Bonding In Orthodontics

GUIDE : Dr. Shubhaker Rao J sir Dr. Bilal Ahmed Afaq

Co-Guide : Dr. Vamshilatha Ma’am.
1ST YEAR POST GRADUATE
DEPT.OF ORTHODONTICS & DENTOFACIAL ORTHOPEDICS
Contents
 Introduction
 History
 Banding preferred over bonding
 Bonding procedure

a) Cleaning
b) Enamel Conditioning Acid Etching
i) Moisture Control Sand Blasting/Air abrasion
ii) Enamel Pre-treatment
Laser Etching
c) Sealing
Crystal Growth
2
2
 -Bonding Agents:
 First generation
 Second generation
 Third generation
 Fourth generation
 Fifth generation
 Sixth generation
 Seventh generation
d) Bonding
- Direct Bonding
 De-bonding
 Advantages of Bonding - Indirect Bonding
 Disadvantages of Bonding
 Conclusion
 References
3

3
Introduction

 The basis of bonding:

 Bonding of attachments, eliminating the need for bands, was a dream for many
years before rather abruptly becoming a routine clinical procedure in the 1980’s.

 Bonding is based on mechanical locking of an adhesive to irregularities in enamel

surface of the tooth and to mechanical locks formed in the base of the orthodontic
attachment.

4
 Successful bonding in orthodontics therefore requires careful
attention to three components of the system:

a)The tooth surface and its preparation.

b)The design of the attachment base.

c)The bonding material itself.

5
Definitions:

ADHESIVE BONDING:
“ The process of joining two materials by means
of an adhesive agent that solidifies during the
bonding process ” - (Ref: Philips Science of Dental
Materials -11th Edition)

BONDING IN ORTHODONTICS:
“A technique of joining orthodontic brackets or other
attachments directly to the tooth, using orthodontic adhesives” -
(Ref: Mosby’s Dental Dictionary)

6
 Bonding (AAO glossary 2012)
“The process by which orthodontic attachments are affixed to the teeth by an
adhesive.”

 Direct bonding (AAO glossary 2012)

“An intraoral procedure during which orthodontic attachments are placed on a tooth
surface directly.”

 Indirect Bonding (AAO glossary 2012)

“A two-step process by which orthodontic attachments are affixed temporarily to
study cast teeth and then transferred en masse to the mouth by means of a molded
matrix that preserves their predetermined orientation and permits them to be
bonded simultaneously.”

7
“Attachment Between Bracket
And Tooth Surface is
Micro Mechanical.”
(Through Resin Tags)

Mechanical attachment:- Strong attachment of

two substances accomplished

mechanically.
8
HISTORY:

 1955: MICHAEL BUONOCORE first demonstrated acid etch

technique.

 1965: NEWMAN applied it in direct bonding of orthodontic

attachments.

 1968: SMITH introduced Zinc polycarboxylate cement &

bracket bonding with this cement.

9
 1971:MIURA et al introduced an acrylic resin (Orthomite) for bonding plastic
brackets.

 1971: BOWEN -Diacrylate resins introduced into orthodontics (bis GMA-

Most widely used) [BOWEN’S RESIN]

10
 1977: ZACHRISSON : Stated that the objective of bonding was
to get as good as mechanical as possible between
enamel and adhesive and evenly distributed etching
pattern with marked surface roughness, but little actual
loss of enamel is most desirable to achieve mechanical
interlock.

 1979: Survey conducted in US by LEONARD GOERLICK - 93%

of Orthodontists used bonding for bracket
attachment.

11
 1984 : Proposed ARI Score by Artun and Bergland
 1992 : Nganga PM et all compared the tensile bond
strength and the bond failure site of brackets bonded
directly to flourotic and non flourotic teeth.
 2000 : Chung C et all conducted a study on the effects
of 2 adhesion boosters, Enhance LC and All bond 2. All
bond 2 significantly increases bond strength.

12
 2007 : Adanir et all carried out a study to determine the
effects of changing the fluorosis and bleaching on shear
bond strength of orthodontic brackets. Teeth with
bleaching agent showed least Bond strength.
 2011 : Isci D et all conducted a study to compare the
SBS of brackets bonded to flourosed and non flourosed
teeth with self etching primer (SEP) and 37% PA. The
SEP showed low bond strength Values for orthodontic
brackets bonded to mildly flourosed teeth.

