Dental braces for straightening teeth

Braces are a non-removable orthodontic device for the treatment of dental anomalies. Orthodontic treatment is a slow and complex process. The force is created by a metal arc installed in the grooves of the braces. Work productivity increases if the doctor and patient find each other. The design of the bracket system, the doctor’s experience and the patient’s responsibility lead to correct occlusion and stable results.

The material was verified by Anna Rimkevich, senior product manager at Ormco Russia.

A brace system is a tool for correcting a bite in the hands of an orthodontist. Teeth move under the influence of a constant weak force. To speed up the movement of teeth, the doctor uses additional elements: springs, chains, bite pads and elastic rods. After completion of treatment, a correct bite and an aesthetic smile will delight the patient for many years.

The result of orthodontic treatment

The goal of treatment with braces is to form the correct closure of teeth in the sagittal, vertical and transversal planes. In 1972, physician Lawrence Andrews formulated six keys to optimal occlusion in the permanent dentition. When correcting incorrect position of teeth and correcting the relationship between the upper and lower jaw, orthodontists of the 21st century are guided by the signs identified by the researcher:

fissure-tubercle contact of the molars of the upper and lower jaws;
crown angulation;
crown inclination;
lack of tooth rotation;
tight approximal contacts;
parallelism of the occlusal plane of the upper and lower jaw to the true horizontal.

The orthodontist forms the correct occlusion, improves the torque of the teeth and the exposure of the incisors. As a result of treatment, the doctor expands the dentition and creates an ideal smile.

What is an ideal smile? When a person smiles, the anterior teeth, premolars, and mesial surfaces of the first molars are visible. The cutting edges of the incisors and canines of the upper jaw follow the contours of the lower lip and form the arch of the smile.

result of bite correction

History of the creation of braces

Doctors of the ancient world of the 9th - 6th centuries BC straightened teeth using improvised devices. In 1728, surgeon Pierre Fauchard published a study, one chapter of which was devoted to orthodontics. In the 9th century, the American Edward Engle created the first prototype of the braces system. The scientist invented four devices:

E-arc gold alloy;
modification of the E-arch with pins and tubes;
ribbon arc;
edgewise braces.

The operating principle of the structures underlies the operation of 21st century braces.
The E-arch, which expands the dentition, was made of a gold alloy and fixed into rings installed on the molars. Each tooth was tied to an arch with wire. Subsequently, Engle refined the design: adjustable tubes appeared on each tooth and pins on the arch. The pins fixed the arch into the slots, the doctor adjusted the pins, and the teeth moved. The system was not actively used in clinical practice, and the E-arm remained an intermediate option.

Later, an American scientist created a ribbon arch. Engle replaced the tube design on each tooth with a vertical rectangular groove. The crowns of the teeth tilted under the influence of the arc, but the roots remained in place. The limitation in the width of the groove and the low elasticity of the arc did not allow the torque to be controlled.

In 1928, Edward Engle designed the edgewise braces system. The scientist compared the geometry of the groove and the arc and replaced the ribbon arc with a rectangular wire. Engle established the slot size of 0.022 x 0.028 inches, which is what 21st century orthodontists use.

Edgewise braces were not wide enough to rotate the tooth under the force of the archwire. To achieve the result, orthodontists installed two braces on the tooth at once. The design formed the basis of ligature systems. With the development of orthodontics at the beginning of the 20th century, the gold alloy from which the arch was made was replaced by stainless steel. The increased rigidity of the steel compensated for the reduced arc thickness. A groove size of 0.018 x 0.025 inches has appeared, which, along with 0.022 x 0.28, is used in practice by orthodontists.

Damon Clear with arc

How do braces work?

The system consists of brackets fixed to the teeth, into the groove of which an orthodontic arch is inserted, and additional elements. On the sixth and seventh teeth, the doctor installs buccal tubes to secure the ends of the arch. The force on the tooth depends on the rigidity of the arch and the position of the arch in the bracket groove, the use of additional metal and elastic elements:

metal ligatures;
chains;
springs;
bite pads made of composite material or bite braces;
buttons;
hooks;
additional arcs;
elastics.

Damon Q2 with hook

Metal ligatures press the archwire tightly against the bracket, and springs and elastic chains create the force to move individual teeth. Using additional elements of the system, the doctor controls the impact on each tooth.

The arc straightens and pulls the bracket, the force is transmitted to the tooth and causes a process of aseptic inflammation in the surrounding tissues. Osteoclast cells destroy bone at the junction of the root and the alveolar wall. On the other side of the tooth, osteoblast cells synthesize new bone tissue. The balance of osteoblast and osteoclast activity ensures natural tooth movement. Braces direct and accelerate the physiological effect of the force of the arc and additional elements.

arc in groove Damon Q2

The operating principles of self-ligating and ligature systems differ. Self-ligating passive braces provide physiologically adequate force to move teeth due to low friction of the archwire in the closed space of the groove. In self-ligating braces with an active type of ligation, the clip and the arch press against each other. In classic ligature braces, the arch is held tightly in the groove by elastic or metal ligatures.

Braces - what are they and what are they for?

Braces are a permanent orthodontic device designed to correct malocclusion or unevenness of individual teeth. The system consists of clasps attached with dental glue to each tooth and a metal arch threaded through them. Along the edges of the dental row, the system is attached with rings to 6 or 7 teeth. The degree of tension in the arch allows the teeth to gradually move in the desired direction specified by the orthodontist. To ensure that the teeth move as they should, the doctor periodically monitors and adjusts the degree of arch tension. Different types of braces require different frequency of monitoring.

