Task 19: Gather materials to bond partner using toothpaste as etchant Take a photo of gathered materials and submit with this completed checklist BOCL-01: Bonding Materials Checklist Date: Patient: Operator: Points out of 15 possible points: 1 Select and organize the brackets you will be using according to the treatment plan before the patient arrives Bend in bracket hooks as needed (Microetch the pads of the brackets if necessary for optimum adhesion) 2 Select the method and materials used to isolate the teeth for bonding Check that the retraction system is working, sterilized, and has no sharp edges 3 Select dry angles, cotton rolls, 2x2 gauze, and other necessary supplies 4 Collect cotton absorbents, prophy paste or pumice, a sterilized slowspeed handpiece, prophy head and cup, and dispensing container for the paste or pumice 5 Select toothpaste as an acid etchant, porcelain etchant and barrier system, or self-etching primer 6 Prepare the water tip and syringe and place disinfection barrier; check the air line for oil or moisture 7 Place the highspeed evacuation tip with disinfection barrier 8 Place saliva ejector tubing into slow speed evacuation with disinfection barrier 9 Select an air dryer if desired and place disinfection barrier 10 Select the bonding sealants and bonding adhesives and applicator tips 11 Select all instruments such as a mouth mirror coated with defogging solution, explorer, wire director, hockey stick or hollenback or scaler for flash removal, anterior bracket holder, posterior bracket holder, measuring gauges 12 If using a light cure adhesive, select a bonding light, check for correct light intensity, and cover with disinfection barrier Obtain operator protective glasses and bonding light shield to prevent adhesive from premature curing due to ambient light 13 Prepare the microetcher if bonding metal, porcelain, or composite or use highspeed handpiece with diamond bur or green stone 14 Select appropriate adhesion enhancers if bonding deciduous teeth, fluorosed teeth, porcelain, metal, or composite 15 Select headrest cover, patient protective glasses, patient bib and holder, operator gloves, and other barrier devices to prepare the unit for the procedure International Training Institute wwwiticoursescom BOCL-01 Checklist Page 1 of 1 Page 1 of 15
Task 20: Pumice your partner s teeth Assemble the NOLA and insert it into your partner s mouth Name: NOLA-01: Assembly and Insertion of NOLA Steps Checklist 15 Possible Your Score: 1 Select the best size of NOLA for your patient Gather all of the materials 2 Attach the cheek retractors of the NOLA to the frame properly so that the tubing will be held correctly when the NOLA is inserted 3 Feel the underside of the tongue cage for roughness and smooth it if necessary 4 Push the female end of the tubing into the male end of the tongue cage on both sides Be certain to secure the tubing tightly into place or the tubing may come off of the tongue cage once it has been placed in the mouth 5 Attach the saliva ejector attachment to the tubing Plug in the attachment to the saliva ejector, turn it on, check that there is sufficient suction 6 Gently spoon shape the proper size of dry angle Using a hemostat, grip the rounded end of the dry angle Pull the cheek tissue forward and insert the pointed end of the dry angle back around slightly behind the maxillary second molars if these teeth are going to be bonded Place the dry angle over Stensen s duct Place the dry angle on the other side in the same manner 7 Insert the lip retractors so that the inside extensions push out on the inside of the cheek keeping the buccal mucosa off the molars Be certain the lip part of the retractors are retracting out the lips properly The cheek retractors should be pulling out to the sides evenly, not too high on one side and too low on the other 8 Insert the tongue cage Slip one slider into the slot of the cheek retractor and push the slider as far back as possible 9 Instruct your patient to put the tongue into the tongue cage 10 Insert the slider of the other side into the slot of the cheek retractor and slide it all the way back 11 Check that the suction tubing is behind the posterior holders in the lower vestibule 12 Check that the tongue is completely contained within the tongue cage 13 Place the tubing in the holders of the external frame 14 Plug in the suction to the tubing and turn it on checking that it is removing saliva from the floor of the mouth without causing pain to your patient 15 Check that you have access to place the brackets in the posterior with a bracket holder and that there is access for indirect vision through a mouth mirror International Training Institute wwwiticoursescom NOLA-01 Checklist Page 1 of 1 Page 2 of 15