13
 2013 : conducted a study to evaluate the SBS, sited of
failure , and micro morphology of bonded molar tubes
and on teeth affected by DF. Results show flourotic
enamel affects the adhesion of bonded molar tubes.
Over etching ( MOF) and micro abrasion and etching
( SEF) provides suitable adhesion for fixed appliance
therapy.

14
Bonding Procedure

a) Cleaning
b) Enamel Conditioning
i) Moisture Control - Acid Etching
ii) Enamel Pre-treatment
- Sand Blasting/Air abrasion

c) Sealing - Laser Etching

- Crystal Growth

d)Bonding
- Direct Bonding

- Indirect Bonding
15
Graber, Vanarsdall :Fifth Edition : Orthodontics Current Principles
And Techniques : pg 728
Cleaning

 Remove Organic Pellicle and Plaque.

 Pumicing using rubber cup / polishing brush.

 Avoid traumatizing the gingival margin.

16
Enamel conditioning

1. Moisture control:
 Lip expanders.
 Cheek retractor.
 Saliva ejectors.
 Tongue guards.
 Salivary duct obstructers (Dri-angles).
 Cotton or gauze rolls.
 Antisialagogues- Probanthine, Atropine sulphate.

17
18
 Banthine tablets – 50 mg per 100 lb in
a sugar free drink 15 min before
bonding is adequate.

Richard .N. Carter; Salivary Control. JCO 1981 VOLUME 15 : NUMBER 08 :

PAGES (562-564) 19
 2. Enamel pre-treatment:

Acid etching Crystal growth Sand Blasting Laser

etching

20
Morphology of Enamel

21
 No. of rods per tooth range from:

 5 million-lower lateral incisors.

 12 million –upper first molars.

 Sub-microscopically-key hole pattern.

(Reference: Orban’s Oral Histology & Embryology -11th

22 Edition)
Acid Etching

 A concept of etching enamel surfaces with phosphoric

acid, first proposed by Buonocore in 1955 to increase the
bond strength between the composite resin and etched
enamel.

 30%-50% phosphoric acid for 15 - 60 sec

 37% phosphoric acid (most commonly used): Dissolves

5-10m of enamel surface & a zone of etched enamel
23

rods for about 15-20 m.

Rationale of etching

 To remove small amount of interprismatic enamel & open up pores between the
enamel prisms, so that the adhesive can penetrate into the enamel surface.

 Etching process creates calcium monophosphate

and calcium sulphate by-products which are
removed by water rinse.

24
Various acids for enamel etching:
 37% phosphoric acid (Most commonly used)

 10% Phosphoric acid

 10% Maleic acid

 2.5% Nitric acid

 10% Polyacrylic acid

25
Mechanism
Acid
etching

Dissolution of
hydroxy-apetite
crystals
Loss of
interprismatic
enamel rods

Increase in
enamel
porosity

Increase in
surface area 26
Image courtesy: William R. Proffit : Contemporary Orthodontics
27
: Fifth
Edition :365
 Frosty white appearance of teeth after
enamel etching indicates successful etching.

Graber, Vanarsdall :Fifth Edition : Orthodontics Current Principles

28
And
Techniques : pg 729
* MACRO TAGS – Which are formed at the periphery. They are 2- 5 nm in length.

* MICRO TAGS – Which are formed at the cores of enamel prism.

29
Concentration of Acid vs Bond Strength
 Etching with 10% or 37% phosphoric acid produces the highest bond strengths
(28 MPa) to enamel.

 Etching with 10% maleic acid results in comparatively lower bond strength(18
MPa).

 No significant difference in bond strengths are observed when enamel is etched

with phosphoric acid ranging in concentration from 2% to 37%.

Graber, Vanarsdall :Fifth Edition : Orthodontics Current Principles

30 And
Techniques
Duration of etching
 No differences in bond strength are detected between 15-seconds and 60 seconds
etching with 37% phosphoric acid, however shorter etching times cause less
enamel damage on debonding.

 SEM shows that etching with 37% phosphoric acid for atleast 30 seconds produces
more optimal etching patterns than etching for 15 seconds.

 Etching for 0-5 seconds reduces bond strength (less than 3MPa)

31
William Brantley : Orthodontic Materials – Scientific and clinical aspects
Procedure:

 Isolation.
 Cleaning with pumice and then drying.
 Gentle application of etchant.(usually 37% phosphoric acid)
 Should not be rubbed.
 Rinsed with water spray for about 15 seconds. (after 20-30 seconds)
 Dry with moisture and oil free source.
 Avoid salivary contamination– if occurs, re - etch the tooth.

