Orthotown July/August 2020 - 14

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Bend or Repo
After receiving advice from his mentor, a Townie wonders about the best way to handle brackets

below
Member Since: 08/07/09
Post: 1 of 10

Question for you all: I have been recently told by a mentor to reposition more and bend less.
I understand the thought and respect him very much, so will try to discipline myself to do so.
I realize that with significant movement, it is much more efficient to reposition for nearly all
movements.
I feel, however, that I could reposition the brackets continuously but still not achieve the
correct torque or step-in/-out on a tooth due to the morphology of individual teeth that do not
meet the Rx of the bracket pad. My thought is that if I were to finish in a straight wire, there is
no way that I could get all of the details of an ABO case.
After seeing patients back from this extended coronavirus break, I have had a few teeth come
back with excessive torque because of the rectangular wire sitting in the bracket too long.
Thank you for your opinions. ■
5/28/2020

Fenrisúlfr
Member Since: 02/25/09
Post: 2 of 10

Very rare for me to finish in a straight wire. I do both repos and bending, depending on
the situation. If groups of teeth need vertical or in/out, I place step bends. For smaller torque
changes, I will bend. For larger changes, I'll flip the slots. If a tooth is off in more than one plane,
repositioning is way more expedient. I very rarely reposition premolars. Much easier to bend. As
a clinician, it helps to be very proficient with both. ■
5/28/2020

below
Member Since: 08/07/09
Post: 3 of 10

Thank you for your response. I fully agree and do the same as you. I sometimes find that a
rectangular wire can take 6-8 months to fully express itself, and by then I have already started
placing bends in the wire, so a reposition at that point is difficult in a steel. I suppose I should restrict
myself from placing bends too early and let the wire sit for longer. It seems to me that repositioning
too early would be similar to placing bends too early unless the discrepancy is obvious. ■
5/28/2020

Fenrisúlfr
Member Since: 02/25/09
Post: 4 of 10

A rectangular wire will not normally express the prescription beyond six weeks or so, unless
there is a substantial curve of Spee or the arches were not fully leveled. Even then, this would
only affect the third order. ■
5/28/2020

danbraces
Member Since: 11/09/08
Post: 5 of 10

justinudm
Member Since: 09/29/14
Post: 6 of 10

I like to step up and down. Repo for tip and torque. ■
5/28/2020

I usually repo brackets for rotational or root angulation issues early on. Torque, I will typically
bend wire. I often find myself having to step down the L3-3. (This is my issue with initial bracket
placement, either anteriors too deep or posteriors too shallow.)
But I think what your mentor was getting at was getting the brackets on as accurately as
possible at the start of treatment is important to achieve as much efficiency as possible. But most
cases will need some relatively simple wire bending to achieve good results. ■

5/29/2020

14

JULY/AUGUST 2020 // orthotown.com

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Orthotown July/August 2020

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