Task 21: Evaluate quality of inserted NOLA Have faculty evaluate and sign off NOLA-02A: Inserted NOLA Quality Checklist Faculty Sign: Name: 15 Possible Points Your Score: 1 The best size of NOLA has been selected for your patient 2 The cheek retractors of the NOLA have been attached to the frame properly 3 The underside of the tongue cage is smooth and comfortable for your patient 4 The tubing is attached to the tongue cage properly on both sides so is does not come off when it is in the mouth 5 The saliva ejector attachment is attached to the tubing properly and plugged into the saliva ejector and there is sufficient suction 6 A foil dry angle is placed properly over Stensen s duct up by the maxillary second molar on each side preventing contamination of the second molars The dry angle is not coming apart from too much manipulation 7 The lip retractors are retracting out the insides of the cheeks keeping the buccal mucosa off the molars The lip part of the retractors are retracting out the lips properly keeping the lips off of the anterior teeth The cheek retractors are pulling out to the sides evenly, not too high on one side and too low on the other 8 The tongue cage is holding the entire tongue properly 9 The slider of the tongue cage on the right side is positioned in the slot of the cheek retractor and pushed as far back as possible 10 The slider on the left side is positioned in the slot of the cheek retractor properly and pushed all the way back 11 The suction tubing is behind the posterior holders if the tongue cage in the lower vestibule 12 The tubing is in the holders of the external frame correctly and being held out of the way 13 The saliva ejector is removing saliva from the floor of the mouth without causing pain to your patient 14 You have access to place the brackets in the posterior with a bracket holder and there is access for indirect vision through a mouth mirror 15 Your patient is comfortable International Training Institute wwwiticoursescom NOLA-02A Inserted NOLA Checklist Page 1 of 1 Page 3 of 15
Task 22: Etch the teeth with toothpaste Have a faculty member monitor your placement and time the procedure Photograph etchant placement if possible Name: Patient: BOCL-13: Etchant Placement Steps Faculty Signature: Points out of 10 possible: 1 Select the best etchant (toothpaste in this exercise) 2 Place etchant on upper and lower right molars 3 Place etchant on upper and lower left molars next 4 Place etchant upper right 5 through upper right 1 5 Place etchant on lower right 5 through lower right 1 6 Place etchant on upper left 1 through upper left 5 7 Place etchant on lower left 1 through lower left 5 8 Rinse etchant off of teeth in upper right quadrant then off lower right quadrant 9 Rinse etchant off of teeth in upper left quadrant then off of lower left quadrant 10 Dry the teeth thoroughly and inspect for complete removal of etchant International Training Institute wwwiticoursescom BOCL-02 Checklist Page 1 of 1 Page 4 of 15
1 2 3 4 1 2 3 4 Task 23: Place toothpaste etchant on your partner s teeth as if it were real etchant while faculty times you Evaluate etching product of teeth with this checklist BOCL 13A Etching 7-7 Name Total Score 0-112 Standard Maxillary Right Maxillary Left 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Correct etchant used Etchant placed in bracket area only Etching period timed and correct Etchant rinsed correctly Total Points 0-4 each (56) Standard Mandibular Right Mandibular Left 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Correct etchant used Etchant placed in bracket area only Etching period timed and correct Etchant rinsed correctly Total Points 0-4 each (56) Orthodontic Etching 7-7 International Training Institute 2009 wwwiticoursescom BOCL 13 Etching 7-7 Checklist Page 1 of 1 Page 5 of 15
Task 24: Prepare your partner s teeth for bonding and place brackets correctly Have faculty monitor steps and sign off that performed correctly Name: Patient: BOCL-03: Tooth Preparation and Bracket Placement Checklist For a Full Bonding with Light Cure Adhesives Faculty Signature: Points out of 42 possible: 1 Dry the teeth with clean compressed air 2 Microetch or roughen any porcelain, metal, or composite restorations 3 Place etchant on the enamel of each tooth to be bonded only in the area where the bracket will be placed 4 Etch adult anterior teeth and bicuspids 15 seconds to 30 seconds being careful to not over etch 5 Etch adult molars for 60 seconds 6 Etch primary teeth, fluorosed teeth, or hypocalcified teeth for 90 seconds 7 Suction the bulk of the etchant off and rinse each tooth for 10 to 20 seconds rinsing several teeth at a time 8 Dry each tooth with clean compressed air or an air dryer 9 Apply a thin coat of sealant to each etched area 10 Blow with compressed air to help the