Technical Bulletin

Lab Requirements
Send upper and lower models poured in ortho stone along with a wax bite.
     Models must be bubble-free and smooth, so vacuum spatulation is preferred.  Trim models to a minimal base
and without perforations.  Allow 24 hours for models to dry, unless using a slow heat releasing oven.
     Doctor needs to request which
brackets they want to use and which tray system they are using: one or two.

Doctor Steps
When the doctor receives the trays
back, they need to check to make sure the back of the brackets are clean.  If there is a residue, it can be removed by the air/water syringe or the Micro etch system.
     Prior to setting, the doctor needs to cut the interproximal areas of the tray.  This will make the removal process easier when using the indirect bonding technique.
     This technique requires a dry field. One way to achieve this is by using the Nola dry field check retractor-suction system.  Follow the steps below.

• Pumice or clean the teeth where the brackets are to be placed.
• Etch teeth for at least 30 seconds.
• Prime the teeth.  (Depending on the primer, they might also need to be light-cured.)
• Place bonding material on each of the brackets in the matrix.
• Place matrix in mouth in a hinged motion.  Be sure to keep equal pressure on matrix to ensure a good bond.
• Light cure each bracket (Time will vary depending on what you are bonding with.)
• Remove matrix once all the
  light cure is finished.
• Remove the matrix in sections. Cut matrix interproximally and peel downward from incisal to gingival.
• Clean up can be done with a scaler or a high speed handpiece using a composite finishing bur.

The indirect bracketing system is the ultimate time saver and there is no inventory to maintain.  Typical bracketing time is 20 minutes or less for
both arches.

Impressions
An excellent alginate impression must be taken of "clean" teeth.  A bite registration in a
centric occlusal relationship is also required.  Extractions and procedures such as Air Rotor
Stripping should be postponed until after bonding, but recontouring of restorations of individual teeth can be done prior to taking the
impressions.  The clinician has the option to band the molars before the working cast impressions or at the bonding appointment.