32
Fluorosed teeth
 Teeth with higher concentration of fluoride are more resistant to acid etching than
normal teeth and may require an extended etching time.

 Even with additional etching time for severely and moderately fluorosed teeth,
bond strengths were decrease by 40% compared to normal teeth.

 “Orthodontic brackets adhesion to tooth enamel is negatively influenced by

dental fluorosis. Doubling the etching time does not increase the adhesion of
orthodontic brackets to fluorosed enamel.” *

*rev port estomatol med dent e cir maxilofac

33
Shear bond strength of orthodontic
brackets to fluorosed enamel. 2014;55(2):73–77
 “Use of an Adhesion Promoter(Scotchbond Multipurpose Plus Bonding Adhesive)
provides a clinically successful adhesive bonding protocol of orthodontic brackets
to severely fluorosed human teeth.”

James Noblea; Nicholas E. Karaiskosa; William A. Wiltshire; In Vivo Bonding of

Orthodontic Brackets to Fluorosed Enamel using an Adhesion Promotor; Angle
Orthodontist, 2008 ;Vol 78, No 2, 34
Patterns of etching
 Type 1
- Selective removal of rods.
- Peripheries intact.

(Reference: Ten Cate’s Oral Histology-Development, Structure, &35Function -

7th edition)
 Type 2
- Reverse process.
- Inter-rod Enamel Removed.
- Cores intact.

(Reference: Ten Cate’s Oral Histology-Development, Structure, & Function

36 -
7th edition)
 Type 3
-Surface loss [irregular & indiscriminate] without exposing underlying prisms.

(Reference: Ten Cate’s Oral Histology-Development, Structure, &37Function -

7th edition)
Possible Iatrogenic effects of acid etching of
enamel

 Fracture and cracking of enamel upon debonding.

 Increased surface porosity- Possible staining.

 Loss of enamel during etching.

 Resin tags retained in enamel - Possible discolouration of

resin.

 Rougher surface if over etched.

38
Crystal growth
 1st demonstrated by Maijer & Smith (1979).

Orthodontics: Diagnosis and management of malocclusion and dentofacial

39

deformitites : Kharbanda . First Edition

Mechanism of action:
Poly-acrylic acid solution (containing
sulfate ions.)

Growth of calcium sulfate dihydrate

crystals.

Needle like crystal projections formed on

enamel surface.
40
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.

41
Bond strength

Farquhar reveal that crystal growth exhibits bond

strength only one third that of phosphoric etching
and resin bonding.
Farquhar: Polyacrylic acid vs phosphoric acid
technique in direct bonding: AJODO : 90:187; 1986.

He found that “crystal growing solutions provided retention

similar to those after etching with phosphoric acid with less
risk of enamel damage at Debonding”
Maijer R. Smith Dc : A new surface treatment for bonding: J
Biomed Mater Res: 1979 Nov;13(6):975-85)

42
MECHANISM OF RETENTION:

 Mechanical attachment is created around the

crystalline interface.

43
Advantages of Crystal growth
 Debonding quicker and easier.

 No damage to enamel.

 No resin tags left behind.

 Less residual adhesive left on the tooth.

 Possibility of incorporating fluoride in crystal interface – anticariogenic action.

44
Sand blasting / Air abrasion

 Also known as Micro-Etching.

 Introduced in 1940 by Dr. Robert black

 Makes use of high speed stream of Aluminium Oxide particles ( 50-90 µm 3

seconds) propelled by air pressure against the surface of enamel causing abrasion
of the surface.

 Bond strength only 50% to that of acid etched enamel.

 Air abrasion of Metal Brackets or Bands is an effective way of improving bond

strength.

45
46
 Objective: To compare bond strength and bond failure location of lingual brackets
indirectly bonded after lingual enamel sandblasting with 27-, 50-, and 90-µm
aluminum oxide particles followed by 37% phosphoric acid etching.
 Material and Methods: Eighty maxillary premolars were randomly divided into
four equal groups according to the method of lingual enamel surface conditioning:
Group 1 (control) was etched with 37% phosphoric acid, and group 2, group 3, and
group 4 were sandblasted with 27-, 50-, and 90-mm aluminum oxide particles,
respectively, prior to acid).
 Results: There were no statistically significant differences in mean shear bond
strength or ARI scores between the four enamel-conditioning procedures.

