Dr. Khaira and Dr.

Romero

Bracket Placement
 Full or Partial Setup?
• Blocked out teeth and deep-bite cases (not using bite plate or
occlusal buildup): delay placement
 Enamel reduction cases
• Reshaping in cases with triangular-shaped incisors
Visualization
 Horizontal Accuracy
• Teeth with more rounded facial surfaces (canine and premolars) –
accuracy is important to prevent unwanted rotations
• View canines, premolars and molars with mouth mirror
• Lower canine – placed on vertical midline of slightly mesial (ensure
good contact with lateral)
Rotated Incisors
 Axial Accuracy
• Bracket wings should be parallel to the long axis of the tooth
 Vertical Accuracy
• Most difficult aspect
• Use gauges and positioning chart
Gauges and Charts
Gauges and Charts
Bracket-Positioning Charts
Abnormal Incisal Edges
Molar bands
Molar Bands
 Direct Bonding
1. Place bracket at estimated midpoint with wings parallel to long
axis. Do not press all the way
2. Remove excess bonding agent

3. Check vertical position (probe or gauge)

4. Re-check rotational and horizontal positioning – firmly press bracket
5. Remove excess bonding material prior to light curing
 Special Considerations
• Canines: long axis (most convex part of labial surface) is more mesial than the
true MD center.
• Molars: Buccal grove as long axis point.
• Upper lateral incisor: size and shape discrepancy (2nd to 8’s). Use L surface as
reference and extend the long axis from the L to the B surface
• Premolars: Difficult to visualize, use mirror
 Questions?
• Do you bond the whole arch at once or do you do quads or anterior
first then posteriors?
• When you bond the 6’s and 7’s, where is the point of reference on the
bracket?
• What about placing the U2 brackets and the U1’s on the same level
rather than 0.5mm lower on the U2’s?
• Should you bond and cure the 6’s first?
• What’s the best way to hold posterior brackets to deliver them in the
mouth?
• When do you place silane on porcelain bonding?