Ash bonding

Contents
 Adhesive science
 Structure of enamel
 Adv/disadv of banding & bonding
 Direct bonding
www.indiandentalacademy.com

Broad Rationale of Adhesive Science
 Charect. Req.& prop. Of orthod. material
molecular structural
Why do materials cohere at all?

 Range of attractive forces that may
operate in & b/w molecules
 Covalent bonds
 Hydrogen bonds
 Weak intermolecular forces
 Self coherent solids
 Gold & waxes
 Welding & brazing

 Most other solids (tooth & ortho brackets)
 Surface forces operate very short dist & ↓
rapidly with inverse 6th
– 7th
power of separation
 Solids- micro. rough

FLUID AGENT
Contact angle Viscosity
Smaller contact angle
Larger contact angle

 PHASE CHANGE
 Physical means
 Chemical setting mechanism
 Dimensionally stable
 Volumetric expansion/shrinkage

 Adhesion :-- Attraction b/w unlike molecules
 Cohesion :-- Attraction b/w like molecules
 Mechanical bonding:-- Strong attachment of 2
substances accomplished mechanically rather
than by molecular attraction.
penetration of adhesive into micro & submicro
irregularities

BONDING= ADHESION+ATTACHMENT

Enamel
 Highly mineralized tissue
 Hardest tissue in human body
 Clinically visible
 No regenerative capacity

Morphology of Enamel
Enamel prisms (rods) – 5-12 million
Extend from DEJ to outer surface
Prismless enamel

 Longitudinal section under microscope
 Wider – Prisms
 Narrower – Prism tail

 Cross section under electron microscope
- Keyhole pattern or fishlike apperance.

 Keyhole pattern
 Head – incisal region
 Tail – cervical region
 Prisms contain
hydroxyapatite crystals

 Hydroxyapatite crystals
- Run parallel to long axis
of prism and become
perpendicular as they
approach tail.

Acquired pellicle
 Precipitation of salivary glycoproteins
 Removed by pumicing
 Reform almost immediately

Factors affecting enamel solubility
 Pre – eruptive factors
 Post – eruptive factors

 Pre – eruptive factors
 Affect chemical and histological characteristics
- Hypoplasia
- Hypocalcification
- Fluorosis

 Post – eruptive factors
- Topically applied fluorides
- Organic pellicle
- Plaque

Factors affecting bonding to ideally
etched surface
 Patient Operator
- salivary contamination - oil / water via spray
- contact with lips and - rubbing /touching
tongue etched surface
- exhalation vapor

Direct Bonding: Past and present
BANDING - W.E. Magill – 1871
Negative factors –
- Time and skill
- Impacted / partially erupted teeth
- Decalcification / discoloration
- Gingival irritation
- Closure of band spaces
- Unaesthetic
- Placement of separators is painful

The goal was to have brackets, tubes and
other attachments directly cemented on
the tooth surface to eliminate problems
encountered with metal bands.

Banding preferred to bonding
 Teeth that receive heavy intermittent forces eg.
Upper 1st
molar
 Teeth that need both labial and lingual
attachments
 Teeth with short clinical crowns
 Teeth surfaces difficult to bond eg. Amalgam
rest., Porcelain rest., Fluorosed teeth.www.indiandentalacademy.com

Advantages of bonding
 Esthetics
 Faster and simpler
 Less patient discomfort
 Arch length not increased
 No band space closure
 Partially erupted or
fractured teeth can be controlled
 Lingual orthodontics

Advantages of bonding
 Interproximal enamel reduction and composite build
up possible
 Bond artificial tooth surface
 Caries risk eliminated
 Bracket may be recycled
 More hygienic www.indiandentalacademy.com

Disadvantages of bonding
 Weaker than bands
 Better access for cleaning
does not guarantee better
 No protection against
interproximal caries
 Rebonding > recementing
Debonding > debanding

Bonding Procedure
 Cleaning
 Enamel conditioning
moisture control enamel pretreatment
 Sealing
 Bonding

Cleaning
 Remove organic pellicle and plaque.
 Pumicing using rubber cup / polishing brush
REISNER et al
Buccal surfaces lightly abraded with TC bur at
slow speed (25000rpm) > Pumicing for 10 sec.

