title: Lingual orthodontics for children and adolescents: improvement of the indirect bonding protocol.
abstract: BACKGROUND
  Demineralization of the dental enamel is a finding associated with fixed orthodontic treatment. When an indirect bonding procedure is used in children and adolescents the area beneath the bracket base may be affected.
  
  
  OBJECTIVE
  To evaluate if the addition of an extra layer of a hydrophilic resin, to a conventional indirect bonding protocol, can reduce the incidence of demineralization beneath the bracket base.
  
  
  METHODS
  40 patients under 18 years of age were treated with completely customized lingual appliances. Two different bonding protocols were used either with or without the application of an additional layer of hydrophilic resin. Demineralization beneath the bracket base, after de-bonding, was evaluated by standardized intra-oral photographs.
  
  
  RESULTS
  The addition of an extra layer of a hydrophilic resin helps to reduce the number of demineralized areas beneath the bracket bases significantly (three times less). The severity of the few remaining defects were minor and without any clinical consequence.
  
  
  CONCLUSIONS
  When bonding a completely customized lingual appliance in children and adolescents, an extra layer of a hydrophilic resin should be added to the teeth.
authors.affiliation: Department of Orthodontics, Hannover Medical School, 30625 Hannover, Germany. wiechmann@dw-consulting.de.
authors.forename: Frauke
authors.initials: F
authors.lastname: Beyling
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwestka-Polly
authors.forename: Dirk
authors.initials: D
authors.lastname: Wiechmann
mesh_terms: D000293:Adolescent; D002648:Child; D001840:Dental Bonding / Q000009:adverse effects / Q000379:methods*; D003743:Dental Enamel / Q000293:injuries; D006801:Humans; D016382:Orthodontic Appliance Design; D016910:Orthodontic Brackets / Q000009:adverse effects*; D009970:Orthodontics / Q000379:methods; D019279:Resin Cements; D017001:Tooth Demineralization / Q000209:etiology / Q000517:prevention & control*
chemical_list: D019279:Resin Cements
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