Braces are installed by an orthodontist after preliminary diagnosis and identification of the patient’s pathology.

Incorrectly selected or installed braces can lead to systemic disorders such as headaches, poor posture, decreased vision, and even cerebrovascular accidents.

It is very important to choose a dental clinic that has a positive experience in installing braces. You can do without negative side effects!

Braces allow you to straighten your teeth and correct your bite

Fixing the system

Before installing braces, the orthodontist conducts a diagnosis and agrees on a treatment plan. The doctor refers the patient to professional oral hygiene. The procedure is necessary to keep the enamel under the braces intact.

The doctor treats the area of fixation with orthophosphoric acid and applies a primer. The primer contains fluorine compounds that penetrate the enamel. Fluorine molecules are embedded in the crystal lattice of hydroxyapatite enamel and reduce permeability to carious bacteria. Before fixation, the doctor applies light-curing materials, for example Blugloo, Grengloo, Enlight, to the base of the bracket.

Fixation methods

The doctor fixes the braces directly or indirectly. Regardless of the method, installation is painless for the patient.

In the case of the direct method, the orthodontist positions each bracket according to anatomical landmarks, the projection of the root in the bone tissue and the inclination of the tooth manually. Next, the material is illuminated with a polymerization lamp. The patient spends 30 to 50 minutes in the chair.

With the indirect fixation method, the manipulation takes 10–15 minutes and does not cause discomfort to the patient. The procedure consists of several stages:

The orthodontist manually positions each bracket on plaster models of the jaws;
transfers braces to a silicone tray;
applies adhesive to braces;
During the visit, he moves the elements of the system from the tray onto the prepared enamel and illuminates it with a polymerization lamp.

Fixation of the structure is a key stage of treatment, regardless of the method used. The orthodontist adjusts the width of the teeth and creates an aesthetic smile arch through the correct positioning of each element of the system. Braces work out torque, rotation and angulation. The doctor installs the arc into the slots and releases the patient until the next activation.

How to correct a malocclusion

In orthodontics, there are a number of methods that help correct this jaw pathology. The most common of these are braces. They effectively correct malocclusion and dental imperfections. But wearing them is associated with some issues that the patient needs to know about before starting the correction.

Firstly, you need to prepare yourself psychologically that you will now have to wear a non-removable appliance on your teeth for a long time (at least a year). With it you will have to acquire new habits for caring for the oral cavity, in addition, braces change the shape of your face. Why is this happening? To do this, you need to understand how braces work.

Removing braces

After completion of treatment, the long-awaited moment comes - removal of braces. Using special atraumatic forceps, the orthodontist peels off the bracket from each tooth with one movement of his hand. The patient hears a click and the bracket painlessly moves away from the enamel surface.

Next, the doctor grinds off the remaining glue and polishes the enamel to return the tooth to its original appearance. Grengloo bracket bonding material reduces the excessive impact of rotating instruments during polishing: removing adhesive from the tooth surface does not cause additional damage to the enamel. When there is no green material left, the enamel surface is cleaned.

Doctors from the Department of Orthodontics at the Tabriz University of Medical Sciences in Iran conducted a study and compared the differences in enamel damage after removing two brace designs - with a mesh-type base and with posts.

Researchers have scientifically substantiated the influence of the design of the bracket base on the adhesion strength to the enamel. According to the results of a study by orthodontists, at the base with columns the degree of adhesion to the enamel is higher. At the same time, braces with a mesh base cause less damage to the enamel when removed.

Doctors of the 21st century prefer systems with a mesh base to reduce the number of enamel microcracks during debonding. An example is the Damon Q and Damon Q2 self-ligating braces and the Mini Diamond ligature systems. Ormco's patented bracket base treatment makes removal safe for the enamel.

Damon Q2 with mesh base

Types of braces

The structures are classified according to the material of manufacture, location in the oral cavity and type of arch fixation. Here are examples of each type of braces.

Material of manufacture

1. Metal braces . Self-ligating Damon Q and Damon Q2 are made from 17-4 stainless steel alloy. In addition to orthodontic products, the high-strength alloy is used in the aviation and chemical industries. An example of metal ligature braces is Mini Diamond and Orthos.

Damon Q2 with lid open

Mini Diamond model

2. Devices made of bioinert titanium alloy . This material is chosen if the patient is allergic to nickel or chromium. An example is the classic Titanium Orthos braces.

