Applying Braces

Back to the Future

The actual application of today’s braces is one of the most critical steps in the orthodontic process. Each orthodontic brace is designed to apply specific forces to an individual tooth in order to move it into a desired position in the dental arch form. Orthodontic wires are engaged in a slot or groove in the face of each brace and guide this positioning. The bracket for each tooth has its own unique orientation of this “edgewise slot.” Different types and materials of wire are used at each stage of treatment for specific reasons. Most often, treatment begins with very light and flexible round wires with thicker rectangular wire used for more control later in care.

Since the braces are designed and manufactured specifically for each tooth, it reasons that they must be positioned on the tooth in a precise manner. Consequently, the application of braces by the orthodontist has evolved into two distinct methods. The direct bonding technique involves the direct application of each brace onto the tooth during the “bonding” procedure. In this manner, the orthodontist moves each brace to its final position with the patient in the clinic chair. The second technique is the indirect method. First, braces are temporarily placed on a model of the patient’s teeth. A plastic tray is formed over those positioned braces and when it is removed from the model, the braces are embedded into the plastic material. The tray is then transferred to the patient’s teeth and all of the braces are “bonded” at one time in the clinic. Ultimately, the orthodontist is responsible for the correct positioning of the braces in either instance and there are advantages and disadvantages of each application method.

Dr. Bowman was asked to write an article about his direct bonding technique as a counterpoint to his classmate, Dr. Kevin Walde, who described indirect bonding. Dr. Bowman’s resulting paper, Back to the Future: A Direct Approach to Orthodontic Bonding, was published in Orthodontic Products and it featured many of the simple devices that he has developed to enhance the application process. Subsequently, the Journal of the Indian Orthodontic Society published an expanded version entitled, Orthodontic Bonding: A Direct Approach.

click here to read the back to the future article

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