Direct and indirect fixation of braces. Habitual and little-known methods of fixing braces. Ligature braces and non-ligature braces - which are better

It is rare to meet a person who would not know by experience what caries is and would not be familiar with its unpleasant consequences. Few people know about the causes of the disease (except for the abuse of sweets and insufficient oral hygiene).

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from the Crimean Medical Institute. institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry, including implantology and prosthetics on implants.

I think that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then the treatment really may not reach the point - it will not be required. Microcracks and small caries on the teeth can be removed with ordinary paste. How? The so-called filling paste. For myself, I single out Denta Seal. Try it too.

The disease occurs against the background of malnutrition (depleted in foods containing calcium, fluorine, phosphorus, vitamins), weakened immunity, and irregular brushing of teeth. Under these conditions, an ideal environment is created for the reproduction of pathogenic bacteria (streptococci) in the oral cavity.

They penetrate into small cracks in the tooth enamel and begin their harmful activity there, as a result, organic acids are produced that destroy tooth tissues. Dental plaque serves as a breeding ground for bacteria. And their favorite food is processed confectionery, pastries made from white flour.

At the initial stage, it is not difficult to stop the pathology. It is enough for the doctor to put a seal on the site of the cavity eaten away by bacteria. But when the destructive processes reach the inner layers of the tooth, where the nervous, circulatory and lymphatic structures are located, the treatment will be complex and lengthy. With the possible removal of the dental nerve and dental unit.

Is caries contagious?

Since caries (from the Latin for “rotting”) has a bacterial etymology, it can be spread through the transmission from one person to another of pathogens through food, utensils, personal hygiene products, etc. (but not by airborne droplets).

However, dentists do not attach much importance to this, since streptococci, the main causative agents of the disease, are present in the oral cavity in almost all people, starting from the age of three. So an additional portion of them, received from another person, is unlikely to negatively affect the situation in the oral cavity.

The formation of carious holes in the dental tissue is not due to infection with bacteria, but due to the presence of a favorable nutrient medium for their life activity (consisting of carbohydrate food residues) in the oral cavity.

These microbes are firmly fixed on the surface of the enamel and produce, by processing sucrose, in addition to lactic acid, which destroys tooth tissues, a viscous compound that forms a yellowish substance of plaque. In it they feel comfortable, actively breed. If the substance is not regularly removed (by brushing and rinsing the mouth), then the risk of carious lesions increases.

Is cavities transmitted by kissing?

Of course, streptococci, like other bacteria, are transmitted during a kiss. But here another important factor should be taken into account - increased salivation. When people kiss, the activity of the salivary glands increases. There is an exchange of a liquid substance containing, in addition to the microorganisms present in the mouth, a lot of useful substances: minerals, proteins, natural antibacterial components.

As a result, partners exchange not only bacteria, but also means of suppressing them (natural antibiotics contained in saliva), as well as building material for dental tissues. In addition, immunity is strengthened. The body develops defenses against foreign microbes. There is no mention of caries infection. Except when the immunity of one of the kissers is weakened by some other disease. Here, it is better to temporarily refrain from kissing, since the patient does not need additional bacteria at all.

A special situation occurs when parents, grandparents kiss children under the age of three. In the saliva of babies, antiseptic components are still absent. Because their body is not protected against streptococcal bacteria. If they receive harmful microorganisms from adults, then the risk of developing caries in their milk teeth increases significantly.

Since streptococci are absent in the oral cavity in infants, it is not worth rushing to infect them with these microbes through kisses.

Kissing babies is permissible, but not on the lips, but on the cheeks, forehead and other parts of the body. The later the child becomes infected with this type of bacteria, the better.

Precautionary measures

Preventive measures play a huge role in preventing the development of caries. They are aimed mainly at preventing the active development of carious bacteria.

These measures include:

• regular brushing of teeth with an antiseptic paste;
• the use of dental floss (floss) and other means to maintain oral hygiene;
• rinsing with antibacterial solutions, balms;
• chewing sugar-free gum for 10 minutes after eating (it doesn’t last longer, chewing gum becomes a distributor of microbes over time);
• providing yourself with a balanced diet that includes dairy products, raw vegetables and fruits;
• diligent chewing of food, especially hard (this helps to cleanse the enamel of the teeth from plaque, better absorption of trace elements from food by the body);
• moderate consumption of sweets, cakes, pastries made from white flour, sweet soda;
• annual preventive examinations at the dentist;
• not delaying visits to the doctor if any problems appear in the oral cavity.