3. Ceramic systems . Damon Clear/Clear2 translucent braces are made from durable polycrystalline aluminum oxide (PCA). The period of adaptation to foreign structures in the oral cavity increases, since Damon Clear is larger than metal Damon Q.

translucent Damon Clear

4. Braces made from artificially grown sapphire . Inspire Ice transparent ligature devices have durable wings that do not break off under stress.

transparent ligature Inspire Ice

Location in the oral cavity

The orthodontist fixes the braces vestibularly or lingually. For vestibular localization, the elements are glued to the visible part of the teeth. An example is Damon self-ligating braces. Lingual systems are installed on the dentition from the tongue side, the design is invisible to others. The adaptation period to internal braces is longer than to vestibular systems: it is not easy for the tongue to get used to a foreign structure in the oral cavity. An example is STb braces. Due to the fact that the bases of the braces are made individually according to exact impressions of the jaw, the cost of lingual systems is higher.

vestibular ligature braces Mini Diamond on typodont

Arc fixation type

The arch is attached to classic edgewise braces with elastic and metal ligatures. Ligature braces correct the position of individual teeth and correct complex dental anomalies. The ligatures press the arc tightly against the groove, increasing friction in the system. Example – Mini Diamond and Orthos.

ligature Orthos made of metal

Self-ligating brackets hold the archwire without ligatures: the cover of the structure closes and closes the groove space. In devices with a passive type of ligation, the groove does not interfere with the movement of the arc, the cover is motionless, the arc slides without obstacles, and friction in the system is minimal. The Damon Q and Damon Q2 systems work out the parameters embedded in the braces and start the physiological process of moving teeth.

closed Daimon Q

In active self-ligating structures, the clip puts pressure on the archwire and has a mechanical effect on the entire system. Teeth move in an adequate force zone under the influence of load vectors.

Types and composition of bracket systems

Modern orthodontics has several types of braces in its arsenal. They may differ in design features, method of attaching the orthodontic arch and material of manufacture.

Depending on the method of fastening the arch, ligature and non-ligature systems are distinguished. Ligature systems are evolutionarily earlier. Here the arch is attached to the braces using ligatures, which have the form of rubber bands, wires, plastic rings, etc. This fastening reliably fixes the arch, which determines its complete immobility relative to the bracket. One of the advantages of this design is its relatively low cost. The disadvantages are the laboriousness of treatment - you need to frequently visit a doctor to activate the arc, and the process itself takes quite a lot of time. In addition, the ligature partially compensates for the force of the arc, which leads to an increase in the wearing time of the structure and difficulty in predicting the outcome of treatment.

In non-ligature systems, the arch is attached to the bracket using a special lock. This method of fastening facilitates the installation and activation of the arch and helps to ensure the displacement of teeth due to the action of weaker forces, i.e., the treatment occurs more physiologically. Non-ligating braces are also called self-ligating, and there are two ligation methods - active and passive. Active ligation involves a lock structure in which the arc is actively directed towards the groove. With passive ligation, the lock does not put pressure on the archwire and does not press it against the bracket. In other words, the arc can move relative to the groove to a certain extent. This makes the entire structure more physiological and makes it possible to better predict the result. Today it is considered the most progressive braces system.

Braces are also classified depending on where they are attached to the teeth. There are vestibular and lingual braces. Vestibular ones are attached to the front surface of dental crowns. Of course, they are noticeable to others, but at the same time they are easier to work with, they provide high predictability of treatment and are cheaper than lingual analogues.

Lingual braces are respectively attached to the lingual side of dental crowns. They are absolutely invisible to others, therefore they have high aesthetic characteristics. At the same time, there are a number of significant disadvantages - the volume of the oral cavity decreases, the design interferes with the tongue, rubs it, diction is impaired, and there are difficulties with chewing food. Such designs cannot be used for certain malocclusions and tooth alignment. In addition, such systems are expensive.

Braces are also classified according to the material they are made of:

Metal braces are a classic of the genre. They are reliable and affordable.
Plastic braces. The color is similar to tooth enamel, therefore they are more aesthetically pleasing than metal ones. But at the same time, they are more fragile and may not withstand the application of large forces, so the period of wearing the system increases. The advantages of plastic braces: they are more aesthetically pleasing, affordable, and quite convenient to use (less damaging to soft tissues). The disadvantages are fragility, duration of treatment, tendency to stain with food coloring.
Ceramic braces. In terms of their aesthetic properties, they are as close as possible to tooth enamel, therefore they have high aesthetic characteristics. The material is more durable than plastic, but they are also more expensive.
Sapphire braces are absolutely transparent and invisible on the teeth (as far as possible). Fragile, reliable, not painted with dyes, but expensive. Hard to remove

Which braces are more profitable to install?

Self-ligating and ligature braces correct the bite and correct complex dental anomalies. Non-ligating systems are more expensive, but the installation of self-ligating structures reduces the number of visits to the clinic. At a lower price for edgewise braces, the patient visits the orthodontist an average of 24 times during treatment, 2.5 – 3 years. When installing self-ligating systems, approximately 12 visits to the doctor are required. The course lasts from 1 to 2.5 years.

Clinic management is often not ready to purchase expensive systems and pay for additional training for orthodontists. Doctor A.V. Tikhonov economically substantiated the advantages of installing ligature-free braces. The orthodontist compared the rate of arch replacement during activation of self-ligating structures and traditional models with ligatures. On average, removing and installing the arch takes 8 minutes. 14 sec. on classic systems and 1 min. 21 sec. – on self-ligating ones. Usually the arches are changed on the upper and lower jaws - the duration of the manipulation is doubled.

treatment on Damon Q2

According to the researcher, taking into account the reduction in treatment time and the number of visits to the doctor, ligature-free braces are more economical for the clinic and the patient. The ergonomics of working with the ecosystem of Damon braces and additional elements reduces the appointment time and the total financial costs of the person visiting the clinic.

How long should you wear braces?

This question is also individual and depends on the existing problem and the age of the patient. The younger the person, the shorter the period of wearing the system. In children and adults, the average treatment period is 18 months.

