A new method for successful indirect bonding in relation to bond strength

The aim of the work was to develop a new transfer method for indirect bonding of brackets to improve the bond strength by applying a uniform contact pressure over the entire dental arch. This has a great potential to reduce the bracket loss rate during clinical treatment. A suitable shape memory polymer (SMP) was selected and prepared in the chemistry laboratory. This SMP applies a force to the brackets during bonding and thus increases the bond strength by applying uniform contact pressure. Various transfer trays were equipped with SMP platelets and the transfer of brackets from the plaster model to the real human tooth model was performed in vitro. The transfer accuracy and bond strength of the bonded brackets were investigated by 3D-overlay and shear tests, respectively. The transfer accuracy was technique sensitive and showed higher accuracy for the trays with SMPs and self-curing silicones than for the vacuum formed trays with SMPs. The bond strength of the indirectly bonded brackets with SMPs was on average 1-2 MPa higher than the bond strength of the brackets indirectly bonded with a conventional two-layer vacuum formed tray without SMPs. Thus, transfer trays with SMPs can provide a significant improvement in bond strength during indirect bonding after appropriate adjustment.