sealant penetrate the etched enamel 11 Light cure sealed areas for 5 seconds each doing two teeth at once 12 Pick up each anterior bracket correctly in the best bracket holder, place adhesive over the whole pad 13 Place each anterior bracket on the respective tooth, positioning it over the etched area within a half a millimeter of its final position, and press gently until the bracket lightly sticks to the tooth 14 If desired, check slot height using a bracket slot measuring gauge being careful to hold the slot gauge perpendicular to the long axis of the tooth 15 Press the bracket more firmly against the tooth to extrude excess adhesive from under the pad 16 Carefully remove this excess adhesive or flash from around each edge of the bracket so that you do not move the bracket more than ½ millimeter International Training Institute wwwiticoursescom BOCL-03 Tooth Preparation and bracket Placement Checklist Page 1 of 3 Page 6 of 15
Task 24: Prepare your partner s teeth for bonding and place brackets correctly Have faculty monitor steps and sign off that performed correctly 17 Position all 12 anterior brackets 18 Request that the orthodontist do final positioning 19 Light cure each anterior bracket 40 seconds per bracket or as directed by the light manufacturer 20 Place sealant on all posterior mandibular bracket pads 21 Using highly-filled bonding adhesive place a small amount of adhesive on each mandibular bracket pad and press the adhesive into the pad with a micro-tip or quick-tip 22 Check the mandibular bicuspids and molars for moisture contamination and rinse and dry if necessary It is not necessary to re-etch and seal if you have already light cured the sealant Dry each mandibular posterior tooth thoroughly 23 Place each mandibular posterior bracket on the respective tooth, positioning it over the etched area within a half a millimeter of its final position, and press gently until the bracket lightly sticks to the tooth 24 If desired, check slot height using a bracket slot measuring gauge 25 Press the bracket more firmly against the tooth to extrude excess adhesive from under the pad 26 Carefully remove this excess adhesive or flash from around each edge of the bracket so that you do not move the bracket more than ½ millimeter 27 If a bracket slips easily out of position, remove it, clean the bracket, reseal, place new adhesive, re-rinse the tooth, dry thoroughly spraying air into the gingival margin where there may be seepage, replace and repress the bracket, remove flash, and have the orthodontist do final positioning immediately and light cure, possibly holding the bracket in position with a wire director while light curing 28 Request that the orthodontist do final positioning 29 Light cure the appropriate amount of time 30 Place sealant on all posterior maxillary bracket pads 31 Using highly-filled bonding adhesive place a small amount of adhesive on each bracket pad and press the adhesive into the pad with a micro-tip or quick-tip 32 Check the maxillary bicuspids and molars for moisture contamination and rinse and dry if necessary It is not necessary to re-etch and seal if you have already light cured the sealant Dry each maxillary posterior tooth thoroughly 33 Place each maxillary posterior bracket on the respective tooth, position it over the etched area within a half a millimeter of its final position, and press gently until the bracket lightly sticks to the tooth International Training Institute wwwiticoursescom BOCL-03 Tooth Preparation and bracket Placement Checklist Page 2 of 3 Page 7 of 15
Task 24: Prepare your partner s teeth for bonding and place brackets correctly Have faculty monitor steps and sign off that performed correctly 34 If desired, check slot height using a bracket slot measuring gauge 35 Press the bracket more firmly against the tooth to extrude excess adhesive from under the pad 36 Carefully remove this excess adhesive or flash from around each edge of the bracket so that you do not move the bracket more than ½ millimeter 37 Request that the orthodontist do final positioning 38 Light cure the appropriate amount of time 39 When finished light curing all brackets, finish other bonding procedures such as bonding bite buttons, lingual hooks, or other attachments 40 Remove the retraction system and dry angles 41 Instruct your patient to not bite together yet 42 Allow your patient to rinse International Training Institute wwwiticoursescom BOCL-03 Tooth Preparation and bracket Placement Checklist Page 3 of 3 Page 8 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist BOCL-04E: Bracket Placement And Final Positioning Steps Checklist Date: Name: Patient POINTS out of 36 possible: 1 Lay all of the anterior maxillary and mandibular brackets canine to canine on their respective teeth