Seps and Bands

Question 1

Appointment Planning

Answer 1

Visit 1- bond teeth and seps
Visit 2- Band placement and archwire
OR
Visit 1- seps
Visit 2- bands, bond up and archwire

Question 2

How many days between 1st visit and 2nd visit?

Answer 2

7-10 days

Question 3

Types of separators?

Answer 3

• Elastomeric separators
• steel springs
• brass wire

Question 4

Difference between separating in children and adults?

Answer 4

Children has less tight contact than adult

Question 5

Elastomeric separator

Answer 5

Advantages: easy to place and remove and good separation

Disadvantages: uncomfortable, easily displaced, 1week between visits.

Question 6

Placement of seps

Answer 6

• separating plier
• mosquitoes
• floss
• don’t forget finger rest otherwise it can easily slip
• count them separator in
• Place mesial and distal of upper molars

Question 7

Separating steel springs

Answer 7

Advantages: good for tight contact, gentle separation, good for adult
Disadvantage: awkward to remove, 1 week appt , easily displaced

Question 8

Brass wire separation

Answer 8

Advantages: good for tight contacts, comfortable when in situ, good for long term

Disadvantages: uncomfortable to place, time consuming , can be difficult to remove

Question 9

Separator removal

Answer 9

-Use probe to remove seps
-finger rest important to prevent any hazards
- count separator in and out.

Question 10

What do we do if seps missing?

Answer 10

Ask the pt if they know how they lost it. Did they see it come out? If they aren’t sure we look with a mirror. If we can’t see it we get a specialist to look. WE CANNOT look sub gingival for it.

Question 11

Placing orthodontic bands

Answer 11

• choose correct size. Should be tight to tooth. Why?
• stretch over tooth with bite stick
• marginal ridge, mesial and buccal cusps visible, avoid expose lingual and palatal enamel at gingival margins
• bite in lower band Buccally
• bite in upper bands palatally
• cement with GIC/ RMGIC/ composer

Question 12

Upper and lower band

Answer 12

Upper molar bands - double tube
Lower molar bands - single tube

Question 13

Band Removal

Answer 13

• Carefully use of band removing plier
• approach from buccal in lower arch and palatal in upper arch
• finger rest
• think carful about placement of pliers

Question 14

Why do you need to check there is no void in the cement ?

Answer 14

Food impaction can cause caries.

Question 15

Why do we use GIC?

Answer 15

• leaches fluoride
• bond enamel to steel

Question 16

GIC glass ionomer cement made of?

Answer 16

• Aluminosilicate glass
  Calcium , aluminium, fluoride
• polyacrylic acid

Question 17

Resin Modified GICs

Answer 17

• 85% glass polyalkenoate
• 15% resin HEMA
• Direct bond anterior teeth only
• high 12.4 % bond failure rate
• chemical and light cure
• no need to pumic
• conditioner , rinsing, little drying.

Question 18

Resin Modified GICs adv / dis adv

Answer 18

Advantages: - bond failure rate lower than composite if enamel conditioned prior to use
- less decalcification
- wet field bonding

Disadvantages:
- mix powder/ liquid
- higher bond failure rate than composite if enamel not etched / conditioned.
- high failure if enamel dried

Question 19

Polyacid modified composite
TRANSBOND +

Answer 19

Example : Bandlock , Transbond +
- HEMA , inorganic filler
Aluminosilicate glass

Question 20

Do we always need separators?

Answer 20

No , if there is enough space we don’t need it.