Neglect of these recommendations is fraught with the appearance of carious holes in the dental units, pain and expensive treatment. Therefore, they should be treated responsibly. It is important to teach proper oral care to children from an early age.

Do you get nervous before visiting the dentist?

YesNot

How not to infect a child with caries?

Violation of hygiene standards when communicating with babies under three years of age contributes to their premature infection with caries bacteria. Which can negatively affect the health of milk teeth in infants. To avoid this, you must follow the rules:

• do not kiss small children on the lips, do not allow relatives to do this;
• the nipple that has fallen to the floor, before giving it to the baby again, wash it with water, and not suck it;
• do not taste the baby’s drink for taste or temperature by sucking on the bottle;
• do not eat with him from the same plate, do not drink from the same glass;
• do not give the child food from his own spoon (he must have his own spoon);
• after each meal, clean the baby's mouth first with a finger, with a piece of bandage wrapped around it, then teach the baby to use a personal brush);
• keep his toothbrush separate from adult brushes (which carry streptococci);
• teach the child to rinse his mouth after eating with warm boiled water.

Grown up children acquire natural immunity against harmful microorganisms. They begin to produce antiseptic components in their saliva. They can perform oral hygiene procedures. They eat hard, enamel-cleansing food.

Therefore, kisses for them in terms of infection with caries are not terrible.

Caries (from the Latin caries - decay) is a rather long, unnatural pathological process, which consists in the decay of hard tooth tissues.

The disease occurs due to improper oral care, beriberi, genetic predisposition or reduced immunity. Provoke caries microorganisms Streptococcus mutans - bacteria that cause the conversion of the carbon environment into acid. The acid begins to act on the tooth enamel, causing its decomposition.

The first sign of caries is plaque. It is there that an ideal environment is created for the development of bacteria. Other indicators include darkening of the enamel, a reaction to cold and hot food, a reaction to sweets. These symptoms describe the initial and middle stages of the development of the disease. Deep caries is characterized by pain without the action of extraneous stimuli.

For a long time, scientists argued and continue to argue about whether caries is contagious. It used to be thought that only poor hygiene and lack of fluoride and calcium lead to tooth decay. Now that it has been scientifically established that bacteria are also the cause, it can be argued that the disease can be transmitted from person to person, like any other infection. However, caries should not be compared with the flu or hepatitis virus. He's not that dangerous. For example, it is impossible to get infected by airborne droplets. But such methods of transmission as the use of common dishes, personal hygiene items, and even a kiss with a sick person, under certain conditions, are quite relevant.

Is it possible to get caries through a kiss

Speaking about infection with caries, first of all, we mean infection with microorganisms Streptococcus mutans. Theoretically, it is clear that if the indicated bacterium enters the oral cavity of a healthy person through a kiss, then infection is inevitable. But it must be remembered that absolutely all people are carriers of streptococci. The only exceptions are children under three years of age. Therefore, everything depends on a person’s immunity, on how regularly he brushes his teeth, how much he eats carbohydrates and dairy products - a source of calcium.

To answer the question of whether caries is transmitted through a kiss, let's find out what happens to the human body during a kiss.

A kiss is a whole complex of chemical influences. During a kiss, people share proteins, fats, minerals, microorganisms with each other. There is an increase in heart rate, breathing quickens, hormones begin to be produced, salivation increases. It is in human saliva that there is a huge amount of calcium salts, phosphorus compounds, and other minerals. It performs the function of a natural antibiotic, is a kind of antibacterial agent. By exchanging it with a partner, you not only block third-party, “foreign” bacteria, but also develop immunity to new microorganisms. Therefore, the likelihood of contracting caries through a kiss is reduced to almost zero.

Is caries transmitted by kissing to children

The situation is a little more complicated with children from one to three years old. The body of a child of this age category is not yet able to produce antibodies to acid-forming streptococcus bacteria. The answer to the question of whether caries is transmitted from parents to a child during kissing is positive. Parents need to be as careful as possible: do not lick the baby's nipple, do not eat from the same plate, do not try food from the child's spoon, do not kiss him on the lips. However, you should not panic too much either. It is pointless to treat a child’s dishes and his nipple with alcohol, it is impossible to categorically forbid him to kiss or communicate with grandparents who have problems with their teeth. It is only necessary to warn adults about the danger to the child.

