Orthotown May 2019 - 35

T

he goa l of accurate bracket
placement is to increase the
efficiency of orthodontic treatment. While there are many advantages to
having a fully digital orthodontic office,
none of them increases efficiency and reduces
treatment time more than accurately placing
brackets using a digitally designed bonding
jig. With this process, you can correct
the malocclusion in relation to the whole
tooth, instead of placing brackets based
on a measurement from the incisal edge
of the tooth.
This system uses the advantages of digital
manipulation software to create a bracket
placement guide against which flash-free
brackets are bonded directly to the teeth.
An arch can be bonded in less than four
minutes with no flash to clean up. In fact,
it takes me longer to explain the process
to patients than it does to place and cure
the brackets.
Here are the tools I use:
* Trios 3Shape scanner
* Orchestrate 3D software
* Juell 3D-2 printer
* Orchestrate 3D resin
* Clear Splint Biocryl 0.75mm
* 3M Clarity Advanced Ceramic
Brackets precoated with 3M APC
Flash-Free Adhesive
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.
All my new patients get a 3D scan, photos
and an ultra-low-dose CBCT that I discuss
with them during their first exam. Once
they decide to initiate orthodontics with
fixed orthodontic appliances, we can design
their bracket placement.
I trained using only indirect bonding
in my residency program. This system
allowed for less chair time at the bonding
appointment. On bonding day, the trays were

retrieved and glue placed on the brackets.
The teeth were prepared, the tray was fit,
the glue was cured and then the indirect
tray was removed. Hopefully there were no
brackets (that didn't adhere to the tooth) left
in the tray, so the orthodontist could see the
next patient. Then, the assistant spent the
next 30 minutes finding and removing flash
from around the brackets and between the
teeth. This uncomfortable patient procedure
was unacceptable to me.
To avoid this long and uncomfortable
patient experience, I placed brackets directly

Fig. 1

Fig. 2

Fig. 3

orthotown.com \\ MAY 2019

35


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Orthotown May 2019

Table of Contents for the Digital Edition of Orthotown May 2019

Orthotown May 2019 - Cover1
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Orthotown May 2019 - 1
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