Correction of vertical crown positions, marginal ridge relationships, and contact points should be completed during the rectangular I IANT stage of treatment. If this is not done, these corrections must be made during the finishing and detailing stage of treatment, shortly before bracket removal. This does not ensure stability of vertical tooth positions. It is much belter for stability to allow these relationships to be correct for 1 to 2 years before bracket removal. Correct bracket placement at an early stage is critical for stability.
The chapter on bracket placement (p. 62) discusses in detail the technique used by the authors for proper vertical bracket placement. The charts have been used for 6 years and have proven to be most effective. They have reduced the need for bracket repositioning by approximately 50%, and have enhanced the efficiency of treatment and the stability of results.
As discussed earlier, upper canines and lower first premolars frequently have long and pointed cusps, and for such teeth the bracket positioning should be approximately 0.5 mm more gingival. This will minimize the need of settling or detailing bends at the end of treatment (Fig. 10.13).
The posterior figures on the bracket-positioning charts (p. 63) are based on averages, for teeth with normal marginal ridges, in correct position. I lowever, for posterior teeth with cusp heights which vary from the norm, or with abnormal marginal ridges, bracket positions may need to be slightly modified to accommodate these differences. The need for this can easily be observed at the rectangular I IANT stage of treatment. Brackets can then be repositioned to correct the marginal ridges at thai time.
It is sometimes necessary to make minor archwire bends in the finishing stages of treatment, to correct improper vertical bracket position, but these procedures are somewhat unstable near the end of treatment. It is far better to correct vertical bracket positions much earlier in treatment.
Was this article helpful?