PMC6512033_01
Front view of initial occlusion.
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He was diagnosed with a bilateral Class I canine relationship and left Class I molar relationship in the permanent dentition with a crossbite of tooth 12 (Figures 1-3).
Occlusal view of initial occlusion.
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He was diagnosed with a bilateral Class I canine relationship and left Class I molar relationship in the permanent dentition with a crossbite of tooth 12 (Figures 1-3).
3D intraoral scan view of initial occlusion.
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He was diagnosed with a bilateral Class I canine relationship and left Class I molar relationship in the permanent dentition with a crossbite of tooth 12 (Figures 1-3). The procedure for the virtual indirect bonding started with the polishing of all dental surfaces with pumice powder; then, intraoral scan (Figure 3) was performed by a 3D intraoral scanner (True Definition, 3M, US).
Case planning with virtual brackets.
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The software realized a virtual set-up, and then, the orthodontist placed the virtual brackets on 3D virtual models according to the lingual prescription (Figure 4).
Virtual transfer tray.
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Once all brackets were positioned on the 3D models, the software allowed designing a virtual transfer tray for indirect bonding (Figure 5).
Prototype of digital transfer tray.
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A prototype of the digital transfer tray was manufactured using a rapid-prototyping machine (Figure 6). exocad software (exocad GmbH, Germany) was used to create bilateral posterior overlays to act as customized bite raisers (Figures 7 and 8).
Virtual customized bite raisings.
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A prototype of the digital transfer tray was manufactured using a rapid-prototyping machine (Figure 6). exocad software (exocad GmbH, Germany) was used to create bilateral posterior overlays to act as customized bite raisers (Figures 7 and 8).
Customized bite raisings.
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A prototype of the digital transfer tray was manufactured using a rapid-prototyping machine (Figure 6). exocad software (exocad GmbH, Germany) was used to create bilateral posterior overlays to act as customized bite raisers (Figures 7 and 8).
Etching procedure.
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The patient wore protective glasses to prevent eye damage, and the tooth surfaces were first etched with 37% orthophosphoric acid gel (3M, US) for 30 seconds (Figure 9) followed by washing and drying.
Adhesive application.
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A primer (Transbond XT, 3M, US) was applied in a thin film on the etched tooth surface (Figure 10). 2D lingual brackets (Forestadent, Germany) were positioned inside the prototyped transfer tray, and an adhesive resin (Transbond XT, 3M, US) was applied over the bracket bases.
Device placement.
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The brackets were then positioned in the maxilla on the upper teeth (Figure 11), using the prototyped transfer jig, and were light cured for 60 seconds each by an LED lamp (Elipar DeepCure, 3M, US).
Transfer tray removal.
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Subsequently, the transfer tray was removed by forcing a probe in the fracture line (Figures 12 and 13) and separating the jig in two halves.
Wire placement.
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Subsequently, the transfer tray was removed by forcing a probe in the fracture line (Figures 12 and 13) and separating the jig in two halves.
Setting of prototyped overlays.
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On the lower jaw, prototyped overlay were set using an adhesive technique (Figure 14).
Front view of final occlusion.
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Finally, brackets were removed, and teeth were polished (Figures 15 and 16).