Infection with Streptococcus mutans will certainly occur, but better later than earlier. When a child reaches three years of age, the risk of infection is significantly reduced:

• the child himself can brush his teeth and rinse his mouth;
• the baby is able to eat solid food, which contributes to self-cleansing of teeth from plaque;
• normalizes the production of saliva that can resist demineralization.

To keep your child healthy, you need to follow the basic rules of hygiene. Each child should have separate dishes, a personal toothbrush. The axiom should be two-time brushing of teeth, rinsing of teeth during the day with special solutions. A balanced diet is an equally important factor in maintaining dental health. The presence of dairy products is a must! Try to reduce the amount of sugar-containing products, flour products. Teach your child to chew food thoroughly. Don't forget to include raw vegetables and fruits in your diet. They help keep your teeth clean.

Do not forget about visiting the dentist, starting from the very birth of the baby.

Caries is a severe, long-term developing disease. If we talk about whether it is possible to get infected with caries through a kiss, then this is unlikely, almost impossible. The exceptions are small children (up to three years old) and adults with reduced immunity. The danger also increases when the body is weakened by a disease (for example, a cold). But if you follow the simplest rules of personal hygiene, the possibility of infection is zero.

The result of treatment with braces depends on the coincidence of many different factors, but the correct fixation of braces is one of the most important and significant. This is due to the fact that if the fixation turns out to be incorrect, then the closing of the teeth will become a serious problem for the patient and his doctor, respectively, the entire treatment process will be jeopardized.

Fixing bracket system

There are two ways to fix the system: direct, when each element is installed separately by a specialist, and indirect, when a plaster model is created, filled with hot glue, after which a cap is made that exactly repeats the dentition. The indirect method is more accurate, but more time consuming. Both options have the right to life, therefore they are used everywhere in dental practice.

Pain sensations appear after fixation is not so rare, but they pass quickly, you should not worry about it, except when the pain is acute and does not go away after two or three days.

Preparing for braces

It is impossible to proceed with the installation of the system without preliminary preparation. The oral cavity must be thoroughly cleaned of tartar, pellicle and plaque, after which care should be taken to isolate the working surface of the teeth from saliva, this will directly affect the reliability of fastening the structure. This aspect remains important in modern conditions, although now a material is successfully used that does not lose its adhesiveness even in wet conditions.

Direct bonding of braces

The orthodontist starts installing the system after completing the preparatory procedures, and the technology will depend on which method of installation will be used: direct or indirect. Direct fixation is based on the use of phosphoric acid as an adhesive base. It gives the enamel surface a more porous structure, which provides more reliable and high-quality adhesion of the bracket system to the surface. In addition, this substance has the ability to clean the surface of glycoprotein deposits that contribute to the formation of enamel deposits.

Prior to the use of acid, each tooth is wrapped with tampons so that this material does not fall on the non-working surface. Etching takes place quickly, no more than one minute, or even faster, which depends on the age characteristics and susceptibility to caries of a person. The acid is removed by water, and half-life products are released simultaneously with it. It happens that not an acid is used, but a gel created on its basis, it is a more convenient material in handling, in particular, it is easier to control the removal of the gel than acids.

Given the fact that the enamel becomes chemically active after etching, it is immediately covered with a composite so that the effect of saliva is not negative. The oral cavity is well dried and now the specialist can proceed with the installation of the structure.

A paste with a catalyst is applied to the surface of the bracket system adjacent to the teeth, and the tooth surface is wetted with a monomer. The braces are firmly pressed to the surface and this pressing is fixed with tweezers, the remaining excess of the substance must be removed. A similar algorithm of actions is repeated for each tooth. The mixture solidifies in a day, so that the load on the structure is reduced, the specialist installs weak arcs for the patient and recommends not to take hard and solid food during this period of time.

Installation of braces by indirect method

The sequence of actions in the event that an indirect installation of the system is performed will be as follows:

1. Manufacturing of an elastomer cap in order to improve the accuracy of applying the substance used in the etching process to the tooth surface. To create such a cap, impressions of the teeth are needed, after removal of which a plaster model is prepared and marked along the vertical and horizontal axes of the place where the bracket system will subsequently be installed.
2. Fixing braces to the model using burnt sugar. On the basis of the created cast, two caps are made, one of which is thinner (about 0.4 mm) and the second is thicker (1.2 mm). This option makes it possible to reduce the risks of enamel etching at the same time as obtaining a better result.
3. Putting a cap on the dentition. The slots in the structure are filled with orthophosphoric acid or a gel made on its basis, after a minute etching, the substance is washed off with water, the cap is removed and the tooth surface is completely dehydrated. The braces and the surface of the teeth are lubricated with an adhesive composition, and after that the cap is put on again, but for a longer time, for about 80 minutes. This is necessary in order for the structure to be securely fixed and become motionless.

