CLINICIANS' CORNER
A little bit of history: The first direct bonding
in orthodontia
Herbert Ivan Cueto, Dr. Odont., DMD, MS, D. Orth.*
Falls Church, Va.
I n 1966, in the Orthodontic Department of had a working time of about 1 minute and a setting
the Eastman Dental Center, a direct-bonding technique time of 2 to 4 minutes.
was developed and used for the first time on several Before application of the adhesive, the enamel sur-
patients. The experimental round metal brackets had face was cleaned with pumice, rinsed with water, iso-
single-groove 0.018 × 0.025-inch bracket slots with a lated with cotton rolls, and completely dried with warm
plastic resin attached to the base (Unitek, Monrovia, air. A mixture of 50% phosphoric acid and 7% zinc
Calif.) (Fig. 1). The adhesive resin was the same kind oxide was applied to the enamel with a cotton-roll pellet
used in previous experiments by Cueto and Bounocore and allowed to remain on the surface for 45 seconds.
for the sealing of pits and fissures, x'2 This experiment The teeth were again rinsed with water, isolated with
was done to see if it was feasible to attach a bracket cotton rolls, and dried with compressed air. A whitish
directly to tooth enamel without the use of orthodontic area, indicating a superficial decalcification of the tooth
bands. enamel, was now noticeable. The powder-liquid ad-
The adhesive consisted of a liquid monomer, hesive was then mixed, and a small amount was placed
methyl-2-cyanoacrylate (Eastman 910, Eastman Ko- on the back of the bracket. The brackets were then
dak, Rochester, N.Y.), and a silicate filler. This mixutre placed in the correct position with cotton pliers. Only
the four upper anterior teeth, and in some cases the
upper canines, were bonded in this way. During sub-
sequent visits, arch wires were placed.
*Clinical Dental Fellow at Eastman Dental Center, University of Rochester,
New York, 1957-58. From a period of 8 to 18 months, only a small
8t1/18473 percentage of brackets failed to remain bonded. In one
Fig. 1. Direct-bonding brackets in position with O.018oinch round arch wire.
276
Volume 98
Clinicians' corner 277
Number 3
case, the brackets r e m a i n e d in position for the duration New York: University of Rochester Medical and Dental School,
o f the t r e a t m e n t - - 1 ½ years. In another case, the brack- 1965.
ets r e m a i n e d for 9 months, at w h i c h t i m e the teeth w e r e 2. Cueto IH, Bounocore M. Sealing of pits and fissures with an
adhesive resin: its use in caries prevention, J Am Dent Assoc
debonded. 1967;75:121-8.
T h e historical v a l u e o f this incident m a y interest
Reprint requests to:
the reader, since it was the first time direct b o n d i n g was
Dr. Herbert I. Cueto
used in dentistry. 3705 South George Mason Dr.
Suite C-7-S
REFERENCES Falls Church, VA 22041
1. Cueto IH. Sealing of pits and fissures with an adhesive compound
and its use in the prevention of caries. [MS Thesis] Rochester,
AAO MEETING CALENDAR
1991--Seattle, Wash., May 11 to 15, Seattle Convention Center
1992--St. Louis, Mo., May 10 to 13, St. Louis Convention Center
1993mToronto, Canada, May 16 to 19, Metropolitan Toronto Convention Center
1994--Orlando, Fla., May 1 to 4, Orange County Convention and Civic Center
1995mSan Francisco, Calif., May 7 to 10, Moscone Convention Center
1996--Denver, Colo., May 12-15, Colorado Convention Center
