When you first begin with bracket placement, indirect bonding is a cost-effective solution available from a variety of vendors. If you do them freehand, you will get them horribly wrong and will have to learn the hard way. The same thing happens in orthodontics during residency, where they make a lot of mistakes with bracket placement and gradually learn how to do it correctly. It’s extremely difficult to learn how to do bracket placements because many dentists believe there is an instrument that can be used to accurately freehand brackets, but you wouldn’t like this as it doesn’t turn out very well because every set of teeth is unique.
I recommend that all general dentists utilize indirect bonding, but there will be instances when a bracket will break and you won’t have a template and don’t want to wait for another one to be created and you don’t want to rescan, so you’ll have to freehand. This post will walk you through the procedure.
I don’t use an instrument to put brackets, and I’ve seen a lot of examples where one was used and it failed to work properly. Instruments are ineffective since people’s tooth anatomy differs and it only works with normal sized teeth. If you rely on an instrument for bracket placement, there are numerous variables that will affect the position of the brackets.
If you have to place brackets freehand, pick a recent panel, hold it up in front of you, and shift your attention back and forth. Don’t do the entire mouth at once, just an arch. I would suggest working on a quadrant and an arch at a time. When you get faster, you can do the entire mouth at once.
The important issue is to reflect the suitable teeth to each other, for example, 6 must be mirrored to 11. Make sure the four front teeth are mirror images of each other. You must know what you intend to perform, such as align the gum lines and then repair the gum lines. That is why indirect bonding is the ideal choice because it allows you to see everything before making changes.
Draw a long axis of each tooth on the panel and bisect it to identify the center of each tooth. This is the location for your bracket. In many cases, the front teeth are slightly longer than the rest of the teeth, thus the brackets must be placed in the middle of the clinical crown to align them.