There is another technology for installing brackets by an indirect method, its difference is that after fixing with burnt sugar, a silicone impression is created, which is then finalized so that the edges of the system elements become visible from the side of the gums. Then the metal elements are peeled off, the model is placed in water, where the sugar dissolves, and the braces remain, and after that it is only necessary to rinse them and fix them to the template again. Next, the system is applied to the teeth using a catalyst, thanks to which the structure is securely fixed in place.

What is different about the new method?

On a note: When determining which method will be used to fix the braces, unnecessary haste and inattention should be avoided.

The original technique, which was used back in the days when braces were perceived as a curiosity, was based on the use of the method of fixing rings with braces. The installation procedure was unpleasant for the patient and difficult for the doctor, so it is not surprising that it was soon replaced by a new technique, which was based on gluing the structure to the tooth enamel. It is successfully used even now, a serious advantage is the minimum of preparatory procedures, but there are also disadvantages, which include:

• difficulty in correctly determining the point for installing the system;
• the inability to perform a comprehensive examination of the teeth before installation, due to which positional errors can often occur: bite opening, excessive interdental spaces, and so on;
• the success of the installation largely depends on the experience of the specialist, novice orthodontists often experience problems in this matter.

It is indirect fixation that makes it possible to get rid of such complications. In our country, it is not yet very common, although in the West this technique is very popular in the dental environment.

Pros and cons of indirect fixation

Indirect fixation of brackets is more precise and less stressful, especially for the patient. The made plaster model makes it possible to examine it in the smallest details, analyze the position of all elements and make the necessary adjustments in a timely manner. The cap created on its basis fully corresponds to the existing shape of the teeth.

This method of installation is very accurate, but its significant, although, in fact, the only drawback, is the duration of the manufacturing process of all elements of the system, but the pluses compensate for this moment, and more than:

• installation does not take much time, because the design is placed immediately on all teeth, and not individually;
• high degree of accuracy of the system allows to reduce the duration of treatment;
• force majeure circumstances are excluded during treatment;
• the comfort of treatment is high, the probability of painful bending is practically reduced to nothing.

If there is a choice, it is more rational to give preference to the indirect method, as it is faster and painless for the patient.

Patients have a great many questions regarding the operation of the structure, recommendations are given below to highlight this issue in more detail.

Question

Does the person experience pain after the system has been installed?

Answer

There is no definite answer, different situations may arise, but the absence of pain is not a sign that the teeth are not aligned. Everything will depend on the individual characteristics of a particular patient, most often, if pain occurs, then this is due to food intake and it lasts no more than two weeks. The pain is not acute and soon passes, but if everything is different, then this is an occasion to urgently see a doctor.

Question

What medications should be taken?

Answer

In this case, any drug that relieves pain can help, for example, various analgesics, such as Ketanol or Nise. You should not lean too much on the tablets, it must be borne in mind that due to their intake, the movement of the teeth will slow down, since the enzyme contained in them comes into play, which has just such an effect.

Question

Do pills affect the treatment process?

Answer

Yes, if the patient has any other diseases and drugs are taken to combat them that affect the condition of the bone tissue. This situation must be discussed with the orthodontist in advance in order to find compromise solutions to the problem.

Question

Is it possible to make wearing the system more comfortable and less time consuming?

Answer

A feature of the arcs installed after fixing the structure is that they have high thermoactive properties. This means that at first, eating cold foods (drinks or ice cream) can successfully replace painkillers, but then you should not get carried away with them, since a permanent decrease in temperature in the oral cavity will slow down the treatment process and negatively affect its effectiveness.

Question

What are the food restrictions?

Answer

The ban is subject to viscous and sticky food, as well as solid. The rest of the products can be safely eaten, but it is better to cut them into small pieces so as not to unnecessarily risk the integrity of the bracket system.

Question

What's wrong with taking off your braces?