It is also necessary to take into account that after removing braces, orthodontic treatment does not end. The position of the teeth still remains unstable due to the characteristics of the osseous-ligamentous apparatus of the jaw. If the teeth are not fixed, they will tend to return to their original position, which will lead to relapse. Therefore, additional fixation is required.

For this purpose, retainers and retention mouthguards are used on the upper and lower jaws. Mouthguards are worn for several hours a day, for example, while sleeping. Fixed retainers have the form of an arch, which is attached to the vestibular surface of the teeth using special adhesive materials. It is impossible to remove it yourself. The retention time is determined individually. In most cases, it is twice as long as you wear braces. However, for some patients, retention is indicated for life.

Dental health depends not only on timely diagnosis and treatment of carious lesions, but also on the overall development and well-being of the dental system, including periodontal condition, bite and other factors. Therefore, correcting the bite and straightening the teeth using vestibular braces is not limited to purely aesthetic purposes, but is also designed to preserve the health of your teeth and the entire oral cavity for as long as possible! And due to the close relationship of all body systems, healthy teeth and correct bite will be the key to normalizing the functioning of the gastrointestinal tract.

In our clinic we use brace systems from different manufacturers, but the best, in the opinion of our orthodontist, are the Experience series braces (GC Orthodontics, Japan) - the world leader among interactive non-ligature systems. Today, Experience is manufactured at the Japanese plant of TOMY Inc., which has been developing and manufacturing high-quality orthodontic systems since 1959 and is the owner of the Japan Quality Medal, the highest award for quality control in the world.

Phases of orthodontic treatment

Orthodontic treatment consists of four stages:

leveling;
basic mechanics stage;
detailing and completion;
retention.

Leveling

After fixing the braces, the leveling stage begins: the doctor installs round arches. The sequence of arch replacement is standard; if necessary, the orthodontist adjusts or supplements the protocol.

Protocol for replacing wires during treatment with Damon:

0.014″ CuNiTi – 10 – 12 weeks;
0.016″ CuNiTi – 6 – 8 weeks (intermediate arc if necessary)
0.014x0.025″ CuNiTi – 10 – 12 weeks;
0.018x0.025″ CuNiTi – 4 – 6 weeks;
0.019x0.025″ TMA or SS.

arc in groove Damon Q

0.013″ wires are typically used for severely crowded teeth. The higher the degree of crowding, the more difficult it is to install the arch into each groove. For moderate to mild crowding, the doctor begins treatment with an arc with a cross-section of 0.014″.

Round arches of low rigidity are made from a thermoactive nickel-titanium alloy with the addition of copper. The temperature of the oral cavity activates the physical properties of the metal, and the arc straightens to its original state. The doctor changes the arches in accordance with the treatment protocol. Thanks to the initial arches of low rigidity, the alignment of the dentition occurs, the rotation and position of individual teeth are corrected.

Correctly selected braces torque at the beginning of treatment reduces the number of visits at the final stage.

Basic Mechanics

After the leveling stage, the doctor installs rectangular arches. CuNiTi arches with a cross section of 0.014″, 0.016″ and 0.014x0.025″ are used to completely correct tooth rotations, begin to practice angulation and torque, and create the shape of the dentition. Steel, TMA and nitinol rectangular archwires are used to stabilize the dentition, close spaces, control torque, angulation and rotation.

girl with Damon Clear

During the basic mechanics phase, the doctor sometimes needs to re-bond the braces. This is a standard manipulation that does not cause any difficulties for the orthodontist. The position of the teeth and the vector of force application change, the doctor re-fixes the braces so that the teeth move in the right direction. At this stage, a complex change in the bite occurs; the doctor prescribes elastics. The doctor bends the arches, closes the interdental spaces, makes occlusal linings made of composite material, secures the hooks and installs microscrews.

Final stage

At the final stage, the doctor carries out the details: corrects the position of individual teeth, bends the arches and re-prescribes the scheme for wearing elastics. At the final stage, the doctor uses rectangular TMA 0.019x0.025″ archwires to create detailed bends and then softly transition to 0.019x0.025″ steel archwires, if necessary. A large selection of Damon torque options due to the implementation of the braces prescription allows the doctor to reduce the number of bends on the arches. The orthodontist corrects torque: the vestibulo-oral inclination of the tooth in the sagittal plane. Steel arches with a cross section of 0.019x0.025″ fill the groove, and the bracket fulfills the parameters laid down in the groove.

Retention period

To consolidate the results of orthodontic treatment, the doctor installs a retainer - a metal wire on the palatal and lingual surfaces of the anterior group of teeth. At the age of 25, the formation of the bones of the facial skeleton ends. Up to this age, patients wear a retainer twice as long as treatment with braces. After 25 years, a wire retainer is installed on both jaws for life. Regardless of age, doctors recommend wearing a transparent retention mouthguard at night. If the patient does not follow the doctor's recommendations during the retention period, the teeth may return to their original position.

