title: Effectiveness of an indirect bonding technique in reducing plaque accumulation around braces.
abstract: OBJECTIVE
  To evaluate if the use of an indirect braces bonding protocol for localized enamel etching and adhesive application could help reduce plaque accumulation and demineralization around the brackets compared with a conventional direct-bonding technique.
  
  
  METHODS
  Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides and the other two as control sides. During the first 6 months, the plaque presence around the braces was recorded monthly according to a plaque accumulation index (PAI), as was the presence of demineralization. PAI values were measured at each of the four bracket sides for every bonded tooth. Analysis of variance was used to identify significant differences between different bracket margins and between test and control sides.
  
  
  RESULTS
  Test and control sides differed significantly for PAI measurements from t(1) (1 month after bonding) to t(4) (4 months after bonding), with the highest value of significance (P < .001) at t(1) but with no significant differences from t(5) to t(7) (treatment end). Considering whole-mouth results, different bracket margin PAI scores did not differ significantly. PAI scores were higher at t(1) and progressively decreased during the treatment. At debonding, the onset of 21 new white spots was recorded overall for the control sides and eight new white spots for the test sides.
  
  
  CONCLUSIONS
  Especially during the first 4 months after brackets placement, this indirect bonding protocol allowed for significant reduction in plaque accumulation around the braces and reduced onset of white spots during the orthodontic treatment.
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy. dalessandridomenico@libero.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Dalessandri
authors.forename: Michela
authors.initials: M
authors.lastname: Dalessandri
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonetti
authors.forename: Luca
authors.initials: L
authors.lastname: Visconti
authors.forename: Corrado
authors.initials: C
authors.lastname: Paganelli
mesh_terms: D000134:Acid Etching, Dental / Q000295:instrumentation / Q000379:methods; D002648:Child; D001840:Dental Bonding / Q000295:instrumentation / Q000379:methods*; D003731:Dental Caries / Q000517:prevention & control; D003738:Dental Cements / Q000737:chemistry; D003743:Dental Enamel / Q000648:ultrastructure; D003761:Dental Impression Technique; D003773:Dental Plaque / Q000517:prevention & control*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D003765:Models, Dental; D009042:Motivation; D009910:Oral Hygiene; D016910:Orthodontic Brackets; D013499:Surface Properties; D013997:Time Factors; D017001:Tooth Demineralization / Q000517:prevention & control
chemical_list: D003738:Dental Cements