The modified HIRO system and laboratory process

The process of creating a flawless, hand-crafted product involves many steps. We use the impression documents to first create corrective impression casts with the desired optimal tooth positioning. These casts are used as the basis for positioning the brackets. In our specialist laboratory, the work process takes around three weeks. The brackets can then be transferred and fixed in place on the patient.

Method — The Modified HIRO Technique  

The HIRO technique originates from Japan. In this technique, the term "modified" refers to reusable transfer media.

Distinctive features of this technique are the placement of the bracket using a straight arch wire—that has been adapted by hand—on hand-crafted set-up casts, as well as the reusable transfer media that are applied to individual teeth.

Pre-fabricated products, such as brackets and arch wires, enable seamless and independent working.

Overview of lab process

A precision impression of the upper jaw made from A-silicone.

The resulting dental arch
made from modeling resin.

Dissection of the dental arch,
tooth by tooth.

The prepared wax-based preoperative cast (malocclusion) of both rows of teeth for subsequent set-up of the teeth.

Set-up is performed in an articulator. The articulator simulates the action of biting in relation to the temporomandibular joints

The finished wax-based set-up cast
with the required tooth positioning

The finished corrective impression cast.

We create a specific set-up in accordance with the treatment planning. Documents such as treatment plans and x-ray images can significantly help the laboratory in this regard. All relevant overcorrections, such as any approximal enamel reduction (AER) and torque, are incorporated into the set-up. The position of the tooth in the set-up is crucial. Active control of the set-up by you as a specialist is an essential part of our work together. For this work step, we create digital photos of the set-up and malocclusion and send them to you via email. It is also possible to perform a check of the wax set-up at your practice so that you can make your own changes. A commitment to cooperation between the practice and laboratory is essential. Final production of the "dental brace" begins only after we receive your consent.

The brackets are bonded indirectly to the previously created set-up cast with an individually curved, slot-filling steel wire (18x25). The torque values of a bracket base are therefore not important in this method.

The pre-fabricated SMART™ components.

The joined SMART™ components on the bracket/tooth. In the production of the transfer caps, the brackets remain bonded with the arch on the cast until the end. This procedure shows the accurate fit of the transfer caps and the accuracy of the bracket position.

The process of forming the plastic mold, securing the bracket position to the surface of the tooth.

The form-fitting individual transfer cap on the cast. The defined bracket position determines the torque and angulation of the tooth.

The individual transfer cap positioned on the natural tooth with a bracket. This creates a key position of the brackets in relation to the surfaces of the teeth for the treatment period that can be reproduced.