How to choose a brace system

The primary task for the patient is to find a doctor with whom a trusting relationship will be established. The orthodontist will conduct a diagnosis, discuss a treatment plan and offer several braces to choose from. The doctor recommends braces based on the patient’s financial capabilities, the complexity of the clinical case and the anatomical features of the dentition. The decision-making is influenced by the doctor’s personal preferences - some specialists work only on self-ligating braces using the straight arch technique, others prefer a multi-loop arch and ligature structures.

young man with Ormco translucent self-ligating braces

Ceramic and sapphire systems are chosen to partially camouflage orthodontic treatment. Bite correction with clear braces takes longer than with metal Damon Q braces due to the higher friction of the archwire and ceramic groove bottom.

treatment with Inspire Ice

Price for braces in Moscow

As a rule, the cost of braces in Moscow is formed from the price of the system itself, as well as the total costs of installation and further treatment. The cheapest braces are, of course, metal. Their price starts from 50,000 rubles. Relatively inexpensive ceramic systems that cost about 75,000 rubles. The cost of a sapphire bracket system starts from 85,000 rubles. You need to be careful here, as ceramics are sometimes passed off as sapphire. The most expensive will be lingual systems, especially if they are made to order, their approximate price starts from 100,000 - 150,000 rubles. When figuring out the cost, be sure to ask what is included and what services will need to be paid additionally. It happens that the initially low price of braces increases significantly during the treatment process. However, when choosing an orthodontist and a braces system, you should not focus solely on cheaper or more expensive; remember that poor-quality orthodontic treatment is fraught with a lack of results and the occurrence of a number of complications.

A country	Manufacturer	Manufacturing materials	Price
USA	3M Unitek	Metal braces	from 25,000 rubles
		Ceramic braces	from 70,000 rubles
		Sapphire braces	from 80,000 rubles
	Ormco	Metal braces	from 20,000 rubles
		Ceramic braces	from 45,000 rubles
		Sapphire braces	from 50,000 rubles
	American Orthodontics	Metal braces	from 40,000 rubles
		Ceramic braces	from 70,000 rubles
		Sapphire braces	from 50,000 rubles
	Ortho Technology	Metal braces	from 15,000 rubles
		Ceramic braces	from 35,000 rubles
		Sapphire braces	from 40,000 rubles
		The Dentsply GAC	Metal braces	from 20,000 rubles
	Ceramic braces	The Dentsply GAC	from 30,000 rubles
	Germany	TOP-Service für Lingualtechnik GmbH	Gold-platinum alloy braces (lingual only)	from 175,000 rubles
Forestadent		Metal braces	from 30,000 rubles
		Ceramic braces	from 60,000 rubles
		Sapphire braces	from 90,000 rubles
Korea	HT Corporation	Metal braces	from 20,000 rubles
Korea	HT Corporation	Sapphire braces	from 30,000 rubles
Italy	SIA Orthodontic	Metal braces	from 20,000 rubles
Italy	SIA Orthodontic	Ceramic braces	from 25,000 rubles

Photos of teeth before and after braces

Trust in a doctor consists of many factors: reviews and recommendations from friends, a well-conducted consultation, doctor’s certificates, diplomas and awards, photos of clinical cases “before” and “after” of treatment with braces published on the Internet. Doctors actively maintain groups on social networks and blogs on clinic websites, post videos on YouTube, and post photographs with the results of orthodontic treatment.

deep bite

high crowding, flat profile

moderate crowding, asymmetry

high degree of crowding, open bite, posterior crossbite

case without removal

bilateral crossbite with a high degree of crowding of the anterior group of teeth in the upper jaw

Most Popular Brands

DamonQ

photo: during and after treatment with Daimon Q braces

This is a passive self-ligating metal system, which is characterized by its miniature elements. The smoothness of the lines ensures wearing comfort and ease of care.

Clarity

photo: before and after treatment with the clarity system

Ceramic braces that also contain metal. This is what distinguishes them from most aesthetic designs. Clarity braces feature a reinforced metal slot that increases strength and durability while reducing archwire friction.

Incognito

photo: treatment in adults, after 6 months

These are lingual braces that are completely custom made . For each tooth, the required shape of the bracket and the exact location of attachment are calculated separately. Another difference is that a gold alloy is used for production, which practically does not cause allergies.

In-ovation

photo: during treatment

Ligature-free braces. Three modifications are presented:

R is a metal vestibular design with a unique locking clasp that speeds up the installation process.
C – ceramic braces, which are reinforced with a thin layer of zirconium dioxide.
L – lingual system with an individual approach.

STB

photo: before and after 6 months of treatment

Lingual braces are made of durable metal alloy. They are distinguished by their minimal dimensions and special very low attachment to the base of the tooth , which allows the main load to be directed precisely to this part.

Alternative to treatment with braces

An alternative to braces is aligners. Transparent hard aligners are used to move teeth in cases where the patient has increased aesthetic requirements. The aligners are made in the laboratory on a 3D printer based on an impression of the jaws. Patients change aligners in the order specified by the doctor. The disadvantage of aligners is the high cost of treatment, but the advantage is the aesthetic component: the aligners are invisible to others. Treatment with aligners takes longer and is suitable for clinical cases of mild to moderate complexity.

The doctor attaches attachments made of composite material to the teeth, on which the mouth guard presses. The teeth move slowly; halfway through the treatment, the orthodontist takes an impression of the jaw and sends it to the laboratory to make new aligners.

Is it possible to get lingual braces cheaply?

Many patients are concerned about the question of whether it is possible to fix lingual braces without much damage to their wallet. These are quite expensive devices, most of which are manufactured exclusively for the patient. However, there are options here.

