TL Bonding Protocol
Bonding Challenges for TL Patients


Dr John Fricker has initiated a bonding protocol based on the specific needs and challenges of the patients in Timor-Leste. Patients with CLP have a higher occurrence of Molar Incisor Hypomineralisation (MIH) which affects 16% of children worldwide. The prevalence of moderate to severe enamel defects amongst CLP patients has been reported  as 75% of bilateral and 39% of unilateral CLP.  Hypoplastic teeth have abnormal prism structure with the bond strength reported as low as two thirds that of normal enamel. Furthermore the removal of brackets can lead to more severe surface enamel damage. 

The project is using resin modified glass-ionomer cements (RMGIC) for bonding brackets. GC Australia generously donate the Fuji Ortho LC for all of the patients. The reported shear bond strengths are above the 5.9 MPa threshold deemed clinically acceptable with the additional benefit of fluoride release. Further research is planned on this cohort of patients.

TL Bonding Protocol

  1. Pumice slurry prophylaxis 

  2. Water rinse 

  3. Retraction 

  4. Enamel conditioner 10 secs using 10% polyacrylic acid.

  5. Rinse and leave enamel surface moist 

  6. 1x capsule of Fuji Ortho LC can be spread out over 3 x brackets bases 

  7. Light activate for 60 seconds. 

  8. Engage light archwires.