Julissa Janet Robles-Ruíz  et al; Effect of lingual enamel sandblasting with aluminum
oxide of different particle sizes in combination with phosphoric acid etching on
indirect bonding of lingual brackets; Angle Orthodontics ; 2014;84:1068–1073
47
BONDING AGENTS

48
 To understand adhesion to enamel:
1) Wetting.
2) Interpenetration. (formation of hybrid zone)
3) Micromechanical interlocking.

 WETTING:
 Relative interfacial tension between a liquid and a solid substrate
that results in a contact angle of less than 90° .

49
Anusavice; Phillips ; Science of Dental Materials ; 11 Edition; pg 382
th
 HIGH CONTACT LOW CONTACT
ANGLE
ANGLE

• Low contact angle enables proper wetting of

the surfaces.
50
Ideal requirements of bonding agents:

1. It should not have any toxic effects.

2. It must be of low viscosity so that it penetrates the enamel surface.

3. It must have excellent inherent strength and should be dimensionally stable.

4. It must have minimal expansion and water absorption.

51
5. The operator should have the option of being able to bond
directly or indirectly.

6. The material should be stain resistant.

7. Sufficient working time before setting occurs.

52
Generations of Bonding Agents
First Generation: (No longer in use)
 Buonocore (1955) – Demonstrated the use of glycerolphosphoric acid
dimethacrylate – containing resin, would bond to acid etching dentine.
 Bowen (1965), tried N-phenylglycine and glycidyl methacrylate.

 Mode of action:
Chelation of bonding agent to calcium

 Bond strength:
Low (1-3MPa)
Eg: Cervident , SS White

53
 Second generation: (No longer in use)
 Introduced in mid 1970’s
 Stabilized resins - polymerizable phosphates added to Bis- GMA
 Bond strength - 2-8 Mpa

 Mode of action:
Phosphate group binds to calcium in enamel.
 Drawbacks:
 Micro-leakage.
 Post –operative sensitivity.
 Insufficient bond strength but considerable improvement
over first generation. 54
 Eg : Scotch Bond(3M)
Clearfil (Kuraray)
Bondlite
Creation Bond
Prisma
Universal Bond

55
 Third generation: (Etch and rinse)
 Introduced in late 1970’s
 Multi-step procedure.

 Two component Primer - Adhesive system.

 Primer contains hydrophilic resin monomers which include hydroxyethyl trimelliate
anhydrate and bisphenyl dimethacrylate.
 Adhesive contains chlorophosphoric acid ester of bis-GMA.

 Modify smear layer.*

56
 Bond strength: (8-18 Mpa)

 Drawbacks:
 Bonding to smear layer covered dentine was not very successful.

 Eg :
Mirage bond
Scotch bond 2
Prisma Universal bond 2 & 3

57
 Fourth Generation: [Etch and rinse] (Total Etch*/3
step)
(Removal of Smear Layer – Complete)

 Mid-late 1980’s.
 Developed by - Fusayama & Nakabayashi.

 Bond strength: 17-25 MPa

 TOTAL ETCH technique is one of the main characteristics of 4th generation of

bonding agents.*

 Hydrophilic primer solution can infiltrate collagen network forming the “Hybrid
Layer” 58
 According to Nakabayashi (1982) hybrid layer is
defined as “the structure formed in dental hard
tissues by demineralisation of the surface and
subsurface, followed by infiltration of monomer
and subsequent polymerisation”

59
 Mode of action:
Total removal of smear layer & smear plugs.

Resin tags responsible for retention.

Wet bonding - hydrophilic primer infiltrates the

collagen network when placed on slightly moist
dentin.

 Advantages:
Decreased post operative sensitivity

High bond strength

Moist dentin bonding 60

Eg: All bound-2 (BISCO)
Scotch bond Multipurpose(3M)

61
 Fifth generation: [Etch and rinse] (Total etch / 2 Step)

 Introduced in early 1990’s.

 Two different types of adhesive materials the so called “one bottle”

systems and the “self etching primer” bonding system.

 One Bottle System combined the primer and adhesives into one solution.
Should be used after total etch.

 Bond strength : 20-25 Mpa

 Mode of action:
 Similar to 4th generation adhesives.

62
 Advantages:
Single component - less error.

Decreased post operative sensitivity.

Easy to use.

63
 Eg: Singlebond (3M)
One step (BISCO)
Optibond solo (kerr)
Xeno iii ( Denstply)

64
 Sixth generation: (Self Etch / 2 Step)

 Mid-late 1990’s.

 Self Etching Primers & Primer + Adhesives.

