How are braces placed on teeth? Direct and indirect fixation. Methods and features of installing braces Direct installation method

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, 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 associated 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.

Fixation of braces is the most important stage of orthodontic treatment.

The positioning of the locks on the teeth determines how successful and fast the correction of the anomaly will be.

The strength of the braces is also of great importance. A detached lock will require an urgent visit to the doctor for gluing it, and, possibly, correction of the treatment.

Preparatory activities

All actions to prepare for the fixation of braces can be divided into three groups:

• ensuring a healthy state of the oral cavity (sanation);
• contributing to qualitative correction (removal of problematic elements);
• performing preventive functions (professional cleaning).

Sanitation of the oral cavity is a mandatory event carried out before any orthodontic treatment.

Its implementation includes:

• treatment of visible and hidden(they appear on the radiograph, give themselves out as a change in the color of the teeth) carious cavities;
• elimination of inflammatory processes in the pulp(vital or devital depulpation);
• restoration of broken crowns(depending on the nature of the lesion, intracanal pins are installed, artificial crowns are put on, or restoration is carried out with composite materials);
• treatment of inflammatory processes on the oral mucosa(gingivitis, periodontitis).

Maintaining a clean oral cavity is essential. Before fixing the bracket system, it is desirable to carry out professional cleaning with the removal of subgingival and supragingival deposits.

Sick, non-viable elements and roots are removed before installing the orthodontic system.

Surgical correction of pathological frenulums and removal of wisdom teeth is carried out only if they cause a functional disorder of the jaw apparatus.

Positioning Methods

Before you go to the clinic to install braces, you need to eat (to reduce salivation) and brush your teeth.

The locks of the system are attached to the outer or inner surface of the teeth with adhesives. The correct vertical position of the castle depends on the type of the latter (canine, incisor, painter or premolar), its anatomical structure and position.

In addition to individual requirements, there are general rules for positioning braces:

• The center of the lock groove must match the center of the clinical crown. vertically and horizontally.
• The value of the compensatory height changes from the central incisors to the side, and on to canines, premolars and molars.

There are two main fixing methods:

• straight;
• indirect.

direct method

The technique of the direct method involves the fastening of each lock separately. The following materials and tools are used.

materials

• Etching Gel or a 37% phosphoric acid solution.
• Glue for fixing braces. Various adhesives can be used - two-component composite compositions (base solution + catalyst), No-Mix materials (activator + adhesive), composites and light-cured glass ionomers.

Tools and fixtures

• Crescent scaler.
• Cotton tongs.
• Saliva ejector.
• Reverse tweezer.
• Lip retractors.

Sequence of operations

Fixation of braces using the No-Mix adhesive composition is performed in the following sequence:

• markup(a vertical and horizontal axis is drawn on the surface of the tooth, the intersection point of which during installation must coincide with the center of the bracket groove).

• Etching of enamel.
• Washing the "pickling" with water or a special neutralizer.
• Drying blown air or dryer.
• Checking the quality of etching. With normal etching, the surface of the tooth becomes matte. The presence of gloss indicates poor etching.

  Its cause may be the properties of the patient's enamel (increased acid resistance), the use of fluoride pastes, enamel hyperplasia, saliva or moisture that got on the tooth during etching, insufficient rinsing or drying.

• Application of the activator on the enamel and base of the bracket.
• Adhesive application on the supporting surface of the lock, pressing the bracket to the tooth and keeping it under load for 10 seconds. Then the excess glue is removed.

The advantages of the direct method are time saving (no need to take impressions, mold a plaster mold, make a cap for transferring braces).

The disadvantages include:

• Errors in positioning sometimes leading to treatment failure. The situation with the position of the teeth may be worse than before the treatment.
• High requirements for professionalism doctor.
• Significant physical and emotional stress dentist.

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

indirect method

The indirect method involves the installation of braces in two stages - first on a plaster model, then transferring them to the dentition.

Various technologies for transferring brackets from a plaster model to the teeth are used - BEST, CLASS, TOP, Esipovich cap, etc.

They differ in some parameters (using 1 or 2 caps, transferring in 1 or 2 steps, etc.), but their basic principle of operation is the same and is as follows:

• The braces fixed on the plaster model are covered with a silicone or other compound, which, when cured, turns into a cap with locks fixed in the position in which they were on the model.
• After etching and smearing the teeth and bases of the brackets with adhesive, the cap is installed, pressed tightly and removed again.

As a result of this operation, the braces remain on the teeth in the same position as they were on the plaster model. Sometimes a mouthguard with braces is cut into segments that are easier to put on and take off.

