Introduction to the concepts of bracketing for dental assistants

1. Bracketing:
A Basic Teaching Module for Dental
Assistants
Dr Jean Marc Retrouvey
McGill University, Faculty of Dentistry

2. General steps in bracket
bonding

3. Prophylaxis
• Pre-bonding prophylaxis procedure –
Using oil-free pumice mixed with water:
tooth surfaces where the brackets are to
be bonded must be cleaned.

4. Isolation of teeth (Cheek retractors)

5. Acid Etching

6. Proceed by quadrants

7. Apply a light coat of resin

9. Select the proper bracket

10. Position the bracket as precisely as
possible

11. Use a mirror to verify if the bracket is
centered on the crown

12. Excess composite
Remove excess composite around the
bracket with a scaler or an explorer before
light curing. If not, it will encourage plaque
accumulation.

13. Use height gage properly

14. In the canine, premolar and molar
regions, the gauge is placed parallel with the
occlusal plane

15. Verify bracket positioning

16. Tip and Torque in the position of
incisors

18. GENERAL ORTHODONTIC
INSTRUMENTATION FOR FIXED
APPLIANCES

19. Examination kit
• Cotton pliers. This instrument
is used to hold brackets
securely when placing them
onto the tooth surface.
• Explorer. In orthodontics, this
is commonly used to remove
elastics, in place of a scaler. In
addition, it can be used to
remove excess resin after
bracket placement.
• Mouth mirror. This is used to
verify the MD position of the
bracket

20. Bidirectional ligature director.
This instrument is used to tuck
metal ligatures under the
archwire, to keep the ends free
from irritating the soft tissue.
Bracket height gauge. This is
used to measure the distance
from the occlusal/incisal
surface to the bracket slot.
Distal-end cutter. This
instrument cuts the distal end
of archwire while holding the
cut end. Therefore, this can be
used in an intraoral setting.

21. Mathieu plier. This is an instrument
that locks (like a haemostat) and
braces small metal parts. In
general, they are used to hold and
twist the ends of metal ligatures, and
also to place elastic ligatures.
Ligature-cutting plier. To avoid
damage to the instrument, these
pliers must only be used to cut small
gauges of “dead soft” stainless steel
ligature wire (<0.014”) intra orally.
Hard wire cutter. This instrument is
designed to cut thick wire (> 0.014”)
extraorally.

22. Ladmore composite instrument. This
non-stick instrument is used to
place resin onto the base of the
bracket.
Cheek and lip retractor. This is an
adjustable device that retracts away
the lips and cheeks to maximize
visibility and to minimize salivary
contamination.
Debonding plier. This instrument is
used to remove brackets by holding
the bracket mesio-distally and
applying slight pressure by torquing
or turning in a clockwise motion.