Wires — Ortho Advisor

The rule: flip vs swap (read this first)

Flip: rotate the tooth's own bracket 180° in the plane of its base, so its gingival and occlusal ends trade places. Swap: bond the same tooth's bracket from the other side of the arch (right on left).Watch out · 4

Flip: torque reverses, tip stays — the same bracket turned 180° keeps its slot angle from the front, but its slot now tilts the other way in profile, and the hook moves to the opposite corner. Swap: tip reverses, torque stays — the other side's bracket mirrors the slot angle and keeps the profile. Angles enlarged to be seen.

How: Flip: rotate the tooth's own bracket 180° in the plane of its base, so its gingival and occlusal ends trade places. Swap: bond the same tooth's bracket from the other side of the arch (right on left).
What changes: A flip reverses torque (the sign changes) and any built-in rotation or offset, and moves the hook to the opposite corner; tip is unchanged. A swap reverses tip and any offset; torque is unchanged. Flip and swap together reverse both tip and torque but keep the offset. Examples: MBT U2 +10° → −10°; MBT U3 −7° → +7°; MBT L1 −6° → +6°; Damon Q2 L1 −3/−6/−11 → +3/+6/+11; MBT L3 tip +3° → −3° by a swap.
When: Before bonding any flipped or swapped bracket.

Watch out

A flip changes torque by twice the bracket's value; a 0° bracket gains nothing from a flip.
Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Words differ: some call the right–left move 'switching', others 'swapping' and keep 'switching' for an upper–lower move. Name the move, not the word.
A nominal reversal is not an expressed one: slot play, wire size and crown shape all reduce it.

Evidence: Geometry, stated as 'flip spares the tip, swap spares the torque' in a 2025 review and in clinical journal articles; both checkers re-derived it.

Sources (4)

Published studyPMID 41281695 (opens in a new tab)
Published studyPMID 32053498 (opens in a new tab)
Published studyPMID 41453412 (opens in a new tab)
Published studyPMID 41453408

Flip the upper lateral bracket for a palatal lateral

Make more room than the tooth is wide, align it (often on a piggyback NiTi under the steel base wire), then bond its own bracket upside down. A practitioner alternative: reverse the bracket and ligate passively until there is space.Watch out · 6

How: Make more room than the tooth is wide, align it (often on a piggyback NiTi under the steel base wire), then bond its own bracket upside down. A practitioner alternative: reverse the bracket and ligate passively until there is space.
What changes: MBT +10° → −10° (a 20° swing); Roth +8° → −8°; Andrews +3° → −3°; Damon Q2 standard +8° → −8°. Tip is unchanged (MBT +8°). The root follows the crown labially instead of staying palatal.
When: Palatally erupted, blocked-out or crossbite upper lateral.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Laterals often still finish under-torqued; finish with third-order bends in 19×25 steel or TMA if needed.
Once the root is in place, flip the bracket back and rebond, or the root keeps moving labially.
The textbooks describe the inversion mid-treatment too: once space is recreated after initial alignment, the inverted bracket goes on with a piggyback NiTi under the steel working wire; or when an inclination difference arises during treatment.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Maker-documented option and textbook convention; supported by case reports, no trial.

Sources (10)

Textbook

Flip the upper canine bracket (−7° → +7°)

Turn the canine's own −7° bracket 180° on the same tooth. The maker designed the −7° MBT bracket to work turned over.Watch out · 4

How: Turn the canine's own −7° bracket 180° on the same tooth. The maker designed the −7° MBT bracket to work turned over.
What changes: MBT and Andrews −7° → +7°: palatal root, labial crown torque (a 14° swing); tip kept (MBT +8°). Roth −2° → only +2°. A 0° canine bracket flipped is still 0°.
When: Canine moved into a missing lateral's site; prominent canine root or labial recession; buccally placed canine.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Check the bracket in hand: some textbooks list the MBT canine as 0°, and the maker also sells a separate 0° canine.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Maker design and textbook convention; one checker found case reports, none found a trial.

