Orthodontic Appliance Types
In order to achieve the desired goal in orthodontic treatment, a treatment plan is first made and to implement this plan, the most appropriate treatment tool is selected for that person according to the patient's age, degree of problem, aesthetic or social concerns, and socio-economic status. These treatment tools are quite diversified today. If we list the types of orthodontic treatment tools, starting from the most well-known and frequently used ones:
Fixed Appliances:
Fixed appliances are the most commonly used type of orthodontic appliances. With these, different types of tooth movements can be made on many teeth. In addition, fixed appliances are the only type of orthodontic appliances that can provide different movements to different teeth at the same time. Another advantage of fixed appliances is that less patient compliance is required compared to removable appliances, because, as the name suggests, they are glued to the teeth and remain fixed throughout the treatment.
Fixed appliances generally consist of bands, brackets and wires. Brackets are square-shaped materials that are adhered to the teeth with materials similar to special filling materials. They serve to transmit the forces created by arch wires to the teeth. Since bracket adhesives are materials produced for this purpose, they are resistant to breaking up to a certain force. For this reason, ruptures may occur at forces exceeding this certain limit. Although bracket rupture does not cause much damage to tooth enamel, it disrupts the course of treatment and prolongs the treatment time. For this reason, in order to prevent the brackets from breaking off from the teeth, our patients should not consume hard foods and avoid sports or trauma that will apply direct force to the brackets. Your doctor will inform you about this with necessary warnings before the treatment and at each session, and will give you a list of food and beverage prohibitions and things to pay attention to.
Brackets are basically divided into two types, metal brackets or transparent brackets, depending on the materials they are made of. Metal brackets are the most commonly used and best known. Apart from its bright and plain appearance, metal has advantages such as being easy to clean. When metallic or transparent colored elastics are used, it can give a plain look, but when you want it to be more cute or eye-catching, it can also be given the appearance of colored wires by attaching colored elastics to it.
In recent years, many innovations have been made to make brackets less visible and more comfortable to use, and thus smaller, elegant-looking mini brackets have been developed. Clear brackets made of porcelain or hardened plastic instead of metal have also come into use. Since the first transparent brackets were produced from acrylic (plastic) material and later from porcelain-structured materials, these brackets were more likely to break and break, and since they increased the friction force, they extended the treatment period compared to conventional metal brackets. Nowadays, these disadvantages have been eliminated with the production of transparent brackets, called glass-sapphire brackets, which are more aesthetic and have the same friction and durability as metal.
Movable Appliances:
These are devices that the patient can put on and remove himself. Removable appliances are generally used to move a single or a group of teeth and their capacities are limited. It is generally used in children (between the ages of 7 and 12) who have not all their permanent teeth and are in the mixed dentition period. The aim here is to expand the jaw by taking advantage of the potential of the developmental period if there is a lack of space in the jaw bone, thus creating the necessary space for the erupting permanent teeth. Sometimes, what we call two-stage treatment can be completed with the early treatment, in which removable appliances are used for jaw expansion, and then the second stage treatment, in which fixed brackets are glued after all permanent teeth emerge.
Appliances Applied Extraorally
These are devices that give strength to the teeth and jaws by taking support from areas outside the mouth, such as the nape, forehead, and tip of the chin. These are used to support intraoral appliances during the collective movement of a group of teeth or to direct the development of the entire upper or lower jaw bone. These devices, which are generally used in children of developmental age, can be used when the child is at home, apart from daily activities such as school, and when going to bed at night.
With the developing new technology, extraoral appliances have been replaced by microimplants that are applied from the inside of the mouth and are not visible from the outside.
Microimplants:
Nowadays, instead of large and disturbing appliances that are supported outside the mouth, mini screws (microimplants) that remain inside the mouth and are invisible are offered to orthodontists. By placing one or more microimplants in the required areas, they can be removed when the desired tooth movements are completed without leaving a scar or causing damage, and they have a wide range of uses.
Functional Appliances:
These are appliances used to correct the deteriorated relations of the lower and upper jaw relative to each other at an early age. Most often orthopedic treatment (jaws
n harmony is ensured) and orthodontic treatment (the closing harmony of the teeth is ensured) are carried out together. Removable and removable functional appliances, as seen in the picture above, have now been replaced by new technology fixed functional appliances, as shown in the picture below, due to their large size and dependence on patient use.
Reinforcement Appliances
Reinforcement devices installed at the end of orthodontic treatment protect the tooth in its new position until the newly formed bone hardens completely. Reinforcement treatment is performed until the teeth take the desired position and the newly formed alveolar bone hardens. Reinforcement apparatus can also be mobile or fixed. Removable reinforcement appliances can be in the form of transparent plaques or acrylic appliances, but it should not be forgotten that they depend on the patient's use and if the patient does not use these appliances regularly at the end of the treatment, undesirable deteriorations and reversals may occur in the corrected teeth. Fixed reinforcement appliances are thin wires that are attached to the tongue side of the teeth and are preferred especially by adult patients because they are not visible and do not affect speech.
The duration of the consolidation phase should last at least 3 years, depending on the duration and type of treatment. In some cases, fixed reinforcement devices may never be removed due to the need for lifelong reinforcement.
Treatment with Transparent Plates:
Almost all kinds of orthodontic treatment can be performed with plaques made of transparent materials designed and produced individually with special programs based on three-dimensional digital measurements taken with today's developed intraoral cameras. It is necessary to wear these patient-specific transparent molds, which will be changed every two weeks, for approximately 20 hours a day. Each treatment requires an average of 60 pairs of different corrective molds (upper and lower jaw). The treatment time is close to the treatment time with braces. It varies between 6 months and 24 months depending on the case.