Enamel conditioning
1. Moisture control
 Lip expanders
 Cheek retractor
 Saliva ejectors
 Tongue guards
 Salivary duct
obstructors(dri-angles)
 Cotton or gauze rolls
 Antisialagogues

Antisialogogues
 Both tab. & injectable solns :
 Banthine
 pro- Banthine
 Atropine sulfate
 Excellent & rapid saliva flow restriction pro-
Banthine---- no longer advised
 Banthine tab. – 50mg/45kg(100lb) body wt. in a
sugar free drink,15 min before bonding

Enamel conditioning
2.Enamel pretreatment
 Acid etching
 Other alternatives to acid etching
1. Crystal growth
2. Sand blasting / Air abrasion
3. Laser etching

Acid Etching
 1955 Buonocore - 85% phosphoric acid for
30 sec.
 37% phosphoric acid – 15 - 60 sec
 Nordenvall et al - 15 sec for deciduous & young
permanent teeth
 30 – 60 sec for adult teeth
 Longer periods – less bond strength due to loss
of enamel structure

Acid Etching
Procedure
 Isolation
 Gentle application of etchant
– should not be rubbed
 Rinsed with water spray
 Dry with moisture and oil free source ( pref with chip
blower)
 Avoid salivary contamination– if it occurs, re etch the
tooth.

Acid Etching
 Dull frosty white appearance
 Teeth that do not appear dull and frosty white
should be re - etched

Acid Etching
 Alternative acids for etching
- 10% Phosphoric acid
- 10% Maleic acid
- 2.5% Nitric acid
- Polyacrylic acid
Most widely used is 30 – 50% ( 37%) phosphoric
acid

Rationale of etching
 Gwinnet, Matsui and Buonocore & others
 Primary attachment mechanism of resin is “resin
tags”.
 Micromechanical bond

Rationale of etching
 Removes about 3-10 microns of enamel surface
 Etching also increases the wetability and surface
area of the enamel substrate.
 Resin tag penetrate upto the depth of 80 um or
more

Conc. Of etchant
 Most widely used concns. of phosphoric acid
from 30% - 50% with an application of 30 -60
seconds.
 20 – 50% / 60 sec. Most retentive surface
( Silverstone )
 > 50% phosphoric acid –
Monocalcium phosphate monohydrate
< 27% phosphoric acid
Dicalcium phosphate dihydrate

Acid for etching
Maleic Phosphoric Nitric acid
10% 37% 2.5%
 Bond st similar similar less effective
 Morphological
pattern similar ‘’
 Depth of etched
surface less

Patterns of etching
According to Retief
 Type 1
- Selective removal of enamel prism cores
- Peripheries intact (honey comb app.)

Patterns of etching
 Type 2
- Reverse process
- Peripheries removed
- Cores intact (cobble stone app.)

Patterns of etching
 Type 3
- surface loss w/o exposing underlying prisms

Effects of enamel etching time on
morphology
Barkmeier,Gwinnett & Shaffer JCO January
1985
 The morphology of enamel following etching for
15 or 60 secs. differed only in the amount of
gross enamel loss with 50% phosphoric acid
 No morphological differences in the pattern or
character of the etched enamel rods.

Bond strength with various etching
times
Wang et al AJO-DO July 1991
 Compared the tensile bond strength at various
etching times 15, 30, 60, 90, 120 secs
 37% Phosphoric acid
 TBS was not statistically different for 15, 30, 60,
90 secs
 TBS decreased – 120 secs
 Amount of enamel fragments increased in
proportion to the length of the etching times
 Optimal etching time should be 15sec

SEM Study & SBS measurement with
5% & 37% phosphoric acid
AJO-DO oct,1995
Wasundhara A. Bhad, Pushpa V. Hazarey,
G.D.C.Nagpur
 PURPOSE: To use an acid concn. Of H3PO4 that
yielded max. bond strength with minimal enamel
loss & to measure & compare the SBS b/w 5% &
37% H3PO4 with 60 sec acid etching time.

 SAMPLE: 60 Premolars
 1st
grp  10 teeth, used to study etching pattern with
5% & 37% H3PO4
 2nd
grp  50 teeth, used to study & compare SBS
after etching with 5% & 37% H3PO4
 CONCLUSION:
 5%H3PO4 can be used for etching tooth surface
before bonding instead of 37% H3PO4 concn; as with
5%H3PO4, there is minimal enamel loss & bond
strength is not affectedwww.indiandentalacademy.com

Variations in acid-etch patterns with
different acids and etch times
Alastair Gardner, Ross Hobson, AJO 2001
 Compared the enamel etch patterns produced by
37% phosphoric acid and 2.5% Nitric acid for 15,
30 & 60 secs
 Concluded
- 37% phosphoric acid > 2.5% nitric acid for all
three applications
-optimum time for applying 37% phosphoric acid is
30 sec