With the indirect method, most of the work is done in the laboratory.

Sequencing

• Removal of impressions from the jaws.
• Making plaster models from impressions.
• Installation of braces on a plaster model.
• Transferring them to the cap.
• Preparing the surface of the enamel (the same steps are performed as with direct fixation - etching and smearing with glue the teeth and the bases of the locks in the cap).
• Installing a mouth guard with braces on the teeth, crimping it.
• Cap removal (brackets remain on the enamel).

Advantages of indirect fixation:

• Predictability results.

• Patient comfort, getting rid of the need to spend a lot of time in the chair.
• Exclusion of medical errors and their corrections. Ultimately, the time spent on treatment with an indirect method is often less than with a direct one.
• Comfort for the doctor and a technique that can do the main work in the laboratory without haste and psychological stress.

The only but significant drawback of the indirect method is the increased labor intensity associated with the need to make impressions, plaster models, and caps.

See in the video how braces are installed indirectly.

Thomas Pitts table

One of the main difficulties when installing braces is their vertical positioning on the tooth. Many protocols have been developed to facilitate this work for the orthodontist (MBT, Alexander, etc.).

Their essence lies in the fact that the location of the bracket on a particular tooth is determined by adding or subtracting from the basic value of the compensatory height, the value of which is different for each element.

The base value is the height of the bracket on the premolars. The value of compensatory heights for different teeth are summarized in tables that dentists use when installing orthodontic systems.

Dentist researcher Dr. Tom Pitts and his colleague Dr. Thomas Castellanos developed their table for the vertical positioning of brackets. Its difference from other methods is that it provides not only teeth alignment and normalization of occlusion, but also an aesthetic component, called the “smile arc”.

Another feature of the Tom Pitts table is lack of compensatory height in it. Instead, it contains the absolute values ​​of the heights of the locks.

Reference. The harmony of the face during a smile depends not only on beautiful even teeth, but also on the correspondence of the contour of the edge of the upper frontal units to the shape of the lower lip.

Ideally, the line drawn through the tops of the center tops should be parallel to the top line of the lower lip.

Below is a table by Tom Pitts, which contains the required height for positioning brackets on different units.

Using the Pitts table

• Tooth length is measured- the distance from the edge (for incisors it is a cutting edge, for molars and premolars - a tubercle) to the edge of the gum.
• The Pitts table contains the value of GPS-A corresponding to the measured tooth height.
• By GPS-A in horizontal rows of the table are the positioning heights of brackets for specific teeth.

To get the perfect smile arc, the edges of the frontal units are sometimes recontoured (sanded) before using the Pitts chart.

Resilience adhesive system

Resilience adhesive is designed to fix braces and trainers made of various materials.

Characteristics

• light cured(does not harden until it is irradiated with light, which allows you to work without haste).
• fluid(due to the low viscosity and the presence of various nozzles, it is possible to use in hard-to-reach places).
• Contains fluorine.
• Hardens immediately after light treatment, so there is no need to pause between irradiation with light and setting the arc.

Purpose

• fixation of lingual and vestibular braces and retainers made of metal, ceramic and composite.
• Making overlays in the lateral segments to open the bite when using the indirect method of attaching brackets.

Equipment

The package includes:

• Primer (1 pack 7 ml);
• Glue in syringes (4 pcs. 3.5 g each);
• Etching gel (1 syringe, 4 g);
• Replaceable tips, 5 pcs.;
• Mixing pad, 2 pcs.;
• Mixing sheets, 50 pcs.
• Holder, 1 pc.;
• Tassels 20 mm long (40 pcs.) and 50 mm long (10 pcs.).

The cost of one set is from 10,000 rubles. A trial set is also offered at a price of 2500 rubles.

Issue price

The cost of installing braces depends on their type (lingual or vestibular), manufacturer and brand, material (metal, ceramics, sapphire, plastic). The status of the clinic and its location also affect the price.

Estimated prices for the installation of braces, depending on their type and material

• Proper hygiene oral cavity.
• selective nutrition. Exclusion from the diet of solid, too cold and hot food.
• Regular visits to the dentist(immediate in case of braces coming off).

To keep your teeth with braces in perfect cleanliness, one brush is not enough. It is recommended to purchase additional products - a single-beam, orthodontic and lingual brush, flosses, brushes, toothpicks, rinses, elixirs, deodorants, irrigators.

If the elements of the bracket system injure the mucous membrane, orthodontic wax should be used.

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 course 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.

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

This is done so 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.