 Light & Dual cured options.
 Two bottle system.
 Bond strength: 18-25 Mpa*

 Advantages:
Ease of application

65
 Eg: One UP bond F

66
 Seventh generation [Self etch/ 1 Step]

 No-mix , Self –Etching Adhesive

 One bottle-no mixing required
 Bond strength: 18-25 Mpa (same as 6th gen)

 Advantages:
 No mixing required
 No rinsing required
 Simple procedure

67
 Eg: Prompt-L-Pop (ESPE)

68
One Component self etching primer : a
seventh generation of orthodontic
bonding system.
 Purpose of this study was to compare bond strengths
and to evaluate the debonding site using ARI.
 Composites used were – Transbond XT, Xeno IV, Fuji
Ortho LC
 With regard to ARI score , Highest mean value was
found in Fuji Ortho . (Lowest SBS)
 Xeno IV was able to bond orthodontic brackets in
association with Transbond XT composite.

EJO, 32(2010) 567-570 69

70
Sealing:
 “Sealant is a material which when applied to the
surfaces of a substrate, can join them together, resist
separation and transmit load across the bond.”

 Sealer / Primer / Intermediate resin.

 An ideal bond is obtained in two steps:

1. The etched enamel surface is sealed by an application of a low viscosity resin.

(more wettability)

2. The attachment is bonded to the sealant with a high viscosity resin of relatively
greater strength.

Packham DE. Adhesion. In: Packham DE, editor. Handbook of adhesion.

71 First edition.

Essex: Longman; 1992. p. 18.

Various Concepts On Sealant Application:

 Necessary to achieve proper bond strength.

 Resistance to micro leakage.

 Enhance wettability of the enamel surface.

 Promote chemical bond between adhesive & tooth surface.

72
Composition of sealants:

 Low viscosity monomer (bis-GMA) dissolved in an

organic solvent (ethanol /acetone).

73
SOLVENT ADVANTAGES DISADVANTAGES

ACETONE Dries quickly Very technique sensitive

ETHANOL Evaporates less quickly Extra drying time

WATER Slow evaporation Long drying time, water

interferes with adhesive
bonding if not dried
completely

SOLVENT-FREE No drying, single coat Higher film thickness

74
PROCEDURE OF SEALANT APPLICATION:

 After the teeth are completely dry and appear frosty white, a thin
layer of sealant may be painted over the entire etched enamel
surface.

 It is applied with a small foam pellet or brush with a single inciso-

gingival stroke on each tooth.

 The sealant coating should be thin, since excess sealant may induce
bracket drift and unnatural enamel topography when polymerized.

 Time of application & duration of setting or polymerization varies

among manufacturers. 75
 RECENT TRENDS IN SEALANTS:

Self Etching Primer:

 Priming & conditioning into one step.

 Composition : ACID - PHENYL SOLVENT

PRIMER - HEMA & DIMETHACRYLATE

 Type of Bonding: Chemical bond with calcium than a

mechanical bond seen in conventional acid etch procedure

76
 Application of Self Etching Primer

Image courtesy : Graber, Vanarsdall : Fifth Edition : Orthodontics Current

77 Principles And

Techniques : pg 733
 1st compartment:
Methacrylated phosphoric acid esters, stabilizers,
photosensitizers.

 2nd compartment:
Water & soluble fluoride.

 3rd compartment:
Applicator micro-brush.

78
Procedure for self etch primer

79
Mechanism to stop acid etching process:

 Acid groups neutralizedby forming complex

with calcium from hydroxy-apatite.

 As the solvent is driven from air-burst step,

viscosity increases slowing down transport of
acid groups.

 As the primer is light cured, polymerization

occurs, transport of acid groups is stopped.
80
 “SEPs provide adequate bond strength with a more
conservative etch pattern and also enable easy
debonding, thereby reducing the enamel damage”

Lalita G Nanjanawar et al: Effects of a self Etching primer and 37% phosphoric
acid etching on enamel : The journal of contemporary dental practice:
81
An SEM
may-june 2012;13 (3): 280-284
Enamel loss with SEP

• In a study by Hosein et al AJO 2004; Enamel loss during

bonding, debonding, and cleanup with use of a self-etching
primer

• He stated that:
• After pumicing and conventional etching, the enamel loss was
2.76µm ranged from 1.11µm-4.57µm
• With the SEP’s, the median enamel loss was significantly
lower, at 0.27µm the range was 0.03µm– 0.74µm.

• Scanning Electron Microscopy revealed that self-etching

primer produced less dissolution of enamel surface
compared with phosphoric acid. 82
Moisture Insensitive Primer (MIP)/
Moisture Resistant Primer (MRP)

 Hydrophilic in nature.

