Molar Bands Bands • Bands are passive components that provide space for fixing various attachments onto the teeth. • They are generally made of soft stainless steel. Weldable brackets buccal tubes and other auxiliary attachments are soldered or welded over the bands, which are then cemented around the intended teeth. • Are fabricated in such a way that some portion of a cusp should be visible and the band should be cemented in the middle third of the crown. Availability 1. Custom-made bands are fabricated using band materials, which are available in the form of spools. 2. Preformed seamless bands are available in different sizes, which can be directly cemented around the tooth. Preformed bands are increasingly being used in recent years. Banding Procedures Direct Banding Procedure • Where bands are fabricated as a chair side procedure, with presence of the patient Indirect Banding Procedure • In this procedure, bands are fabricated on the diagnostic cast of the patient in the laboratory Steps in Banding Step 1: Separation of Teeth • Teeth have to be separated so as to create adequate space for the placement of the band. • Any of the different separators described earlier can be used for the purpose and may take 24 hours or more to effect the separation of interdental contact depending on type of separator used. Step 2: Selection of Band Material • Band material of appropriate width and thickness is selected depending on the type of tooth to be banded. Step 3: Pinching of the Band • Band material of adequate length is taken and two ends are assembled and then welded together using a spot welder. • The band is then passed through separated interdental contacts of the tooth to be banded. • Using band pinch able pliers, the band is tightly drawn around the tooth to form a ring and pinched. The pinched band is removed from the tooth and welded close to the pinched ends. • The excess band material is then cut off and the ends are adapted close to the band and the bent portion is spot welded. The margins are smoothened and gingival contouring is done on the material and distal gingival margins. Step 4: Fixing the Attachments • Once the band fabrication is complete, appropriate attachments are selected and welded on the buccal/ palatal surface of the band according to the need. Step 4: Fixing the Attachments 1. A bracket of weldable type 2. Buccal tubes often used on a molar band 3. Lingual attachments a. Lingual buttons b. Lingual sheath c. Lingual cleats d. Lingual eyelets e. Lingual ball and hooks f. Seating lugs. From buccal or labial aspect, seated band should allow visualization of cusps of the tooth to be banded and it should be in the middle third of the tooth Lingual Attachments • Brackets and buccal tubes are usually placed on buccal aspect of the teeth. Sometimes, attachments may also be needed on the lingual surface of the tooth for example, for engaging the elastics. • Their attachments can be weldable or bondable. Lingual Buttons • Buttons with different base shapes are available for attachment of elastics/elastomerics can be weldable bond. • Flat based ones are for centering on molars. • Curved ones for mesial/distal placement on molars and extra-curved ones are used on premolars. Lingual sheaths • Lingual sheaths may be weldable/bondable and are used for attaching accessories, such as transpalatal arches, Quad helix, NITI molar rotators and expanders Lingual Cleats • These are available in weldable/bondable forms, are welded/bonded in the center with the ends being open. • They are also used for engaging elastics/elastomerics. Lingual Eyelets • They are hollow in the center and their two sides are welded. • These are used for tying elastic threads/ligature wires. Lingual Ball End Hooks • There are small balls attached to weldable flat arm. • They are used to engage elastic/elastomerics from lingual aspect. Lingual Seating Lugs • Lingual seating lugs are helpful in the placement of the bands. • Based on the base: Lingual seating lugs, based on its base, are of two types: 1. Flat: Used for anteriors and molars 2. Curved: Used for cuspids and bicuspids. • Use: These help in seating of the bands. Step 5: Cementation of the Band References: • Graber: T.M: Orthodontics Principles & Practice 3rd Edition • Proffit, William et.al: Contemporary Orthodontics 4th Edition • Moyers Handbook of Orthodontics 4th Edition End
