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What are Orthodontic Brackets

Bracket is defined as a device that projects horizontally to support auxillaries and is open on one side usually in vertical or horizontal

Brackets are the passive components of fixed orthodontic appliance therapy. Brackets act as handles to transmit forces from active components (archwire) to teeth.They have one or more slot to accept archwire.

                 

                      

According to type of slot

Ribbon arch
Edge wise
 
According to mode of attachment

Weldable brackets
Bondable brackets
 
According to material used to fabricate the bracket

Metallic
Ceramic
Plastic

According to slot size:

0.018’’× 0.025’’
0.022’’×   0.028’’

Edge Wise Brackets

Used in edgewise and straight wire technique.
They have horizontal slot facing labially.
They provide greater control over tooth movement and do not permit tipping of teeth.

 
 

Ribbon Arch Brackets

They are used in Begg fixed appliance therapy.
They possess vertical slot facing occlusal or gingival direction.
Slot is narrow mesiodistally.
This is used with round wires to bring about tipping of the teeth in labiolingual as well as mesiodistal direction.


Bondable Brackets

Brackets which are directly boded over the enamel are called bondable brackets.
Undersurface  of bondable brackets have meshwork or grooves to help in interlocking with the adhesive.

Weldable brackets

They are welded or soldered onto the bands which in turn are cemented around the teeth.
They have metal flange which can be welded to the band.

Metallic Brackets

 
 
 

Most commonly used are stainless steel brackets.
But due to allergic reactions to nickel content, titanium brackets are also available

Advantages of metallic brackets

They can be recycled
They can be sterlised
They resist deformation and fracture
They exibit least friction at wire-bracket interface
They are not very expensive

                        

Disadvantages of metal brackets
Non-esthetic
Tend to get corrode and cause staining of teeth.

Ceramic Brackets

  1. Introduced to orthodontics in late 1980’s
  2. Made of aluminium oxide or zirconium oxide.

Advantages of ceramic brackets

  1. They are dimensionally stable and do not distort in the oral cavity.
  2. They are durable and resist staining in oral environment.

Disadvantages of ceramic brackets

  1. They are very brittle and therefore fracture or crack when undue forces are applied.
  2. To compensate it’s brittleness their size is increased which tend to increase their bulk.
  3. They exhibit greater friction at wire-bracket interface


 

 

Plastic Brackets

  1. Introduced during early 1970’s
  2. Usually made of polycarbonate or modified form of polycarbonate.
  3. Available in tooth colored or transparent forms.

Disadvantages of plastic brackets

  1. Tend to discolor particularly in patients who smoke or drink coffee
  2. They offer poor dimensional stability
  3. Their slot tend to distort
  4. The friction between bracket and metal archwire is very high
     

Lingual Brackets

  1. These are modified brackets bonded to lingual surface of teeth.
  2. These are similar to conventional metallic brackets, but treatment mechanics involved in lingual orthodontics differ from standardized labial brackets.
     
 
 

Invisalign Braces

Invisalign is a series of clear, removable aligners that both orthodontists and dentists use as an alternative to traditional metal braces

 

Advantages of Invalign Braces

  1. The most obvious advantage of the treatment is cosmetic: the aligners are completely transparent, therefore far more difficult to detect than traditional wire and bracket braces..
  2. The aligners are marketed as being more comfortable than braces.
  3. Due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.
  4. Aligners avoid many of the side effects of traditional fixed appliances, for example the effects on the gums and supporting tissues. The aligners give less force per week and less pain than do fixed appliances (traditional metal braces). Fixed appliances are adjusted approximately every six weeks and apply greater forces.
  5. Aligners should be removed to eat, drink, to clean the teeth, or to have them checked by the clinician. (It is acceptable to wear aligners while drinking water.)
  6. Computerized treatment planning is compulsory as part of the Invisalign protocol. As with other forms of orthodontic treatments that incorporate a computerized plan, this allows the prospective patient to review the projected smile design, learn how long the treatment is likely to take, compare different plans, and make a more educated decision about whether or not to use Invisalign.
  7. Invisalign treatments have been claimed to be quicker than traditional orthodontics.

Disadvantages of Invisalign Braces

  1. The product also has potential disadvantages: the very fact that the aligners are removable means they are not continually correcting the teeth.
  2. Unlike traditional fixed braces, they are largely dependent on a patient's habits and their consistency in wearing the aligners.
  3. The success of the Invisalign aligners is based on a patient's commitment to wear the aligners for a minimum of 20-22 hours per day, only removing them when they are eating, drinking, or brushing their teeth.
  4. The system is also somewhat expensive, as conceded by the Align company, and can be more expensive than traditional wire and bracket systems.
  5. The aligners must be removed for eating. They and the teeth should be cleaned before re-inserting afterwards. This can be troublesome for people who are constantly snacking and may mean the patient has to clean their teeth up to six times daily.
  6. By their very nature, Invisalign aligner trays are not as proficient as fixed braces at moving teeth in the vertical dimension. severe skeletal problems are also difficult to treat.
  7. Unlike traditional braces, if a patient grinds or clenches his or her teeth during the day or while sleeping, the aligners can become damaged
  8. The aligners are constructed of implantable grade polyurethane, there may be cases of allergic and toxic sensitivity reactions to Invisalign

Treatment

Diagnosis and treatment plan. Then, impressions and pictures teeth will be taken for digitization purposes.

The impressions of teeth will be digitized in order to work with a computerized 3-D image of teeth. Then, planning of tooth movements throughout the entire treatment timelineis done. Patient will  be able to see a virtual representation of teeth before, during, and after completion of the Invisalign process customized aligners are created with advanced technology to wear at each stage of treatment. While the number of aligners varies for each individual situation, a full set of treatment typically includes 20-30 aligners per arch.patient  should wear aligners at all times, with the exception of eating and drinking, in order to complete treatment in the timeline determined doctor. During the entire treatment process, patient will be able to watch his teeth gradually moving into place. Aligners are changed after every two weeks.

 

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