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Braces are the most conventional orthodontic system, well-know for us all. It is widely extended and known to all. It consists of a fixed multibrackets system adhered to the internal (lingual brackets) or external (vestibular brackets) surface of the tooth. Once each bracket has been placed on each tooth in a specific position (the doctor will determine the height and position of the braces depending on the movement required), wires (arches) of different thicknesses and materials are joined.
The teeth will be aligned progressively until the aesthetic and functional results are reached.
Lingual orthodontics have the advantages of aesthetic orthodontics and the mechanics of braces orthodontics. It consists of placing the brackets (conventional or self-ligating) on the inside of the teeth.
Despite having many advantages in terms of aesthetics and functioning, this technique has many disadvantages in terms of discomfort (sores or ulcers on the tongue due to continuous friction with braces and wires when speaking and eating), hygiene (it makes good brushing difficult as it is more tricky to clean correctly around the bracket on the inside of the teeth), and lastly, the price. Due to the anatomy of this dental surface, it will be necessary to use customised brackets for each patient, which increases the cost compared to a bracket system attached to the outside of the teeth.
Conventional braces are a fixed appliance system that has been used since the appearance of orthodontic treatments. The main feature of this is the system that joins the brackets and arch (the wire that connects all the brackets).
Traditionally this union was carried out by means of elastic or metallic ligatures. A rubber band that is placed around the brake (which children prefer coloured) and that maintains the support of the arch and that the movement we need is reproduced.
Today, there are few treatments in which we prefer to use this type of braces, because by incorporating an elastic system it will generate a less continuous force, it is inactivated earlier with contact with saliva, it retains more bacterial plaque and it causes the treatments to be longer, requiring a greater number of visits to carry out the change of the elastic ligatures.
For many years, this has been the most aesthetic orthodontic system we had. It works the same way as conventional metal braces, but these had the advantage that the colour of the braces themselves could be white or transparent, thus offering adult patients the possibility to have less visible braces.
There are many drawbacks to this technique, and therefore in recent years we have rarely applied it. The elastics that surround the braces absorb the staining of food and tobacco and thus this system becomes a very unsightly system, instead of being an aesthetic one, due to the brownish or yellowish colour it acquires. The contact of the wire with the material of the aesthetic braces does not favour to correctly perform the necessary movements either, which is why these treatments tend to need more time.
These braces can be made of porcelain, ceramic, plastic or sapphire. However, now we can combine aesthetics with optimal functioning with other types of orthodontic systems.
Currently this is the most used and most advanced braces system.
These braces use a specialised clip in place of elastics to help the archwire guide teeth into place. It offers improvements in terms of treatment time, discomfort for the patient or reduction in the number of office visits required.
Aesthetic self-litigating metal braces offer an advanced desing to improve the treatment time and the orthodontic efficacy, and additionally, it offers an improvement in aesthetics compared to self-litigating metal braces.
The bracket is transparent or white. This option is preferred by adult patients who opt for a bracket treatment.
Contact Dr. Concha Gross and tell her about your case. We’ll tell you which type of braces best suit your mouth.
The step prior to starting any of these treatments is the same for any type of orthodontic treatment. An oral cleaning is carried out and we have to check if it is necessary to perform any previous general dentistry treatment.
Once we have guaranteed the oral health of the patient, we can proceed with orthodontics.
As mentioned in the section about orthodontic treatment with aligners, before starting a treatment with braces, it will be necessary to assess the state of the oral health of the patient. If it is necessary, it will be improved and an orthodontic study will be carried out.
This study will require the same tests (intraoral and extraoral photographs, panoramic radiograph, teleradiography, dental CBCT in adult patients, and virtual models using an intraoral scanner). It must be taken into account that before deciding to apply a treatment with braces or aligners, it is necessary to carry out a complete diagnosis to assess what suits best the patient’s needs.
When the patient decides to follow the treatment with braces, the first step is to proceed with the cementation (placing each bracket on the tooth) for starting the orthodontic treatment.
This visit at the office will be the longest one, since this procedure takes 60-90 minutes
approximately. After explaining to the patient the details of the orthodontic treatment, the hygienist from our orthodontic team will proceed to prepare the teeth for placing the braces. The tooth surface is cleaned with a cup or brush to remove any remains of bacterial plaque.
A cheek retractor is placed to keep the teeth as isolated and dry
as possible, and the doctor will carefully and delicately place each bracket in its position. After joining them all with a very thin archwire, the patient will be taught the hygiene techniques to follow at home. Additionally, the patient will be told about the possible inconveniences that may arise during treatment and how to solve or prevent these, as well as the indications regarding to foods that should be avoided.