within a half millimeter of their final position Press them lightly so they will adhere to the teeth 2 Starting with the maxillary right central incisor: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum to the facial surface and position the bracket MESIODISTALLY Using direct vision adjust the slot HEIGHT from the final incisal edge to be about 4mm Using indirect vision, site down the cingulum of the tooth, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision Then check indirectly o The final position o If the bracket is flush against the tooth o If all flash is removed 3 Next position the maxillary left central incisor bracket: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum and position the bracket MESIODISTALLY Using direct vision adjust the slot HEIGHT aligning the central incisors incisal edges if this is directed in the Treatment Plan Using indirect vision, adjust the slot ANGLE Check ANGLE again with direct vision Adjust symmetry with the maxillary right central incisor Press the bracket firmly and remove all flash Then check indirectly o The final position o If the bracket is flush against the tooth o If all flash is removed on the tooth 4 Next, position the maxillary right lateral incisor bracket: Press it firmly and remove most of the flash Using indirect vision, project a line out from the cingulum and position it MESIODISTALLY Using direct vision adjust the slot HEIGHT to be ½ mm more incisal than the central incisor bracket or at 35mm Using indirect vision, adjust the slot ANGLE and check ANGLE again with direct vision Press the bracket firmly and remove all flash on the tooth International Training Institute wwwiticoursescom BOCL-04E Checklist Page 1 of 6 Page 9 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist 5 Next, position the maxillary left lateral incisor bracket: Press it firmly and remove most of the flash Using indirect vision, project a line out from the cingulum and position it MESIODISTALLY Using direct vision adjust the slot HEIGHT to be ½ mm more incisal than the central incisor bracket or at 35mm Using indirect vision, adjust the slot ANGLE and check ANGLE again with direct vision Adjust symmetry with the maxillary right lateral incisor Press the bracket firmly and remove all flash on the tooth 6 Next, position the maxillary right canine bracket: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum to the facial surface and position the bracket MESIODISTALLY Sometimes the height of contour of canines is more mesial Using direct vision adjust the slot HEIGHT be about 45mm gingival from the cusp tip but this varies with cusp tip shape Using indirect vision, site down the cingulum of the canine, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision 7 Next, position the maxillary left canine bracket: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum to the facial surface and position the bracket MESIODISTALLY Sometimes the height of contour of canines is more mesial Using direct vision adjust the slot HEIGHT be about 45mm gingival from the cusp tip but this varies with cusp tip shape Using indirect vision, site down the cingulum of the canine, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision Adjust symmetry with the maxillary right canine bracket 8 Next, position the mandibular incisor brackets: Press each firmly to the tooth extruding and removing most of the flash Using direct vision position each bracket MESIODISTALLY checking it indirectly if you can Using direct vision adjust each slot HEIGHT be about 4mm gingival from the incisal edge Using direct vision adjust slot ANGLE to be almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Adjust symmetry with the other incisor brackets Then check directly the final position, if the bracket is flush, and if all flash is removed International Training Institute wwwiticoursescom BOCL-04E Checklist Page 2 of 6 Page 10 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist 9 Next, position the mandibular right canine bracket: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum to the facial surface and position the bracket MESIODISTALLY Sometimes the height of contour of canines is more mesial Using direct vision adjust the slot HEIGHT be about 475mm gingival from the cusp tip but this varies with cusp tip shape Using indirect vision, site down the cingulum of the canine, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision 10 Next, position the mandibular left canine bracket: Press it firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the cingulum to the facial surface and position the bracket MESIODISTALLY Sometimes the height of contour of canines is more mesial Using direct vision adjust the slot HEIGHT be about 475mm gingival from the cusp tip but this varies with cusp tip shape