Adhesives for fixed orthodontic bands

Background: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period. :Objectives: To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of: (1) how often the bands come off during treatment; and (2) whether they protect the banded teeth against decay during fixed appliance treatment. Search methods: The following electronic databases were searched: Cochrane Oral Health's Trials Register (searched 2 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 5) in the Cochrane Library (searched 2 June 2016), MEDLINE Ovid (1946 to 2 June 2016) and EMBASE Ovid (1980 to 2 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria: Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. Data collection and analysis: All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. Main results: Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria. Authors' conclusions: There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.

The effect of variability in the powder/liquid ratio on the strength of zinc phosphate cement

Aim: To investigate (a) variability in powder/liquid proportioning (b) effect of the extremes of any such variability on diametral tensile strength (DTS), in a commercial zinc phosphate cement. Statistical analyses (a = 0.05) were by Student's t-test in the case of powder/liquid ratio and one-way ANOVA and Tukey HSD for for pair-wise comparisons of mean DTS. The Null hypotheses were that (a) the powder-liquid mixing ratios observed would not differ from the manufacturer's recommended ratio (b) DTS of the set cement samples using the extreme powder/liquid ratios observed would not differ from those made using the manufacturer's recommended ratio. Methodology: Thirty-four undergraduate dental students dispensed the components according to the manufacturer's instructions. The maximum and minimum powder/liquid ratios (m/m), together with the manufacturer's recommended ratio (m/m), were used to prepare cylindrical samples (n = 3 x 34) for DTS testing. Results: Powder/liquid ratios ranged from 2.386 to 1.018.The mean ratio (1.644 (341) m/m) was not significantly different from the manufacturer's recommended value of 1.718 (p=0.189). DTS values for the maximum and minimum ratios (m/m), respectively, were both significantly different from each other (p<0.001) and from the mean value obtained from the manufacturer's recommended ratio (m/m) (p<0.001). Conclusions: Variability exists in powder/liquid ratio (m/m) for hand dispensed zinc phosphate cement. This variability can affect the DTS of the set material.