Answer

If one bracket breaks off and is not glued back within a short time, then one tooth will stop moving in the right direction, unlike all the others. When changing the arc to a more rigid one, which happens several times during the treatment, such a tooth will not give the opportunity to do this, respectively, the whole process can go down the drain.

Question

Bracket peeled off: what to do?

Answer

The ideal option is to stick it back within a couple of days, a maximum of a week. On the front tooth, this does not pose any problem, the element will simply hang on the arc, but when the lock is peeled off, there is a real risk of swallowing it or simply losing it. The solution is simple - visit the dentist as soon as possible and restore the integrity of the system.

Question

If swallowed braces?

Answer

There is no threat or risk to health, it will come out naturally.

Question

Do braces rub?

Answer

In normal use, this should not happen. If discomfort is felt, this means that the element has peeled off or there are problems with the arc. Everything is solved simply by making a visit to the orthodontist.

Question

What is orthodontic wax for?

Answer

When getting used to braces, discomfort of the lips or mucous membranes of the cheeks is possible, although this does not happen very often. Wax helps to alleviate discomfort, it is attached at any point in the oral cavity, it is edible and can be safely swallowed.

Question

What about speech defects in the process of wearing the structure?

Answer

If the system is external, then there can be no defects in principle. When wearing internal braces, this is possible, but the more the patient talks, the faster the adaptation takes place.

Question

How are braces removed?

Answer

With the help of special forceps, the element of the system is compressed at its base and bounces off the tooth. The material remaining on the surface is removed with a bur, polishing discs and rubber bands. In this case, the enamel remains intact and the tooth does not receive any damage.

Related videos

One of the most common and effective ways to correct bite defects are braces.

These designs are attached to each tooth and worn throughout the treatment period. An important role in the course of treatment is played by the correctness and reliability of fixing the locks of the braces.

Preparing for positioning

Installation of braces requires a preparatory stage. After an initial consultation with an orthodontist, the patient will have to carefully prepare the oral cavity.

Braces are installed only on healthy elements of the jaw arch.

Basic preparation steps:

1. Treatment of carious lesions. It is necessary to detect and treat all available places for the development of caries, even the smallest ones;
2. Checking old fillings. If there are seals that have been installed for a long time, you need to check their strength and replace if necessary;
3. Periodontal diseases. The mucous membrane of the oral cavity must be absolutely healthy. Even the most minor inflammation can worsen after the installation of braces;
4. Remineralization. If there are areas of enamel thinning, hypersensitivity or cracks on the teeth, a remineralization procedure should be performed. It will help strengthen tooth enamel and avoid the development of certain diseases during the period of orthodontic treatment.

Complete sanitation of the oral cavity is a prerequisite that must be performed first of all before installing braces.

Depending on the initial state of the oral cavity, the preparation phase may take several months.

During the period of treatment, you need to do panoramic x-rays of the jaws. Based on them, the doctor draws up a treatment plan and determines the places for fixing the locks.

Just before fixing braces need professional teeth cleaning. During this procedure, the surface of the teeth is cleaned, tartar and plaque are removed.

This is done to ensure that the surface of the teeth is absolutely clean, and when gluing the structure, nothing interferes with the strong adhesion of the surfaces.

direct method

After carrying out all the preparatory procedures, the doctor can begin to fix the bracket system. There are two main ways to attach braces to your teeth - direct and indirect.

The direct method involves manually gluing locks on each tooth. This work is quite painstaking, requires a lot of attention and experience of a specialist.

To some extent, such work can be compared with jewelry. All teeth have different sizes, respectively, and the locks must be accurately matched and glued.

During the installation of the structure, the doctor uses tweezers, a clamp, a holder and a positioner. With their help, the orthodontist holds the locks, measures their exact position in accordance with the marks on the panoramic images and fixes them on the teeth.

Direct installation steps:

• The retractor is installed;
• A special composition based on phosphoric acid is applied to the enamel. It helps to roughen the surface of the enamel, which creates the most reliable grip;
• After 30 seconds, the composition is washed off with water;
• A healing composite is applied to the enamel, which creates a protective layer;
• An adhesive composition is being prepared (as a rule, it consists of two components);
• Glue is applied to the back of the locks;
• The lock is fixed on each tooth in turn;
• Excess glue is removed;
• After the glue has hardened, a metal arc is inserted and ligatures are attached.