Using indirect vision, site down the cingulum of the canine, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision Adjust symmetry with the mandibular right canine bracket 11 Request that the orthodontist do final positioning 12 Light cure each anterior bracket the appropriate amount of time 13 Place sealant on all posterior mandibular MOLAR bracket pads 14 Place a small amount of highly-filled bonding adhesive on each mandibular MOLAR bracket pad and press the adhesive into the pad with a micro-tip or quick-tip 15 Check the mandibular bicuspids and molars for moisture contamination and rinse and dry if necessary It is not necessary to re-etch and seal if you have already light cured the sealant Dry each mandibular posterior tooth thoroughly 16 Lay the brackets on the mandibular posterior teeth close to their final positions and gently press removing most of the excess flash International Training Institute wwwiticoursescom BOCL-04E Checklist Page 3 of 6 Page 11 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist 17 Next, position the mandibular first premolar brackets: Press each firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the lingual cusp and fossae to the facial surface and position the bracket MESIODISTALLY at the height of contour Using direct vision adjust the slot HEIGHT be about 4mm gingival from the cusp tip but this varies with cusp tip shape The slot should be almost a millimeter more occlusal than the slot on the canine Using indirect vision, site down the lingual cusp, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision 18 Next, position the mandibular second premolar brackets: Press each firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the lingual cusps and mesial and distal fossae to the facial surface and position the bracket MESIODISTALLY at the height of contour Using direct vision adjust the slot HEIGHT be about 4mm gingival from the cusp tip but this varies with cusp tip shape The slot should be even with the first premolar and molar, but almost a millimeter more occlusal than the slot on the canine Using indirect vision, site down the lingual cusps and fossae, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Check ANGLE again with direct vision The pad of the bracket should be an even distance down gingivally from the mesial and distal marginal ridges 19 Next, position the mandibular first molar brackets: Press each firmly to the tooth extruding and removing most of the flash Using indirect vision look at the size of the distal cusp Position the bracket MESIODISTALLY so it will align the three buccal cusps and the central groove If the distal cusp is large, the bracket will be positioned more distally to align it If the distal cusp is small place the bracket more mesially to align the mesial and distobuccal cusps Using direct vision adjust the slot HEIGHT be about 4mm gingival from the cusp tip but this varies with cusp tip shape The slot should be even with the premolar and second molar bracket slots, but almost a millimeter more occlusal than the slot on the canine Using direct vision, adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Looking directly at the molar brackets position the upper edge of the bracket pad (or slot ANGLE) parallel with the cusp tips, flat with the occlusal table, and down evenly from each marginal ridge International Training Institute wwwiticoursescom BOCL-04E Checklist Page 4 of 6 Page 12 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist 20 Next, position the mandibular second molars: Press each firmly to the tooth extruding and removing most of the flash Position the bracket MESIODISTALLY so the indent of the bracket pad is at the buccal groove and the bracket will align the buccal cusps and central groove Using direct vision adjust the slot HEIGHT be about 4mm gingival from the cusp tip The slot should be even with the premolar and first molar bracket slots, but almost a millimeter more occlusal than the slot on the canine The slot should be placed more occlusal in high mandibular plane angle patients or openbite patients Using direct vision, adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Looking directly at the molar brackets position the upper edge of the bracket pad (or slot ANGLE) parallel with the cusp tips, flat with the occlusal table, and down evenly from each marginal ridge 21 Finally, site down all the bracket slots and estimate if the slot heights will align the cusp tips evenly 22 Request that the orthodontist do final positioning 23 Light cure the appropriate amount of time 24 Place sealant on all posterior maxillary molar bracket pads 25 Place a small amount of highly-filled bonding adhesive on each molar bracket pad and press the adhesive into the pad with a micro-tip or quick-tip 26 