Simple Technique for Forming a Composite Button Aiding Tooth Alignment

Objectives: To find a simple, quick and efficient method for forming a composite button on a tooth in order to extrude, intrude or align it. Methods: Using an 'acid etch' technique and 1/8 inch intra oral elastics as a matrix, 3 different types of light cured composite and adhesive methods were tried to assess ease of formation, effectiveness and strength of a composite button. Extracted teeth were etched with 37% phosphoric acid, washed and air dried. Primer was added and light cured for the anterior composite. No primer was used for the 'fissure sealant' composite or the 'flowable' composite. An elastic was filled with composite and the composite set according to the manufacturers instructions. A second elastic was placed in an offset position to give a recess within the button. The elastic was filled with composite and the composite cured. Finally the elastic bands were removed from the button. Results: All three composites formed buttons of adequate adhesion and strength. The anterior composite required a primer adhesive to be cured first increasing the clinical time. The stiffness of this composite meant that it was difficult to obtain a completely smooth finish on the surface. The 'flowable' composite gave the smoothest finish and required no finishing. The fissure sealant composite gave a reasonably smooth finish without polishing. Conclusions: The use of 'in house' composite material to fabricate a button could assist in the repositioning of teeth in conjunction with a removable appliance. The extrusion or intrusion of teeth requires vertical movement, which is very difficult to achieve without a fixed attachment. A simple composite button, easily applied, allows vertical movement of teeth when used in conjunction with a removable appliance and could be constructed from materials normally in use in a dental surgery even where fixed orthodontic brackets are not available.