Bracket positioning and case setup

Introduction 57

The need for accuracy 57 Patient management 57

Full or partial set-up? 58

Thcor)' of bracket positioning - avoiding errors 59

Horizontal accuracy during bracket positioning 60

Axial accuracy 61

Vertical accuracy 61

Vertical bracket positioning with gauges and charts 62

Clinical use of gauges 62

Recommended bracket-positioning chart 63

Individualized bracket-positioning charts 63

Placing molar bands 66

Separation 66

Upper molar band placement 66

Upper molar bands - rapid maxillary expansion cases 66

Lower molar band placement 67 Direct bonding of brackets 68 Indirect bonding of brackets 69 Advantages of indirect bonding 69 Disadvantages of indirect bonding 69

INTRODUCTION

Setting up of the case is the most important aspect of the treatment, after correct diagnosis and treatment planning. Banding and bonding should therefore not be delegated and should be managed by the orthodontist, to ensure accuracy of appliance placement.

The need for accuracy

Accuracy of bracket positioning is essential, so that the built-in features of the bracket system can be fully and efficiently expressed. This helps treatment mechanics and improves the consistency of ihe results.

Patient management

A calm and unhurried approach to the case set-up helps to minimize patient apprehension and discomfort. This builds early patient confidence, and can raise the level of cooperation later in the treatment.1

Proper post-set-up advice should be given, as discussed in Chapter 5 (p. 112).

The use of light-cured systems for bonding brackets and cementing bands is helpful. These reduce time pressure on the orthodontist when setting up cases. The bonding materials should be carefully used exactly to the manufacturer's recommendations, with correct light, to ensure good bond strength and reduce the risk of bond failure.

Triangular Space Reduction Orthodontics

Fig. 3.1 This vertically and horizontally displaced upper right canine was not bracketed at the start of treatment. It was necessary to create space before attempting to bring it into the line of the arch.

Reshaping Canine Teeth

Fig. 3.2 Triangular-shaped incisors normally require reshaping to avoid unesthetic black triangles. It can be helpful to delay placement of brackets in the lower incisor region to reduce unwanted proclination early in treatment. Treatment mechanics can be easier if lower incisors of a triangular shape are re-shaped before bracket placement.

FULL OR PARTIAL SET-UP?

For many patients, it is correct to place all the brackets and bands at the start of treatment so that any discomfort is limited to one episode, and all the teeth start to be corrected from the outset. However, in some situations, listed below, ii may be beneficial to consider partially setting up the case, leaving individual teeth, and in some instances groups of teeth, without attachments.

Blocked-out teeth

If individual teeth are vertically or horizontally displaced from the primary arch form (Fig. 3.1), it is often good technique to delay bracketing the displaced tooth until the other teeth are well aligned, and space has been made available.

Deep-bite cases

The methods of starting deep-bite cases are shown on pages 134 and 135. In some cases, when it has been decided not to use a bite plate or occlusal build-up, upper arch treatment should be started first. Later, after the overbite has started to correct, it will be possible to place the lower incisor brackets without discomfort to the patient or risk of damage to the enamel or the newly placed brackets.

Sliding jig cases and mixed dentition cases

Enamel reduction cases

It is normally necessary to carry out enamel reshaping in cases with triangular-shaped incisors (Fig. 3.2). It may be helpful to delay bracketing the incisors, especially in the lower arch. If lower incisors are bracketed at the start of treatment, they will inevitably procline a little during tooth alignment, especially in a non-extraction case. Subsequent enamel reduction, followed by retroclination is a form of round tripping. This undesirable effect can be avoided by not bracketing lower incisors at the outset.

Fig. 3.2 Triangular-shaped incisors normally require reshaping to avoid unesthetic black triangles. It can be helpful to delay placement of brackets in the lower incisor region to reduce unwanted proclination early in treatment. Treatment mechanics can be easier if lower incisors of a triangular shape are re-shaped before bracket placement.

Fig. 3.1 This vertically and horizontally displaced upper right canine was not bracketed at the start of treatment. It was necessary to create space before attempting to bring it into the line of the arch.

Upper bicuspids and sometimes upper canines are normally not bracketed when starting cases where a sliding jig (Case TC, p. 195) will be used to control or distalize upper molars.

In many mixed dentition treatments, only the permanent teeth are included in the set-up. Primary teeth may be included in some cases, either to improve the strength and stability of the appliance, or to influence the position of the primary teeth.

