Self-etch primers and pre-coated brackets are removing clinical variables to make unscheduled bonding appointments a predictable reality.
By Greg Thompson
The traditional multi-appointment process for starting orthodontic treatment is giving way to a more streamlined model: the same-day start. As practices seek to improve efficiency and meet patient demand for convenience, the ability to scan, plan, and bond in a single visit has become a significant competitive advantage. This shift is largely enabled by innovations in bonding materials that make direct bonding faster and more predictable than ever before.
“Being able to bond quickly, and do it well, is what matters most,” says Ryan Allo, DDS, MS, owner of Servant Heart Orthodontics in Rowlett, Tex. “With same-day starts, it’s all about efficiency. Universal adhesives and self-etching primer systems help streamline that process—which cuts down on steps.”
THE CASE FOR SAME-DAY STARTS
For many practices, the push toward same-day starts is driven by a simple business reality: case acceptance rates decline significantly once a potential patient leaves the office. Capturing that commitment during the initial consultation is crucial for practice growth.
“Once patients leave your office, the odds of them starting goes down a good percentage,” says Allo, a solo practitioner who bought his practice in January 2025. “If they leave without scheduling their start appointment, odds go down even more. Doing a consult, presenting fees, and starting on that same day is best for the practice because it saves you time on the back-end, and is usually more convenient for patients.”
Preparing patients for this possibility begins before they arrive. At Allo’s practice, the team tactfully introduces the option during the pre-consultation call, framing it as a convenience to save families from taking additional time off from work or school.
“If you wait to mention it, it could seem pushy,” Allo says. “But if you tell them ahead of time, they can ponder the decision and it’s not a shock.”
MANAGING THE UNSCHEDULED APPOINTMENT
While the benefits are clear, same-day starts present a logistical challenge. Practices must balance speed with quality, treating the appointment as an unscheduled bonding procedure that requires maximum efficiency.
“Typically when you’re planning a same-day start, you don’t have that full-time blocked out in your schedule because if they don’t start, you don’t want to be wasting time,” Allo explains. “Cutting down on steps will make you quicker and more efficient.”
This is where advanced bonding solutions become critical. By removing steps from the clinical workflow without sacrificing bond reliability, these materials provide the predictability needed to confidently offer same-day treatment.
REMOVING STEPS WITHOUT SACRIFICING QUALITY
Today’s bonding systems are engineered to reduce complexity and minimize the variables that can lead to bond failure. Products that combine steps or eliminate them entirely are key to achieving consistent results in a compressed timeframe.
“Transbond Plus Self-Etching Primer combines the etching and priming step and eliminates the typical rinsing and drying step between the two,” says David Solid, global orthodontics portfolio expert at Solventum in St Paul, Minnesota. “APC Flash-Free Adhesive, pre-coated to brackets, eliminates the step of adding adhesive and then clearing away excess adhesive—delivering an average bond failure rate of under 2% in the first 90 days of treatment.”
By integrating the adhesive directly onto the bracket, this system streamlines the bonding process to just three core actions: etch, prime, and place. This reduction in steps inherently reduces the potential for error.
“Every step in the bonding process includes variability, and too little or too much in any step can lead to bond failure,” Solid explains. “Solventum bonding solutions remove steps, immediately removing variability, and reducing the sensitivity of variability for a more consistent result.”
DIRECT BONDING’S EFFICIENCY EDGE
While indirect bonding has its own efficiencies, the immediacy of direct bonding is perfectly suited for the spontaneous nature of same-day starts.
“When it comes to same-day starts, the benefits of direct bonding in comparison to indirect bonding is obviously that you can just get the brackets out and put them on,” Allo adds. “You don’t have to wait for anything, plan anything, or send anything to the lab. With self-etching primers, you’re cutting out that etch and rinse step.”
Rapid-cure bonding agents further accelerate the process. Allo notes that the time savings from reducing cure time from 20 seconds per bracket to five seconds are substantial over a full case.
“If you’re putting on anywhere between 12 to 28 brackets for a full case and you’ve got to cure them for 20 seconds each, it adds up,” he says. “When you multiply it over 28 teeth, these little steps cut down on your time and can take a bonding appointment from an hour and a half to 45 minutes. That may allow for another appointment slot.”
A SYSTEMIZED APPROACH IN PRACTICE
At Fishbein Orthodontics, a practice with nine locations in Northwest Florida, a systemized approach to bonding has allowed them to achieve an 80% same-day start rate for new patients.
“We use the Transbond Plus Self-Etching Primer and the pre-pasted brackets from Solventum,” says Ben Fishbein, DDS. “That allows us to get patients in and out—from consult to leaving the same day with braces—in about an hour.”
The use of pre-pasted brackets is a cornerstone of their efficient workflow. Each bracket comes in an individual container with adhesive already applied, eliminating a manual and often variable step for the clinical team.
“That saves you a step,” Fishbein explains. “With other brackets, you have to actually take the glue and apply it on the back of the bracket. Sometimes that works well and sometimes it doesn’t, but it certainly saves a step when they are pre-pasted.”
This standardization not only improves speed but also clinical outcomes and staff training. “We train everyone the same way with the same steps for bonding,” says Amberley Gilstrap, clinical manager at the practice. “And of course the new systems lead to less bond failure. We’ve tried it many different ways, but that’s the only way we’ve found that we are not getting bond failure.”
ENHANCING THE PATIENT EXPERIENCE
Ultimately, the efficiencies gained from advanced bonding systems translate into a better overall experience for the patient. Faster appointments and more reliable bonds mean less time in the chair and fewer unscheduled visits for repairs.
“With Solventum pre-pasted brackets, we have fewer bracket breakage and emergency appointments than we did prior to using them,” Fishbein adds. “It’s a better experience for patients when there are fewer emergency appointments. It’s also a quicker appointment for patients. The bonding goes faster so patients are not in the chair as long.” OP
Photos courtesy of Solventum.
Greg Thompson is a contributing writer for Orthodontic Products.