Acid etching in pri. teeth
 Outer 30um of pri. Enamel is prism less  no
uniform etch
 Higher organic content
 Prism rods approach the surface at greater
angle

Acid etching in pri. teeth
 STUDIES:
 SILVERSTONE:- 120 sec etch necessary to
establish proper enamel porosity
 MUELLER(1977):- By increasing the etch time
an increase in tag formation was seen
 NORDENVELL et al :- Compared pri. Young &
mature perm. Teeth using var. etch times b/w
15-60 sec. found that 15 sec gave greatest
surface irreg. in pri. teeth.
 REDFORD:- etch time of 15 sec with 38% phos
acid was adeq for pri. teeth.

Commonly asked questions
 Should the etch cover the entire facial enamel or
only a small portion outside the bracket pad?
 Are gels preferable to solutions?
 What is the optimal etching time? Is it different for
young and old teeth?
 Is sandblasting as effective as acid etching?

 What is the preferred procedure for deciduous
teeth?
 Is prolonged etching necessary when teeth are
pretreated with fluoride?
 Will incorporation of fluorides in the etching soln
increase the resistance of enamel to caries attack?
 Is etching permissible on teeth with internal white
spots? www.indiandentalacademy.com

 How much enamel is removed by etching and how
deep are the histologic alterations? Are they
reversible? Is etching harmful?
 Should other means than acid etching( e.g. crystal
growth ) be preferred?

Alternatives to acid etching
 Crystal growth
 Sand blasting / Air abrasion
 Laser etching

Iatrogenic factors
Maijer & Smith 1986 AJO-DO
1.Loss of enamel caused by etching
 10-20 um lost - acid etch
 6-50 um lost - after debonding
2.Retention of resin tags – discoloration of enamel
 Resin tags – 80um or more
 U/V cured resin – didn’t contain u/v absorber

Iatrogenic factors
3.Leakage at the bracket interface Bracket
corrosion and staining
 Small pores – pathway for bact., stains etc.
 Ceen & gwinnett and maijer & smith – stain due
to biodgradation of the metals

Iatrogenic factors
4.Enamel loss  fracturing of enamel at time of
debonding.
 Reported by Reteif(1974) and Reteif &
Denys(1979)
5.A rougher surface with enamel cracks
 2 step procedure should be used
 1st
step – debonding pliers,hand instru,u/s
scalers
 2nd
step – abrasive cups/discs with polishing
medium

Iatrogenic factors
6.A softer enamel surface with lower fluoride
content, more predisposed to decalcification
 Acquired fluoride – 10um

Crystal growth
 1st
demonstrated by Smith & Cartz
 Maijer & Smith 1979 did lot of work
 Polyacrylic acid + sulfate ion long needle
shaped crystaline deposit
 CALCIUM SULPHATE DIHYDRATE (Spherulitic
habit)

Crystal growth
 Crystalline interface produced tensile bond
strength equivalent to conventional acid etched
surface.
 Debonding – fracture at crystal resin interface
 Other soln – Sulphuric acid anion ( more reliable
and uniform growth )

Crystal growth
 MECHANISM OF RETENTION
 Calcium sulphate crystals must enucleate from
bound calcium
 To achieve this some etching is required
 Enamel solubility ~ crystal enucleation
 Mechanical attachment is created
around the crystalline interface
and superficially etched enamel.

Crystal growth
 Artun and Bergland 1984
 Sulphuric acid – crystals not as long and needle
like as with polyacrylic acid but were rounder and
flatter.
 Hence debonding was easier.

Advantages of Crystal growth
 Debonding quicker and easier
 No damage to enamel
 Minimal effect on outer fluoride containing enamel
 No resin tags left behind
 Possibility of incorporating fluoride in crystal interface
– anticariogenic action.

Crystal growth – Procedure
 One drop of viscous liquid placed on tooth surface
 Left undisturbed for 30 sec
 No mechanical agitation
 Rinsed for 20 sec
 Forceful water spray to be avoided as it will break
crystals
 Dull whitish deposit
 Bracket bonded in usual way.

