Clinical Procedures for Seating, Bonding, 
and Removing DIBS 3D-Printed Bonding Trays

 

Please click here for a printable version of this information.

 

 

Our Bonding Product Recommendations

 

Option 1: Opal Orthodontics

 

Pumice

Recommended: Opal Consepsis.  Preferred alternative to traditional pumice.  Also works as a good antibacterial solution.

 

Etch

Recommended: Opal Etch.  Unique self-limiting properties to prevent over-etching.

 

Primer (and Sealant) 

Recommended:  Opal Seal.  Works as a good primer and sealant, reducing decalcification, and acts as a bonding enhancer.

 

Adhesive

Recommended:  Opal bond Flow.  Easy delivery and placement.  Prevents slumping.

 

 

Option 2: 3M Unitek

 

Pumice
Recommended: Nada Pumice Paste (Patterson Dental Supply). Blend of polishing and cleaning agents to prepare tooth surfaces prior to bonding.

Self-Etching Primer (SEP)
Recommended: Transbond Plus Self-Etching Primer.  Eliminates costly errors normally associated with the bonding process.

Adhesive
Recommended: Transbond Supreme LV.  Excellent strength, flow, and wear properties.

 

 

General Procedure

 

When bonding with our 3D printed trays, it is important to remember that DIBS trays have some unique properties, so please read and follow these tips carefully.

It would be beneficial to first watch our Clinical Procedures video. 
Another helpful video, recommended for both doctor and staff, demonstrates good technique for using tweezers to correctly insert brackets into your DIBS trays: Inserting Brackets

 

1. After a tray has been seated over the teeth, please have the patient bite down on cotton rolls. This helps secure and completely seat the tray while light curing. If unable to use cotton rolls, then apply constant pressure to the tray incisally (with a finger) near each bracket during the light curing process. Again, this ensures the tray stays in place and the brackets bond to the correct position.

2. While curing, apply slight pressure (with the light cure stem) against the facial/buccal side of the tray on the bracket. This will ensure there are no potential gaps between the surface of the tooth and the bracket pad. 

3. Light cure once, directly on the facial/buccal side; then a second time from the incisal edge/buccal cusp ridge. This helps penetrate through the tray and create a complete bond, with better resistance to bond failure. After removal of the trays, again light cure each bracket from the gingival side. 

4. Please avoid placing bands on the teeth after you have taken the scan or impression that will be used in creating your DIBS trays. Movement/shifting of teeth in the interim could adversely affect the proper fit of the trays at bonding time. 
 

 

Doctor Recommendations

 

We asked DIBS users to share their recommended methods and products. Here are some of the replies we received:

DIBS tray 7-7 copy.jpg

1. Reliance Flowtain LV, based on your recommendation

 

and others.

         Dr. Steven Gajda


2. We are using Reliance thin viscosity Light Bond for our DIBS cases, so far. We are still trying to refine our technique to reduce composite flash. I will be happy to share any practical pearls as we increase our skills with the DIBS. 

         Dr. Todd Curtis



3. We use two types of brackets with our OrthoSelect cases, either Clarity Advanced Flash Free by 3M or unpasted SmartClip SL3 from 3M. The Clarity Advanced are pre-pasted with an attached fiber mesh that’s been impregnated with thin layer of adhesive. When bonding these brackets, we condition the teeth with a 35% phosphoric acid etchant for 20 seconds, rinse, follow with an application of 3M Self Etching Primer, then seat the trays/cure brackets. When using the SmartClip brackets, we prepare the teeth in the same way, but Dr. Alvetro will then apply a very thin layer of 3M’s Transbond Supreme LV low viscosity light cure adhesive to the bracket bases just before seating the trays. Using a very thin layer is key, ensuring little to no flash during bonding. 

After curing and removing trays, we seal all around the brackets with Vanish XT light cured glass ionomer, also from 3M. 

Summary:
3M gel etch, 35% phosphoric acid
3M Transbond SEP self etching primer
3M Transbond Supreme LV low viscosity flowable composite. 
Seal all around the brackets with Vanish XT light cured glass ionomer, also from 3M. 

          Leighann Jones, COA,  Alvetro Orthodontics


4. The composite that we recommend is 3m Transbond Supreme LV with OrthoSolo universal bond enhancer. Suggestions: Divide the trays before trying them in the patient.

          Deanna Brown I Office Manager / Ortho Certified CDA II , Dr. Baby & Rojas, Specialists in Orthodontics


DIBS Compact for Web.jpg

5. We use transbond by unitek, no flowable cements because there is no custom base. Hope this helps!

          Dr. Christine Ferrell, West Chester Orthodontics


6. Used Transbond LR on first case and got little or no flash.

          Dr. Bryn Cooper


7.  I used 3M Unitek Transbond supreme LV Flowable. I also used Flowtain from Reliance.
I found that I like the flowable composites much more than the thicker composite. The thicker composite gave too much flash. I did like the 3M Transbond supreme LV the best. I felt I could see the composite on the pad better before placing the tray.

           Cassie Vazquez, Clinical Consultant, Hummingbird Associates


8. I didn’t use a flowable. I just used my regular GAC neobond composite and used a very little bit. I cured it buccal/facial 10 seconds then gingival/incisal 5 seconds each. 

         Jordan Sanabria, Treatment Coordinator, Wesley Hills Orthodontics