Once the treatment with braces is started, the check-ups will be carried out every 4, 6 or 8 weeks, depending on the type of brackets used, or the phase of the treatment. In each revision, it will be checked if any brackets have been detached, and in that case, these will be placed again, the rubbers will be changed in case of using a conventional bracket technique. Also, every 3 months approximately, the archwire will be replaced, progressively increasing in size and varying its material.
After these check-ups, you may feel some pressure on your teeth, but it shouldn’t cause you pain. As a general rule, check-ups take approximately 15 minutes, but these can last some more time if the replacement of any braces is needed or adding an additional accessory is necessary.
When the orthodontic treatment is complete, an appointment will be scheduled for removing the braces. This appointment, like the first, will be longer than the check-ups.
One of the hygienists of the orthodontic team will remove the brackets from each tooth one by one, which is a painless procedure. Then, the composite remains will be removed from the tooth surface and the retainer is placed.
Treatments with braces require more care than orthodontic aligners, since these can cause more issues that need to be treated as emergencies and which we have to try to avoid for the correct evolution of the treatment.
Use of dental wax to avoid sores and chafing
The mucosa of the mouth is very delicate and the contact with new elements such as braces can cause damage, sores or chafing. These appear usually in the first days of the orthodontic treatment. However, these can be avoided if dental wax is used correctly —in the first visit, we will show you how to use it—.
Avoiding excessively hard or sticky foods.
There are certain foods that should be avoided when we begin an orthodontic treatment. Very sticky foods such as gum, sweets, candies such as Sugus will adhere to the braces causing the brackets to come off when you open your mouth. I n the same way, very hard foods (nuts, popcorn, very hard bread…) can also detach the brackets, causing discomfort for the patient, and provoking a delay in the end date of the treatment if this occurs repeatedly.
Hygiene
One of the most important points when starting the treatment with braces is to insist on the dental hygiene guidelines at home. It is essential to brush your teeth after each meal, to avoid possible food remains that can be retained around the braces. The duration of brushing should be longer than usual, accessing all the nooks and crannies where food and bacteria can get trapped. We will advise you which brush you should use, and we will show you how to use superfloss and interdental brushes for a better result.
For orthodontics with aligners apply the same tips.
Once the brackets are removed, the fixed retention will be placed and the mouth will be measured for making the removable retainers.
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Sapphire braces are a type of aesthetic orthodontics used to solve alignment and bite problems, just as effective as traditional ones but with the feature of being very translucent.
Currently, many patients request dental alignment treatments and they don’t only look for an effective treatment, but they want it to be as invisible as possible while wearing it. That is why we will talk about the advantages and disadvantages of sapphire brackets.
The main advantage of sapphire braces is that, thanks to this material, the braces are completely transparent and their colour does not change over time, thus blending with the natural colour of the teeth. But still, it is important to have into account that staining can occur depending on the patient’s habits and dental hygiene.
Completely transparent and their colour does not change over time.
The habits that can cause staining are smoking, beverages such as wine or coffee, or certain food colourings. Even so, if patients maintain a correct dental hygiene routine, staining problems should not appear.
Sapphire brackets are much more resistant compared to plastic or ceramic brackets. The reason behind this is that the latter experience changes over time, thus losing their aesthetic qualities. In this respect, the metallic ones are still the best.
To benefit from the advantages of the different types of braces, these two systems can be used, wearing the sapphire braces on the more
visible teeth (upper part) and the metal braces on the rest of the teeth.
One advantage of sapphire braces over metal orthodontics is that these cause fewer sores and chafing in the mouth.
Being just as effective, the treatment with sapphire brackets requires more time than with metal ones. This is because sapphire increases friction with the arch, slowing down the movement of the teeth.
For patients who practice contact sports, there are sports protectors manufactured especially for these cases.
This type of foods can cause the bracket to break and consequently, it will have to be replaced to continue with the treatment.
La rutina para una correcta higiene cuando llevas brackets seria la siguiente:
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CLINICA DENTAL GROSS SL ha sido beneficiaria de Fondos Europeos, cuyo objetivo es la mejora de la competitividad de las PYMES, y gracias al cual ha puesto en marcha un Plan de Acción con el objetivo de impulsar el uso seguro y fiable del ciberespacio y la competitividad de las pymes durante el año 2024. Para ello ha contado con el apoyo del Programa Pyme Cibersegura de la Cámara de Comercio de Málaga. #EuropaSeSiente
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