Topics of the day:
1. Re: Self Ligation and bracket repositioning
With regards to self-ligating brackets, I have been using them for the past 18 months. We found the greatest challenge to be working with the Damon 3 brackets because they would not stay on the premolars. Having changed our bonding technique (D2 on premolars and Mx on lower arch) we decreased broken brackets to a level no greater than that with any other system that I have used in the past. Actually, other than something I will mention below, I have found bracket repositioning to disappear in my office since going to the Damon system. I believe that it is due to the length of the bracket making it is much easier to follow the long axis of the tooth. Prior to this, we almost always set aside a 45 minute appointment to reposition mandibular 1st premolars, maxillary lateral incisors and sometimes mandibular lateral incisors. No longer is this a concern.
Now for my aside, has anyone else found that the Damon 3 central incisor brackets, specifically on tooth #9. tend to create too much distal root tip, We have had a number of these patients present with a discrepancy between the central incisors. I use a gauge on the incisors so height is equal. The brackets appear to follow the long axis of the tooth in the mouth and on x-ray yet the teeth present with excessive tip. I have not called the company, so I do not know how many other offices have reported this discrepancy. I know that we had it on the mandibular canines, with the original D3, but it turns out that this was due to a mishap on their end, mislabeling the left and right canine brackets. We no longer use D3 on any teeth other than upper 3-3.
Repositioning Self-ligating Brackets,
We have been using self-ligating brackets for over three years and the benefits we have experienced are great. I would never switch back to conventional edgewise which I used for over 30 years. I have personally found the number of repositioned brackets to be less with self-ligating brackets. However, when I do find a tooth not tracking properly it is almost always due to the fact that I don't have the bracket in the correct position. I feel that is a great check of my ability to correctly position brackets and after using self-ligating brackets for this length of time it is rare that I ever need to reposition a bracket. I have found that the length of treatment is somewhat less but the real saving is in patient chair time which in our practice has been reduced by about one-third. I could reposition every bracket in the mouth with this much time saving and still come out ahead. As Bill Proffit stated, "Self-ligation is the future of orthodontics", and I truly believe that.
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