The entire procedure for installing the bracket system takes approximately 1-1.5 hours. Complete hardening of the glue occurs in about a day.

During this period, the patient should take only soft and liquid food.

The advantages of this method are:

1. Precise installation of locks, according to the plan;
2. Ability to make adjustments during installation;
3. Reliable fastening of locks;
4. Exclusion of food getting between the locks and enamel.

The disadvantages can be called:

• Takes a long time;
• The patient must remain still during the entire installation;
• The doctor needs a lot of effort and attention.

The video shows the process of the direct method of fixing braces.

Indirect installation

Recently, the indirect method of fixing braces has gained popularity. This method allows you to stick products on all teeth at the same time using a special cap.

The indirect method of fixing brackets reduces the time of direct installation, but requires longer preliminary preparation in the laboratory.

What is the preparation:

1. Impressions are taken from the patient's jaws, on the basis of which an accurate plaster model is made;
2. Places of installation of locks are marked on the model using guide lines
3. With the help of burnt sugar or heating of the model, fixation is carried out locks on the jaw model;
4. A special kappa is being made, accurately repeating the contours of the teeth;
5. The cap is pressed against the model, thereby transferring locks to it.

Installation of the structure to the patient is carried out in the following way:

• The retractor is installed;
• Tooth enamel is etched with an orthophosphoric compound;
• After 30 seconds, the solution is washed off;
• The surface of the teeth is dried;
• A protective composite is applied;
• An adhesive is applied to the reverse side of the locks;
• A cap with braces is worn on the jaw;
• After an hour, the cap is removed;
• Install a metal arc and ligatures.

Among the advantages of this method are:

• Fast installation due to simultaneous gluing on all teeth;
• Comfort for the patient;
• The accuracy of the installation helps to avoid unnecessary pain and speeds up the treatment process.

The cons are:

• It is difficult to determine the desired installation point;
• Inability to control the fixation process on each tooth;
• Difficult to remove excess adhesive;
• Long preparation process.

See in the video how braces are installed indirectly.

Thomas Pitts table

The above methods of installing braces are based on the personal approach of the attending physician. In addition to this approach, a special protocol for fixing orthodontic systems has been developed.

This approach was developed and proposed by the American doctor Thomas Pitts. The Pitts position ensures that bite defects are quickly corrected.

For ease of understanding and use, these rules were translated by Dr. T. Castellanos into numerical parameters, taking into account the length of the teeth.

The Pitts system consists of two parts and has the following scheme.

upper jaw

Lower jaw

The installation location of the brackets is determined according to the following scheme:

1. The length of the crown of the tooth is measured;
2. The resulting figure is looked up in the GPS-A column;
3. Next is the installation height according to the norm of the tooth.

This system helps to quickly determine the desired position for fixing the braces, reduces installation time and reduces the likelihood of subjective errors.

Resilience adhesive system

The most popular adhesive for fixing braces is the Resilience system. Its adhesive is very soft and sticky, ideal for bonding braces. With the help of the composition, you can fix both metal and sapphire and ceramic products.

The adhesive hardens under the action of the light flux. Until the moment of highlighting, it remains soft, which makes it possible to accurately install the lock.

The adhesive cures completely under the action of light. The metal arc can be installed immediately after fixing the locks.

The Resildines system consists of several drugs. The cost of one set can vary between 10-15 thousand rubles.

The kit includes:

• Adhesive (in a syringe);
• Etching gel (in a syringe);
• primer;
• Different tips for syringes;
• Palette for mixing components;
• Holder;
• Brush with three nozzles of different lengths.

Issue price

In many dental clinics, the cost for installing braces is a separate line.

But there are also such clinics where the amount for fixing the orthodontic system is included in the total cost of manufacturing the system. On average, this service is estimated at about 30% of the total cost of the braces.

The price of installation of products from different materials will vary. The more expensive the system itself, the more it will cost to install.

The direct method is the most common installation method. The indirect method is still used in a limited number of clinics. This is due to its novelty and little experience of specialists.

Due to the need to manufacture a plaster model and special caps with an indirect method, its cost will be increased by about 6-9 thousand rubles, in comparison with the direct method for each type of product material.

Correcting an overbite with braces can take a long period of time. The speed and result of defect correction depends on how accurately the patient fulfills all the doctor's recommendations.

In the first time after fixing the orthodontic system to the patient solid food and increased stress on the jaw should be excluded. Preference should be given to soft or liquid foods.

