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CLINICAL INNOVATION
Sugareddy et al
A Clinically Customized Bracket
Positioning Device
1
Sugareddy, 2Roshan Sagarkar, 3Priti Mulimani, 4Namit Nagar
ABSTRACT
With the advent of preadjusted edgewise appliance, the bracket positioning on the individual tooth has become critical. The concept of
judging the position using ones' naked eye is not accurate enough and the use of indirect bonding technique for every case can be
cumbersome. A simple yet efficient bracket positioning device is presented which enables a clinician to place brackets accurately and
efficiently.
Keywords: Bracket positioning, Bracket holder, Bonding.
How to cite this article: Sugareddy, Sagarkar R, Mulimani P, Nagar N. A Clinically Customized Bracket Positioning Device. J of Ind Ortho
Soc 2010;44(4):152-154.
INTRODUCTION
1
Ever since Andrews introduced the straight wire appliance,
the importance of placing the brackets in the center of the clinical
crown has become self-evident in orthodontic clinical practice.
Especially the alteration in the accurate placement of the bracket
in the vertical dimension can have significant clinical
repercussions. According to Thurow, two different vertical
positions of a bracket on a tooth will result in two different
buccolingual axial inclinations.2 Also, Meyer and Nelson
showed that a 3 mm error in vertically placing the bracket on a
premolar can result in 15° torque alteration and 0.04 mm
alteration in the in/out adjustments.3
Hence, in order to simplify and make this vertical positioning
more accurate we have devised a new addition to the bracketholding device which eliminates the need for using a Boons
gauge to mark the vertical height before placing the bracket
and again after placing the bracket to check the accuracy of the
positioning.
CONSTRUCTION
3. A piece of 0.039 inch wire
4. A 9 mm NiTi closed coil spring.
PROCEDURE
1. The center of the beak of the bracket holder is marked with
a marker
2. The required measurement (3.5, 4, 4.5 or 5 mm) is marked
on the head-gear tube from the superior border of the tube
to the extended flange (Fig. 2)
3. The head-gear tube is held on the bracket holder vertically,
so that the markings on the bracket-holder and the flange
coincide. The assembly is welded in this position (Fig. 3)
4. The wire is passed through the head-gear tube, so that equal
amount of wire comes out from either side of the tube and
is parallel to the long axis of the bracket (Fig. 4). This wire
held in this position would provide the vertical height the
bracket has to be bonded at, thus eliminating the step of
using a Boon gauge before bracket placement
The components required to assemble this bracket positioning
device are (Fig. 1):
1. Bracket holder
2. Head-gear tube—0.040 inch diameter
1
Professor, 2-4Assistant Professor
PMNM Dental College, Bagalkot, Karnataka, India
4
Pacific Dental College, Udaipur, Rajasthan, India
1-3
Corresponding Author: Sugareddy, Professor, PMNM
Dental College, Bagalkot 587101, Karnataka, India, e-mail:
sugaortho @yahoo.co.in
Received on: 19/10/10
Accepted after Revision: 14/12/10
152
Fig. 1: Appliance components
JIOS
A Clinically Customized Bracket Positioning Device
Fig. 2: Marking the position of tube on head-gear tube flange
Fig. 5: Welding the coil-spring on wire end
Fig. 3: Welding the head-gear tube on bracket holder
Fig. 6: Welding the coil-spring on head-gear tube
Fig. 4: Insertion of wire on welded head-gear tube
Fig. 7: Picking the bracket with the appliance
5. The NiTi coil spring is welded in two spots—one at the end
of the wire away from the beaks and second on to the tube
(Figs 5 and 6). The welding of the spring provides a
retraction mechanism for the wire to be withdrawn in the
tube while picking up the bracket (Fig. 7).
TECHNIQUE
1. Mark the long axis of the tooth
2. Using the bracket holder, pick-up the bracket such that the base
of the bracket is perpendicular to the long axis of the bracketholder, by pressing the wire against the flat surface (Fig. 7)
The Journal of Indian Orthodontic Society, October-December 2010;44(4):152-154
153
Sugareddy et al
ordinary bracket-holding device, we eliminate the need for using
the Boon’s gauge repeatedly and ensure quicker bonding.
ADVANTAGES
1. Eliminates the need to use Boons gauge during bonding
2. Allows the bracket to be placed accurately the first time
itself, without creating a need to recheck position after
placement of bracket
3. Minimal manipulation of bracket and bonding material
occurs due to accurate placement, as the need to shift bracket
after rechecking is eliminated
4. Allows quicker bonding
5. Economical
6. Easy to fabricate and repair.
Fig. 8: Placing the bracket on the tooth
3. The bracket is then placed along the long axis of the tooth
with the wire exactly below and touching the incisal edge
of the crown (Fig. 8).
This assembly provides a customized and economical
alternative to the expensive calibrated bracket positioning
devices in the market. By building in the calibration to an
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REFERENCES
1. Andrews FL. The SWA syllabus of philosophy and techniques.
San Diego: LF Andrews Foundation for Orthodontic Education
and Research 1974.
2. Thurow CR. Edgewise orthodontics (3rd ed). St Louis: CV
Mosby 1972.
3. Meyer M, Nelson G. Preadjusted edgewise appliance, theory
and practice. Am J Orthod 1978;73:485.