Bonding the Brackets

Before the brackets are bonded, all teeth are cleaned and polished. Then the surfaces of the teeth on which the fixed braces are to be bonded are slightly etched on the surface with a diluted acid. The patient is then given a lip and cheek retractor, and the teeth are dried with cotton rolls and suction. The etched tooth surfaces now look matt in contrast to the shiny, untreated enamel.

Then the orthodontist applies a water-clear, thin-flowing adhesive to the teeth in a fine layer, while the dental assistant applies a thick-flowing adhesive to the base of the brackets, the parts of the fixed braces. The assistant now hands the orthodontist one bracket at a time.

The orthodontist places each one individually on the tooth, aligns it and carefully removes the excess adhesive with a scaler. When all the brackets are bonded, the cheek retractor is removed and the patient can first rinse thoroughly to recover.

Then the orthodontic wires are inserted into the braces and fixed to the brackets. Finally, the teeth are usually fluoridated to prevent tooth damage. The whole procedure takes between 30 and 90 minutes. There may be a little pinching here and there, but on the whole the insertion of fixed braces with brackets is pressureless, painless and harmless.

In our practice in Mannheim, we like to use the indirect bonding technique. The brackets are placed on a jaw model by the dental technician in the dental laboratory. Afterwards, a transfer tray made of silicone is made over the glued-on brackets and delivered to the practice. After etching and drying, the two trays for the upper and lower jaw can be used much faster than when gluing individual brackets.

Besides the shorter working time, more precise placement and less excess adhesive around the brackets are further advantages of indirect bonding.