Subsequently, the following recommendations should be followed:

1. Visit your doctor regularly. This is necessary to assess the condition, adjust the pressure on the teeth, change the ligatures and make the necessary adjustments;
2. Thorough oral hygiene. You should brush your teeth several times a day after eating. If there are no conditions for brushing your teeth, you must rinse your mouth thoroughly;
3. Apply additional hygiene products(irrigator, floss, brush, etc.);
4. Adhere to a special diet. The patient should be excluded from the diet too hard, sticky or tough food;
5. Perform periodic professional cleaning teeth;
6. Eliminate bad habits.

Indirect bracket fixation is a relatively new and more accurate bracket positioning method than the classic direct brackets. In Europe and the USA, it is already successfully used everywhere, while in domestic clinics the technique is only gaining popularity.

How does indirect bracket positioning differ from direct bracket positioning?

In orthodontic dentistry, two methods of fastening braces are used: direct and indirect or one-stage.

The first one consists in the stage-by-stage fixation of each bracket (bracket body or bracket) on a separate tooth. Although direct fixation is more common in Russian dentistry, it is more complex. The orthodontist needs to calculate the position of the brackets directly in the patient's mouth. And this is difficult, because because of the soft tissues there is no complete view of the jaws. Therefore, the risk of error is high, which affects the correctness of the entire treatment.

In addition, direct bonding is lengthy and uncomfortable for the patient. The procedure takes 1 - 2 hours. The patient must keep his mouth open at all times.

Single-stage fixation of orthodontic systems eliminates errors and discomfort. All brackets are simultaneously transferred from the tray to the teeth in a few minutes.

Important! Regardless of the method of attachment, there are mandatory preparatory procedures: X-ray diagnostics, the choice of design for correction, sanitation of the oral cavity. And just before the enamel is etched with orthophosphoric acid, the ceramic or metal from which the staples are made is isolated, access is improved using a retractor (to lift the lips) and a special stop for the tongue.

Stages of one-stage fixation

Indirect fixation of the bracket system consists of several stages:

1. Removing an impression. It will be used to make a diagnostic model from supergypsum.
2. Drawing out the resulting print. The vestibular slopes of molars and premolars are contoured, the incisal surfaces of the anterior teeth are outlined, and longitudinal and vertical axes are applied. At the point of their intersection is the median center. You need to understand that this is exactly the place where the brackets will be attached.
3. Bracket positioning. They are attached to plaster crowns with a special adhesive (bond). In the same position, they will be on the real teeth of the patient.
4. Making a silicone portable mouthguard. A special material is applied to the model and evenly distributed. After solidification, the resulting shape is removed along with the brackets, cut off from excess silicone.
5. Transferring braces to teeth. A kappa is put on crowns etched with phosphoric acid and dried. Pre-enamel and staples are treated with adhesive solutions. The cap is left for 1 hour until the fixative hardens. At this time, the patient can close his mouth and rest.
6. Removal of mouthguards and fastening of a power arc. Onlays are removed, teeth and braces are cleaned of silicone and adhesive residues. An arc is threaded into the brackets and fixed with ligatures or in slots-locks.

Additional Information! Since full bonding of the adhesive takes place within 24 hours, the clinician may postpone the installation of the power arc until the following day.

The installation of braces using the indirect fixation method looks better on professional training videos.

Advantages of indirect fixation of braces

The method of indirect fixation is preferable to direct fixation due to numerous pluses:

• less stress for the patient and the orthodontist due to the quick installation of the brackets;
• on the diagnostic model, it is possible to determine the position of each bracket to fractions of a millimeter and correct it in a timely manner, this is impossible with direct bonding, since it is impossible to fully assess the size and position of the crowns due to soft tissues and the lack of a normal view of the inner surface of the teeth;
• due to the high accuracy of the location of the brackets are reduced;
• complications associated with positional errors are excluded - bite opening, the formation of excessive interdental spaces, and others.

Important! The only disadvantage of the technique is the long-term production of casts and mouthguards. But it is more than offset by significant benefits.

Both methods of fixation of braces - direct or indirect - are successfully used in orthodontics. But, if possible, it is better to prefer the second. It eliminates the risk of errors and related complications. If you have to use direct positioning, you need to choose a dentist with more experience. This technique is complex, and its implementation, in fact, is a jeweler's work. Therefore, it can be difficult for young doctors with insufficient practice.