 Composition:
 Co-polymer of methacrylate & poly-alkenoic acid.

 Uses:
 In bonding partially erupted teeth.
 Impacted canines.

83
Reliance Orthodontic Products

3M UNITEK MIP

84
MOISTURE ACTIVE PRIMERS

 Moisture Active :
 Cyanoacrylates.
 Initiation through exposure to water.
 Enamel surface intentionally wetted.
 New product.
Eg: SMARTBOND (Gestenco)

Moisture- insensitive adhesives : reactivity with watsr and bond

strength to wet saliva contaminagted enamel.
85
T. Eliades et al
EJO 24(2002)35-42
Composite Resins

86
 Basic Ingredients

 Resin matrix: Bis-GMA,UDMA,TEGDMA

 Filler: Reinforcing particles (Silica)

 Coupling agent: Organosilanes

 Activator - Initiator Systems *

 Inhibitors – Butylated Hydroxy Toluene 0.01%

 Optical Modifiers / Colouring Agents

Sturdvants : Textbook of Conservative Dentistry.
87
Classification of Composite Resins Used In
Orthodontics

 Based on composition
 Acrylic based resins
 Diacrylic based resins

 Based on curing
 Self cured(two-phase & one phase)
 Light cured (UV & light)
 Dual cured resins

88
 Based on moisture sensitivity
 Moisture sensitive

 Moisture active adhesive

 Moisture resistant adhesive

89
 According to filler size
 Traditional: 10-100 micron
 Midfill: 1-10 micron
 Minifill: 0.1-1 micron
 Microfill: 0.01-0.1 micron
 Hybrid: mixed range of fillers(0.4-1 microns)

90
Based on composition:

Acrylic resins Diacrylate resins

• Derivatives of ethylene • Aromatic ester of di

& contain vinyl group methacrylate
synthesized from epoxy
resin & methacrylate
• Linear polymers formed • Three dimensional
cross-linking network
• Less strength & more • More strength & less
polymerization polymerization
shrinkage shrinkage

91
 Based on curing

SELF CURED
 Two phase
 Benzoyl peroxide initiator - Base paste.
 Tertiary amine activator- Catalyst paste.

 Setting initiated by mixing of 2 paste

 Clinical handling
Laborious, time consuming, air entrapment.

 Eg: Concise (3M)

92
 One phase (NO-MIX ADHESIVES)
 Application of liquid component on enamel & paste on
bracket base.
 No mixing involved.

 Clinical handling:
 Efficient application, limited time requirement.

 Limited data on bond strength.

Eg: SYSTEM 1 + (Ormco)

RELY-A-BOND (Reliance)
UNITEk (3M)
93
 Light cured:

 Supplied as single paste in light proof syringe.

 Photosensitizer: Camphoroquinone.

 Inhibitor: Butylated hydroxy toluene.

94
 Dual cured

 Combines advantages of rapid initiation for photo-

polymerizing resins & high conversion rates for chemically
cured resins in the bulk material.

 Surface exposure to light.

 Followed by polymerization by chemical curing.

Sturdvants : Textbook of Conservative Dentistry.

95
 Generations of Dental
Composites
 1st Generation : Consists of Macroceramic reinforcing
phases in resin matrix.
 2nd Generation : Consists of colloidal and micro ceramic
reinforcing phases in resin matrix.
 3rd Generation : Combination of both Macroceramic And
Microceramic.

Sturdvants : Textbook of Conservative Dentistry.

96
 4th generation : Hybrid composite, Instead of macro
ceramic it Contains irregularly shaped highly reinforced
composite macro particles.
 5th generation : The resin phase is reinforced with micro
ceramics and Heat cured, irregularly shaped macro
particles.
 6th Gen : The resin phase consists of heat cured,
irregularly shaped spherical highly reinforced macro
particles with micro ceramics.

Sturdvants : Textbook of Conservative Dentistry.

97
References
 Orthodontics current principles & techniques: Graber & Vanarsdall, 5th Edition

 Philip’s science of dental materials 11th Edition

 Contemporary orthodontics: Proffit 5th Edition

 Orthodontic Materials Scientific & Clinical Aspects: William A. Brantley, Theodore

Eliades

 Sturdvants : Textbook of Conservative Dentistry.

 Craig’s Restorative dental Materials: 12th Edition

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 Mónica Mendes et al; Shear bond strength of orthodontic brackets to fluorosed enamel; rev
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