A 12-month clinical comparison of resin-modified light-activated adhesives for the cementation of orthodontic molar bands. Banding versus bonding of first permanent molars: a multi-centre randomized controlled trial. Bonded versus banded first molar attachments: a randomized controlled clinical trial. A comparative clinical trial of a compomer and a resin adhesive for orthodontic bonding. A clinical evaluation of a glass ionomer cement as an orthodontic bonding adhesive compared with an acrylic resin. An investigation into the use of two polyacid-modified composite resins (compomers) and a resin-modified glass poly(alkenoate) cement used to retain orthodontic bands.
A clinical trial is reported on the retention rates of resin-modified light-activated adhesives for the cementation of orthodontic molar bands. Fifty consecutive cases were fully banded and monitored over 12 months. Fuji II LC (GC International) recorded a failure rate of 2.9%, Bandlok (Reliance Orthodontic Products) 8.1%, with Ketac Cem (Espe) chemical cure 3.5%. There were no statistically significant differences between these rates. Fuji II LC and Ketac Cem failed at the interface between the adhesive and the metal, while Bandlok failed at the interface between the enamel and the adhesive. It is suggested that Fuji II LC and Ketac Cem will afford greater protection to the enamel against microleakage and demineralization than Bandlok. To assess the effectiveness of banding versus bonding of first permanent molars during fixed appliance treatment; in terms of attachment failure, patient discomfort and post-treatment enamel demineralization.
                Multi-centre randomized clinical trial. Setting: One District General Hospital Orthodontic Department and two Specialist Orthodontic Practices. Participants: Orthodontic patients aged between 10 and 18 years old, randomly allocated to either receive molar bands (n=40) or molar bonds (n=40). Method: Bands were cemented with a conventional glass ionomer cement and tubes were bonded with light-cured composite to all four first permanent molar teeth for each subject. Attachments were reviewed at each recall appointment to assess loosening or loss. The clinical end point of the trial was the day of appliance debond. Enamel demineralization at debond was assessed using the modified International Caries Assessment and Detection System (ICDAS).
                The first time failure rate for molar bonds was 18·4% and 2·6% for molar bands (P=0·0002). Survival analysis demonstrated molar bonds were more likely to fail compared with molar bands. First permanent molars with bonded tubes experienced more demineralization than those with cemented bands (P=0·027). There was no statistically significant difference in discomfort experienced by patients after banding or bonding first permanent molars (P>0·05).
                This study shows that as part of fixed appliance therapy, American Orthodontics photoetched first permanent molar bands cemented with 3M ESPE Ketac-Cem perform better than American Orthodontics low profile photo-etched and mesh-based first permanent molar tubes bonded with 3M Unitek Transbond XT in terms of failure behaviour and molar enamel demineralization. To compare the clinical failure rates of bonded first molar tubes with those of cemented bands during fixed appliance therapy.
                Prospective randomized controlled clinical trial.
                Two UK hospital orthodontic clinics, February 2001-December 2004.
                Hospital waiting list patients needing fixed appliances (n = 110).
                Patients were randomly allocated to two groups. Experimental group patients (n = 55) received single first molar tubes (n = 181) bonded with a no-mix chemically cured composite (Rely-A-Bond) after a 30-second etch. Control group patients (n = 55) were treated with bands (n = 186) cemented with Intact glass ionomer cement (GIC). First-time failures were recorded together with the time of failure. All patients were followed to the end or discontinuation of treatment.
                First-time failures: bands = 18.8%; bonds = 33.7 %. Bonded tubes were more likely to fail [RR 2.4; 95% CI (1.4, 4.1)] compared with bands. Experimental group patients also had more bracket failures (P = 0.009), when analysed at patient level.
