Orthodontic appliances: know the differences and their indications
The first questions that patients ask when they enter the orthodontist's office are: "Will I use a device? When? Fixed or mobile? Can I choose the color?". After installation and after the news, the next question is: "When will I take the devices?" In order to try to kill this curiosity, I present here a little of the orthodontic universe.
The devices can be divided into two groups: removable and fixed. The removable ones are embedded in the mouth, being able to be removed by the patient or orthodontist, and depend on the collaboration of the patient. They can be orthodontic - that perform small dental movements -, or orthopedic, used in the corrections of bone alterations of growth. The latter are placed in children and adolescents during the growth phase, inhibiting or stimulating the development of bones, or even redirecting an unfavorable growth trend. To be effective they should be used for the most hours per day.
Fixed appliances are used when moving teeth into the bone. They are composed of brackets that can be metallic, plastic or porcelain, which support the metal arch. With the use of fixed appliances, better meshing between the upper and lower teeth is achieved, restoring a balanced smile.
It is very difficult to predict how long a treatment lasts
Each device has a precise indication and who will determine which the best type and how long treatment is the patient's dental arch. Each case is a case and each device is designed and designed to correct that case in the best way and in the shortest possible time.
Today, the number of adult patients seeking the orthodontist is very large and usually the best indication in the most cases is the fixed appliance for more effective tooth movement. Removable appliances move the teeth more slowly and very slowly. Orthopedic appliances are contraindicated at this stage, as growth is over.
For adults who deal with the public and do not want the metallic option, there are aesthetic and invisible options. There are devices such as polycarbonate, sapphire or porcelain, which are quite aesthetic, in which the support parts are mixed with tooth coloration - however, these devices have two drawbacks. The first is that because of the friction of the ceramic with steel wire, these appliances are less efficient and can increase the duration of treatment. The second disadvantage is that it has a much higher cost than conventional steel fixed appliances.
There is also the lingual technique where the parts are glued on the inside of the teeth and has as main disadvantage the nuisance to the tongue. We can still cite a series of molds that promote the correct alignment and leveling of the teeth.
It is very difficult to predict how long a treatment lasts, because it depends on several factors such as biological response of the organism, type of malocclusion, type of indicated device and patient collaboration . The important thing is to find a qualified professional, use the indicated appliance in the best way possible and attend the monthly maintenance queries for activation and control.
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About 60 % of patients improve with the first treatment used. In others, there is a need to change medications. Some people are especially resistant to the effects of the drugs and need to make several attempts on different medications until they are good. The exchange of medications follows some guidelines, and in general, the psychiatrist chooses a medication with a different or more potent mechanism of action in the sequence.
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