Sand blasting / Air abrasion
 Makes use of high speed stream of aluminium
oxide particles ( 50-90 um) propelled by air
pressure
 Produces rough surface
 Used for cavity preparation
 Remove old composite resin
 Improve the retentive surface of loose bracket

Sand blasting / Air abrasion
 Could contribute to better bond strength with
less enamel loss
 Factors affecting bond strength
 Particle size
 Air pressure
 Exposure time
 Microstructure of enamel surface

Sand blasting
Albert Feilzer,AJO Jan 2000
Compared bond strength and enamel loss b/w
sand blasting and conventional acid etching at
varying exposure times and air pressure
Enamel loss – equal or less depend on time of
exposure and pressure
Bond strength –
Sand blasting < Acid etching

Conclusion
Sandblasting Acid etching Crystal growth
 Enamel loss
controlled by operator remineralized less
 Bond strength
low than A E Optimum low than A E

Laser etching
 LASER – Light Amplification by Stimulated
Emission of Radiation
 Maiman 1960 – developed first laser
 Generation of monochromatic, coherent &
collimated radiation by a suitable laser medium in a
optical resonator

Laser etching
 Laser unit – 3 elements
1.Lasing medium - liquid/solid/gas
2.Energy source - xenon flash lamp/electrical
discharge
3.Optical resonator- 3prop.
 coherence
 collimation
 monochromacity

Laser etching

Laser etching
USE OF LASER SYSTEM
 Soft & hard tissue lesions t/t
 Caries prevention
 Desensitization of teeth

Laser etching
Classification
 According wavelength
1. UV range ( Krypton
fluoride, Argon fluoride)
2. Visible light ( Helium
Neon, argon laser )
3. Infrared range (carbon
dioxide , Nd: YAG )

Laser etching of enamel for direct
bonding Von Fraunhofer 1993, No.1 AO
 Phosphoric acid – 30 sec.
 4 power settings on the laser etching unit were used:
80mJ, 1W, 2W and 3W.
 Melting and ablation of enamel surface (roughness)
Result
 Acceptable shear bond strength,(0.6kg/mm), could
achieved at laser power settings of 1 to 3W but not at
the lowest setting (80 mJ).
 Shear bond strengths lower than acid etching.

Laser etching
Dr. Francis 2001
 Aim – to compare tensile & shear bond strength
obtained by acid etching & krypton flouride excimer
laser.
 KrF(440MJ/cms, 460 and 480)
 Optimum bond strength achieved with 460 & 480
 TBS - highest with 460 then480 & acid etching
 SBS- highest with 480
 both Least with 440
 Adhesive more on E with acid etching

Bonding Procedure
 Cleaning
 Enamel conditioning
- Acid etching
- Crystal growth
- Sandblasting
- Laser etching
 Sealing
 Bonding

Sealing
 Sealer / Primer / Intermediate resin
Low viscosity resin which is applied prior to bonding
VARIOUS CONCEPTS
Necessary to achieve proper bond strength
Resist. to microleakage
Both reasons
Not needed at all

Sealing
 Sealants 2 types
 light cured
 chemically cured
CEEN & GWINNETT
Light cured sealant protect the enamel adjacent to
the brackets from dissolution & subsurface
lesions
Chemically cured polymerize poorly & have low
resist. to abrasion

Evaluation of sealant in Orthodontic
bonding
Wei Nan Wang et al AJO 1991
 Evaluated the TBS with & w/o use of sealant
 No statistically significant difference in the bond
strength of the two evaluated groups
 The distributions of debonding interface between
groups were similar and also had no statistical
difference.
 Sealant in the two-paste self polymerize bonding
system for enhanced strength is unnecessary.www.indiandentalacademy.com

Sealing
 However the use of sealant
 May offer extra protection to enamel during
debonding
 As chances of enamel surface detachment
without use of sealant was greater.

Self Etch Primer
 Traditional orthodontic bonding systems
 Fourth-generation bonding systems such as(All-
Bond 2)
 Fifth-generation bonding (Prime & Bond NT)
Etchant & Primer + Adhesive into one step.
 Sixth-generation adhesive (Prompt L-Pop,
Transbond Plus Self Etching Primer)

Self Etch Primer
 Prompt L Pop
 Transbond self etch primer
Liquid begins to etch as soon as it is applied
Saves time www.indiandentalacademy.com

Self Etch Primer
Composition of Prompt L-Pop –
 Methacrylate phosphoric acid ester
 Phosphine oxide
 Parabenes
 Stabilizer
 A fluoride complex
 Water

Procedure For Self Etch
 Teeth are pumiced
 Self etch primer gently swirled on to each enamel
surface for 2 to 5 secs
 As pH rises , etchant is converted to primer
 Primer is thinned with burst of air
 No rinsing with water
 Bracket then bonded in usual way.www.indiandentalacademy.com

