In some situations, it may be decided to gradually remove the appliances, over two or more visits. If one arch requires a lot less treatment than the other, for example, then it may be logical to consider early appliance removal in that arch. In some longer treatments, the patient may be glad to be offered early removal of upper appliances, in return for agreeing to a few more months of lower arch treatment.
Progressive appliance removal is recommended for adult treatments where bands are used, or where teeth were extracted. The terminal molar bands may be left in place and elastic chain or active tiebacks used to close band spaces elsewhere.
Fig. 11.6 Band-seating pliers (3M Unitek 900-711) are used to collapse the Clarity™ bracket by squeezing mesio-distally, so that it closes like a book. The pliers are applied approximately 1 mm away from the tooth surface.
Fig. 11.3 A special debracketing instrument or old ligature cutters can be used to remove metal brackets.
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