Absolutely everyone can become the owner of a beautiful smile now. In the dental clinic, you will be offered a variety of orthodontic designs to choose from, depending on the problems and financial possibilities. In most cases, to achieve the desired result, it is necessary to use braces. With their help, you can eliminate almost any pathology of the bite. Today we will analyze in detail how the installation of braces goes, what to expect from this procedure.

At the initial appointment, the orthodontist will conduct a visual examination and make a preliminary diagnosis. To confirm it and develop a treatment plan, you will need to carry out additional procedures - take x-rays, take casts. In addition, special preparation is required for the installation of braces.

1. Braces put a lot of stress on the teeth, so before installing you need to make sure that there are no carious lesions. Teeth must be perfectly healthy. Before installing braces, a thorough sanitation of the oral cavity is carried out. All old weak fillings are necessarily replaced, carious damage to the enamel is eliminated.
2. Before you install braces, you need to cure all periodontal diseases. If there are even minor inflammatory processes, they can become aggravated with increased load while wearing orthodontic structures. Therefore, it is first recommended to cure and strengthen the gums.
3. Another important condition is that braces must be installed on an absolutely clean surface. Therefore, professional cleaning is preliminarily carried out, tartar and plaque are removed. Now there are several methods of professional teeth cleaning. For example, ultrasound or special fluorine-containing preparations.

Before placing braces on your teeth, the orthodontist will warn you about the importance of good oral hygiene during treatment. The doctor will give recommendations on the use of various tools that will help you maintain impeccable cleanliness of your teeth and provide reliable protection against caries.

Installation steps

Now let's look at what stages the procedure for installing orthodontic structures includes, how long it lasts and what sensations you will experience.

1. For convenience, the orthodontist installs a special expander that provides free access to all teeth. Preparatory procedures are carried out - the enamel is polished and covered with a restorative composition. Then it is washed off, and the teeth are well dried.
2. Each element to be installed is fixed to the surface of the tooth with a special adhesive. This is the most critical part of the braces installation process. An error of just one millimeter will lead to incorrect load distribution.
3. The braces are connected to each other into an integral system with the help of an arc, which will be responsible for the movement of the teeth. Depending on the type of construction, its fastening is carried out with special locks or ligatures.
4. After installation and throughout the entire period of correction, activation of the braces should be carried out periodically. This is a common procedure for orthodontic systems. In order to create the right level of pressure on the teeth, the braces must be periodically activated. This consists in the replacement of arcs and ligatures, as well as the imposition of rods, springs and other elements of the system designed to create constant pressure. The procedure for activating the bracket system is carried out at the time appointed by the orthodontist.

There are general points for installing any type of braces. In any case, the design is installed first on the upper and only then on the lower jaw. The average time for all manipulations can be 1.5-2 hours. But there are also differences. For example, how lingual and vestibular braces are installed. Due to fixation on the inside of the teeth, lingual structures are much more difficult to install.

Methods for fixing braces

If you don't know how braces are placed, then it will be new to you that there are two completely different ways to install these orthodontic structures.

1. The direct method involves the manual, piece-by-piece installation of each element. Since this must be done with the utmost precision, the orthodontist checks the panoramic image during installation. Only after gluing the bracket on one tooth does the specialist move on to the next one. In modern orthodontic practice, this method is still the most common.
2. Indirect fixation of braces is a fairly new technique, which is not yet used in all dental clinics. But it is more accurate, reduces installation time, and discomfort is minimized. The technique involves the simultaneous gluing of all braces using a cap. How it's done? An exact plaster model is made according to a cast of the patient's dentition. Braces are placed on it and in this form are transferred to a special cap. Putting a cap on the patient's dentition, the orthodontist simultaneously fixes all the braces.

Many orthodontists consider the indirect fixation technique to be more advanced and effective. As already mentioned, the duration of the procedure is reduced, there are guarantees that the braces will stand correctly. Over time, this technique has become more and more in demand in the practice of qualified orthodontists.

Period of adaptation to the system

The first days after the installation of braces, the patient inevitably experiences unpleasant or painful sensations. They do not appear immediately - the installation itself proceeds completely painlessly. But literally after a couple of hours, pain in the jaw area makes itself felt, there is a feeling that the teeth are slightly loose. This is completely normal and only indicates that the process of bite correction has begun safely..

Painful sensations usually occur only at the very beginning of the correction. Literally after a few days, in rare cases within two to three weeks, they weaken, and then disappear altogether. If on the first day you experience such pain that it is impossible to endure, then it is allowed to take an analgesic tablet. The adjustment period is different for everyone.

