This article includes information on the LightPlan software and bonding technique for the feature tooth extension.
Tooth Extension allows the orthodontist to receive custom brackets for teeth that are under-erupted and/or have a limited tooth surface.
LightPlan Software: Tooth Extension
LightForce Technicians will extend the gingival borders of these teeth up to 0.6mm to obtain a manufacturable bracket
In the Initial view, the indication that a tooth has been extended is that the bracket may appear to be placed subgingivally.
The technician will include a comment in the case note if any teeth were extended:
“# tooth surface was extended to permit slightly sub-gingival bracket placement”
Bonding Protocol
We recommend partially erupted teeth receive adequate cleaning and preparation at the gingival margin before bonding subgingivally.
(Pro tip! Have a team member review oral hygiene techniques at scanning if unerupted teeth are present. This will improve periodontal health and reduce the likelihood of bond failure due to mild gingivitis, if present.)
IDB segments with extended teeth will require a trial fit of the tray prior to bonding. Some extended teeth may erupt or shift from the original day of scanning, and may need to be trimmed/cut into individual trays to bond all of the teeth in that segment accurately.
NOTE: If the technician experiences bouncing or rocking of the tray, trim the tray and trial fit. After trial fitting, it is important to clean the bracket by applying acetone or 100% isopropyl alcohol to the bracket base with a cotton tip, then drying with compressed air before applying adhesive.
If the tray becomes distorted while trimming the tray, the technician can use the rebond trays to bond teeth individually with more stability. Trays can be trimmed/cut using crown and bridge scissors, ligature cutting pliers, or an exacto knife.
It is recommended to review the position of the bracket on the 3D LightPlan prior to the bonding procedure as well as applying additional facial pressure to the IDB tray and bracket during the bonding process. See below the bonding protocol for tips on bonding with an extended tooth.
- Full acid etch – Rinse thoroughly
- Air dry teeth – Confirm chalky finish
- A recommendation for additional tooth preparation, is to use self etching primer for subgingivally placed brackets (gently scrub tooth thoroughly for 5-10 seconds)
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- Apply thin layer of Assure Plus™ primer to the teeth included in the segment
- Lightly air dry Assure Plus primer on teeth
- Light cure Assure Plus 3 sec/tooth
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- Seat tray and light cure bracket mesially/distally for 3-5 seconds each tooth
- Remove lingual to buccal
- Clean flash with scaler and/or floss
- Final cure 3-5 seconds