The orthodontic business and treatment models are changing. Patients are demanding esthetic treatment options, and you need options designed for efficiency and reliability from start to finish. That’s why we added Clarity™ Ultra™ Self-Ligating Brackets to the 3M™ Clarity™ Esthetic Orthodontic Solutions family last year. Now, you have even more options to help deliver a range of flexible, individualized esthetic treatment plans.
Many of the benefits of the Clarity Ultra System have been experienced by the early adopters, so we wanted to further elaborate on these attributes, provide additional clarification and tips, and offer comparisons to other competitive products.
The Clarity Ultra Bracket design elements help in proper placement and positioning of the brackets. They are shipped with the door open to maximize efficiency by eliminating the extra step of opening the door to place the archwire. Similar to other door-type brackets, it is recommended to always grip the bracket mesial/distal in order to avoid closing the doors during placement.
Some practitioners may have used the occlusal edge of their current bracket as horizontal guidance during positioning. When positioning a Clarity Ultra bracket with the door open the door may mask the occlusal edge of the bracket for visual positioning of the upper brackets. However, feedback from the current users shows that the lower edge of the open door in the maxilla can be used as a reference against the occlusal edge of the maxillary teeth for positioning.
The washable horizontal and vertical reference marks on the Clarity Ultra Bracket can also be used for effective visualization and positioning of the bracket versus the axis of the tooth. Other self-ligating brackets with doors may have small, plastic parts used as reference markers that need to be removed and disposed of after bonding the brackets.
When bonding brackets with doors using traditional bonding adhesives, it can be difficult to remove adhesive flash from under the open door. The Clarity Ultra Brackets, unlike any other self-ligating brackets with doors, offer the option of 3M™ APC™ Flash-Free Adhesive. Since no adhesive flash removal is needed when using the Clarity Ultra Brackets with APC Flash-Free Adhesive, there is low potential of moving the bracket from its final position due to the flash removal step.
With traditional adhesives, when a bracket is accidentally moved from its final position during the flash-removal process, additional time is used during the bonding appointment to reposition, or, the bracket will need to be debonded and rebonded during a future appointment. Either scenario results in inefficiencies and added chair time. Another benefit of the APC Flash-Free Adhesive? Unlike other brackets, cured excess adhesive flash will not interfere with the proper door opening/closing function. The APC Flash-Free Adhesive forms a thin meniscus at the edge of the bracket base, eliminating the excess paste adhesive clumps that may form under the bracket door during positioning.
Clarity Ultra Brackets are molded from small ceramic particles that contribute to high bracket strength, resisting bracket fracture. The smooth ceramic surfaces of the bracket are stain resistant and the rounded corners and edges are designed for high patient comfort.
Additionally, the Clarity Ultra Bracket is fully ceramic with no metal parts showing. There is a very small Nitinol pin hidden inside the door mechanism, not visible to the naked eye. The pin is covered by the ceramic bracket structure on one end and an adhesive plug on the other end.
When treating with a passive self-ligating appliance, it is important to take full advantage of the system efficiencies. Following is an archwire sequence guideline for Clarity Ultra Brackets. Of course, each case may require a slight variation in the type and sequence of the archwires. But it is very important to keep in mind that leaving small, lower-force archwires in place to gently move teeth until all deflection in the archwire is resolved is a benefit of treatment with passive self-ligating brackets like Clarity Ultra Brackets.
Tandem archwires can be used with Clarity Ultra Brackets to help fill the archwire slot with low force wires. Clarity Ultra Brackets can be used with the Tandem Archwire technique using a combination of two .014 round Nitinol archwires. If the practitioner desires to level and align teeth early in treatment and correct rotations, when using a passive self-ligating bracket, the horizontal plane of the archwire slot can be engaged with small, low-unloading-force wires. Using two flexible round archwires in tandem may fill both the horizontal and vertical planes of the bracket slot. This configuration is designed to correct and manage rotations early in treatment while simultaneously correcting vertical discrepancies. The tandem archwire can be inserted directly on top of the initial archwire used in treatment.
The Clarity Ultra Bracket doors have been designed to provide versatility and ease-of-use in opening and closing the doors. If the 3M™ Unitek™ Open-Close Instrument for the Ultra SL System cannot be used to close the bracket doors due to anterior crowding, severely rotated teeth, or difficult-to-access bicuspids, they can be closed with fingers. It is important to ensure that the archwire is fully inserted into the archwire slot before attempting to close the door. Gently support the lingual surface of the tooth and push the door closed with one finger while the other finger is placed on top of the bracket.
A best practice for archwire insertion in severely rotated teeth when using a self-ligating bracket is to start the process by inserting the archwire and closing the door on the most difficult to ligate bracket on the arch*. Next, should be the 2 adjacent brackets, followed by the rest of the brackets on that arch.
The Clarity Ultra Bracket doors have been tested to survive more than twice the length of a traditional orthodontic treatment, assuming an open-close cycle every 4 weeks during the course of the treatment.
When attempting to open the bracket door, it is important to understand that it is not necessary to forcefully insert the Open-Close instrument into the instrument tip slot and pull the door down. The action of opening the door occurs with the gentle rotation of the instrument tip exerting a reciprocal force on the door.
For additional details about archwire considerations, sequence, activation and other best practices click on one of the learning modules below.
Armineh Khachatoorian received her B.S. in Chemistry from the University of Southern California. She joined 3M in 1997 as a Sr. Technical Service Engineer in R&D. In 2002 she became a Marketing Product Manager and helped launch the 3M™ APC™ Adhesive Coated Appliance Systems, 3M™ Ortholux™ Curing Lights, 3M™ Transbond™ Primers, and others. She served as Scientific Affairs Manager, working with new product launches and technical publications until her recent retirement from 3M.
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