How much does it cost to install braces?

When planning to start bite correction with braces, everyone is interested in how much this procedure costs. There are a considerable number of factors that form the final cost of bite correction with bracket systems. First of all, this is the cost of the braces themselves. Depending on which type of design is chosen, their cost varies from 20,000 to 100,000 rubles per jaw. The cheapest are classic vestibular metal braces, the most expensive are lingual braces, installed on the inside of the teeth.

The price also includes the installation process itself, additional orthodontist appointments throughout the entire period of correction, replacement of archwires. The need to treat teeth before installing the structure is another cost item. That is why it is very problematic to calculate some average figures for the cost of orthodontic treatment - there are too many individual factors that must be taken into account.

Now you know how bracket systems are installed, what you need to be prepared for when contacting an orthodontist, and how long the adaptation period lasts. In conclusion, we invite you to watch a video that schematically demonstrates the process of installing metal braces.

From this article you will learn:

• what are the braces for teeth: photos, which ones are better,
• ceramic braces, metal braces - reviews,
• how much do braces for teeth cost - price 2020 in Moscow.

Braces have been used to correct crooked teeth since 1955. The term "braces" refers to only one element of the bracket system - these are metal or ceramic plates that are glued to the teeth. In addition to the braces themselves, such a system includes a metal arc, ligatures, springs and many other elements ...

How many wear braces -
the average duration of bite correction with braces is approximately 2-3 years. But with small changes in the bite, it can last about 1 year. The optimal period for the start of correction of malocclusion is from 8 to 14 years (at this age, the facial bones are still growing, which fits the movement of the teeth). In adults, tooth movement takes longer than in children.

Ceramic, lingual and metal braces: photos

How braces work

The standard bracket system consists of 3 main components –

1. braces (special plates that are glued to the teeth),
2. metal arc (with its help the braces are interconnected),
3. the mechanism for fixing the arc in the bracket groove (with the help of ligatures or locking fasteners).

Braces work by applying constant, slight pressure to the teeth. Pressure is generated by a metal wire that passes through each bracket and connects them to each other. In the process of treatment, the orthodontist will use metal arcs of different shapes and thicknesses, will weaken or tighten the ligatures more - all this allows you to change the degree of pressure on the teeth, achieving their desired position.

It must be said that not only the teeth themselves experience pressure, but most importantly, the bone tissue around them. Under the pressure experienced in the bone tissue, the processes of bone remodeling are launched (parallel bone resorption in the direction of tooth movement, and its formation behind the direction of tooth movement). This process is very slow and therefore the treatment takes a long time.

Types of braces -

All types of braces can be classified according to several parameters, for example, according to the type of material and design features. The pros and cons of each type are detailed below.

Bracket system: types (table 1)

Braces: photo

In the photo you can see different types of braces listed in Table 1

How to choose the right braces

We offer you a model for choosing braces based on several points:

• firstly, to determine the acceptable level of aesthetics,
• secondly, with the level of comfort, reliability and speed of treatment,
• thirdly - with a design (ligature or non-ligature),
• the fourth criterion is the cost of braces.

1. Evaluate the acceptable level of aesthetics first

To choose the right braces, first you need to decide on the level of aesthetics that you expect from them (website). If you are not at all embarrassed by the fact that people will see them, feel free to choose metal braces that are fixed on the front surface of the teeth. Such braces are the most reliable and effective.

If you would like braces to be less visible, then you will have to choose between sapphire and ceramic braces on the one hand, and lingual braces on the other. Braces that are fixed from the inside of the dentition are called lingual braces (these braces are not visible at all).

There is practically no difference between sapphire and ceramic braces. The former are made from monocrystalline alumina, the latter from polycrystalline alumina. They differ from each other only in the degree of transparency. Ceramic - white opaque (they are suitable for people with a darker shade of teeth). Sapphire - translucent (they are more suitable for light-colored teeth).

2. Compare different types of braces with each other in terms of comfort, reliability and speed of treatment -

table 2

To learn more about each type of braces (their advantages and disadvantages), to find out which manufacturers produce this type of braces, and which manufacturer's braces are better to choose - you can read in the detailed reviews ...

3. Ligature braces and non-ligature braces - which are better?

Ligature braces - they have special elastic bands or thin orthodontic wire as a mechanism for fixing the arc in the bracket groove (Fig. 1-5,11,13). Non-ligating braces are also called self-ligating braces; on their surface there is a special snap lock that securely holds the metal arc in the bracket groove (Fig. 12,14, gif).

