A Novel Method for Repairing Broken Bands : The

Scaffold Technique - A Case Report

Virinder Singh Kohli*, Sarvraj Singh Kohli**

Abstract
Preventive and Interceptive Orthodontic procedures play a pivotal role in eliminating factors that would
restrict the normal development of the dental arch and maxillary and mandibular growth, thereby achieving
a harmonious, functional and esthetically acceptable occlusion in the permanent dentition. The pediatric
dentist employs a wide variety of fixed and removable appliances to achieve these goals. Almost all fixed
appliances rely on banding of the teeth for secure attachment of the appliance. However, patients often report
with broken bands, their repair by conventional methods entail a considerable loss of time and significant
expenses. To overcome this problem, a new technique called the Patch-Weld Technique is described in this
article which cuts down both on clinical chair-side time, and laboratory charges.
Key Words : Scaffold technique, Patch-weld technique, Orthodontic bands, Band repair

INTRODUCTION

3.

t has been frequently seen in clinical practice that

patients often report with a complaint of broken bands
and hence a dislodged assembly. The repair work
conventionally comprises of forming a new band over
the tooth, then making working models to re-solder the
appliance back in its original position, in some cases
the entire appliance has to be re-made. This entails a
considerable loss of clinical chair-side time and
increased expenses. To overcome these problems we have
evolved a method to efficiently repair broken bands
without incurring significant expenses or loss of time.
We call this technique the Patch-Weld Technique.

CASE REPORT
A 12 year old girl reported to the department with a
broken band in relation to 26, which was a part of the
HYRAX appliance that had been placed to correct the
bilateral posterior crossbite (Fig. 1). The Patch-Weld
Technique as illustrated below was used to repair the
broken band. Optionally a working model can be
obtained for contouring the broken band.
1. The appliance was removed from the oral cavity with
the help of a band removing plier, and cleaned of all
the residual debris by manual scrubbing followed
by ultrasonic cleaning in the presence of enzymatic
disinfectants.
2. The broken band was contoured with a band
contouring plier to obtain a precise match so that
the torn edges could be approximated.
*Professor & Head; **Assistant Professor, Department of
Orthodontics & Dentofacial Orthopaedics, Hitkarini Dental
College and Hospital, Jabalpur, MP, India.
234

4.

5.

7.
8.
9.

A small sliver of stainless steel band material

(dimension 125 x 003) was cut, and spot-welded on
the inside surface of the distal edge of the broken
band (Fig. 2).
The welded sliver was contoured to act like a scaffold
over which the torn mesial edge can be welded and
yet the anatomical shape will not be lost.
The torn mesial edge was adapted and welded in
close approximation to the distal edge, over the
scaffold-like sliver of band material (Fig. 3).
Additionally a few spot welds were done on the
repaired junction.
The repaired band was inspected for fit and size,
and imperfections were corrected before insertion.
The appliance was, cemented in place, using Type I
Glass Ionomer Cement (Fig. 4).
The patient was instructed regarding care of the
appliance and maintenance of oral hygiene.

DISCUSSION
In order to achieve a normal well developed
permanent dentition the orthodontist employs
preventive and interceptive orthodontic procedures that
aid in eliminating factors, that restrict dental arch
development and maxillary and mandibular growth.1
Preventive Orthodontics is defined as the prevention
of potential interference with occlusal development, and
Interceptive Orthodontics is defined as the elimination
of existing interference with key factors involved in the
development of the dentition.2 Although these two
facets of orthodontics seem similar at the first glance,
the difference lies in the timing of the services rendered.
Preventive and interceptive orthodontic procedures make
JIDA, Vol. 5, No. 2, February 2011

Fig. 1 : Occlusal view of the

HYRAX appliance with the
broken band in relation with 26.

Fig. 2 : A sliver of band material

is welded on the inside surface of
the distal edge and contoured.

use of both fixed and removable appliances. The fixed

appliances include band & loop space maintainers,
passive lingual arch, distal shoe space maintainer,
modified Roche distal shoe appliance, transpalatal arch,
quad helix, palatal crib, Nance appliance, soldered W
arch, fixed Halterman appliance, open coil space
regainer, Gerber space regainer, Hotz lingual arch, lip
bumper, Mayne space maintainer, rapid palatal
expansion (Hyrax appliances) etc. which are commonly
utilized by the pediatric dentist to prevent and intercept
malocclusions.3-6 It can be observed that almost all of
these appliances rely on banding of teeth for secure
attachment of these appliances to the teeth.

CONCLUSIONS
The Patch Weld Technique is an effective and
efficient chairside technique to repair broken bands that
can be employed by the orthodontist. The advantages of
using this technique is the considerable gain in clinical
chairside time (as the entire procedure can be completed
in less than ten minutes), the inventory used is routinely
available in orthodontic offices, the cost-effectiveness of
the technique as no extra material is required during the
procedure and since there is no laboratory processing

JIDA, Vol. 5, No. 2, February 2011

Fig. 3 : The mesial edge of the

bracket is welded over the scaffold
in close approximation to the
distal edge.

Fig. 4 : Occlusal view of the

repaired HYRAX appliance
cemented in place.

involved the laboratory charges are also eliminated.

The Patch-Weld Technique is a simple & costeffective measure; and can be utilized in the orthodontic
office to repair broken bands.

REFERENCES
1.

Tausche E, Luck O, Harzer W. Prevalence of malocclusion in

early mixed dentition and orthodontic treatment need.
European J Orthod 2004; 26 : 237-44.

2.

Ackerman JL, Proffit WR. Preventive and interceptive

orthodontics: a strong theory proves weak in practice. Angle
Orthod 1980; 50(2) : 75-87.

3.

Carter NE. The paedodontic /orthodontic interface. In:

Welbury R, editor. Paediatric Dentistry. 2nd ed. Hong Kong:
Oxford University Press; 2001. pp. 299-335.

4.

Christensen JR, Fields HW. Space maintenance in the primary

dentition. In: Pinkham JR, Casamassio PS, McTigue DJ, Fields
HW, Nowak AJ, editors. Paediatric Dentistry: Infancy
through adolescence. 4 th ed. Missouri: Elsevier Saunders;
2005. pp. 423-30.

5.

Dean JA, McDonald RE, Avery DR. Management of the

developing malocclusion. In: McDonald RE, Avery DR, Dean
JA, editors. Dentistry for the child and adolescent. 8th ed.
Missouri: Mosby; 2004. pp. 625-83.

6.

Graber TM. Orthodontics: Principles and Practice. 3rd ed.

Philadelphia: WB Saunders Company. 2001. pp. 627-708.

235