Check the maxillary premolars and molars for moisture contamination and rinse and dry if necessary It is not necessary to re-etch and seal if you have already light cured the sealant Dry each maxillary posterior tooth thoroughly 27 Place each maxillary posterior bracket on the respective tooth, basically position it, and press gently extruding excess adhesive Remove this flash 28 Next, position the maxillary premolar brackets: Press each bracket firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the palatal cusp to the facial surface and position the bracket MESIODISTALLY at the height of contour Using direct vision adjust the slot HEIGHT be about 4mm gingival from the cusp tip The slot should be almost a millimeter more occlusal than the slot on the canine Using indirect vision, site down the lingual cusp, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Looking directly at the premolar brackets position the occlusal edge of the bracket pad (or slot ANGLE) flat with the occlusal table and down evenly from each marginal ridge International Training Institute wwwiticoursescom BOCL-04E Checklist Page 5 of 6 Page 13 of 15
Task 25: Position brackets 7-7 following this checklist Take photos when 3-3 are cured, Md 4-7 are cured, and Mx 4-7 are cured Attach to this completed checklist 29 Next, position the maxillary second molar brackets (this will allow better access not working around the first molar brackets): Press each bracket firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the palatal cusps to the facial surface and position the bracket MESIODISTALLY placing the indent of the bracket pad at the buccal groove Check that the wire tube will align the palatal cusps Using direct vision adjust the slot HEIGHT be about 35mm gingival from the buccal cusp tips The slot should be a little more occlusal than the slot on the first molar so the tooth is not extruded opening the bite causing functional interferences Using indirect vision, site down the lingual cusps, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Looking directly at the second molar bracket position the occlusal edge of the bracket pad (or slot ANGLE) flat with the occlusal table and down evenly from each marginal ridge 30 Next, position the maxillary first molar brackets: Press each bracket firmly to the tooth extruding and removing most of the flash Using indirect vision project a line out from the palatal cusps to the facial surface and position the bracket MESIODISTALLY placing the indent of the bracket pad at the buccal groove Check that the wire tube will align the palatal cusps Some clinicians align the opening of the tube on the bracket with the mesiobuccal cusp height of contour Using direct vision adjust the slot HEIGHT be about 4mm gingival from the buccal cusp tips The slot should be even with the slots on the premolars Using indirect vision, site down the lingual cusps, move your vision labially, site down the bracket, and adjust the ANGLE of the bracket to be at the correct angle almost perpendicular to the long axis of the tooth Confirm this angle with the panorex or other root image Looking directly at the first molar bracket position the occlusal edge of the bracket pad (or slot ANGLE) flat with the occlusal table and down evenly from each marginal ridge 31 Site down all maxillary posterior bracket slots and evaluate final bracket HEIGHTS relative to estimated final cusp tip lengths 32 Request that the orthodontist do final positioning 33 Light cure the appropriate amount of time 34 Finish other bonding procedures such as bonding bite buttons, lingual hooks, or other attachments 35 Remove the retraction system and prepare it for sterilization 36 Instruct your patient to not bite together and have your patient rinse International Training Institute wwwiticoursescom BOCL-04E Checklist Page 6 of 6 Page 14 of 15
1 2 3 4 5 1 2 3 4 5 Task 26: Evaluate bracket positions on partner Write a note below about any problem Have faculty check Where you and faculty disagree, deduct 1 point Deduct total disagree points from 140 for score BOCL-04F Bracket Positions 7-7 Name Faculty Sign: Score 0-140 Standard Bracket centered Mesiodistally Maxillary Right Maxillary Left 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Slot height is correct Slot Angle has draw with the tooth long axis Flush against the tooth No Flash Total Points 0-5 each (70) Standard Bracket centered Mesiodistally Mandibular Right Mandibular Left 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Slot height is correct Slot Angle has draw with the tooth long axis Flush against the tooth No Flash Total Points 0-5 each (70) Orthodontic Bonding International Training Institute 2009 wwwiticoursescom BOCL-04F - Bracket Positions 7-7 Checklist Page 1 of 1 Page 15 of 15