The assessment of orthodontic bonding defects: Optical coherence tomography followed by three dimensional reconstruction

Orthodontic bonding is a simple yet important procedure that can influence the outcome of treatment in case it is performed incorrectly. An orthodontic treatment shadowed by repeated bonding failures can become unduly long and will decrease patient trust and compliance. Optical coherence tomography has been widely used in ophtalmology but is relatively new to dentistry. Using OCT one can detect aerial inclusions within the orthodontic adhesive or even identify incongruence between the bracket base and the tooth surface. The aim of our study was to identify bonding defects and reconstruct them three-dimensionally in order to be able to characterize them more accurately. We bonded 30 sound human permanent teeth with ceramic orthodontic brackets using a no-mix self-curing orthodontic adhesive. Prior to bonding all teeth were stored in tap water at 4°C and then professionally cleaned with rotary brushes and pumice. The samples were processed by the same person and the rotary brushes were changed after every fifth tooth. All interfaces were investigated by means of OCT and 4 defects were found. Subsequently, the defects were reconstructed threedimensionally using an open-source program. By identifying and reconstructing bonding defects we could assess the quality of the bonding procedure. Since bonding tends to be more accurate in vitro where the environmental conditions are close to ideal, it is probable that defects found in vivo be even greater in number, which leads to the conclusion that this type of investigation is potentially valuable. © 2011 SPIE.