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Letters to the Editor

Dear Editor

I read with interest the article by Banks and Thiruvenkatachari,¹ the commentary on it by Professor Eliades,² and your editorial upon the conclusions from another study upon the same subject,³ namely SEP as an alternative to conventional acid etching in bonding. The conclusions that can be drawn from these highly scientific studies are clear and simple –there is no significant difference between the two methods. However, I feel that it should be emphasized that these studies only apply to a specific aspect of bonding, that of the non-molar teeth. The majority of my patients are adults and in most cases I bond all erupted teeth including third molars from the start of treatment. Whilst it is possible to isolate all of the non-molar teeth at once for bonding with either method, this is certainly not possible with molar teeth. Thus, when using SEP there is a very significant time saving and a much more pleasant patient experience as each quadrant of molars can be isolated and bonded separately. To achieve the same outcome with acid etching requires up to four (if isolation is challenging) separate etches and rinses. This would negate the time advantage gained from avoiding prophylaxis mentioned by Professor Eliades. (Incidentally, why is there such a lot of interest in avoiding prophylaxis? Apart from in patients at risk from bacteraemia it is harmless and it only takes a few seconds!)

I find SEP much easier and quicker for re-bonding brackets as there is no irrigation, aspiration or application of sealant required before applying adhesive to the bracket. My assistant can begin applying adhesive to the bracket straight after giving me the SEP and as a result a bond failure causes less stress and time delay. Most importantly, its ease and simplicity make the elective repositioning of brackets, which is required at some stage in most treatments, much easier.

I would suggest that in the case of randomized clinical trials on clinical procedures, at the planning stage they should be subject to the observations of clinical orthodontists from outside the research team who use each of the techniques in question. Their input might improve the study design and increase the clinical value of the outcome. The observation of a declining interest of researchers in SEP² strikes me as premature – other important questions regarding its use, namely its efficiency in bonding posterior teeth and rebonding brackets have perhaps not yet been answered. This would be research of great clinical relevance.

References

1 Banks P, Thiruvenkatachari V. Long-term clinical evaluation of bracket failure with a self-etching primer: a randomized controlled trial. J Orthod 2007; 34: 243–51.[Abstract/Free Full Text]

2 Eliades T. Commentary. Long-term clinical evaluation of bracket failure with a self-etching primer: a randomized controlled trial. J Orthod 2007; 34: 233.[Free Full Text]

3 Luther F. Award winning papers. So what? J Orthod 2007; 34: 209–23.[Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Huntley, P. Search for Related Content PubMed PubMed Citation Articles by Huntley, P.