A simplified indirect bonding technique.

A successful indirect bonding technique allows accurate positioning of the brackets on all teeth, uses transfer trays with sufficient strength to hold the brackets securely in place while the adhesive polymerizes, reduces the duration of the bonding procedure and thus patient discomfort, and minimizes laboratory expense and chairtime. Indirect bonding using thermal glue transfer trays is inexpensive, simple, accurate, and reliable. The modified technique described here has several advantages: using a composite resin instead of a water-soluble adhesive to bond the brackets to the working cast reduces the amount of excess adhesive. The use of a flowable composite as the bonding agent allows any excess around the bracket base to be easily removed with an ultrasonic scaler. In our technique, the application of a thin layer of medium-viscosity silicone impression material prevents the thermal glue from seeping into the undercuts of the brackets, allowing complete bracket coverage without significantly increasing the cost of the procedure. The silicone layer facilitates removal of the transfer tray and reduces the risk of debonding. Extension of the glue matrix to the buccal surfaces of the teeth increases the stiffness of the transfer tray, preventing distortion of the matrix and reducing mistakes in bracket positioning. This procedure can be used to bond a full arch, including brackets and molar tubes for the first and second permanent molars. Trays in two or three sections can be used if the field of vision is restricted, however, or if cheek and tongue retraction is too difficult