Lingual braces for one jaw

First, it is worth discussing with your orthodontist whether it is possible to install braces on the inside of the teeth on one jaw. This can be in combination with the normal vestibular system or alone in uncomplicated cases. Thus, it is quite possible to install lingual braces on the upper jaw or only on the lower jaw in order to correct the unevenness of only one row of teeth if the patient has the following problems.

Mild crowding without complications in the anterior jaw.
Gaps in the front part of the jaw, while the lateral teeth close together correctly.
Strongly erupted lateral teeth without antagonists.
Gaps to be closed after tooth extraction.

Partial lingual braces

In some cases, when the patient’s teeth are crooked in a certain place, you can get by with partial lingual braces, which the doctor will fix not on the entire dentition, but only in the area where it is planned to eliminate the local defect. Partial lingual braces with installation will cost the patient almost half as much as a device for the entire dentition.

The final decision on whether it is possible to install a lingual brace system on only one jaw or locally can only be made by the attending physician - taking into account the clinical picture and subject to a stable result.

Budget system models

Another way to save money when installing invisible braces on your teeth is to choose a budget system. The most expensive today are Incognito lingual braces. However, other internal dental braces are no worse in effectiveness than designs from the premium segment. They only differ in the materials of manufacture, the method of fixation and the size of the locks - braces. Table of approximate prices for popular brace systems (for one jaw):

Bracket system	Cost in rubles
STB	from 60 000
Incognito	from 100,000
Win	from 65 000
2D	from 35 000
In Ovation L	from 25 000

In addition to the cost of the braces themselves, the final price of orthodontic treatment will also include diagnosis, installation, regular correction and removal of the lingual brace system. For example, the cost of correcting a malocclusion or crooked teeth using Incognito lingual braces will ultimately cost 300,000 - 400,000 rubles. And if you choose a more budget option, for example, Win or STB lingual braces, then the cost of treatment will be up to 230,000 rubles. So, if you wish, you can install lingual braces inexpensively and become the owner of the smile of your dreams.

Partial bracket system

For children in the period of changing temporary teeth to permanent ones, a “2 by 4” system is installed. Braces are fixed on four incisors and two molars. The design is used to close large interdental spaces when there is insufficient space for permanent teeth, early removal of temporary teeth to save space. Often, a 2-by-4 system prepares a child for primary orthodontic treatment with a full brace system. Braces are fixed at 6–7 years of age, when the first permanent molars erupt.

There is no age limit for orthodontic treatment. At any age, braces are firmly fixed to the enamel, and teeth move. Implants or ankylosed teeth in the mouth serve as support and do not move or participate in orthodontic treatment.

How to fix crooked teeth without braces?

Today, dentistry offers several alternative solutions that allow you to straighten teeth without braces:

Restoration: correction of defects in the dental crown using composite materials. Provides quick results at an affordable price, but will last about five years, and the color of the material will change over time.
Veneering: fixation of plates on teeth that are almost indistinguishable from natural enamel. The method is used instead of braces for small curvatures or large gaps and is not suitable if the patient has complex dental curvature or malocclusion.
Installation of removable braces. Essentially, these are orthodontic structures that do not need to be worn constantly. However, calling them braces is not entirely correct; these are completely different systems.

Duration of treatment

How long do you wear braces? Treatment with ligature structures averages 2.5 – 3 years. Self-ligating devices are usually worn for 1 – 2.5 years. The duration of treatment depends on the model of braces, the experience of the doctor, the complexity of the clinical case and cooperation with the patient. If you do not wear elastics and do not follow the orthodontist's recommendations, treatment will slow down.

girl with Mini Diamond metal braces

The patient comes to the appointment with the regularity specified by the doctor. At the initial stage of treatment with a self-ligating brace system, the intervals between visits are 8 – 10 weeks. During the basic mechanics phase, the patient visits the orthodontist every month. When installing ligature structures, he comes for activation at least once a month at each stage of treatment.

teenagers with Ormco braces

How to brush teeth with braces

Regardless of the type of braces and the number of visits to the clinic, a person needs to carefully monitor their oral hygiene. Orthodontic patients follow a diet. Doctors recommend eliminating sticky foods: toffee, halva, nougat, chips, chewing gum, consuming with caution and cutting hard vegetables and fruits into pieces. It is not recommended to drink coffee, red wine and other drinks with dyes. Orthodontists advise avoiding cold or very hot foods: sudden temperature changes damage metal and sensitive ceramics in the oral cavity.

With braces, brushing your teeth becomes more difficult. Using circular movements of an orthodontic toothbrush, the patient removes food debris and plaque from the vestibular surface of the teeth and the space around the bracket. The internal and chewing surfaces are cleaned with a manual toothbrush. The space around the braces and in hard-to-reach places is cleaned with a monotuft brush and dental brushes. Doctors advise using superfloss and irrigator.

It is necessary to brush your teeth three times a day after meals and perform professional oral hygiene in the clinic every 2 to 4 months. By following the doctor's recommendations and maintaining oral hygiene, the patient speeds up treatment.

Braces do not damage the enamel; caries occurs as a result of poor hygiene. The intensity of plaque depends on the type and size of the structure, but the main factor is the patient’s willingness to brush their teeth thoroughly and regularly. Caring for the oral cavity with small self-ligating appliances is easier than with ligature structures. Food remains under elastic and metal ligatures, which leads to the formation of caries.

