| Surgical-Dentistry.Info |
| Exposing & Bonding of Brackets to Teeth |
The objective of exposing +/- bonding a bracket on to
an unerupted tooth is to move the tooth into a good
functional & aesthetic position.
Exposure of a tooth at its simplest, consists of removing the
gum overlying the crown of the unerupted tooth under Local
Anæsthetic. Most unerupted teeth are deeper within the
jaw and require the removal of bone as well as the gum to
expose and disimpact them; as a consequence, this may be
done under General Anæsthetic
The application of traction (using the chains attached to
braces) to stimulate and guide the eruption of buried teeth
is necessary as the teeth are unfavourably angled (and
spontaneous eruption is inhibited), where buried teeth are
obstructed from eruption by other teeth & where teeth are
exposed long after their root development is complete.
Teeth most likely to be exposed and bonded are the upper
canines / eye teeth, upper central incisors, molars and the
occasional premolars.
an unerupted tooth is to move the tooth into a good
functional & aesthetic position.
Exposure of a tooth at its simplest, consists of removing the
gum overlying the crown of the unerupted tooth under Local
Anæsthetic. Most unerupted teeth are deeper within the
jaw and require the removal of bone as well as the gum to
expose and disimpact them; as a consequence, this may be
done under General Anæsthetic
The application of traction (using the chains attached to
braces) to stimulate and guide the eruption of buried teeth
is necessary as the teeth are unfavourably angled (and
spontaneous eruption is inhibited), where buried teeth are
obstructed from eruption by other teeth & where teeth are
exposed long after their root development is complete.
Teeth most likely to be exposed and bonded are the upper
canines / eye teeth, upper central incisors, molars and the
occasional premolars.
| Picture of a Gold Chain & Bracket |
This list is not exhaustive nor is it predictive. The most
pertinent warnings have been included here.
You are to have a tooth exposed +/- bracketed. You can
expect the following:
Exposing +/- Bracketing of Tooth Specific Warnings:
Stitches. The extraction site will often be closed with
stitches. These are dissolvable and ‘fall out’ within 10 – 14
days. If a pack has been sewn in or the chain is ‘parked’
high up in the sulcus, non-dissolving stitches are used, that
will need to be removed at some point.
Brackets. These are small golden plaques with chains
attached. These are stuck onto the teeth that need to be
moved. Sometimes, the cement sticking the chain onto the
tooth can break after traction is applied to the tooth; if this
happens, the bracket will need to be re-cemented on.
Occasionally, the chain itself breaks and this will mean that
the chain and bracket have to be replaced.
Gauze Pack. Sometimes, it is not possible to stick the
chains onto the teeth. If this is the case, a gauze pack
impregnated with an antiseptic (BIPP) is placed over the
exposed tooth and sewn into place. The pack is removed
after approximately a week and the chain will be stuck on at
this point.
Ankylosis of Tooth. Occasionally, even if the tooth has
traction applied to it, it still refuses to move. If this happens,
it is sometimes necessary to explore the area – there may
be a lip of bone preventing the tooth from moving or the
tooth has fused with the surrounding bone.
Repeated Operation. The gum can easily grow back over
the exposed tooth. If this is the case and the tooth doesn’t
have a bracket stuck on it, the tooth will need to be re-
exposed, hence another operation.
General Surgical Warnings:
Pain. As it is a surgical procedure, there will be soreness
after the tooth removal. This can last for several days.
Painkillers such as ibuprofen, paracetamol, Solpadeine or
Nurofen Plus are very effective. Obviously, the painkiller
you use is dependent on your medical history & the ease
with which the tooth was removed.
Swelling. There will be swelling afterwards. This can last
up to a week. Use of an icepack or a bag of frozen peas
pressed against the cheek adjacent to the tooth removed
will help to decrease the swelling. Avoidance in the first few
hours post-op, of alcohol, exercise or hot foods / drinks will
decrease the degree of swelling that will develop.
Bruising. Some people are prone to bruise. The bruising
can look quite florid; this will resolve but can take several
weeks (in the worst cases).
Mouth Opening. Often the chewing muscles and the jaw
joints are sore after the procedure so that mouth opening
can be limited for the next few days. If you are unlucky
enough to develop an infection in the socket afterwards, this
can make the limited mouth opening worse and last for
longer.
pertinent warnings have been included here.
You are to have a tooth exposed +/- bracketed. You can
expect the following:
Exposing +/- Bracketing of Tooth Specific Warnings:
Stitches. The extraction site will often be closed with
stitches. These are dissolvable and ‘fall out’ within 10 – 14
days. If a pack has been sewn in or the chain is ‘parked’
high up in the sulcus, non-dissolving stitches are used, that
will need to be removed at some point.
Brackets. These are small golden plaques with chains
attached. These are stuck onto the teeth that need to be
moved. Sometimes, the cement sticking the chain onto the
tooth can break after traction is applied to the tooth; if this
happens, the bracket will need to be re-cemented on.
Occasionally, the chain itself breaks and this will mean that
the chain and bracket have to be replaced.
Gauze Pack. Sometimes, it is not possible to stick the
chains onto the teeth. If this is the case, a gauze pack
impregnated with an antiseptic (BIPP) is placed over the
exposed tooth and sewn into place. The pack is removed
after approximately a week and the chain will be stuck on at
this point.
Ankylosis of Tooth. Occasionally, even if the tooth has
traction applied to it, it still refuses to move. If this happens,
it is sometimes necessary to explore the area – there may
be a lip of bone preventing the tooth from moving or the
tooth has fused with the surrounding bone.
Repeated Operation. The gum can easily grow back over
the exposed tooth. If this is the case and the tooth doesn’t
have a bracket stuck on it, the tooth will need to be re-
exposed, hence another operation.
General Surgical Warnings:
Pain. As it is a surgical procedure, there will be soreness
after the tooth removal. This can last for several days.
Painkillers such as ibuprofen, paracetamol, Solpadeine or
Nurofen Plus are very effective. Obviously, the painkiller
you use is dependent on your medical history & the ease
with which the tooth was removed.
Swelling. There will be swelling afterwards. This can last
up to a week. Use of an icepack or a bag of frozen peas
pressed against the cheek adjacent to the tooth removed
will help to decrease the swelling. Avoidance in the first few
hours post-op, of alcohol, exercise or hot foods / drinks will
decrease the degree of swelling that will develop.
Bruising. Some people are prone to bruise. The bruising
can look quite florid; this will resolve but can take several
weeks (in the worst cases).
Mouth Opening. Often the chewing muscles and the jaw
joints are sore after the procedure so that mouth opening
can be limited for the next few days. If you are unlucky
enough to develop an infection in the socket afterwards, this
can make the limited mouth opening worse and last for
longer.
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
| Photos, from the front and side, of an Upper Left Canine that has had a Bracket & Chain bonded on to it |
| Tooth that has had a Bracket & Chain attached to it |
| Please click here to send any comments via email. |