Fixed appliances are the most commonly used type of orthodontic appliances. With these, different types of tooth movements can be made on many teeth. For each tooth, a special bracket was produced for that tooth, taking into account its root length, morphological structure, location and angle on the dental arch, and arch wires in various sizes and materials were produced to suit this bracket system. Thus, 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 and having low friction force. Since the metal itself will not change color, there will be no problems such as yellowing etc. on the metal brackets even if colored foods are consumed. 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. These colored elastics can be changed every month so that the wires appear in a different color every month. It should be noted that only when transparent colored elastics are used, these elastics may become colored.
Since metal brackets contain stainless steel in their structure, there is a risk of deteriorating the image quality during some special imaging methods (MRI or Computed Tomography). It may be necessary to remove the brackets before such procedures. However, in this case, it should be shared with the physician that the orthodontic treatment will remain incomplete and the principle of profit and loss should be acted upon. Due to this disadvantage and high visibility of metal brackets, the need and interest in transparent brackets has increased.
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. Although the first transparent brackets were made of this type of acrylic (plastic) material, they were not long-lasting due to their easy breakage, discoloration and wear problems. Later, brackets were produced from porcelain-like materials. Although porcelain brackets are more durable and resistant to coloring than plastic, they still prolong the treatment period by an average of one and a half times compared to conventional metal brackets, as they are more likely to break and break compared to metal brackets and increase the friction force. In addition, although porcelain brackets are produced in colors close to the color of the teeth, they are noticeable with their white color on the teeth because each individual's own tooth color is different.
Nowadays, these disadvantages have been eliminated with the production of transparent brackets, called glass-sapphire brackets, which are completely transparent, much less visible as they reflect the color of the underlying tooth, are more aesthetic, and have almost the same friction force and durability as metal brackets.
Despite these advantages of transparent brackets, they are not recommended in terms of aesthetics, as the transparent elastics attached to them will turn yellow when colored foods are consumed, creating a yellowing appearance, especially in smokers.