What are the different types of braces (6 bracket systems)? 

Different types of braces

There are different types of braces used in dental practice to straighten crooked teeth and to improve the bite, smile, speech, and overall dental health of the patient. 

What are braces and their components?

Braces are appliances that are put on the teeth to align them. They have three main components; bands, brackets, and archwire. 

Bands are ring-shaped metallic components bonded to the four first molars in the mouth. It has a central tube that provides support to the archwire. 

Brackets are square or rectangular-shaped components bonded to the upper and lower teeth. They have slots that provide attachment to the active components of the braces, such as the archwire and power chain, and deliver force from the active component to the teeth.

The archwire is a u-shape metallic wire made of different materials (stainless steel or nickel-titanium) and of varying thickness that transfers force to the teeth through brackets. It is changed every month and moves the teeth to the desired position. 

There are different varieties of brackets available, and the choice of brackets depends on the patient’s affordability and individual case requirements.

What are the different Types Of Braces?

Edgewise Or Traditional Brackets

Edgewise or traditional brackets are the commonest and the most affordable system among the available braces. They were introduced in 1928 and have been used with several modifications.

They have a horizontal slot that houses the archwire. The archwire is held in the slot by an O-ring elastic tie. O-rings are available in different colors. Young patients love to select their colors and wish to get a new color every time. 

The edgewise braces are made of stainless steel and are often a patient concern due to their metallic appearance. They may also be initially uncomfortable for the patients leaving indentations on the inner surface of cheeks and lips.  

They are less expensive and can be sterilized and reused if they come off (debond). 

Due to their hardness, they resist deformation and fracture. They offer greater friction at the archwire bracket interface and therefore prolong the treatment duration. Furthermore, they may corrode in the moist oral environment and cause staining of teeth.

Self-Ligating Brackets (Offer less friction)

Self-ligating brackets were introduced in 1980. The bracket has a door mechanism that is opened and closed to hold the archwires. They don’t require an elastic tie to hold the wire compared to the traditional brackets.

They have enhanced efficiency and are simple to use. They offer reduced friction at the bracket and wire interface and thus reduce the overall treatment time. They efficiently align the severely irregular teeth and give better plaque control due to their small size and smooth surface.

Moreover, self-ligating brackets are less uncomfortable for the patients and reduce the risk of lip injuries because of their smooth, curved outer surfaces. 

These brackets are made up of stainless steel. Therefore, they aren’t satisfying for the patients in appearance, and the patient tends to have a metallic smile. However, they are costly in comparison to the standard edgewise brackets.

Because of their low friction design, some practitioners find trouble fixing the minor tooth movements necessary to finish the treatment. A tight contact between the archwire and bracket slots (the more significant the friction) is required for the precise teeth movements for ending a case.   

Damon Brackets (expands the dental arch)

Damon brackets were introduced in 1996 by Dr. Dwight Damon. They are self-ligating brackets but offer the least frictional resistance to the archwire of all the bracket systems available. These brackets have the following advantages over the other types.

  • They tend to expand the upper and lower arches and reduce the need for tooth removal to align the teeth. 
  • They reduce the overall treatment duration by up to 7 months, decreasing the number of appointments. 
  • Patients experience reduced pain as the force applied to the teeth is minimal throughout the treatment.
  • They require less chair-side time due to the locking door system.

Plastic Brackets – less noticeable on smiling 

Plastic brackets were first introduced in the 1970s. They are made from polycarbonate and were developed to improve the appliance’s appearance.

These brackets are available in tooth-colored or transparent forms. However, they tend to discolor in patients who are habitual smokers or frequently drink coffee. 

Another drawback of these brackets over the stainless steel edgewise is the deformation of their slots because of the poor dimensional stability of the material.

Lastly, the friction between plastic brackets and the metal archwire is higher than metal and therefore takes a little longer for the treatment to complete.

Ceramic Brackets (give a good appearance)

Ceramic brackets began in practice in the late 1980s. They are composed of either polycrystalline or monocrystalline alumina based on their distinct fabrication method.

The primary ceramic brackets were monocrystalline, which were milled from single crystals of sapphire using dimensional tools. Later polycrystalline zirconium was introduced to alumina ceramic brackets.

They have improved appearance and enamel-like translucency and resist staining better than plastic brackets. Moreover, they are more resistant to wear and deformation and are less prone to plaque build-up than stainless steel brackets. 

These brackets are known for their hardness. They are harder than the tooth enamel and can damage it if brought in contact with it. It is essential to remember that your lower bracket shall not touch the enamel of your upper teeth when you chew or make contact with your back teeth. It can occur in patients who have deep bites. 

Regardless, they offer greater frictional resistance between the bracket slot and archwire and can diminish the pace of tooth movement.

Ceramic brackets can not be reused and need replacement. It can cost you a new bracket every time you debond your bracket. However, some clinics use laboratory techniques to reuse them. 

Another shortcoming of ceramic brackets is their lack of flexibility. In other words, rigid ceramic and enamel have little ability to disperse debracketing forces applied by pliers at the end of treatment or if it is required to reposition the bracket.

Thus, there are chances of bracket fracture or enamel damage if proper care and technique (laser, electrothermal or ultrasonic) are not used during bracket debonding.  

Lingual Brackets (placed on the inside surface of the teeth)

This system consists of specially designed brackets placed on the surface of teeth facing the roof of the mouth. This appliance is used in particular cases. 

These braces are customized according to the shape of your teeth. Your orthodontist takes an accurate impression or a digital scan of your teeth, which is then used to create wires and brackets that will snugly fit along the line of your teeth and help to move them into the desired position gradually.

These brackets are not visible, and therefore, the appearance and smile are not compromised by bracket placement. For people whose primary concern is to have no-show brackets, such as people in the media industry, it’s an ideal option for them. However, these brackets are costly compared to other different types of braces. 

They cause no damage to the outer surface of teeth. On the contrary, they can cause difficulty in eating and speech. Because of their inside placement, you need to avoid hard foods and eat a soft, nutritious, and low-sugar diet. Oral hygiene maintenance is critical as plaque deposition can lead to gum inflammation (gingivitis).

Furthermore, they take longer to place because of the difficulty of placement on the inner surface of teeth. The brackets are made of soft precious metal such as gold and possess a smooth surface to avoid any injury to the tongue. However, any sharp wire edge can hurt the tongue or gums. 

Conclusion 

The article summarises the different types of braces used in dental practice. Edgewise, self-ligating, ceramic, plastic, Damon, and lingual brackets are brackets systems orthodontists use. 

Regardless, every bracket system has pros and cons, and dentists recommend it based on individual case requirements and the affordability of the patients. As technology advances, new brackets replace the older ones with improved appearance and increased efficiency.

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