Non-ligature braces: photo

Non-ligature braces can be made of metal, ceramic, or a combination of materials (for example, the body of the bracket is made of ceramic, and the bracket groove or lock is made of metal, as in Figure 9).

Types of non-ligature braces –

• "Victory", "SmartClip" and "Clarity SL" (Germany),
• "In-Ovation- R", "In-Ovation- FROM", "In-Ovation- L"(USA),
• "Damon clear" (Fig. 14), "Damon Q", "Damon 3-MX" (USA).

If your doctor says that only non-ligature braces are suitable for yours, then he is clearly disingenuous. The fact is that they usually cost 2-3 times more to correct an overbite with such braces. And such a price appears not so much because of a slightly increased cost, but primarily due to the fact that self-ligating braces are positioned in advertising as the most modern and most effective.

Comparison of ligature and non-ligature braces -

• Ease of changing the type of ligation(universality) –
  there is active and passive fixation of the metal arc in the bracket slot (ligation type). Active fixation means that the archwire will be tightly clamped in the bracket groove and will not be able to slide freely in it (Fig. 15). With passive fixation, there will be no tight contact between the wire and the bracket slot, and the wire will slide freely in the slot (Fig. 16).

  The only disadvantage of metal braces is that they are clearly visible on the teeth. But you can give them personality and make them colorful by using multi-colored rubber ligatures. And for the most fashionable, it is possible to install braces in the form of hearts, flowers, soccer balls or stars. See table 2 for all the advantages and disadvantages of metal braces.

  How much do braces cost: price in Moscow 2020

  1) Consultation with an orthodontist - usually free of charge,
  2) Diagnosis (taking and making casts, analysis of control diagnostic models, calculation of TRG, analysis of OPTG, preparation of a treatment plan) - 1,600 rubles.

  The cost of braces with installation and retainer −

  Braces - the cost is indicated on average in Moscow for 2 jaws. The price also includes: wire retainer + braces installation + braces removal. Accuracy ±10,000 rub.:

  3) Ligature metal braces - price from 35,000 to 45,000 rubles.

  4) Non-ligating (self-ligating) metal braces −

  • braces "Victory" - 110,000 rubles.
  • braces "Smart Clip" - 120,000 rubles.
  • braces "Damon Q" - 115,000 rubles.
  • braces "Damon 3 MX" - 160,000 rubles.

  5) Ceramic braces −

  • ligature - price from 40,000 to 50,000 rubles.
  • non-ligature (self-ligating) - price from 130,000 to 175,000 rubles.

  6) Artificial sapphire braces −

  • ligature "Inspire-ICE" - price 150,000 rubles.
  • non-ligature "Damon clear" - the price is 160,000 rubles.
  • braces Stb - price from 190,000 to 230,000 rubles.
  • braces In-Ovation-L - the price is about 250,000 rubles.
  • braces brand "Incognito" - price from 300,000 to 400,000 rubles.

  8) Braces correction session (performed once a month) - about 2-2.5 thousand rubles.

  Bracket info: frequently asked questions

  How safe are braces for teeth?

  In general, wearing braces is a safe procedure. However, wearing them complicates oral hygiene, which can lead to the accumulation of plaque and hard tartar. If plaque and stone are not removed in time, this is hello to the development of caries and inflammation of the gums.

  Secondly, the process of moving the teeth leads to the fact that the roots of the teeth become a little shorter (the tops of the roots are partially dissolved). Loss of root length can lead to less tooth stability, especially in people who initially have short physiological root lengths.

  What are the benefits of early treatment?

  When correcting an overbite, in most cases the patient will go through a stage where his upper incisors will (temporarily) protrude forward. Such protruding teeth, especially in children, are most susceptible to injury from falls and bruises; besides, it's not very aesthetically pleasing. Early treatment avoids this situation.

  Also, early correction of the bite allows the orthodontist to positively influence the growth of the jaw, the width of the dental arches, improve the aesthetics and self-esteem of the child, and eradicate bad habits. The process of eruption of permanent teeth is also improved by creating a place for eruption (with its lack), the total time of orthodontic treatment and its cost are reduced, and diction is improved. We hope that our article on the topic: Braces reviews of patients and doctors turned out to be useful to you!

  Sources:

  1. “Orthodontics. Textbook for dentists "(Kutsevlyak V.I.),
  2. American Association of Orthodontists (USA),
  3. National Library of Medicine (USA),
  4. "Conceptual Orthodontics" (Stefan Williams),
  5. "Fixed orthodontic equipment" (Gerasimov S.N.),
  6. https://www.realself.com/.