title: Banding versus bonding of first permanent molars: a multi-centre randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of banding versus bonding of first permanent molars during fixed appliance treatment; in terms of attachment failure, patient discomfort and post-treatment enamel demineralization.
  
  
  METHODS
  Multi-centre randomized clinical trial.
  
  
  METHODS
  One District General Hospital Orthodontic Department and two Specialist Orthodontic Practices.
  
  
  METHODS
  Orthodontic patients aged between 10 and 18 years old, randomly allocated to either receive molar bands (n=40) or molar bonds (n=40).
  
  
  METHODS
  Bands were cemented with a conventional glass ionomer cement and tubes were bonded with light-cured composite to all four first permanent molar teeth for each subject. Attachments were reviewed at each recall appointment to assess loosening or loss. The clinical end point of the trial was the day of appliance debond. Enamel demineralization at debond was assessed using the modified International Caries Assessment and Detection System (ICDAS).
  
  
  RESULTS
  The first time failure rate for molar bonds was 18·4% and 2·6% for molar bands (P=0·0002). Survival analysis demonstrated molar bonds were more likely to fail compared with molar bands. First permanent molars with bonded tubes experienced more demineralization than those with cemented bands (P=0·027). There was no statistically significant difference in discomfort experienced by patients after banding or bonding first permanent molars (P>0·05).
  
  
  CONCLUSIONS
  This study shows that as part of fixed appliance therapy, American Orthodontics photoetched first permanent molar bands cemented with 3M ESPE Ketac-Cem perform better than American Orthodontics low profile photo-etched and mesh-based first permanent molar tubes bonded with 3M Unitek Transbond XT in terms of failure behaviour and molar enamel demineralization.
authors.affiliation: Orthodontic Department, University Dental Hospital Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK. Mariyah.Nazir@manchester.ac.uk
authors.forename: Mariyah
authors.initials: M
authors.lastname: Nazir
authors.forename: Tanya
authors.initials: T
authors.lastname: Walsh
authors.forename: Nicky A
authors.initials: NA
authors.lastname: Mandall
authors.forename: Susie
authors.initials: S
authors.lastname: Matthew
authors.forename: Dee
authors.initials: D
authors.lastname: Fox
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods; D000293:Adolescent; D002484:Cementation / Q000379:methods; D002648:Child; D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003731:Dental Caries / Q000145:classification; D003743:Dental Enamel / Q000473:pathology; D004868:Equipment Failure; D005260:Female; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008277:Magnesium Oxide / Q000737:chemistry; D008297:Male; D008310:Malocclusion / Q000628:therapy; D008963:Molar / Q000473:pathology*; D016382:Orthodontic Appliance Design; D016910:Orthodontic Brackets; D010147:Pain Measurement; D010756:Phosphoric Acids / Q000737:chemistry; D011076:Polycarboxylate Cement / Q000737:chemistry; D019279:Resin Cements / Q000737:chemistry; D016019:Survival Analysis; D017001:Tooth Demineralization / Q000145:classification; D014087:Tooth Movement Techniques / Q000295:instrumentation; D015034:Zinc Oxide / Q000737:chemistry
chemical_list: D003188:Composite Resins; D005899:Glass Ionomer Cements; D010756:Phosphoric Acids; D011076:Polycarboxylate Cement; D019279:Resin Cements; C477790:Transbond XT; D008277:Magnesium Oxide; C040235:Ketac-cem; C030242:phosphoric acid; D015034:Zinc Oxide