Tooth Preparation

for
Bonded Expander

Anthony J. Belgin

Indirect Bonding Consultant

904 North Caroline Street

Ebensburg, Pa 15931
814-242-1878
indirectbondajb@aol.com
 Materials for Bonded Expander

Item # Company Telephone $Price

Product
Reliance 800-323-4348 15.00
Plastic Conditioner
Reliance 800-323-4348 21.00 ea
Maximum Cure (Filled) A&B
Reliance 800-323-4348 60.00
Assure™ Universal Bonding
Resin
Practicon 800-959-9505 Box / 23.29
Centrix Bendable Brushes
Access™ Cheek Retractors: Adult Size CH1 Reliance 800-323-4328 14.95
Pedo Size CH2
Quest Dri-Field Pedo/Adult Ortho Quest 877-678-4696 42.00
Dri Angles Large/Small Dental Supply
Micro Brushes Regular/Super fine Practicon Dental 800-959-9505 10.00
Disposable Mixing Wells Practicon Dental 800-959-9505 3.75
Tooth Dryer J0830 Quest 877-678-4696 83.99
Replacement Nozzle Tips 703949 Quest 877-678-4696

Prices are subject to change as price increases occur.

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 Tooth Preparation
for
Bonded Expander

I. Get Acquainted with the Patient

1. Take a couple minutes to discuss with the patient the procedure that will be
taking place. For instance, the placement of cheek retractors, dri-angles and the
dri-field system, the use of an air syringe, saliva ejector, what the palatal
expander looks like, and etc. This helps take some of the anxiety away that the
patient may be experiencing, which helps reduce the extra saliva flow.

Note: Ask the patient if they had a dental appointment between their last
office visit and today’s visit for dental restorations or for tooth
bleaching.

a. Dental restorations done after the impressions were taken for the Bonded
Expander will alter the fit of the expander.
b. Tooth bleaching: tooth preparation would need to include prophying with a
slurry mix of a vitamin C tablet after pumicing the teeth.

II. Check the fit of the expander and make any necessary adjustments.

1. The appliance cannot rock on the teeth.

2. The plastic of the appliance cannot touch the gingival tissue. The plastic needs
to be at least one millimeter away from the gingival tissue.

3. The appliance cannot have any rough or sharp areas.

4. The patient should occlude evenly on left and right sides of the appliance. They
normally occlude on the first and second molars.

5. Check the expansion screw to make sure it will turn.

6. Make sure the arrow on the expansion screw is pointing posteriorally.

III. Pumice and Rinse

IV. Place Dri-Angles and Check Retractors

V. Place Ortho Quest Dri Field System

VI. Air dry all surfaces of the teeth to be bonded

VII. Etchant – Liquid or Gel (preference liquid)

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VIII. Using a Microbrush dab Liquid Etchant onto the tooth surfaces

• Normal enamel: 45 seconds Lingual Surface

30 seconds Buccal Surface
5 seconds Occlusal Surface

• Atypical enamel (Hypocalcified & Fluorosed)

and
Deciduous enamel: 75 seconds Lingual Surface
60 seconds Buccal Surface
5 seconds Occlusal Surface

IX. Rinse all Etchant from the tooth surfaces. Dry with an Air Syringe and then with a
Tooth Dryer.
• Check the etching of the enamel. If not frosty white in appearance, re-etch for
10 seconds. Rinse and dry the tooth surfaces with an Air Syringe and then with
a Tooth Dryer.

X. Application of Assure® (using a microbrush)

Note: No Assure® is Applied to the Occlusal Surfaces

No Assure® or micro etching is applied to the following surfaces when
bonding the expander:
• Amalgam
• Gold Crown
• Stainless Steel Crown
• Composite Restoration

1. Normal enamel apply 2 coats

2. Atypical enamel apply 4 coats
• Hypocalcified
• Fluorosed
• Deciduous enamel
• Dentin
3. Assure® needs to be air dried with an air syringe
• Wait 10 seconds after applying Assure® and then air dry until the
Assure® is dry and glossy
• When applying 4 coats of Assure® dry after 2 coats and then reapply 2
more coats and dry until the Assure® is dry and glossy.

Note: After drying the Assure® and if it is dry and dull, apply 2 more coats of
Assure®, air dry until dry and glossy.

XI. Teeth are now prepared to bond the expander.

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 Materials Used to
Prepare Bonded Expander
I. Materials
1. Plastic Conditioner®
2. Filled Maximum Cure Sealant®, Part A & B
3. Benda Brush

II. Preparation of the Bonded Expander

1. Micro etch the surfaces of the expander to be bonded.
• Note: If micro etched at the lab, proceed to step 3.
2. Rinse all residues off of the expander and air dry.
3. Use a benda brush to apply Plastic Conditioner® to all surfaces of the expander.
• Note: Step 3 should be started when etchant is applied to the teeth.
4. The plastic needs conditioned for a minimum of 90 seconds.
5. Air dry the surfaces of the expander until they are dry and shiny. If the surfaces
appear dry & dull, reapply Plastic Conditioner® for 60 seconds and re-dry.
• Note: The plastic is conditioned, when it is dry and shiny.

III. Maximum Cure Filled Sealant®

• Note: Start the following steps after the technician starts to air dry the Assure®.
1. Place one drop of part A and one drop of part B in the first molar areas.
2. Mix sealants A & B with a benda brush; apply a thin amount of sealant to the
surfaces to be bonded.