In this new article, I decided to address this topic: types of orthodontic braces. I talk about the most common orthodontic appliances (though of course, many more are used! =) )

Before I start, I want to say that this topic is very important, and aims to answer some questions that patients ask me daily. However, the most important part of the treatment is not the type of appliance. The most important part is the diagnosis—it’s knowing exactly what is wrong and planning the treatment (using different types of appliances) to correct that/those part(s) without changing what is already right! This task should be carried out by a Specialist in Orthodontics, who is dedicated to this branch of Dental Medicine.

Types of orthodontic braces

1. Fixed

1. Metal bracket fixed orthodontic appliance

It is the most common type of fixed orthodontic appliance.

The brackets are glued to the teeth, and a wire (archwire) is placed on them and secured with ligatures. These ligatures can be metallic or elastomeric (colored ligatures). Through the interaction between the wire and the bracket, forces are generated that move the teeth.

Although this appliance is “fixed,” the success of the treatment depends on the patient’s cooperation, namely on attending appointments regularly, proper oral hygiene of the teeth and the orthodontic appliance, and strictly following the instructions given by the responsible clinician.

2. Fixed Orthodontic Braces with Aesthetic Brackets

This type of appliance is similar to the previous one, with the teeth moving according to the same principles, and the forces generated in the same way. This type of appliance is made of more transparent materials or opaque ones with a color similar to that of the teeth, providing better aesthetics compared to metal ones.

Although the improved aesthetics are attractive to adults, making it a very common option, the brackets tend to be slightly larger, more brittle, and generate a bit more friction than metal ones.

3. Fixed Lingual Orthodontic Braces

It is the only completely invisible orthodontic appliance. Since it is placed on the inner surface of the teeth, it is not visible.

The way it works is similar to the metal/aesthetic fixed orthodontic appliance placed on the vestibular side (the visible part of the teeth) – it is also made up of brackets, wires (wires), and ligatures – but the manufacturing process is, in most cases, different.

In most lingual orthodontic appliances, each bracket is individually produced for each tooth (of each patient), making it considerably more expensive.

It is a myth to say that removable braces are no longer used!
There are many types of removable orthodontic appliances, and they are used in various clinical situations, but they always have one thing in common: they depend 100% on the patient’s cooperation! Here are a few examples.

Some are made at the end of the fixed orthodontic treatment to maintain the results of the treatment – removable retention appliances – others are used to guide/stimulate skeletal growth – functional appliances – and others are used to move teeth – removable orthodontic appliances with springs/loops, aligners, etc.

Removable Retention Appliances

At the end of any orthodontic treatment, it is very common for patients to have to use, for a defined period, a removable retention appliance. The goal of these appliances is to keep the teeth in their “new” (and corrected!) positions so that the tendency for them to “shift back” is minimized. The use of these appliances, according to the instructions provided, is crucial for maintaining the treatment results.

Aligner Appliances

These appliances are probably the most well-known orthodontic devices, with advertising campaigns circulating in magazines and on television.

Despite their level of sophistication, it remains important to highlight the circumstances in which they should/can be used.

It is important to seek the opinion of an orthodontic specialist who will present all the treatment options.

These appliances are almost invisible and quite sophisticated, custom-made.

Just like most fixed lingual orthodontic appliances, they are produced using software that allows visualizing and planning the desired results.

Correction is achieved through a series of transparent aligners that fit onto the teeth, applying the previously planned pressure.

Aesthetics is one of the benefits of this type of appliance, as it is transparent and has no wires, making it generally unnoticed.

Since it is removable, it can be taken out for eating and allows for easier brushing compared to fixed appliances.

What is the right age to have the first orthodontic evaluation?

Answer: Before the age of 7!

Although most people think of teenagers when thinking about orthodontic treatment, there are very good reasons to have an evaluation with an orthodontic specialist much earlier than that age. In our opinion, in line with the recommendation of the American Association of Orthodontists, children should have an evaluation with an orthodontic specialist before they turn 7 years old.

Why?

• Orthodontic specialists can detect subtle problems in jaw growth and in primary (baby) teeth;
• Even if the teeth appear straight, there may be issues that require treatment;
• The evaluation can have several outcomes:
  1. Everything is developing correctly – no intervention needed;
  2. Problem identified with a recommendation to monitor the child’s growth and development;
  3. Problem that benefits from immediate intervention.
• In some cases, treatment before adolescence can prevent a problem from worsening, potentially shortening or simplifying later treatments;
• Interceptive treatments may allow the orthodontist to:
  • Guide jaw growth;
  • Reduce the chance of trauma to overly protruding front teeth;
  • Correct potentially harmful habits;
  • Improve aesthetics;
  • Guide permanent teeth into more favorable positions;
  • Improve the position of the lips and how they meet.

By taking younger children for an evaluation with an orthodontic specialist, you are giving them the best opportunity to achieve a beautiful

The Change of Natacha Valongo

Natacha is a 44-year-old woman, a mother, and has a successful professional career. Despite her spontaneous and contagious smile, she was aware that there were some aspects to improve.

After conducting an orthodontic study, which required several complementary exams, and determining that Natacha had a skeletal discrepancy, meaning an imbalance between the upper jaw (maxilla) and the lower jaw (mandible), the most suitable treatment was defined as a surgical correction.

After discussing the case with the patient, she chose to undergo orthodontic camouflage treatment as it was less invasive. This involved fixed orthodontic treatment without orthognathic surgery to correct the bite and, in this way, promote proper dental alignment.

Before placing the fixed orthodontic appliance, a hygiene consultation was carried out, where all oral hygiene instructions were provided, and any doubts about the treatment were clarified.

It is important to emphasize the necessity of rigorous hygiene as there is a higher risk of plaque accumulation, gum inflammation, and other complications that could compromise the final result.

Since this treatment is lengthy, the “before and after” of this smile is not yet completed, but improvements are already noticeable.

See Natacha’s case:

Written by Pedro Fonseca