Sources (4)

Company3M MBT Versatile+ brochure (2012)
TextbookB0046 p.31
TextbookB0045 p.10

Flip the lower incisor brackets

Bond the lower incisor brackets upside down. In Damon Ultima do not flip: order the Procline lower incisor bracket instead.Watch out · 5

How: Bond the lower incisor brackets upside down. In Damon Ultima do not flip: order the Procline lower incisor bracket instead.
What changes: MBT −6° → +6° (a 12° swing; tip stays 0°). Damon Q2 −3/−6/−11 → +3/+6/+11 (6–22°; tip stays +2° central, +4° lateral). Andrews and Roth −1° → +1° change only 2°. The result is labial crown, lingual root torque.
When: Thin gingiva with lower labial recession (to bring the root lingually); Class III camouflage near the limit of lower incisor retroclination; presurgical decompensation of retroclined lower incisors; Damon Class I spacing.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Labial crown torque proclines unless the crowns are held: control arch length and open no space ahead of them.
In a thin symphysis, lingual root torque risks a lingual dehiscence; check the bone first.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Textbook convention and maker protocol; case reports; no trial.

Sources (5)

TextbookB0045 p.10
Practitioner

Flip the upper incisor brackets (Class III camouflage, proclined incisors)

Bond the four upper incisor brackets upside down, each tooth's own bracket on its own tooth (a whole-group flip).Watch out · 5

How: Bond the four upper incisor brackets upside down, each tooth's own bracket on its own tooth (a whole-group flip).
What changes: MBT U1 +17° → −17°, U2 +10° → −10°; Damon Q2 standard +12°/+8° → −12°/−8°. Labial root, palatal crown torque that resists flaring. In Class III camouflage the lower incisor brackets are often flipped too (MBT −6° → +6°) to resist retroclination.
When: Class III elastics flaring the upper incisors; proclined upper incisors treated without extraction.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Not for extraction cases that need much incisor retraction: excessive retroclination and loss of alveolar support.
Check the roots against the labial plate, and flip back once the roots are where you want them.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Case reports (one patient: upper incisor inclination 126.31° → 115.67° over 25 months) and a technique review; no trial.

Sources (4)

Published studyDOI 10.15517/h49cvp86 (opens in a new tab)

Invert premolar brackets for crossbite or scissors bite

Invert the lower premolar brackets for a scissors bite, or the upper premolar brackets for a dental posterior crossbite.Watch out · 5

How: Invert the lower premolar brackets for a scissors bite, or the upper premolar brackets for a dental posterior crossbite.
What changes: Lower: MBT and Damon Q2 L4 −12° → +12°, L5 −17° → +17° (buccal crown, lingual root). Upper: MBT −7° → +7°, Damon Q2 −11° → +11°, Ultima −4° → +4° (buccal crown, palatal root). Inclination changes only; this is not skeletal expansion.
When: Lower premolars tipped lingually in a scissors bite; upper premolars tipped palatally in a dental crossbite.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Never invert the uppers in a scissors bite, nor in a skeletal crossbite where the upper posteriors already lean buccally.
Lingual root torque in a thin lower alveolus risks dehiscence.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Textbook convention; both checkers confirmed the direction; no outcome data.

Sources (5)

TextbookB0045 p.10
Published studyPMID 17545296

Swap the lower canine brackets right for left

Bond the lower-left canine bracket on the lower-right canine and the reverse. Swap sides; do not invert. Add lacebacks or cinch-backs and keep a round or undersized lower wire during space closure.Watch out · 5

How: Bond the lower-left canine bracket on the lower-right canine and the reverse. Swap sides; do not invert. Add lacebacks or cinch-backs and keep a round or undersized lower wire during space closure.
What changes: Tip reverses, torque stays: MBT +3° → −3° (a 6° change; torque −6° unchanged); Roth +7° → −7°; Andrews +5° → −5°; Damon +5° → −5°. The canine crowns tip distally, holding lower arch length and limiting lower incisor proclination.
When: Class III camouflage; mild lower crowding where the reverse overjet worsens during alignment; canine-substitution cases closing upper space, to avoid advancing the lower incisors.

