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      LightForce Custom 7 Bonding Instructions

      This article includes support on bonding LightForce custom 7s with the combination molar tray design.

      Indirect Bond (IDB) Tray and Tube

      The IDB trays for second molars have extension arms that rest on the occlusal surface of the first molar . The custom tube for the 2nd molar comes placed in the tray similarly to the other brackets and tubes. If you do not bond the 7s at the initial appointment, simply (twist off or use a scalpel to remove) the extension arm at the scored notch, as it will no longer seat properly on the first molars.

      Packaging

      The IDB tray and tubes for 7s have been packed in the same well as their respective side trays (i.e. UL7 custom tubes with UL trays). See the image below for reference.


                7 Only, In box (1)

               7s in box with occlusal rests                          7s in box without occlusal rests

      Bonding the 7s can be done at any time during the initial bonding appointment; however, it is recommended to bond the 7s first, before bonding 6-6, to provide better access for placement and reduce the likelihood for  saliva contamination.   

       Tips and Tricks for Successful 7s Bonding 

      1.  Evaluate 2nd molar position in comparison to the LightPlan

      • Has the tooth erupted further?

      • Is there a fixed appliance obstructing access to 2nd molars (RPE bands, bands with tubes, bite corrective appliances, previously bonded brackets, etc.)

      • Does the 1st molar interfere with the tray seating?

      • If so, twist off or use a scalpel to remove the occlusal extension to the first molar

      • Check for adequate access

      Place your index finger between the buccal surface of the 2nd molar and cheek while the patient opens their mouth. If the condyle (top part of the mandible) presses against your finger tightly, ask the patient to shift their jaw towards the side you are bonding.  This will provide more space between the buccal surface and the cheek to make seating the IDB tray easier.

      2.  Is there is visible plaque or calculus on the buccal surface of the 2nd molar?

      • Use a scaler to remove calculus and follow with prophy and pumice to remove plaque as needed (rinse after cleaning)

      • Is the soft tissue of the gingiva inflamed around the buccal of the 2nd molar?

      • Clean teeth with prophy and pumice - use cotton rolls and hemostatic agents if gingival irritation occurs 

      3.  Recommended Isolation Materials

      • Driangles

      • Minnesota retractor (if bonding without Nola present)

      • Cotton rolls

      • Sweflex Saliva ejector

      • Hygoformic Saliva ejector

      Bonding Protocol

      1. 2nd Molar brackets can be preloaded with adhesive prior to bonding. However, trial fitting the tray and practicing the tray insertion technique before applying adhesive is encouraged. To clean the bracket after trial fitting, apply 100% isopropyl alcohol or acetone to the bracket base and dry with compressed air before applying adhesive.
      2. Place the preloaded bracket/tray upside down in the corresponding compartment of the LF box. (both molars in the same arch can fit in the compartment side by side.) Close the lid fully to protect the adhesive from ambient light.
      3. Once the teeth are prepared, open the lid to the patient's box and check that you have the correct bracket and tray number before placing it in the patient’s mouth ( ex. UL7 - placed on upper left second molar).
      4. Use an anterior bracket holder, positioned lingual/buccal on the occlusal brace of the 2nd molar tray. Close the lid of the box after retrieving the corresponding tray to the tooth that will be bonded.
                          
      5. Once positioned on the tooth, use a finger to apply firm pressure  on the occlusal of the tray.  At the same time, apply buccal pressure with the tip of the curing light and cure the bracket.
        .             
      6. Remove the tray with fingers or weingart pliers, making sure to roll towards the cheek from lingual to buccal. 
      7. Check for and remove flash
      8. Final cure directly on the bracket.
      9. Evaluate that the bracket position matches the LightPlan Position
      10. Check interproximal contacts with floss.

      If you have any questions or concerns about the bonding process, please feel free to reach out to integration_team@lightforceortho.com