Orthotown May 2019 - 37

As with all orthodontic procedures, complete and accurate
records are essential. They aid not only your diagnosis but
also the development of your treatment plan.
from your bracket positioning training,
should be the most important. I again choose
the central incisors as the starting point.
On average, I pencil in my first bracket at
4.5mm from the incisal edge of the centrals.
Then, I place the remaining brackets in line
with that bracket (Fig. 4). No measuring,
no second-guessing, just place them in a
straight line because that's where you design
your final wire to fit without bends.
Once the bracket bases are positioned,
I allow the software to return the teeth to
their maloccluded positions and print them
(Figs. 5 and 6). A vacuform tray is formed
over the teeth, and the bracket bases and
their spaces are removed from the tray.
On banding day the patient's teeth are
cleaned, etched and primed, and the jig is
placed (Fig. 7). It will snap into place much
like a clear retainer. Then, to avoid flash and
the risk of bonding a bracket base to the
thermoplastic jig, I place Clarity Advanced
brackets precoated with APC Flash-Free
Adhesive into the guide I designed in the
software and light-cure (Fig. 8). The trays,
lip stretchers and dry angles are removed,
and the patient is allowed to rinse. There is
no flash and no risk of the tray removing a
bracket. This whole procedure takes about
4 minutes for a single arch and about 6
minutes for both.
This digitally designed bracket placement
guide technique allows for better communication with the patient and referring
dentists about the goals and limitations of
treatment. This technique also reduces the
chair time for the orthodontist, the staff and
the patient. In terms of efficiency, however,
I also appreciate significantly reduced
frequency of appointments, wire bends and
treatment time. n

Fig. 7

Fig. 8

orthotown.com \\ MAY 2019

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Orthotown May 2019

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