BRACES

Braces

According to statistics, more than 80% of people on Earth have some kind of malocclusion. There are many reasons for this, and it is almost impossible to completely avoid them. Therefore, do not be discouraged if you are not among the lucky ones who bite correctly. Today's achievements in orthodontic science - and this, by the way, is the most dynamically developing branch of dentistry - allow eliminating almost all dental anomalies and deformities at any age. This is done mainly with the help of braces.

What are braces

Braces are small square or rectangular plates with special grooves - or, as they say, locks - on the outer surface. These plates are glued to the teeth, and a special arc is threaded and fixed into the grooves (locks). All this together is called a bracket system.

How does the bracket system work?

For the full operation of the bracket system, both of its components are important. Let's start with the braces themselves. Naturally, these are not just squares made of metal or ceramics. Each bracket has a unique set of characteristics called prescriptions. From a mathematical point of view, prescriptions are characteristics of the position of the bracket lock in relation to its base. In fact, in the prescriptions, the direction in which the tooth will move during the treatment is programmed, and the correspondence of its new position to the following parameters: the angle of inclination from right to left (angulation), the angle of inclination from front to back (inclination or torque), the angle of rotation along the longitudinal axis (rotation) , position relative to the line of the dentition (in / out).

Now the arc. Initially, it has the shape of a regular jaw and, most importantly, has a shape memory - that is, after any deformation, it will tend to return to its original form. This is its property and underlies the mechanism of the bracket system. In practice, it is usually implemented as follows: brackets are glued on the teeth from the sixth to the sixth or from the seventh to the seventh - individually selected or a ready-made set selected on the basis of preliminary studies. After that, an arc is passed through the grooves of all braces and secured with special locks on the outer braces. Naturally, when threading the arch is deformed according to the actual position of the teeth. This is how the treatment process begins, during which the arch gradually returns to its original shape, smoothly moving the teeth to which it is attached - and the braces, or rather, their prescription, set the parameters for this movement.

Important!!!

Unlike braces, which are bonded once and usually don't come off until the very end of treatment, archwires sometimes need to be replaced. This is done to minimize stress on the patient's dental system. Today, orthodontists have abandoned the universal algorithms for tooth alignment, so the doctor decides on the type of arch used and the need to replace it, and there are cases when it is possible to get by with one arch throughout the treatment. But in difficult situations, it is almost impossible to avoid changing arcs. Then wearing a bracket system is conditionally divided into three stages. At the first stage, the brackets are connected by an arc of circular cross section, since this form provides minimal rigidity with maximum elasticity. As a result, the teeth begin to change their position at the “extremely low speed”, which minimizes pain and discomfort. In fact, this is a buildup for the main stage of treatment, at which a rectangular arc is used. It exerts more intense pressure on the dentition, but thanks to proper preparation in the first stage, the teeth tolerate this relatively easily. This is followed by the final stage using a square-section arc with maximum pressure. Rectangular and square archwires, due to their shape, are more clearly fixed in the bracket and therefore affect both the tooth itself and its root.

The evolution of the approach to orthodontic treatment

More recently, treatment with braces was fairly standardized. This was called the direct arc method. In this approach, the doctor's function was actually reduced to the choice of one or another bracket system, its installation and accompanying the patient during the treatment process. That is, the main work was performed by the bracket system itself, and the doctor was something like an addition to it. The success of treatment then was almost completely determined by the quality of the bracket system and the degree of acceptability of its prescriptions for a particular patient.

Today, the situation has changed dramatically. Now the first violin in the treatment is played not by the bracket system, but by the doctor. This became possible due to the arrival on the Ukrainian market of technologies such as Damon braces (Diamon), where prescriptions are selected separately for each tooth, and the doctor has the ability to independently bend the arc, thereby making the movement of teeth during treatment much more controlled.

These changes affected not only the system for selecting brackets, but also the choice of materials for the manufacture of archwires. Here, products made of medical steel and titanium-molyb received the championship.

Types of braces

Metal braces. They are most often made of stainless steel, nickel-containing alloys are also used. Their main advantages are reliability and low price. There is, however, a drawback - visibility in the mouth.

Most of all, this type of braces is suitable for patients who choose budget treatment options and do not worry about the fact that a rather massive metal structure will be visible on their teeth for many months.

In case of an allergy to steel or nickel, titanium braces can be used. They are somewhat more expensive, but are guaranteed not to cause an allergic reaction. There is another hypoallergenic option - gold-plated braces. When you choose it, you actually install a fairly well-marked piece of jewelry in your mouth. True, in this case, you will have to forget about profitability.

Plastic braces. Modern technologies already make it possible to produce plastic that can withstand quite serious loads. Therefore, in simple cases, patients who choose budget treatment options have the opportunity to put themselves this type of braces.

