Expressly fabricated molar tube bases: enhanced adhesion

Clinicians, Orthodontists and their patients' parents often expect the best results in the shortest time span possible. Orthodontic bonding of molar tubes has been an acceptable risk in a modern era of refined biomaterials and instrumentation. Although many orthodontists still prefer banding to bonding, it is the failure rate of the tubes on molars which accounts to an impedance in molar bonding. One of the reasons for molar attachment failures is attributed to improper adaptation of the buccal tube base with or without increased thickness of composite. Merits of banding the second molars especially when these are the terminal teeth for anchorage have been overemphasized in the literature. The present article presents a simple and relatively less time consuming technique of preparing molar tubes to be bonded on tooth surfaces which may be quite difficult to isolate especially for bonding, for example, mandibular second molars. The increased surface area of the composite scaffold helps not only in enhanced bond strength but also serves to reduce the incidence of plaque accumulation given the dexterity of invitro preparation. The removal of the occlusal part of the molar tube scaffold helps in prevention of open / raised bite tendencies. The present innovation, therefore, is not merely serendipity but a structured technique to overcome a common dilemma for the clinical orthodontist. The present dictum of banding being superior to molar tube bonding may prove to be futile with trendsetting molar attachments. It is also an established fact that bonding proves to be a lesser expensive modality when compared to banding procedures.