Procedure for self etch primer

Self Etch Primer - studies
 Rueggeberg et al (2000) - promt L-Pop w/o acid
etch produce = bond strength as conventional
bracket placement
 Hitmi (2000)- no signi. diff b/w promt L-Pop &
37% phosphoric acid
 Bergeron et al (2000)- resin enamel bond
strength of diff self etching primer including
promt L-Pop, was similar to or better than
multistep

 Fritz et al(2001)- bonding with 3 self etching
primer(Clearfil SE Bond,Clearfil Liner Bond 2V&
Novabond)was = phos acid
 Bishara et al(2001)- self etching primer prod a
signi lower, but clinic acceptable, SBS compared
to acid etch when Transbond XT composite
used

 SHADOW ET AL (2002 JCO)
 clinical eval. bond failure rates with a new self
ething primer- Transbond Plus
 Conclusion
 Traditional AE 15 sec = etch & 15-20 sec =
rinsing.10 sec= primer + curing
 Transbond Plus =3 sec
 Bracket retention > traditional

Hydrophilic Primer ( MIP )
 Bond failure – moisture contamination
 Hormati et al – 50% decreased shear bond st
 Hydrophilic primer ( HEMA & Maleic acid )dissolved
in acetone – 3M Unitek.

Hydrophilic Primer ( MIP )
S.J. Little Wood et al JO 2000
 Compared the bond strength of bracket bonded with
hydrophilic primer with conventional primer
 Bond strength (6.43) was lower than conventional
primer (8.71)
 Bracket bonded with hydrophilic primer were 3.96
times more at risk of failure.

Pre primed brackets
 ADVANTAGES:
 Consistent quality of adhesive
 Reduced flash
 Adequate bond strength
 Less chances of contamination
 Can be used in both direct & indirect tech.
 Both metal & ceramic brackets are available

Bonding Procedure
Four steps
1. Transfer
2. Positioning
3. Fitting
4. Removal of excess

Bonding
 TRANSFER
 Adhesive put on
bracket base
 Bracket placed on the
tooth closed to the
correct position

Bonding
 POSITIONING
 Proper vertical and
horizontal
positioning
( eg Using
placement scaler
with parallel edges)

Bonding
 FITTING
 Bracket firmly
pushed towards
the tooth surface
with one point
contact

Bonding
REMOVAL OF EXCESS
 Gingival irritation
 Plaque build up
 Better esthetics
 Prevents staining and
discoloration

Bonding to Fluorosed teeth
Dr.Veeresh
 Bonding to the fluorosed teeth is difficult with
conventional acid etching.
 Aim – to evaluate the shear bond strength of the
bracket to the fluorosed teeth by using a comb. of
sandblasting & acid etching

Bonding to Fluorosed teeth
 Group 1 – acid etching
 Group 2 – sandblasting
 Group 3 - acid etching followed by sandblasting
 Group 4 – sandblasting then acid etching
Results
 Only group 4 – Bond strength slightly higher than
optimum (8.1Mpa)

Curing Lights
 Tungsten quartz halogen light
 Argon laser
 Xenon plasma arc light
 Light emitting diode curing units ( LED )
 Pulsed xenon plasma arc light

Halogen Tungsten Quartz Curing
Light
 Bulb  quartz
 Filament  Tungsten
 Gas  Halogen
Selective filters – blue light ( 400-500 micron)
 40 seconds per bracket
 15 minutes – both arches

Halogen Tungsten Quartz Curing
Light
Disadvantages
 Curing is time consuming
 Light output < 1% of consumed electricity
 Lifetime – 100hrs
 High heat - degrades components of bulb

Argon laser
 Introduced in the late 80’s &early 90’s
 Promised to reduce the curing time dramatically
 480 microns wavelength
 Curing time
 3 secs – per bracket
 1 min – both arches

Argon laser
 KELSEY ,POWELL
To equal bond strength of 40 sec exposure by
conventional curing light, argon laser must cure
for 10 seconds
Disadvantages
 Laser unit large
 expensive www.indiandentalacademy.com

Xenon plasma arc light
 Introduced in late 1990’s
 Short exposure time at lower cost
 Curing time – 3-5 sec per bracket
 Higher intensity than conventional
 Expensive – argon laser > xenon plasma >
conventional light.www.indiandentalacademy.com

Comparison of efficiency of xenon
plasma light and conventional light
Sheldon Newman et al AJO 2001
 Exposure time
40 secs – conventional curing light
3,6 & 9 secs – xenon plasma light
Bond strength
 Xenon light > with longer exposure time
 To equal bond strength of conventional curing
light the exposure time with xenon had to be 6 –
9 secs www.indiandentalacademy.com

Light emitting diode curing units
Mills –1995
 Instead of hot filament – Halogen bulb.
 LED – junction of doped semi conductors.

