the band is still too high on the tooth, yet slips down just a small amount, then the band may be too small. 12. If the band rocks up and down regardless of contact tightness, the band is too big. 13. After the final seating bite, recheck wire slot position. If the slot position is not ideal, remove the band, recontour the band slightly to fit in the new position, then reseat the band onto the tooth. 14. Burnish the edges of the band into the contours of the tooth. BACL-02A Fitting Bands Checklist Page 1 of 1 Page 4 of 7
BACL-01A: 4-7 Band Fit Quality Checklist Student: Circle teeth banded. 16 points per band, # of bands, Your Score CRITERIA 1. The correct band for the specific tooth and quadrant is used. 2. Auxiliary attachments are on the band as indicated on the treatment plan. 3. The band is completely seated down on the tooth. Maxillary Right Maxillary Left Mandibular Left Mandibular Right UR7 UR6 UR5 UR4 UL4 UL5 UL6 UL7 LL7 LL6 LL5 LL4 LR4 LR5 LR6 LR7 Page 5 of 7 4. The band is tightly fitting so that it cannot be dislodged from the tooth even when it is not cemented. 5. The occlusal edge of the band is parallel with the natural cusp tips of the tooth. 6. The occlusal edge of the band is seated just below the mesial marginal ridge and the distal marginal ridge. 7. The wire slot is perpendicular to the long axis of the tooth producing proper root angulation and parallelism as seen on the panorex. 8. The wire slot is four millimeters down from the occlusal tip of the facial cusps of the tooth. 9. The band is not seated too far gingivally on either the buccal or the lingual surfaces since this distorts the predetermined degree of torque built into the wire slot. 10. The wire slot of the bracket is centered over the height of contour on bicuspids. 11. The wire slot is positioned on the molars so that it aligns the fosse and functional cusps to occlude and function ideally with the molar functional cusps and fosse in the opposite arch. 12. The band is well adapted to all the contours of the tooth so no cement gaps are evident at the occlusal edge or at the gingival edge. 13. There is a good collar around the occlusal edge of the band before cementing. 14. The band does not impinge on the patient s gingiva causing discomfort. 15. The patient does not bite on the band or bracket causing an occlusal interference. 16. There are no rough edges, sharp areas, or poking hooks that cause the patient discomfort. BACL-01A 4-7 Criteria Checklist Page 1 of 1
BACL-03A: Band Cementation Steps Checklist Student Name: Patient Name: 16 Possible Your Score: 1. Remove the fitted bands and organize them into the sequence they will be cemented 2. Place an occlusal "collar" around the occlusal edge of each band. 3. Block out the wire slot or any tubes with wax or Chap Stick. 4. Pumice the teeth. 5. Rinse. 6. Isolate the teeth with the Great Lakes Dry Field System, dry angles, or cotton rolls. 7. Dry the teeth with compressed air. 8. Mix the band cement properly and on a frozen slab if this will slow the setting time of the cement. 9. Load the mixed cement into the band or into several bands. Cover the full inside surface, but do not overfill the bands. Place the filled bands on the frozen slab to continue slowing the setting time. 10. Place the filled band onto the tooth, press it onto the tooth with the plugger in the same way when the band was fitted to the tooth, and have the patient bite it into the same position as before. 11. Wipe off the excess cement with a flavored cotton roll. 12. Burnish the band edges into the tooth grooves. 13. Check the final position of the band and the wire slot, the band occlusal edges, and the patient s occlusion for occlusal interference by the band. 14. Have the patient bite on cotton rolls until the cement is set or light cure the cement. 15. Scale removing remaining excess cement on the occlusal surface of the tooth but not at the margins of the band. Scale around the gingival edge of the band removing any excess cement. 16. Floss between the teeth to remove excess cement and to check that the patient will be able to floss. BACL-03A Band Cementation StepsChecklist Page 1 of 1 Page 6 of 7
BACL-04A: 4-7 Cemented Bands Quality Checklist Student: Circle teeth banded. 16 points per band, # of bands, Your Score CRITERIA 1. The correct band for the specific tooth and quadrant is used. 2. Auxiliary attachments are on the band as indicated on the treatment plan. 3. The band is completely seated down on the tooth. Maxillary Right Maxillary Left Mandibular Left Mandibular Right UR7 UR6 UR5 UR4 UL4 UL5 UL6 UL7 LL7 LL6 LL5 LL4 LR4 LR5 LR6 LR7 Page 7 of 7 4. The band is tightly fitting so that it cannot be dislodged from the tooth even when it is not cemented. 5. The occlusal edge of the band is parallel with the natural cusp tips of the tooth. 6. The occlusal edge of the band is seated just below the mesial marginal ridge and the distal marginal ridge. 7. The wire slot is perpendicular to the long axis of the tooth producing proper root angulation and parallelism as seen on the panorex. 8. The wire slot is four millimeters down from the occlusal tip of the facial cusps of the tooth. 9. The band is not seated too far gingivally on either the buccal or the lingual surfaces since this distorts the predetermined degree of torque built into the wire slot. 10. The wire slot of the bracket is centered over the height of contour on bicuspids. 11. The wire slot is positioned on the molars so that it aligns the fosse and functional cusps to occlude and function ideally with the molar functional cusps and fosse in the opposite arch. 12. The band is well adapted to all the contours of the tooth so no cement gaps are evident at the occlusal edge or at the gingival edge. 13. There is a good collar around the occlusal edge of the band and no cement gaps. 14. The band does not impinge on the patient s gingiva causing discomfort. 15. The patient does not bite on the band or bracket causing an occlusal interference. 16. There are no rough edges, sharp areas, or poking hooks that cause the patient discomfort. BACL-01A 4-7 Criteria Checklist Page 1 of 1