Ceramic braces. Made from dental ceramics. The main advantage of this type of braces is their low visibility on the teeth. This effect is achieved due to the individual selection of the color of the braces, depending on the shade of the patient's tooth enamel. But beauty, as you know, requires sacrifice - so if you decide to put ceramic braces on yourself, then you will have to accept some of the restrictions imposed by them. So, for example, coloring drinks (coffee, red and black tea) will need to be excluded from the diet, but smoking is out of the question. In addition, you will only need to brush your teeth with a soft brush.

Ceramic braces with metal groove. This is a special type of ceramic braces. Their use allows you to combine the aesthetics of ceramics and the effectiveness of metal braces.

Sapphire braces. These braces are completely transparent, so they are completely invisible in the mouth. Some manufacturers claim that they are milled from specially grown artificial single-crystal sapphires, while others admit that we are actually talking about especially durable ceramics baked under special conditions. In any case, the patient who chooses this type of braces puts on his smile the most aesthetic of all currently existing orthodontic structures.

Invisible arcs

For patients who have chosen ceramic or sapphire braces, special wires with a white Teflon coating have been developed. Such products allow the patient to make his bracket system almost completely invisible.

Important!!! There are situations when a patient strives to maintain the aesthetics of a smile, but for financial reasons cannot afford a full range of ceramic or sapphire braces. In this case, we can offer a combined solution: braces of an aesthetic line are placed on the teeth in the smile zone, and metal braces on the rest.

Types of braces

First of all, braces are distinguished by the principle of placement - vestibular braces (on the outer side of the jaw) and lingual braces (on the inside). The price of the former is lower, but it is impossible to achieve absolute invisibility when wearing them. The latter are more expensive, but completely invisible. It would seem that the lingual option is optimal for people in public professions, but there is one pitfall - this type of braces reduces the space allotted to the tongue, and therefore affects diction. So if you are, for example, a fashion model, then the lingual system will really suit you perfectly, but if your activity is related to oratory, then it would be better to put vestibular braces - ceramic or sapphire. A combined variant is also possible, in which a lingual system is placed on the upper jaw, and an aesthetic vestibular system is placed on the lower jaw.

Lingual systems are divided into standardized and individual.

The price of standard ones, of course, is lower, but there are difficulties with them. So, in the practice of our "Club 32" there were cases when, after wearing such systems, the jaw had to be modified with vestibular braces.

Individual lingual systems work much better, but the cost of such equipment reaches up to 6,000 euros.

If the patient decides to install such a system, then casts of his jaw are taken in our clinic and sent to Germany, from where we receive both the braces themselves and the arcs specially made for a particular case. But even such an expensive treatment is not suitable for everyone, and the point here is not at all the price.

Important!!!

There is a myth that orthodontics is more of an aesthetic than clinical medicine - something akin to plastic surgery. This is not true. Despite the fact that quite a lot depends on the financial capabilities of the patient, the doctor makes the final decision on the use of a particular system, based primarily on clinical indications. So, for example, if an Arab sheikh needs to greatly expand his jaw, then he will have to install a vestibular system, because even the best lingual system in the world will simply not be able to solve this problem due to its design features.

Vestibular braces, in turn, are divided into ligature and self-ligature (self-ligating, non-ligating).

The name of both types comes from the word "ligature" - this is the name of the mount (rubber ring, less often thin metal wire), with which the arc is fixed on the bracket.

The advantages of ligature systems include their simplicity, efficiency and price. The disadvantages are bulkiness, complexity of adaptation at the initial stage of treatment and the need for a monthly visit to the doctor to replace the ligatures.

Self-ligating systems are a more advanced type of orthodontic structures, in which the braces are equipped with special locks that fix the arc. Patients are much easier to adapt to such systems, it is easier to take care of them, and most importantly, visits to the doctor during the treatment process can be reduced by three times, which is especially convenient for people who live far from clinics, and simply those who value their time. Speaking of time, the use of self-ligating systems usually reduces the treatment time by three months.

Attention!!!

Regardless of the type of braces you choose, you will need to adhere to certain restrictions. So, from the diet you need to completely exclude crackers, grilled meat and other very solid foods. In addition, you will need to brush your teeth not twice a day, but after each meal.

Post bracket period

The body loves to return everything “to normal”, so the new position of the teeth obtained with the help of a bracket system needs special fixation. For this, retainers are used. They are removable (caps or plate devices) and non-removable. The latter option is the most convenient for patients, since it does not require any attention from them. A fixed retainer is a thin wire that is glued to the teeth on the inside of the jaw. The retainer is completely invisible to others and does not interfere with oral hygiene at all, since it is glued in such a way as to leave interdental spaces free. In especially severe cases, it is possible to prescribe both removable and non-removable retainers at the same time, but usually non-removable retainers are enough. They need to be worn for 5 to 7 years, but since this design does not require replacement and does not cause discomfort, Club 32 orthodontists recommend not removing them at all.

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