Personal experienceBraces in adulthood: Expectations and reality

I decided to get braces at the age of 22, in the spring of this year, after a preventive examination with a general dentist. Outwardly, my imperfections were almost not noticeable, the non-specialized doctor did not have strict recommendations, but I suddenly realized that I wanted (and could!) one day see perfectly straight teeth in the mirror. I thought for a few days and signed up for wisdom teeth removal - this is preparatory work before braces. Removal is the most unpleasant part, but the main thing is to get to the dentist-surgeon’s chair (I got a great one!) and endure the anesthetic injection. After the extraction, the doctor describes in detail what can go wrong, but everything can turn out even better than average: immediately after the removal of the first two teeth, I even went to a party - and the party was great.

In parallel with the extractions, I was looking for an orthodontist. Braces are a long-term treatment, so it is important not to make mistakes with your doctor. As a result, the method of “asking good doctors about other good doctors” helped: I chose an orthodontist on the recommendation of a dental surgeon. It’s funny that after frequent visits to dentists, my “third eye” opened, distinguishing between people with imperfect occlusion. Alas, perfectly straight teeth are almost always the result of correction. Acutely noticing the details around is a so-so superpower, the world has turned into a kind of perfectionist hell, but it seems that this period has passed.

I have noticeable metal braces on my teeth. Firstly, the doctor said that they are effective and unpretentious - transparent mouth guards, for example, need to be worn 22 hours a day, they should be removed while eating, that is, after dinner or lunch out of the house, you need to look for a washbasin and put your jaws in order so that put on a mouthguard. Secondly, truly invisible braces cost several hundred thousand rubles; such an investment in my situation does not seem reasonable.

I hardly feel any everyday inconveniences with braces. Teeth usually do not hurt, but it is better to avoid radishes and whole apples. Braces require careful care of the oral cavity with all sorts of devices, but this is generally useful for everyone, a good habit. I was a little worried about braces due to my profession, since sometimes I have important meetings at work. However, in vain: no one attaches any importance to this, and besides, braces hardly worsen diction (these are not children’s records); on the contrary, they can even improve it. I was pleased with the reaction of my loved ones. A loved one said that braces suit me very well (a dubious, but actually a very nice compliment). Friends praised him for his fortitude. Braces have truly added a healthy amount of self-confidence as a conscious and balanced life choice, and I'm so glad I went for it.

Rationally, braces mean straight teeth and health benefits at the cost of certain organizational efforts and time constraints. But when making a decision on an installation, many are confused by irrational things, reinforced by stereotypes in popular culture: “I’m not a teenager, it’s late, I’ll be like Katya Pushkareva, and everyone will point the finger at me, oh, wasted time...” The strangest thing is that I I heard from this episode: “I would like to get braces... but I can’t, I’m afraid that the lower jaw will change and become too masculine, ugly, oh, I should have done it earlier.” The truth is that you don't wake up a new person after getting braces. Passers-by do not hide their children when they see you on the street, flowers do not wither from your smile, a “crown of celibacy” does not suddenly grow on your head. There are reasonable difficulties in installing braces, it is a serious decision, but prejudices here will not help you make a choice.

Photos: nobeastsofierce - stock.adobe.com, goodween123 - stock.adobe.com, bergamont - stock.adobe.com

Getting used to braces

The patient gets used to the braces system in the mouth within a couple of weeks. When the physiological movement of teeth begins, people experience discomfort due to aseptic inflammation of the bone. Patients with self-ligating braces stop feeling pain after a couple of days; when installing ligature structures, the discomfort goes away on the sixth day. The level of discomfort is influenced by the pain threshold, which is individual for each person.

Sometimes, at the initial stage of treatment, nitinol round wires cause discomfort. A glass of cold water relieves discomfort. Due to the physical properties of the thermal activity of the metal, the tension decreases and the discomfort goes away.

The metal of nitinol arcs is in one of two phases. When the temperature changes, the crystal lattice of the alloy changes from the martensite state to the austenite state and back. The doctor inserts a thermoactive arc into the grooves of the braces; under the influence of the temperature of the oral cavity, the arc straightens and gently pulls the teeth along with it. If the discomfort persists for a long time, the doctor prescribes painkillers to the patient.

Treatment with braces during pregnancy

Pregnancy is not a contraindication for treatment. During pregnancy, women take vitamins that support bone health. Metabolic processes in a woman’s body accelerate, and teeth move faster. Before installing braces, the orthodontist sends the patient for sanitation and professional oral hygiene. To strengthen the enamel, remineralizing therapy is carried out.

Pregnant women, unlike other patients, do not take painkillers to overcome discomfort during tooth movement at the leveling stage. During pregnancy, women often suffer from gingivitis and bleeding gums. Diseases complicate hygiene and are relative contraindications to orthodontic treatment. Sometimes, in order to avoid possible risks, bite correction is postponed until after the birth of the child.

Contraindications for installing braces

The installation of braces on teeth can be hampered by relative and absolute contraindications.

Relative contraindications to braces can be eliminated. These include:

low level of hygiene
caries
allergy to materials contained in braces
periodontitis, periodontal disease
bruxism

Absolute contraindications are serious health problems that make orthodontic treatment impossible. These include:

oncological diseases
epilepsy
psychiatric disorders
pathology of bone tissue
alcohol and drug addiction
venereal diseases
blood diseases
tuberculosis
diseases of the immune and endocrine systems

Removing teeth before installing braces

Sometimes, according to the orthodontist, it is necessary to remove teeth to make room for dentition correction and improve the facial profile. The orthodontist makes the decision about removal after diagnosis and discussion of the treatment plan with the patient. Photometric analysis of the face, examination of X-ray images and diagnostic results help the doctor make the right conclusion.

