Managing Excessive Broken Brackets:
Recommended Options and Guidelines
Overview
Excessive bracket breakage is a recurring issue that can delay treatment progress, impact scan accuracy, and increase overall chair time. This article outlines two potential strategies to reduce bracket failures and improve workflow consistency.
1. Use of Bite Turbos
Description
Bite turbos can be placed to help reduce occlusal forces that contribute to broken brackets—particularly for patients who consistently bite down on lower brackets.
Considerations
- Pre-scan removal: Bite turbos should be removed prior to taking patient scans and photos.
2. Implementation of Rigid Arms for Repeat Offenders
Description
For patients who experience repeated bracket failures (“repeat offenders”), adding rigid auxiliary arms can help stabilize the brackets and reduce further breakage. Rigid arms can be requested in Planner when submitting a new case or any refinement or replacement order.
When to Implement
- After multiple documented bracket failures.
- When breakage is clearly due to occlusal forces or patient habits.
- When bite turbos alone are insufficient or not appropriate.
Benefits
- Enhances bracket stability.
- Reduces the need for repeated emergency visits.
- Helps maintain treatment timelines.
Summary
Excessive broken brackets can be mitigated by:
- Placing bite turbos to reduce occlusal interference (with clear protocols for removal before scans/photos).
- Using rigid arms for patients who consistently break brackets despite standard interventions.