Broken Bracket Repair

When a patient comes in for a broken bracket appointment, this is only a 15 minute appointment, and there will be no adjustments. We will just be repairing the bracket and replacing the wire.

1. When the patient gets in the chair, establish which bracket is broken. You can ask the patient, but it is always a good idea to check and confirm yourself. Once you have established where the broken bracket is, remove the single wire.

2. Remove any wire tie, powerchain, etc that will need to be replaced. While you are doing this, if another assistant is available have them go micro-etch the bracket that will be reused.

3. Remove any remaining glue on the tooth. **If there is band oral hygiene or the tooth is being bonded for the first time the most important first step is that you prophy paste the tooth for a clean bonding surface!!**

4. If it is just a single bracket in the anterior, you can place a small cotton roll in the lip to help keep the tooth isolated. If the tooth is in the posterior, or there is more than one then use cheek retractors, but if not, then cheek retractors are not necessary.

***If cheek retractors are needed, then you can prep the tooth by drying the tooth for 5 seconds, etch the tooth for 30 seconds. Etch is NOT SCRUBBED! Etch is lightly dabbed on the tooth. Then, rinse the etch off for 3 seconds and one more final dry for 5 seconds, making sure the tooth is staying isolated :) But if it is just a single bracket L-pop is more time efficient, but either way works great!****

5. Right as the doctor is coming to put gloves on, use a L-pop to scrub the surface of the tooth for 8 seconds.

6. Dry the tooth for 5 seconds, and make sure that the tooth is staying isolated until the bracket can be put back on. If you are worried that the tooth may have gotten contaminated after the L-pop, you can always dry and add a layer of ortho solo before the bracket is placed as a security measure.

7. After the doctor has bonded the bracket, cure for 10 seconds. If the tooth has moved drastically then you may not be able to replace the same wire. If you are unsure you can confirm with the doctor or your lead assistant. If you do have to drop in wires, make sure to schedule an in between appointment in 3 weeks to replace/increase to the wire that was in before the broken bracket. Also make sure that all hooks and auxiliaries are in place when the new wire is placed.

If same wire was replaced, then the patient can keep their next appointment as scheduled.