|Year : 2018 | Volume
| Issue : 2 | Page : 147-148
A-KAM, bracket positioning device
Anand Ambekar1, Khushbu D Agrawal2, Abhidnya Madansure2, Manasi Sonawane2
1 Prof. and Guide, Department of Orthodontics, MIDSR Dental College, Latur, Maharashtra, India
2 PG student, Department of Orthodontics, MIDSR Dental College, Latur, Maharashtra, India
|Date of Submission||14-Nov-2016|
|Date of Acceptance||27-Jun-2017|
|Date of Web Publication||13-Apr-2018|
Dr. Khushbu D Agrawal
Department of Orthodontics, MIDSR Dental College, Latur, Maharashtra
Source of Support: None, Conflict of Interest: None
Bracket positioning is the heart of preadjusted edgewise appliance. Accuracy of bracket positioning directly affects the treatment outcome. A number of hand-held instruments are available for bracket positioning accuracy including Boon's gauge, MBT gauges, and various other modifications. However, the most commonly used MBT gauges come in a set of two or four jigs with gauges on each end of the instrument making it difficult to carry in the instrument tray for the orthodontists. Our new bracket positioning instrument, A-KAM, bracket positioning device surpasses these difficulties and can be used for reproducible bracket placement from 2.5 mm to 5.5 mm from the base of bracket.
Keywords: A-KAM, Boon's gauge, bracket positioning, MBT gauge
|How to cite this article:|
Ambekar A, Agrawal KD, Madansure A, Sonawane M. A-KAM, bracket positioning device. J Indian Orthod Soc 2018;52:147-8
| Introduction|| |
According to McLaughlin et al., accuracy of bracket positioning is essential so that the built in features of the bracket system can be expressed fully and efficiently. Every effort should be made to achieve accurate bracket positioning which will make the finishing stages of the treatment easier. This helps efficiency in a busy orthodontic practice. In original edgewise appliance, bracket placement was normally carried out using gauges and standard millimeter measurements from the incisal edge of each tooth, irrespective of tooth size. Large incisors had brackets placed more incisally. This in turn led to variations in the amount of torque and in-out produced by the brackets. It is necessary to visualize the vertical long axis of the clinical crown of each tooth to achieve accuracy. Errors will cause incorrect tip position of the teeth. The bracket wings need to be parallel to the long axis. Obtaining axial accuracy is the most difficult aspect. Many instruments  have been introduced to make the bracket positioning convenient, but very few give the easiest way to obtain axial accuracy.
The present article describes a new bracket positioning device, A-KAM, which is modified from a simple straight probe to give axial accuracy, the markings provided with it give horizontal accuracy as well.
| Fabrication|| |
- To fabricate, A-KAM, a straight probe, which is cheapest and often available in any dental practitioner's instrument set is used
- A small piece of 19-gauge stainless steel wire is cut, and it is flattened from one surface such that it will be D-shaped in a cross-section
- It is then soldered at the neck of the probe at an angle of 70° for anterior teeth and at 90° for premolars
- A plaster block can be used for precise soldering. The angles can be scraped in the block for wire and probe placement [Figure 1]
- The markings are then made with the help of discs and markers. Moreover, the markings will be at 2.5, 3.5 mm, 4.5 mm, and 5.5 mm [Figure 2].
[Figure 3] and [Figure 4]
| Clinical Use and Advantages|| |
- Working end of straight probe gives axial accuracy
- Balancing arm stabilizes the instrument while evaluating axial accuracy [Figure 3]
- Horizontal accuracy is provided with the help of markings on the working end
- It can be used in anterior as well as posterior region [Figure 4]
- Design simplicity
- Easy to fabricate
- Requires less time to fabricate
- Easy to transport
- Inexpensive and cost-effective.
A number of modifications to A-KAM can be made:
- Laser markings can be done on A-KAM to standardize the measurements
- The tip of the posterior A-KAM can be covered with a plastic sleeve or can be made blunt to avoid tissue trauma during use.
| Conclusion|| |
While using A-KAM, bracket positioning device, clinician should keep in mind that it is an adjunct to MBT gauges and is used to assess axial accuracy.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
McLaughlin RP, Bennett JC, Trevisi HG. Systemized Orthodontic Treatment Mechanics. Mosby, London; 2001.
Sharma NS, Shrivastava SS, Hazarey PV. A new 2D bracket-positioning gauge. J Indian Orthod Soc 2011;45:202-4. [Full text]
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
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