Watch out

Inverting the same-side bracket does the opposite: it keeps the mesial tip and flips the torque (MBT −6° → +6°).
The swap also reverses any built-in rotation and puts the hook and ID mark on the mesial; label the brackets.
Tip expresses only as the wire stiffens; cinching alone holds arch length but does not change canine angulation.
Distal crown tip moves the canine root toward the lateral's: check root proximity, and swap back before finishing if normal angulation is wanted.
Express full torque only after a positive overjet and overbite.

Evidence: Textbook convention and a 2025 clinical journal article; case-level, no trial.

Sources (7)

TextbookB0046 p.31

Lateral bracket on a canine that replaces a lateral

Bond an upper lateral bracket on the canine in the lateral site and a canine bracket on the first premolar.Watch out · 4

How: Bond an upper lateral bracket on the canine in the lateral site and a canine bracket on the first premolar.
What changes: MBT lateral +10° instead of the canine's −7°: about 17° more palatal root torque, tip unchanged (8° both). For comparison, the canine's own bracket flipped (+7°) gives 14° more.
When: Canine substitution for a missing upper lateral.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
A borrowed bracket brings its own base, in-out and hook: a lateral base is flatter than the convex canine, so check the bond.
Pair it with canine extrusion and premolar intrusion (see the position rules).
Evidence is case-level: case reports and technique articles, no trial.

Evidence: Textbook convention and case reports; no trial.

Sources (3)

TextbookB0199 p.250
Published studyPMID 34760817 (opens in a new tab)
Published studyPMID 39656782

Inverted lower second premolar bracket on a canine

Bond a lower second premolar bracket on the upper canine, oriented to deliver palatal root torque (its gingival ID mark facing occlusally).Watch out · 5

How: Bond a lower second premolar bracket on the upper canine, oriented to deliver palatal root torque (its gingival ID mark facing occlusally).
What changes: About +22° palatal root torque with an Andrews or Roth lower-5 bracket (−22°), +17° with MBT (−17°): a 29° (or 24°) swing from a −7° canine. The bracket carries about 2° of tip, so the canine loses its mesial tip.
When: A canine with a buccally placed root replacing an incisor (one 11-year-old case).

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Orientation trap: seated 'right way up' by its markings it delivers labial root torque, the opposite of the aim.
Premolar base and in-out differ: expect a first-order step, and trim any hook.
Extruding a canine intrudes its neighbours (large anchorage value); use piggyback mechanics.
Evidence is a single case.

Evidence: One textbook case report; a 2025 review describes the same move between arches.

Sources (2)

TextbookB0046 p.31
Published studyPMID 41281695 (opens in a new tab)

Upper central bracket on a transposed first premolar

Bond a U1 bracket (+17°) on the first premolar, with its slot level with the second premolar's slot.Watch out · 4

How: Bond a U1 bracket (+17°) on the first premolar, with its slot level with the second premolar's slot.
What changes: +17° in place of the premolar's −7°: about 24° of palatal root, buccal crown torque. The premolar root moves palatally without crown tipping, clearing a path for the impacted canine, which later gets a +7° bracket.
When: Correcting (not accepting) a canine–first premolar transposition when the premolar root lies close to the canine crown.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
An incisor bracket brings incisor tip, in-out, base shape and hook to a premolar.
The premolar's palatal cusp extruded relative to its buccal cusp; its root showed resorption before treatment and was monitored.
Evidence is a single case (12-year-old, Class III, 25 months).

Evidence: One case report; checkers confirmed the quotes and corrected the indication to transposition correction.