THEORY OF BRACKET POSITIONING -AVOIDING ERRORS

Every effort should be made to achieve accurate bracket positioning. Ideal positioning can result in cases which show good occlusion with little effort, and will make the finishing stages of the treatment easier. This helps efficiency in a busy orthodontic practice.

With the original edgewise appliance, bracket placement was normally carried out using gauges and standard millimeter measurements from the incisal or occlusal edge of each tooth, irrespective of tooth size. With this system, patients with large incisors had brackets placed more incisally than patients with small teeth, relative to the size of the teeth. The brackets were positioned at different curvature on the teeth, and this in turn led to variations in the amount of torque and in-out produced by the brackets. However, because archwire bending was needed in any case, this system was acceptable with the edgewise appliance.

Andrews introduced the concept of the 'middle of the clinical crown', as a more reliable theoretical position for use with the SWA, with bracket wings parallel to the long axis of the clinical crown.2 This overcame the shortcomings of the original edgewise method concerning variations in the amount of torque and in-out produced by the brackets. However, as described below, it proved difficult to obtain accurate vertical positioning using only the middle of the clinical crown. Many vertical errors occurred, and the authors now advocate the use of gauges, but with individualized bracket-positioning charts (p. 63). These adhere to Andrews' principle of the middle of the clinical crown but ensure greater vertical accuracy, with less need for re-bracketing.

When direct bonding brackets, it is helpful to avoid viewing teeth from the side, or from above or below. To properly view the teeth during bonding procedures it will be necessary for the patient to turn the head, and the orthodontist to change seating position from time to time (Fig. 3.3).

View No

Bracket Bonding Procedure

Fig. 3.3 When placing brackets, it is important to view the teeth from the correct perspective.

View No

Fig. 3.3 When placing brackets, it is important to view the teeth from the correct perspective.

Bracket Bonding Procedure

Fig. 3.5 Horizontal and vertical accuracy can be checked from the buccal aspect.

Horizontal accuracy during bracket positioning

Incisors and molars have relatively flat facial and buccal surfaces, and small errors do not significantly affect the position of these teeth (Fig. 3.4). Canines and premolars have more rounded facial surfaces, and therefore accuracy is important because errors in horizontal bracket positioning cause rotations. Viewing canines, premolars, molars, and rotated incisors occlusally or incisallv with a mouth mirror (Fig. 3.6) helps bracket positioning relative to the vertical long axis of the crown. Lower canine brackets should be placed on the vertical midline, or slightly mesial to it, to ensure good contact with the lateral incisors (Fig. 3.7).

Fig. 3.5 Horizontal and vertical accuracy can be checked from the buccal aspect.

Fig. 3.4 Errors in horizontal bracket positioning cause rotations.

Fig. 3.6 Horizontal accuracy in the canine, premolar, and molar regions should be checked with a mouth mirror.

How Position Premolars Bracket
Fig. 3.7 In this case, the lower canine brackets were bonded slightly distal to the vertical midline. The resulting contacts between canines and lateral incisors are less than ideal, especially on the left side.

Horizontal accuracy during bracket positioning

Incisors and molars have relatively flat facial and buccal surfaces, and small errors do not significantly affect the position of these teeth (Pig. 3.4). Canines and premolars have more rounded facial surfaces, and therefore accuracy is important because errors in horizontal bracket positioning cause rotations. Viewing canines, premolars, molars, and rotated incisors occlusally or incisally with a mouth mirror (Fig. 3.6) helps bracket positioning relative to the vertical long axis of the crown. Lower canine brackets should be placed on the vertical midline, or slightly mesial to it, to ensure good contact with the lateral incisors (Fig. 3.7).

Fig. 3.4 Errors in horizontal bracket positioning cause rotations.

Brackets Rotated Teeth
Fig. 3.5 Horizontal and vertical accuracy can be checked from the buccal aspect.

Fig. 3.6 Horizontal accuracy in the canine, premolar, and mole regions should be checked with a mouth mirror.

Fig. 3.7 In this case, the lower canine brackets were bonded slightly distal to the vertical midline. The resulting contacts between canines and lateral incisors are less than ideal, especially on the left side.

Rotated incisors

Slight mesial or distal adjustment is helpful when bracketing rotated incisors. On a rotated tooth, the bracket can be bonded slightly more mesially or distally, sometimes with a very small amount of excess composite under the mesial or distal of the bracket base. In this way, full correction of the rotation can be achieved with no special measures (Fig. 3.8).