The complexity of the clinical case affects the need for removal. The choice of prescription in Damon braces in some cases allows you not to remove teeth. To achieve correct occlusion without tooth extraction, the doctor corrects the bite, installs microscrews and performs separation.

Braces for one jaw and several teeth

If the patient is concerned about the curvature of, for example, only the upper teeth, fair questions arise. For example, why do you need braces on two rows of teeth? And do they put braces on one jaw? Installing only upper braces or only lower braces is indeed possible in the absence of global problems. It is important that the treatment gives an effective result without affecting the function of the jaw.

If a patient has several crooked teeth in one area, the doctor may suggest partial dental braces. They are installed on a specific area of the dentition for about six months.

How much do braces cost with installation?

Orthodontic clinics use different pricing policies. Pricing is based on the composition of the service and the frequency of payments. In some orthodontic centers, the cost of treatment includes the price of braces, while in others they pay for the system separately.

treatment on the Orthos design

There is an option for a one-time payment for the course of treatment and a scenario in which the patient pays monthly for system activation. For the patient, from the point of view of economic justification, full payment is more profitable, since the final price is not affected by fluctuations in the ruble exchange rate and changes in the price list in the clinic.

The cost of activation of ligature and self-ligating braces is approximately the same. Payment for treatment using classical systems with ligatures consists of 24 visits to the doctor and the relatively low price of the structure. Self-ligating devices are more expensive, but require the patient to go to the clinic only 12 times. Convenience of design, reduction of treatment time, the number of visits to the doctor and the time that the patient spends in the orthodontist’s chair give self-ligating devices qualitative advantages.

The cost of the course is determined by the orthodontist after diagnosis and drawing up a treatment plan.

Head of the St. Petersburg clinic “Full Order”, candidate of medical sciences Tikhonova A.V. compared the effectiveness of treatment under the scheme with a one-time payment “All inclusive” and with payment by visits.

We provide an approximate comparison of ergonomics and financial efficiency of treatment for various price options. Prices are set hypothetically, taking into account the estimated average market prices for St. Petersburg at the time of publication of the manual.

information from the book “Myths about the Damon system” by orthodontist A.V. Tikhonov

The results of the study indicate that the all-inclusive one-time payment scheme is preferable for the doctor and the patient. Payment for results allows a competent orthodontist to quickly complete treatment and increase the profitability of the practice, and the patient to receive a beautiful and healthy smile earlier.

perfect smile with Inspire Ice

Metal braces: design features

The design of metal braces includes the following elements:

Braces (plates fixed to the teeth). Most often they are made from various steel alloys, but patients with a high tendency to allergic reactions may be offered braces made of titanium or gold plated;
Corrective power arc, which is one of the key elements in any bracket system. The wire is threaded through the braces and creates tension that forces the teeth to move into the correct position. The power arc is made of an alloy of titanium with other metals - molybdenum or nickel;
Rings. This element is not always present in the design of metal braces. Rings are used for the correction of complex malocclusion defects, when it is necessary to secure the braces on the teeth as firmly as possible;
Fastening elements - clips or ligatures (depending on the area where the braces are fixed).

Some people are convinced that metal braces are inconvenient and not aesthetically pleasing, so it is better to immediately stop using them and choose devices made from other materials. But such an opinion is wrong for several reasons. Firstly, modern metal braces are compact designs, adaptation to which is quick. Secondly, miniature metal brackets on the teeth can be made in the form of funny figures and beautiful symbols, and then the braces will look more like jewelry than a device used for treatment.

The advantages of metal braces also include:

Affordable price. The price of metal braces is significantly lower than prices for analogues made from other materials.

Shortened treatment time. It has been proven that with the use of metal braces, bite correction is faster than with the use of ceramic or sapphire systems.

Versatility. Metal braces can be used in the treatment of the most complex dental anomalies.

High strength, maintaining an aesthetic appearance throughout the entire course of treatment. Metal braces are durable, able to withstand high loads, and do not break as often as their fragile ceramic counterparts. Metal braces do not require the same complex care that is necessary when using ceramic systems: the plates do not stain from contact with food and do not darken. The compact size of the locks does not interfere with oral hygiene.

When drawing up a treatment plan with metal braces, you must also choose a specific type of braces: you will need to decide which system will be best for you - ligature or self-ligating.

How to get a tax deduction for treatment with braces

For three years, Russian tax residents can claim a tax deduction for treatment with braces. Taxpayers receive a refund from the state in the amount of 13% of the amount spent on their own treatment, treatment of minor children, parents or spouses. Only the personal income tax that the taxpayer paid to the state for the last year is returned.

Package of documents for the tax office:

declaration 3-NDFL;
certificate from place of work 2-NDFL;
documents from the clinic - a copy of the treatment agreement, a copy of the clinic’s license, a certificate of payment for treatment, cash receipts.

A person who has undergone orthodontic treatment and is claiming a refund must file a tax return by the end of April.
The state returns 13% of the maximum 120,000 - 15,600 rubles. The material is for informational purposes only and is presented for informational purposes. It does not replace consultation with an orthodontist and is not a guide to correcting dental anomalies.