Abstract
The accurate bracket positioning is essential for the expression of the bracket system that affects the treatment outcome considerably and is also essential for good functional occlusion as well as facial esthetics. The proper alignment cannot be achieved without proper bracket positioning. Thus, the brackets positioning devices are an integral part of orthodontic armamentarium. Here, we present a new innovation that provides a unique combination of reverse bracket tweezer and positioner and hence is very helpful in precise vertical positioning of brackets with increased efficiency.
Keywords: Bracket positioner, preadjusted appliances, reverse action tweezer
Introduction
The success of orthodontic treatment depends on the correct diagnosis, treatment planning, well-planned biomechanics, and efficiency of the bracket system. The accurate bracket positioning is essential for the expression of the bracket system that affects the treatment outcome considerably and is also essential for good functional occlusion as well as facial esthetics. The use of preadjusted appliances has increased the importance of bracket positioning in orthodontics.[1,2,3] Preadjusted appliances are affected by inaccurate bracket positioning for proper expression of inbuilt torque, tip, and in out. The errors in bracket positioning may occur in all three planes.[4] The proper alignment cannot be achieved without proper bracket positioning. Thus, the brackets positioning devices are very important for positioning of bracket at recommended vertical height. The attempts toward improved efficiency in bracket positioning have led to the development of various designs of bracket positioners.[5,6,7] Reverse tweezers and bracket positioners are usually two different instruments that need to be exchanged while bonding each bracket. This innovation provides a unique combination of reverse bracket tweezer and positioner.
PGI Bracket Holder and Positioner
The newly designed instrument for bonding consists of an adjustable bracket positioner welded to reverse bracket holding tweezers on the distal end [Figure 1]. The design of the positioner features two horizontal blade tips. The height of the positioner or the distance between the two blade tips can be adjusted by activating a nut and screw mechanism (spring-loaded ball) [Figure 2]. The pitch of the screw was adjusted at 1.0 mm during fabrication. One-half turn of the screw changes the vertical height by 0.5 mm. The vertical height is adjustable in the range from 3 mm to 6 mm [Figure 3]. The screw shows a prominent stop that signifies an increase in the height of 0.5 mm on every half clockwise turn. The reverse tweezers and the bracket positioner are used to carry and position the bracket to the tooth. To measure the vertical height, one of the tips rests in the bracket slot and the other on the incisal edge [Figure 4].
Figure 1.

Reverse bracket tweezer and bracket positioner
Figure 2.

The activation screw of the positioner
Figure 3.

Bracket positioner with vertical opening
Figure 4.

Intraoral positioning of bracket using the bracket positioner
Advantages
This innovation reduces the armamentarium required for bonding. The reduced exchange of instruments during the bonding procedure lessens the chairside time and fatigue of the operator.
Disadvantages
The instrument is slightly bulky but still not difficult to handle. The use of a lighter metal can further improve the quality of the instrument.
Conclusion
The combination of positioner and tweezer in this instrument is very helpful in precise vertical positioning of brackets with increased efficiency.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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