Long Axis Full Dentition
Fig. 3.8 On a rotated tooth, the bracket can be bonded slightly more mesially or distally. In this way, full correction of the rotation can be achieved.

Axial accuracy

It is necessary to accurately visualize the vertical long axis of the clinical crown of each tooth (Fig. 3.9) to achieve accuracy, because errors will cause incorrect tip position of teeth. The bracket wings need to be parallel to the long axis and to evenly straddle it. It is helpful to disregard the incisal edges of incisors.

Fig. 3.9 To achive axial accuracy it is necessary to visualize the vertical long axis of the crown of each tooth.

Vertical accuracy

This is the most difficult aspect (Fig. 3.10) of bracket positioning, and accuracy is greatly improved by the use of gauges and an individualized bracket-positioning chart (p. 65). This will deal with difficulties such as tooth length discrepancies, labially and lingually displaced roots, partly erupted teeth, and gingival hyperplasia which have been previously reported.3

Fig. 3.10 Vertical accuracy is the most difficult aspect of bracket positioning.
Incisor Bracket Position

Fig. 3.12 In the incisor region, the gauge is placed at 90° to the labial tooth surface.

Fig. 3.13 In the canine and premolar regions, the gauge is Fig. 3.14 In the molar regions, the gauge is placed parallel placed parallel with the occlusal plane. with the occlusal surface of each individual molar.

Fig. 3.12 In the incisor region, the gauge is placed at 90° to the labial tooth surface.

Fig. 3.11 In the incisor region, the gauge is placed at 90° to the labial surface.

VERTICAL BRACKET POSITIONING WITH GAUGES AND CHARTS

Clinical use of gauges

The bracket-positioning gauges are used in slightly different ways in different areas of the mouth. In the incisor regions, the gauge is placed at 90° to the labial surface (Figs 3.11 & 3.12). In the canine and premolar regions, the gauge is placed parallel with the occlusal plane (Fig. 3.13). In the molar region, the gauge is placed parallel with the occlusal surface of each individual molar (Fig. 3.14).

Recommended bracket-positioning chart

In the early 1990s, because of continuing difficulties with vertical bracket positioning, the authors investigated the location of the center of the clinical crown.4 A recommended bracket-positioning chart was published, and is shown in Table 3.1. It was recommended that the tooth size for the patient be determined, by measuring either fully erupted teeth in the mouth, or teeth on plaster models. A row could then be chosen for the upper arch and a row for the lower arch, and gauges used to position the brackets at the vertical heights shown in the chosen row.

Individualized bracket-positioning charts

The recommended bracket-positioning chart can be used for many cases. However, individualized bracket-positioning charts are increasingly used, and are shown in Figures 3.15 and 3.16. It takes little time to produce a handwritten chart for each patient, which can be included in the notes and referred to at the case set-up and throughout treatment as necessary. This is equally useful whether using direct or indirect bonding techniques.

Table 3.1

Recommended bracket-positioning chart

7

6

5

4

3

2

1

Upper

2.0

4.0

5.0

5.5

6.0

5.5

6.0

+ 1.0 mm

2.0

3.5

4.5

5.0

5.5

5.0

5.5

+ 0.5 mm

2.0

3.0

^ 4 .0

4.5

5.0

4.5

-0.5 mm

2.0

2.5

3.5

4.0

4.5

4.0

4.5

2.0

2.0

3.0

3.5

4.0

3.5

4.0

-1.0 mm

7

6

5

4

3

2

1

Lower

3.5 3.0

3.5 3.0

4.5 4.0

5.0 4.5

5.5 5.0

5.0 4.5

5.0 4.5

+ 1.0 mm + 0.5 mm

2.5

2.5

3.5

4.0

4.5

Ü4.0Ü

-0.5 mm

2.0

2.0

3.0

3.5

4.0

3.5

3.5

2.0

2.0

2.5

3.0

3.5

3.0

3.0

m cn

Upper right

Average 2.0 3.0 4.0 4.5 5.0 4.5 5.0

Upper left

5.0 4.5 5.0 4.5 4.0 3.0 2.0 Average

Lower right

Lower left

Average 2.0 2.5 3.5 4.0 4.5 4.0 4.5

Upper left

4.5 4.0 4.5 4.0 3.5 2.5 2.0 Average

Lower right

Lower left

Fig. 3.15 Individualized bracket-positioning chart - before completion. It is helpful to have an adult and a child version available.