Sources (1)

Published studyPMID 26629478 (opens in a new tab)

Inverted upper central bracket on a palatal canine

Once a palatally displaced canine is nearly aligned, bond the same-side upper central bracket inverted and engage 19×25 steel.Watch out · 5

How: Once a palatally displaced canine is nearly aligned, bond the same-side upper central bracket inverted and engage 19×25 steel.
What changes: +17° → −17°: 10° more labial root torque than the MBT canine's −7°. Tip becomes the central's +4° instead of the canine's +8°.
When: Palatally erupted or displaced upper canine whose root stays palatal.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
Turned over, the hook, the clip or door and the ID mark all face the other way: use a hookless bracket or trim the hook, and record the flip so a rebond does not undo it.
Use the same-side central bracket; a contralateral one also reverses the tip.
The canine root sits under a thin labial plate: rebond a standard bracket once the root is upright.
Evidence is case-level: case reports and technique articles, no trial.

Evidence: One case report (20 months, no CBCT of the root).

Sources (2)

Published studyDOI 10.15517/ijds.2025.62488 (opens in a new tab)
Company

Choose a torque option instead of flipping

Order the variant bracket at bonding, chosen from the planned incisor movement.Watch out · 4

How: Order the variant bracket at bonding, chosen from the planned incisor movement.
What changes: MBT: U1 +17° or +22°; U3 −7° or 0° (+7° by flipping); L3 −6° or 0° (+6° by flipping); the 0° canines are suggested in extraction cases to keep roots centred. Damon Q2: U1 Low +2 / Std +12 / High +22; U2 Low −5 / Std +8 / High +13; U3 Low −9 / Std +7 / High +11; L1–L2 Low −11 / Std-Low −6 / Std −3; L3 Low 0 / Std +7 / High +13; L4 Std −12 / High −5. Damon Ultima: Retrocline (low) and Procline (high) brackets for U1–U3 and L1–L3, values not printed. GAC CCO: low-torque U1 +7, U2 +3, U3 0; high-torque L1–L2 −1.
When: Class II elastics, Class II division 2, Class III, extraction cases: wherever the incisor movement is known at bonding.

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
The prescription sets the direction, not the amount: in 28 Damon Q Class II patients, low and high upper central torque moved the teeth the intended way (P = 0.046 and 0.005), but the amount of change needed predicted the result best, and high torque overcorrected.
'Low' and 'high' are relative names: Damon L4 High is still −5°, and GAC's low-torque U3 (0°) is more positive than its standard (−7°).
No flip, so hooks and ID marks stay correct; several Damon Q2 variants were marked 'available in 2018' in the 2017 brochure.

Evidence: Maker options; one retrospective clinical study (Damon Q, 28 patients).

Sources (5)

Company3M MBT Versatile+ brochure (2012)

Rebond high-torque brackets mid-treatment

Debond the standard upper incisor brackets and rebond the high-torque version.Watch out · 6

How: Debond the standard upper incisor brackets and rebond the high-torque version.
What changes: Damon Q2 U1 +12° → +22° adds 10° of labial crown, palatal root torque; the 2008 Damon generation +12° → +17° adds 5°. Only the difference between versions, minus play, reaches the tooth.
When: Upper incisors over-retroclined during treatment (one adult Class II case).

Watch out

Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).
A rebond resets bracket height: check the vertical position.
Alternatives without debonding: torque bends in TMA or steel, a torquing auxiliary, or a pretorqued wire.
Palatal root torque drives roots toward the palatal cortex: watch for resorption.
Evidence is a single case.
No source measures the time cost of a deliberate torque swap; the published 0.6 months is per failed bracket.

Evidence: One practitioner case; checkers confirmed the direction and the arithmetic.

Sources (4)

PractitionerL0281
CompanyOrmco Damon Q2 doctor brochure (2017)
Company

Off-centre bonding to over-correct a rotation

Bond the bracket slightly off-centre toward the side of the tooth that is rotated lingually (mesial for a mesiolingual rotation) and fully engage a .014 or .016 NiTi.Watch out · 4

How: Bond the bracket slightly off-centre toward the side of the tooth that is rotated lingually (mesial for a mesiolingual rotation) and fully engage a .014 or .016 NiTi.
What changes: As the wire engages it brings that side labially and slightly over-corrects. The effect is large on curved canines and premolars, small on flat incisors and molars.
When: Rotated incisors, canines and premolars at the start of alignment.

