Indirect Bonding Of Brackets
Feb 19, 2022
Accurate positioning of the brackets is the key to a good treatment effect. Unlike labial correction, it is difficult for orthodontists to directly adhere the lingual brackets in the correct position by visual inspection. Therefore, the lingual bracket must be bonded indirectly.
(1) Making the model and putting it on the shelf
(2) Teeth arrangement in laboratory
(3) Bracket positioning and indirect bonding in laboratory:
1. Placement of the brackets: place the ligated arch wires with the brackets on the tooth-arrangement model, check whether each bracket is located in the center of the corresponding teeth and ensure that the bottom of the brackets and the tongue surface of the teeth are as close as possible, and finally the arch wires Glue to the model with wax.
2. Make an individualized hard tray: apply a layer of release agent on the tooth-arrangement model. First, use a soft tray made of a film sheet or silicone rubber material, trim the soft tray so that it only covers the surface of the bracket, and then use a chemically cured resin to make an individualized hard tray. Carefully remove the arch wire and the bracket with the individualized hard tray as a whole from the tooth-aligning model.
3. Individualized bracket base: Due to the morphological characteristics of the tongue surface of the tooth, there is a small gap between the bracket base and the tooth surface. Put a small amount of composite resin on the mesh back plate of the bracket to fill the gap. In this way, each bracket base is individually made according to the anatomical shape of the tooth, so it can accurately fit the tooth surface.
4. Clinical bonding: After routine cleaning, moisture insulation, acid etching, washing and drying, apply a thin layer of light-curing treatment liquid on the tongue surface and the bottom surface of the bracket, and apply a small amount of light-curing resin on the bottom of the bracket. Then, carefully place each tray on the corresponding tooth surface, remove excess adhesive, and illuminate for at least 20 seconds. Repeat the same steps until all brackets are bonded, and finally remove the resin tray.