Upper right

5.0

5.0

50

Upper left

Average

2.0

2.5

3.5

4.0

4.0

4.5

4.0

-4T5-

4.0

3.5

2.5

2.0

Average

for children

2.0

2.0

3.0

3.5

4.0

3.5

3.5

3.5

3.5

4.0

3.5

3.0

2.0

2.0

for children

Lower right

Lower left

Lower right

Lower left

Fig. 3.16 Individualized bracket-positioning chart - after completion, for a child with pointed upper cuspids and a chipped upper right central incisor.

Fig. 3.18 This upper right lateral incisor edge should be reshaped before treatment, or else the bracket should be placed 0.5 mm more gingivally.

1. Chart individualization for some upper canines and lower first premolars

2. Chart individualization in cases with abnormal incisal edges

Some cases may have teeth with wear or chipping of the incisal edges, or with crowns that are pointed or have developmental irregularities. The use of gauges and a standard bracket-positioning chart will not deal with chipped or worn teeth, or teeth of abnormal anatomy, such as pointed canines.

In some cases, it will be easier to judge the correct amount of incisal enamel adjustment needed after the teeth have been aligned. In others, the patient may be reluctant to agree to enamel adjustments at the start of treatment, and these have to be made as treatment progresses. For such patients, it is necessary to estimate the final shape of the incisal edge and the length of the crowns, and amend the individualized bracket-positioning chart accordingly.

Fig. 3.17 This patient shows difficult barrel-shaped teeth. The bracket on the upper right central incisor was bonded 0.5 mm more gingivally, in anticipation of the need for reshaping of the incisal edge.

Fig. 3.18 This upper right lateral incisor edge should be reshaped before treatment, or else the bracket should be placed 0.5 mm more gingivally.

It is helpful in some cases to place upper canine and lower first premolar brackets 0.5 mm more gingivally, especially in cases with pointed teeth.

Fig. 3.19 This lower right lateral incisor edge should be reshaped before treatment, or else the bracket should be placed 0.5 mm more gingivally than for the other incisors.

3. Chart individualization in deep-bite and open-bite cases

It can be helpful to place the incisor and canine brackets 0.5 mm more occlusallv in deep-bite cases. In open-bite cases, they should be 0.5 mm more gingival.

4. Chart individualization in premolar extraction cases

In premolar extraction cases, the height of molar attachments is individualized to avoid vertical steps at the extraction sites. In first premolar extraction cases, the adjustment needs to include the second premolar bracket positions also (Fig. 3.20), for the vertical relationships between the marginal ridges of canines and second premolars. In second premolar extraction cases, only the height of molar attachments is individualized (Fig. 3.21). This will ensure good vertical relationships between the marginal ridges of first premolars and first molars.

Upper right

3 3.0 4.0 Average 2.0 - J&r JXT 4.5 4.0 4.5

Upper left

4.5 4.0 4.5 K. 3rfS 2.0 Average

Lower right

Lower left

Fig. 3.20 Individualized bracket-positioning chart for a first premolar extraction case.

Upper right ^

Averaqe 2.0 J2& >ST 4.0 4.5 4.0 4.5

Upper left

4.5 4.0 4.5 4.0 >?T 2.0 Average

Lower right

Lower left

Fig. 3.21 Individualized bracket-positioning chart for a second premolar extraction case.

C T3

Fig. 3.21 Individualized bracket-positioning chart for a second premolar extraction case.

Upper First Premolar Extraction

Fig. 3.22 Blue S2 separators (3M Unitek 406-084) are preferred when possible. Good separation is necessary for accurate band placement.

Premolar Bands Unitec

Fig. 3.23 Metal separators (TP 353-020) are sometimes useful in contact areas between molars, especially distal to upper first molars.

Parallel

PLACING MOLAR BANDS Separation

Good separation is necessary (Figs 3.22 & 3.23). It assists accurate band placement and makes the procedure more comfortable for the patient. Ideally, elastic separating modules should be in place for about a week. Less than a week can cause sensitivity of the teeth during band placement. There is a greater risk of separators falling out if they are left in for more than a week.

It is sometimes difficult to place elastic separators in the second molar regions, and metal separators (353-020) from TP (Pig. 3.23) can be helpful in this area. Normal gray elastomeric modules can sometimes be used between small premolar contact points.

Upper molar band placement

The upper molar tube should straddle the buccal groove, and this can be checked by viewing from the occlusal (Fig. 3.25). Care is needed to prevent the distal aspect of the band from seating too gingivally, and band-seating pressure is therefore applied at the mesial palatal aspect initially, and then the distal palatal aspect. The band should be checked from the buccal to ensure it is parallel with the buccal cusps (Fig. 3.24) It is helpful if the tube is welded more to the occlusal on the band, rather than to the gingival, especially for the second molar.