Advantages:
 Lifetime 10, 000 hrs
 Requires no filters
 Resist shock and vibration
 Little power to operate
 Newer – GALLIUM NITRIDE ( LED ) 400-
500microns www.indiandentalacademy.com

Mills et al ( BJO 1997 )
Compared light source containing LED to
Halogen units
Concluded – LED curing units cured
composites to significantly greater depths
when tested at 40 & 60 sec

 Disadvantages
 Their technology is new to orthodontics,
and the concept still is evolving.
 Their curing time is slower than plasma
arc curing lights and some enhanced
halogen lights. www.indiandentalacademy.com

 Disadvantages
 Their batteries must be recharged.
 They cost more than do conventional
halogen lights.
 They offer a relatively low intensity.

Polymerization of resin cement with
LED curing unit
William Dunn & Louis Taloumis
AJO sep 2002
 Compared the shear bond strength of
orthodontic brackets bonded to teeth with
conventional halogen light and LED curing
units .
 No diff in bond strength of orthodontic
brackets bonded to teeth with conventional
halogen light and LED curing units .

Light Emitting Diode Units
Dr.Ravitej
 Aim - Shear Bond Strength Evaluation of three
commercially Available Light Emitting Diode
Units
 The 3 different LED sources used in the study
1. Elipar Freelight (3M/ESPE)
2. Bee Cool (Confident dental equipments,
Bangalore)
3. Apoza (Meghna and Co., Bangalore)

3 different LED sources used in the study
1. Elipar Freelight (3M/ESPE)
2. Bee Cool (Confident dental equipments,
Bangalore)
3. Apoza (Meghna and Co., Bangalore)

 Study sample -- 70 non-carious extracted
upper premolar teeth
 Divided into 7 groups of 10 each
 Group I Group II-IV Group V-VII
Elipar Freelight Bee Cool (Confident) Apoza
Results
Bond strength of G I and G IV samples fall in the
optimal range.
Bond strength values of other groups were
suboptimal.

 Group I sample (Elipar Freelight-10s,
3M/ESPE) can be considered most suitable
 Group IV sample (Bee Cool-20s, Confident
dental equipments, Bangalore) can also be
considered appropriate

References
 Orthodontics current principles & techniques: Graber
& Vanarsdall, 3rd
Ed
 Philip’s science of dental materials 11th
Ed
 Contemporary orthodontics: Proffit 3rd
Ed
 Orthodontic Materials Scientific & Clinical Aspects:
William A. Brantley,Theodore Eliades
 SEM Study & SBS measurement with 5% & 37%
phosphoric acid - AJO-DO oct,1995
Wasundhara A. Bhad, Pushpa V. Hazarey,
G.D.C.Nagpur

References
 Air abrasion tech vs conventional acid etching
tech.- AJO-DO Jan 2000- Wandela L. et al
 Laser etching of enamel for direct bonding-
AO,1993 no.1- Von Fraunhofer et al
 Clinical trials with crystal growth- AJO-DO Apr
1984 – Artun and Bergland
 crystal growth on outer enamel surface- AJO-DO
March 1986- Maijer & Smith
 Thesis on Laser etching - Dr. Francis
 Thesis on Bonding to Fluorosed teeth -
Dr.Veeresh www.indiandentalacademy.com

References
 Bond strength with various etching times on
young perm teeth- AJO-DO Jul 1991- Wang &
Chau Lu
 Effect of enamel etching time on bond strength
& morphology- JCO Jan 1985- Wayne et al
 Lab.& clinical evaluation of self etching primer
JCO Jan 2001- Robert A. Miller
 Variation in acid etch patterns with diff acids &
etch time AJO-DO Jul 2001- Alastair Gardner et
al

References
 Clinical evaluation of bond failure rates with a
new self etching primer- JCO Dec 2002-
Shadow Asgari et al
 Rapid curing of bonding with xenon plasma arc
light - AJO-DO Jun 2001- Oesterle, Sheldon,
Newman et al
 Evaluation of sealant in ortho bonding- AJO-DO
Sep 1991- Wei Nan Wang
 Bond strength comparison of MIP- AJO-DO Sep
2002- Shane & Timothy

Ash bonding

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