Power chain on braces

power chain

What is a power chain?

A power chain is a long chain of elastic rings used for a number of applications during braces or fixed orthodontic treatment. These seemingly small rings are stretched and placed on the bracket wings over the wire.  

What are power chains used for?

There are several applications of a power chain. It is mainly used to close spaces between the teeth. The space closure is diverse when it comes to orthodontics. Here are its few uses in orthodontics:

  • To close the extraction spaces
  • To pull an impacted tooth with the help of a lingual button 
  • For teeth intrusion with the help of a mini-implant.
  • Correction of midline.
  • Forward movement of a first molar
  • To correct rotated teeth 
  • To close the small spaces at the final stages of the treatment.  

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What do power chains look like? 

They are made of elastic and are available in different colors. The manufacturer provides them as a string of elastic rings wrapped around a reel. The orthodontist cuts the number of power chain units according to an individual patient’s requirement and places it around the bracket wings over the wire. 

how does a power chain work?

The orthodontist places the power chains on the bracket wings with an instrument’s help. When in place, the stretched elastic of the power chain springs back, transmits force on the teeth and pulls them closer, closing the gaps between them.   

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What are the types of power chains?

There are three types of power chain.

  • Close power chain has elastic rings connected to the next ring with no space in between. It is given at the last stage of treatment to close any remaining space and establish close contact with the teeth
  • Short power chain have elastic rings that are separated by a small elastic.  
  • Long power chain have elastic rings that are separated at a more considerable distance. It is connected to every third bracket. 

How long does the power chain take to close gaps?

The time required to close spaces between the teeth depends upon the length of the space. On average, it takes 4 weeks to close a 1-1.4 mm space, so it takes 6-7 months to close the extraction space.

An initial movement of 0.4 -0.9 mm is achieved within a week due to compression of the tooth attachment apparatus and bone bending. In the next two weeks, a plateau is reached and no movement is seen. During this lag phase, the bone slowly resorbs to allow the tooth move in the direction of applied force. Another 0.5 mm of tooth movement is seen in the fourth week when the bone is resorbed, and the tooth moves to a new position. 

Different orthodontists take different approaches to close the extraction space. It also varies from case to case.

Some cases require canine retraction first, followed by the anterior segment retraction (4 front teeth). Others require en-mass retraction, i.e., all six teeth are retracted as a unit. 

Canine retraction takes six months, followed by another six months for the anterior segment.

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Does everyone get a power chain?

No, all patients with braces don’t require a power chain. However, most cases require using it in some way. 

Can you choose to get power chain on your braces?

Power chain is available in different colors, and the orthodontist asks you to choose the color. Most adult patients like to go for a transparent power chain. However, young patients prefer colored power chains. They also want to experience a new color whenever the power chain is replaced.  

Read more: Can you get braces with baby teeth?

How often should the power chain be changed?

The power chain is changed every four weeks. It loses its elasticity in a month and requires replacement. The force applied with the power chain causes the bone and its attachment fibers to remodel. 

The whole process of bone resorption and new bone formation, known as bone remodeling, occurring at different sites around the tooth takes 4 weeks to complete. A light continuous force of 100-200gm is applied to move the teeth that bone and its surrounding tissues can tolerate and adapt without any detrimental effects. 

What comes after the power chain?

Once all the spaces are closed with the help of a orthodontic chain, fine adjustments in the teeth positions are made, if any, to finish the treatment. To accomplish this, the orthodontist makes small bends in the archwire to adjust the position of one or more teeth that require minor adjustments. 

Read more: What is the best age for braces?

Why do power chains hurt so much?

The power chain hurt a lot after the activation for 7-14 days, and then becomes passive. When a power chain is placed, the elastic pull of the power chain causes teeth to move and allows bone around the teeth to remodel. 

The bone remodeling is an inflammatory process. During bone remodeling, the inflammatory, bone-forming, and bone resorptive (removing) cells are recruited to the stress site. This inflammatory process also triggers the pain receptors in the nerves that causes pain. Moreover, you will experience redness, tenderness (pain on touching), and elevated temperature in your gums. 

How to manage orthodontic pain?

It is critical to understand that you can’t take pain medication such as Advil or aspirin to control this pain. These medications belong to the group of Non-steroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation and hence, tooth movement. 

However, you can chew gum or use biting wafer to manage pain. Listening to music or engaging in physical activity may also help change your focus from the pain. 

Cognitive behavioral therapy (CBT) can also help you manage your pain. It would help if you work with a therapist to break your negative thought pattern. 

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How long do power chains hurt?

They will hurt you for 7-14 days after their placement. These episodes of pain will continue to come back after every activation. 

When do you get a power chain on your braces?

Following cases require orthodontic chain during the treatment:

  • Spacing in the teeth 
  • Crowding of the teeth requiring premolar extraction to create the space for teeth alignment. 
  • Forward positioned teeth requiring premolar extraction to pull them back to their correct angulation.

After the premolar extraction, you will probably need a power chain to retract the canine and close the space. However, at this stage, some orthodontists may choose closed coil NiTi springs to close the significant gap with or without a mini-implant. Minor spaces left at the end of the retraction are often closed with a power chain. 

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How to close the braces gap faster?

Fixed orthodontic treatment or braces treatment is a long and tiring treatment and requires a lot of patience to see the results. During orthodontic treatment, light, continuous force is applied to stress the tissues within their physiological capacity without causing any detrimental effects. Heavy force or rapid activation is avoided to accelerate the treatment process as it leads to root resorption or teeth devitalization. 

Taking control of factors like maintaining good oral hygiene, avoiding bracket debonding, and showing up on time at every appointment allows you to complete the treatment in a given time. 

Faster bracket systems

Damon self-ligating bracket system is known to reduce treatment time because it lack the need for elastics to hold the wire. It has built-in gates that hold the wire and reduces friction, thus decreasing the treatment time and discomfort. 

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

Novel approaches

There are a few novel approaches to expedite the braces treatment, but they are unavailable in every orthodontic practice. Lasers, lower-level ultrasound, corticotomy, and growth stimulating injection are few ways to accelerate the process. 

Are braces supposed to make gaps? 

Braces align the teeth in their correct position. In the alignment process, you may see gaps between the teeth, but don’t freak out. Your orthodontist will eventually fix them, and you will have a beautiful smile at the end of the treatment. 

Read more: All about the local anesthesia for wisdom teeth.

What to do if the power chain breaks?

You don’t need to worry about it if power chain breaks. It is not an emergency; however, it will make it ineffective. Get an appointment with your orthodontist and get it fixed. 

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