Fig. 3.23 Metal separators (TP 353-020) are sometimes useful in contact areas between molars, especially distal to upper first molars.

Fig. 3.22 Blue S2 separators (3M Unitek 406-084) are preferred when possible. Good separation is necessary for accurate band placement.

Parallel

Fig. 3.24 When viewed from the buccal, the tube and band should be parallel with the buccal cusps.

Upper molar band selection for rapid maxillary expansion (RME) cases

A different technique is recommended for RME cases. After good separation, bands are selected which are one size too large. They should then be temporarily cemented in place with small amounts of glass ionomer cement, to ensure that they remain in an ideal position during impression taking. After impression taking, the bands can be removed, cleaned, and sent to the laboratory. Separators should then be replaced until the RMF. appliance can be cemented a few days later.

Fig. 3.25 When viewed from the occlusal, the upper molar tube should straddle the buccal groove.

Lower molar band placement

The lower second molar tube should straddle the buccal groove, and the lower first molar tube should straddle the mesio-buccal groove (Fig. 3.26). This should be checked by viewing from the occlusal. Care is needed when banding larger lower first molars to ensure that the tube is not placed too far mesially, and also to prevent the mesial aspect of lower molar bands from seating too gingivally (Figs 3.27 & 3.28). Lower molar bands should be checked from the buccal to ensure they are parallel with the buccal cusps. It is an error to allow the mesial aspect of the band to seat loo gingivally (Fig. 3.28). It is helpful if the tube is welded more to the occlusal on the band (ideally at 2.0 mm or 2.5 mm), rather than to the gingival.

Convertible tubes are more bulky than non-convertible tubes, leading to occlusal interferences, and (he tendency to place the band too gingivally. It is therefore easier to place lower bands with non-convertible tubes (Fig. 3.29).

Fig. 3.26 The lower molar tube should straddle the buccal groove. With large lower first molars, it may be helpful to place the tube a little distal of this position.

Fig. 3.28 It is an error to allow the mesial of the lower molar bands to seat too gingivally, as happened in this case.

Parallel

Fig. 3.27 The mesial of the lower first molar band should not be seated too low.

Fig. 3.28 It is an error to allow the mesial of the lower molar bands to seat too gingivally, as happened in this case.

Fig. 3.27 The mesial of the lower first molar band should not be seated too low.

Parallel

Fig. 3.29 Lower molar non-convertible tubes are often preferable to convertible tubes, because they are less bulky. They are stronger, more comfortable, and cause fewer interferences.

Fig. 3.30B Removal of excess bonding agent. Fig. 3.30C Checking vertical positioning.

Fig. 3.30B Removal of excess bonding agent. Fig. 3.30C Checking vertical positioning.

5. Any additional excess of bonding material is removed before light-curing (Fig. 3.30E).

Fig. 3.30A Positioning at the estimated mid-point of the clinical crown, with bracket wings parallel to the long axis of the crown.

Fig. 3.30D Re-checking axial and horizontal positioning.

Fig. 3.30E Light-curing after removal of any additional excess bonding material.

DIRECT BONDING OF BRACKETS

After cleaning of the enamel surface, etching, and application of primer, the positioning and bonding of the bracket are carried out in five stages:

1. The bracket is positioned at the estimated mid-point of the clinical crown, with bracket wings parallel to the long axis of the clinical crown. The bracket is then pressed three-quarters of the way on to the tooth surface at this position (Fig. 3.30A).

2. Excess bonding agent is then removed (Fig. 3.30B).

3. Vertical position is checked with a gauge, to equal the individualized bracket-positioning chart (Fig. 3.30C).

4. Rotational and horizontal positioning is re-checked, and then the bracket is pressed fully on to the enamel surface (Fig. 3.30D).

Upper left

Average for children Lower left

INDIRECT BONDING OF BRACKETS

There is currently renewed interest in indirect bonding, owing to the improved adhesives which have been developed, better tray materials, and upgraded design of retractors, such as the Nola™ retractors used in the Nola™ Dry Field system. This upsurge in interest is partly driven by the acceptance within the orthodontic specialty that accuracy of bracket positioning is vital to success in modern orthodontics, and that indirect bonding techniques, if carefully used, can provide greater accuracy.

