One of the most important procedures in orthodontia is the proper placement of brackets; if the brackets are not placed at a perfect height, incline, etc., the teeth will not be placed appropriately, and the poorly placed brackets will have to be replaced and rebonded.
Direct bracket placement or direct bonding
This is the “usual” placement method or the one used by the vast majority of orthodontists. It involves placing the brackets directly on the teeth, one by one. This type of placement is slower, less precise and more uncomfortable for the patient, and requires the orthodontist to replace many brackets during treatment. This method is done directly in the mouth, and so it is more complicated to place the brackets properly, since the teeth cannot always be seen from a proper angle. Other factors such as the patient’s tongue and saliva make the process even harder and less precise.
Indirect placement or indirect bonding
Indirect placement or indirect bonding of brackets is the technique that I currently use in 100% of patients. In this placement technique, the brackets are first placed in the patient’s moulds. Placement is easier because the absence of the tongue, saliva and cheeks, and, very importantly, because the teeth can be seen from all angles.
This procedure starts with preparing well cast, neatly trimmed models that are more convenient for working. This reduces the likelihood of errors.
Se The height, incline and position of the brackets are marked on the models.
After it is checked that the heights are correct, the brackets are placed in the models.
Once the brackets have been properly placed, the transfer splint is prepared so that the brackets can be transferred to the patient’s mouth. There are many different types of splints, and each orthodontist uses the one that he or she likes best. I normally use a splint made of silicone, which may be transparent, or a special laboratory silicone, which is coloured.
Once the splints have been prepared, they are cleaned with a strong solvent such as acetone. At this point, they are ready to be placed in the mouth.
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