Watch out

Reposition the bracket to the FA point before rectangular steel, or the over-correction is built in.
Severe rotations still need a couple (chain plus a lingual button).
Rotations relapse: plan retention.
No data show how much later correction it saves.

Evidence: Practitioner technique with textbook support for the direction; no trial.

Sources (3)

PractitionerL0278
PractitionerL0302
TextbookB0051 p.109

Tip-Edge bracket on a retracting canine

Use a Tip-Edge bracket on the canine during retraction instead of a conventional bracket.Watch out · 3

How: Use a Tip-Edge bracket on the canine during retraction instead of a conventional bracket.
What changes: The slot's vertical opening grows from .022 up to .028 as the crown tips distally, so the wire is not deflected: little incisor extrusion and no bite deepening (bench test).
When: Canine retraction in deep-bite-prone cases.

Watch out

Retraction is by tipping: the root must be uprighted later with springs or a full-size wire, which costs time and anchorage.
Tip-Edge brackets are tooth- and side-specific and tip freely in one direction only.
No clinical speed advantage has been shown.

Evidence: A bench study of force transfer and practitioner recommendation; no clinical trial of overbite.

Sources (2)

PractitionerL0312
Published studyDOI 10.1590/0103-6440202205104 (opens in a new tab)

Interchangeable MBT brackets — and the trap

When a bracket is lost: MBT lower incisor brackets fit L1 or L2 on either side; an upper first premolar bracket fits either upper premolar on either side; an upper second-molar tube fits the upper first molar on the same side when no headgear tube is needed.Watch out · 4

How: When a bracket is lost: MBT lower incisor brackets fit L1 or L2 on either side; an upper first premolar bracket fits either upper premolar on either side; an upper second-molar tube fits the upper first molar on the same side when no headgear tube is needed.
What changes: No prescription change: MBT L1/L2 −6°/0°; U4/U5 −7°/0°; U6 and U7 tubes both −14°, 0° tip, 10° offset. A U5 smaller than the U4 can take the U5 bracket with 0.5 mm extra in-out to line up the central fossae.
When: Lost or broken attachment; keeping inventory small.

Watch out

MBT only. Damon upper premolars carry +2° tip (side-specific); MBT upper incisors differ (U1 +17°/4°, U2 +10°/8°); MBT lower premolars differ (L4 −12°, L5 −17°).
A lower second-molar tube on the lower first molar gives −10° instead of −20°: 10° less lingual crown torque.
A bracket moved to the other side carries its hook to the mesial and a mirrored base.
The U7 tube on U6 gives up the headgear and auxiliary tube.

Evidence: Maker statements and practitioner practice; checkers confirmed the values.

Sources (3)

Company3M MBT Versatile+ brochure (2012)
PractitionerL0252

Lower second-molar tubes on the opposite upper molars (Class II finish)

During finishing, bond the MBT lower second-molar tube on the upper first (and second) molar of the other side.Watch out · 3

How: During finishing, bond the MBT lower second-molar tube on the upper first (and second) molar of the other side.
What changes: 0° offset instead of 10° and −10° torque instead of −14° (3M values): the upper molar can sit rotated mesiopalatally in a Class II molar finish.
When: Finishing with molars in Class II, especially after upper premolar extractions.

Watch out

It must go on the opposite side: a same-side lower tube cannot seat correctly.
The base may not fit and hooks may need trimming.
The −10°/−14° arithmetic holds for 3M Versatile+ only; check other systems.

Evidence: Maker technique; described in a 2025 review.

Sources (2)

Company3M MBT Versatile+ brochure (2012)
Published studyPMID 41281695 (opens in a new tab)

A canine 'working bracket', then the standard bracket

Bond a +20° 'working bracket' on an upper or lower canine with a prominent root. Once the expected root movement is obtained, switch it to the standard prescription bracket (+3° or −6°).Watch out · 3

How: Bond a +20° 'working bracket' on an upper or lower canine with a prominent root. Once the expected root movement is obtained, switch it to the standard prescription bracket (+3° or −6°).
What changes: +20° instead of +3° (upper) or −6° (lower) while it is on: 17–26° more palatal or lingual root torque on paper, minus play.
When: Upper or lower canines with prominent roots (one maker's catalogue).