In 1999, Sondhi reported on a new resin, specifically designed for indirect bonding.5 He recommended making a light-cured adhesive base for each bracket and then indirect bonding with the new chemical-cured material. The viscosity of the Sondhi material was improved by the use of 5% fine particle fumed silica filler, which also helped to fill any small discrepancies between enamel and the custom base, and curing was complete in 2 minutes. This material has seen widespread acceptance.

Currently, many improvements are being introduced and evaluated and it is beyond the scope of this book to give full details and recommendations concerning indirect bonding technique. The reader is referred to the publications by Sondhi' and also the technique advocated by Kalange6 using the Sondhi material, as well as the manufacturer's literature.

ADVANTAGES OF INDIRECT BONDING

Indirect bonding is more accurate, especially in the molar regions, and has the advantage that no separation appointment is needed. The technique reduces the amount of chairside time for the orthodontist, and also the patient has a shorter appointment for the case set-up.

It may be preferable to band the upper molars if a headgear is to be used, because posterior bands are stronger than bonds. Otherwise there are no bands on the posterior teeth, which assists in oral hygiene control. It has been recommended that brackets should always be used in preference to bands for patients with a history of bacterial endocarditis.7 Indirect bonding is therefore useful for this small group of patients, who need to maintain a very high level of plaque control, and who should rinse twice daily7 with chlorhexidine 0.2% mouthwash for 2 days prior to the set-up appointment, and also prior to subsequent adjustment visits.

DISADVANTAGES OF INDIRECT BONDING

An extra set of impressions is needed for indirect bonding cases, and the procedure is technique sensitive. Although bonding and tray construction techniques are continuing to be refined, those using indirect bonding confirm that the technique needs to be as perfect as possible, and that it is an advantage if there is a technician with suitable laboratory facilities in the practice.

Considerable laboratory time is required. After the model has been poured, the orthodontist draws a pencil line on the crown of each tooth to represent the long axis. The technician will then be able to place the brackets onto the model in approximately the correct position, and store it in a dark box. The orthodontist will subsequently position the brackets ideally, at a convenient time. The authors find that pre-coated (APC™) brackets are most efficient for laboratory use, as they are convenient, clearly identified (so that mix-ups do not occur), and free from contamination. The technician can then proceed with tray construction and the other laboratory procedures. At the time of bonding, it is important to inform the patient that the bracket positioning was carried out by the orthodontist.

Although there are disadvantages, it is likely that indirect bonding will see greater use than in the past. 'Phis is due to the need for greater accuracy in bracket positioning and because of the improved techniques and materials which are currently available.

REFERENCES

1 Gross A M 1990 Increasing compliance with orthodontic treatment. 5 Child and Family Behavioural Therapy 12(2)

2 Andrews L F 1989 Straight-Wire - the concept and the appliance. 6 Wells Co, LA

3 Bennett J, McLaughlin R P 1997 Orthodontic management of the 7 dentition with the preadjusted appliance. Isis Medical Media, Oxford

(ISBN 1 899066 91 8) pp. 28-40. Republished in 2002 by Mosby, Edinburgh (ISBN 07234 32651)

4 McLaughlin R P, Bennett J C 1995 Bracket placement with the preadjusted appliance. Journal of Clinical Orthodontics 29:302-311

Sondhi A 1999 Efficient and effective indirect bonding. American Journal of Orthodontics and Dentofacial Orthopedics 115:352-359 Kalange J T 1999 Ideal appliance placement with APC brackets and indirect bonding. Journal of "Clinical Orthodontics 33:516-526 Roberts G J, Lucas V S, Omar J 2000 Bacterial endocarditis and orthodontics. Journal of the Royal College of Surgeons, Edinburgh 45:141-145

Was this article helpful?

0 0
Booze Basher

Booze Basher

Get All The Support And Guidance You Need To Permanently STOP The Battle With Alcohol Once And For All. This Book Is One Of The Most Valuable Resources In The World When It Comes To Transformational Tools For Battling Booze Binges And Staying Alcohol-Free.

Get My Free Ebook


Responses

  • lukas
    How to correct deep bite by bracket?
    3 years ago
  • maja
    How can placment bracket on tooth in orthodontic tretment?
    3 years ago
  • Eliana
    How to position brackets correctly in orthodontics?
    3 years ago
  • doris
    What is the bracket positioning on a round mirror?
    3 years ago
  • Isengrim
    Where to place ortho brackets on the tooth bracket gauge recommended heights?
    1 year ago
  • jukka-pekk
    What are in recomended orthodontic bracket heights using the boone gauge?
    6 months ago

Post a comment