In providing orthodontic care for paediatric patients, clinicians often questions whether to begin treatment early-during the primary or early-transitional dentition-or wait until all or most of the permanent teeth are present. A comprehensive knowledge is necessary for planning the implementation of preventive therapy or the choice for interception is left. Early orthodontic treatment is effective and desirable in specific situations. The early treatment eliminates noxious habits, re-orientates dental-maxillary development and compensates for the structural discrepancy between teeth and bone. This leads to a timely correction of defects, which could have a negative aesthetic impact, therefore, contributing effectively to a better harmonization of the child with the human environment where he lives, and improving his feelings of acceptance within it. However, the evidence is equally compelling that such an approach is not indicated in many cases for which later, single-phase treatment is more effective. Therefore, clinicians must decide, on a case-by-case basis, when to provide orthodontic treatment.
A 21-year-old female came with a chief complaint of irregularly placed teeth in the upper and the lower front region. She had no medical and dental history. Her intra oral examination revealed mild crowding in relation to upper and lower anteriors and an increased overbite [Table/ Fig-1,2]. She was decided to be treated by a nonextraction approach with a fixed appliance (M.B.T .022 slot). The bonding of the second molars with the " Express prepared buccal tube bonding technique" was carried out because of inability to band the left second mandibular molar and frequent debonding of buccal tubes. We employed this bonding technique to correct the buccal occlusion and establish " Andrews first key to occlusion that is intra arch alignment.Both the mandibular 2nd molars were bonded using this custom technique for a better bond strength and to provide maximum resistance against being dislodged by the force of a higher dimension stainless steel wire as it is a requisite for levelling.The increased surface area and adherence to anatomic details effect the bonding strength of the buccal tubes and ensure minimal breakage due to torsional stress.
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