Watch out

One maker's catalogue describes it; no clinical data were found.
Switching back is a rebond: a vertical error of up to 1 mm can change inclination by 10° (textbook).
Torque shows only in a near-full-size rectangular wire, and slot play absorbs part of it (11–16° measured for 19×25 steel in a .022 slot).

Evidence: A company convention; no study.

Sources (2)

CompanyForestadent Catalogue No. 9 US (2025)
TextbookB0051 p.109

A single-tooth root-torque auxiliary instead of a rebond

A .016" individual root-torque auxiliary fits any vertically slotted edgewise bracket, narrow or wide: insert it into the vertical slot from the incisal for palatal root torque, from the gingival for labial root torque.Watch out · 2

How: A .016" individual root-torque auxiliary fits any vertically slotted edgewise bracket, narrow or wide: insert it into the vertical slot from the incisal for palatal root torque, from the gingival for labial root torque.
What changes: Torques one tooth in six to twelve weeks without changing the bracket (maker).
When: One tooth needs more root torque mid-treatment and its bracket has a vertical slot.

Watch out

Only brackets with a vertical slot take it.
A company document; no study of the auxiliary was found.

Evidence: A company document; no study.

Sources (1)

CompanyTP Orthodontics Tip-Edge PLUS brochure (2021)

Metal on a problem tooth in a ceramic case

A practitioner source moves a single ceramic bracket that keeps fracturing to a metal bracket mid-treatment and returns to ceramic after the correction. Where there is occlusal interference or severe crowding it bonds metal first and replaces it with ceramic later, and it keeps metal on the premolars.Watch out · 3

How: A practitioner source moves a single ceramic bracket that keeps fracturing to a metal bracket mid-treatment and returns to ceramic after the correction. Where there is occlusal interference or severe crowding it bonds metal first and replaces it with ceramic later, and it keeps metal on the premolars.
What changes: Only the material changes; the prescription stays. The reason given: ceramic brackets are bulkier and more fracture-prone.
When: A repeatedly fracturing ceramic bracket; occlusal interference; severe crowding.

Watch out

The same source keeps two to three sets of ceramic brackets per patient and charges accordingly.
In a 78-patient cohort, ceramic-bracket patients lost more brackets than steel-bracket patients (hazard ratio 1.62, 95% CI 1.14–2.29).
A loose ceramic bracket is best replaced with a new, intact one (textbook); reconditioned ceramic brackets have in vitro data only.

Evidence: A practitioner routine; one retrospective cohort; a textbook statement.

Sources (4)

PractitionerL0274
Published studyPMID 29394090

Aligners to fixed segments and back

In a textbook case, molar uprighting beyond what aligners could deliver was handed to segmental fixed appliances with exaggerated bracket positions, through a window cut in the aligner; the brackets came off after uprighting and aligners finished the case. Another textbook uses limited fixed appliances for severe tipping or space closure alongside aligners.Watch out · 2

How: In a textbook case, molar uprighting beyond what aligners could deliver was handed to segmental fixed appliances with exaggerated bracket positions, through a window cut in the aligner; the brackets came off after uprighting and aligners finished the case. Another textbook uses limited fixed appliances for severe tipping or space closure alongside aligners.
What changes: Fixed segments take over the one movement aligners cannot express; the aligner limits anchorage and the amount of uprighting.
When: Root movements beyond the 6.0 mm the textbook gives as the aligner range; impacted or severely tipped molars; protraction to a TAD.

Watch out

A practitioner source starts typical bracket cases on aligners with the switch to brackets as a stated option and reports rarely needing it.
Hybrid cases — part braces, part aligners — are described by a practitioner source as possible, dependent on planning skill.

Evidence: Textbook cases and practitioner opinion; no trial.

Sources (4)

TextbookB0183 p.79
TextbookB0210 p.634