How to: Create Protection for Ortho Brackets

Maintaining excellent hygiene can be a challenge during orthodontic treatment. However, this problem can be addressed with the use of 3M ESPE’s Vanish™ XT extended contact varnish, combined with ongoing daily brushing with a fluoride toothpaste. Vanish XT immediately creates a protective barrier on the tooth and provides a long-term release of fluoride, calcium and phosphate. The varnish can be applied either directly following bracket placement or later, depending on the patient’s level of risk, and its effectiveness continues for up to six months after placement. This treatment program is very straightforward and can help patients maintain the health of their teeth while undergoing orthodontic treatment.

Benefits

Vanish XT extended contact varnish is a site-specific, light-cured, virtually invisible varnish coating that offers long-term durability, and as previously noted, releases fluoride, calcium and phosphate. Immediately after it is applied, Vanish XT extended contact varnish creates a coating that provides a barrier against demineralization and acid erosion. In addition to its immediate protection, the varnish can be recharged over the course of six months with fluoride dentifrice or other fluoride-containing products.

Laboratory data show Vanish XT extended contact varnish releases more fluoride than a conventional fluoride varnish over a 24-hour period, maximizing its effectiveness from the first day it is applied. Additional in vitro studies demonstrate that the varnish creates a caries inhibition zone under and around the areas where it is applied.

The glass ionomer technology in the varnish makes it unique versus other in-office desensitizers. Vanish XT extended contact varnish delivers the same benefits that other glass ionomer materials offer-adhesion to tooth structure and sustained fluoride release. Furthermore, it has been shown in a laboratory study to provide greater dentin adhesion than a leading resin-modified glass ionomer.

The varnish also has several characteristics that make it easy to use for clinicians. The liquid/paste formula is dispensed from the Clicker™ Dispensing System, which can dispense 80 clicks from one clicker, and which provides simultaneous dispensing of each component for a consistent, pre-measured mix. It is moisture tolerant, so there is no need to completely dry the tooth surface. Additionally, it offers a combination of a prolonged working time with a short set time achieved by light curing. Vanish XT extended contact varnish offers clinicians and patients an ideal set of benefits with an easy-to-follow technique.

Ortho bracket technique

01.To apply the varnish around orthodontic brackets, first clean the tooth surfaces of plaque and debris with a light prophy. Wash and clean around the bracket with water and air dry. For uncut enamel, pre-etching for 15 seconds is required at the site surface.

This technique results in a micro-mechanical benefit in addition to the existing chemical adhesive benefits of the varnish’s glass ionomer component. (If you are applying Vanish XT extended contact varnish directly after bracket placement, the additional etching step is not necessarily required because the enamel has already been etched.) Thoroughly rinse with water and air dry.

02. Dispense the varnish with the Clicker dispenser, and mix the liquid and paste thoroughly on a pad for a minimum of 15 seconds (Fig. 1). One click from the Clicker provides enough varnish to apply to up to 6 teeth, depending on type and size of application.

03. The varnish can be applied with either an instrument such as a ball brusher, or with a brush (Fig. 2). A thin layer of approximately 0.5 mm is sufficient.

04. After applying, light cure for 20 seconds with a curing light (Fig. 3). The material has a delayed auto-setting mechanism, which ensures that material shielded from light polymerization will eventually cure.

05. After curing, simply wipe the coating with a moist cotton applicator to remove the thin film on the surface. The varnish results in an esthetically pleasing, virtually invisible, and durable coating on the tooth surface (Fig. 4).

For additional and ongoing benefits, daily use of a fluoride dentifrice will help continue the remineralization benefits by recharging the extended contact varnish with fluoride. With Vanish XT extended contact varnish and orthodontic treatment, patients can both protect and straighten teeth simultaneously-helping to achieve a healthy and esthetically pleasing smile.  

W. Edward Gonzalez, DMD, is a pediatric dentist in the Tampa Bay, Fla. area.