                First molar tubes bonded with Rely-A-Bond composite showed a significantly higher first-time failure rate than bands cemented with Intact GIC. The study aimed to compare the survival time and cariostatic potential of a compomer to that of a resin adhesive when used to bond stainless steel orthodontic brackets to labial segment teeth only. The effect of the patients' sex, age at the start of treatment and presenting malocclusion on bracket survival time was assessed also. Forty-five consecutive patients who attended for fixed appliance therapy were randomly selected. Four hundred twenty-six brackets were bonded (213 with compomer and 213 with resin adhesive) with a split mouth design; the right or left side allocation of compomer in either arch was alternated. Color transparencies of the maxillary incisors, mandibular incisors, or both, and transparencies of the canines, were taken before treatment. At the debond stage, the transparencies were projected (20x) and assessed by an experienced examiner, who used a caries index. The survival time distributions for brackets bonded with each bonding agent were not significantly different (P = .74, paired Prentice-Wilcoxon test; P = .75, Akritas test), with bracket failure rates of 17% and 20% recorded for compomer and resin adhesive, respectively. Neither the patients' sex (P = .85) nor malocclusion (P = .26) appear to affect significantly bracket survival, but patient age was identified as a useful prognostic indicator of bracket survival (P < .001). On average, there was more decalcification related to brackets bonded with resin adhesive than with compomer (P = .0075). Survival time distributions of brackets bonded with compomer or resin adhesive appear comparable, but decalcification was reduced significantly by bonding with compomer. Glass ionomer cement (GIC) has been suggested as an alternative to acrylic resin in bracket bonding because of its fluoride release. The aim of this clinical trial was to evaluate further the suitability of GIC as a bonding adhesive compared with an acrylic resin with regard to frequency of bracket failure, fracture modes and clean-up time after debonding. Two commercially available brackets were tested, one with a meshed foil base and the other with an integral base. A total of 60 patients, with a mean age of 13 years 7 months (range 10 years 8 months to 19 years 1 month) were consecutively selected. Brackets were bonded with a GIC (AquaCem, De Trey) and a no-mix diacrylate (Unite, Unitek Corp.) according to random assignment for each jaw. One group of patients (n = 30) was bonded with metal brackets with machine cut grooves in the base (DynaLock, Unitek). In the second group (n = 30) brackets with a meshed foil base (Unitwin, Unitek) were used. Bracket failure location during treatment was recorded as were fracture modes and time required for the clean-up of enamel surfaces at debonding. The frequency of failed brackets was higher with GIC (36 per cent) than with the diacrylate (15 per cent). Bracket failures for the cut groove base type occurred in 50 per cent with GIC and 23 per cent with the acrylic, meshed foil bases failed in 22 per cent GIC and in 7 per cent with the acrylic, respectively. The differences in failure between bracket types were significant at P < 0.001 for both bonding materials. Analysis of the fracture modes showed a small but noticeable difference in the strength of adhesion to the enamel surface, favouring GIC. Time required for the clean-up of enamel surfaces showed a significantly shorter debonding time for GIC. It is concluded that the use of a GIC for orthodontic bonding purposes considerably increases the risk of bond failures during treatment, especially in combination with a cut groove base type. One noticeable advantage with GIC bonding, however, is the shorter clean-up time for the enamel surfaces. The aim of this investigation was to determine the effectiveness of a conventional glass poly(alkenoate) cement (Intact) and newer polyacid-modified composite resin cements (Transbond Plus and Ultra Band-Lok) to retain orthodontic bands. In the in vitro part of this study, stainless steel bands were cemented to 240 extracted third molar teeth in three test groups comprising Intact, Transbond Plus and Ultra Band-Lok. The force to deband (N) for all three cements was recorded using an Instron universal testing machine after the following observation periods: 20 minutes and 3, 6 and 12 months. The results indicated that all three cements increased their median force to deband after 12 months. Of the two compomers, Transbondtrade mark Plus demonstrated the highest median force to deband at all four time intervals. In the in vivo part of the study, 30 patients participated in a randomized cross-mouth clinical trial where the molar bands were cemented in place using either Intact or Transbond Plus. Ultra Band-Lok was not used in the clinical part of the study. The results showed there to be no clinically significant difference in band failure rates between the two cements. When patients were asked to score each for taste, there was a significant difference, with the glass poly(alkenoate) cement (Intact) being more acceptable than the polyacid-modified composite Transbond Plus (P < 0.001). No significant differences were observed in the in vitro median force to deband or in vivo band failure rates between the glass poly(alkenoate) cement and the polyacid-modified composite resins. The choice of cementing agent can therefore be made on patient factors, e.g. taste, or operator factors, e.g. ease of handling, cost and shelf life.
There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.