Bretels voor kinderen: aanbevelingen voor de toepassing en de selectie
In a modern society, healthy and smooth teeth are a sign of a good quality of life.More than 80% of people have a variety of anomalies of the dentition and bite pathology.Aesthetic disadvantage of this kind can have the most negative impact on the human psyche.In children and adolescents, an inferiority complex is often formed and the capacity for social adaptation is disrupted.Table of contents: Indications for installation of braces for children What are bracket systems?Historical background Mechanism of the operation of the bracket systems Varieties of modern braces for children and adults Pros and cons of various bracket systems Possible contraindications to the installation of braces for children The removal of brackets and subsequent treatment
Indications for the installation of brackets for children
Orthodontic treatment can be carried out at almost any age,But it must be taken into account that the older the person, the more prolonged it will be.Bite correction is much easier to carry out in children and adolescents, until the growth of the body and the formation of the dentoalveolar system are completed.
The installation of braces for children is shown after 9 years, because at an earlier age the process of amelogenesis( formation of enamel) of teeth of permanent bite has not yet been completed.In this regard, non-removable orthodontic structures, especially against the background of insufficiently thorough hygienic care of the oral cavity, may increase the risk of developing dental diseases, in particular - carious lesions.According to some experts, the lower age threshold for children is 12 years.
What is a bracket system?
Bracket systems, also called orthodontic staples, are complex, non-removable structures designed to correct bite and align the dentition.These devices are attached to the internal( lingual) or external( vestibular) surfaces of the teeth.
Each device has its own "program", allowing you to specify the desired direction of displacement for the teeth.To the braces fixed to the teeth by means of metal or elastic ligatures, an orthodontic arc is tied.This element is the main source of force that affects the dentition and jaw system.
Due to the fact that the metal alloy has a "memory", the elastic arc always assumes its original shape after bending.Additional elements of the apparatus are elastic chains, orthodontic rings, as well as metal springs and cheek locks.
Please note : At present, modernized non-ligating brackets are becoming increasingly common in dental practice.
In these self-regulating systems, instead of the "classic" ligatures, a special kind of latch is used, which is part of the "lock".It can not be asserted that these innovative devices significantly exceed traditional ones.In most cases, the success of treatment does not depend on the variety of the bracket system, but on the skill level of the dentist-orthodontist.
The question "how to fix bite" worried people even in ancient times.In the tombs of Ancient Egypt archaeologists have found gold constructions, which can be considered the prototypes of modern orthodontic devices.
The first braces, which used a modern scheme of the impact on the dentition, were patented by the dentist E. Engel in the US in the early twentieth century.The old designs were cumbersome and not as effective as the current ones.For "resetting" they had to be periodically removed and in general they were unsafe for the patient.
Over time, the devices have been improved and become more aesthetic.A turning point in the development of braces can be considered the creation of a unique alloy of nickel and titanium, which is characterized by thermoactivity.The arcs made of it began to combine flexibility, elasticity and durability.Nickel-titanium elements significantly increased efficiency and reduced the time needed to repair defects in the dentition.
Mechanism of action of bracket systems
Bracket systems allow to "pull out" a tooth from the alveolus, immerse it deeper, turn it about a vertical axis or tilt in any direction.
The human teeth are not fixed in the jawbones motionless.They are retained in the alveoli( wells) with the help of a ligamentous apparatus - radial and tangential periodontal fibers.
Normally, the teeth are able to move both independently( during eruption) and under the influence of external forces.It is this ability to bias due to mechanical action and is the basis of the technique of correcting the occlusion with the help of various apparatuses.
If the tooth is affected, causing it to tighten as tightly as possible to one of the walls of the hole, the bone of the alveolus at this point begins to gradually resolve, freeing up space for movement.On the opposite side, where the ligaments are forced to stretch the bone tissue, on the contrary, it grows, fixing the tooth in the desired position.
Significant pressure when biting off and during chewing dense food does not change the position of the tooth, because it is short-lived.
Displacement in a certain direction becomes possible only if external forces act continuously for a sufficiently long time - months and years.
Please note: The activation of bracket brackets in children is performed by either the dentist orthodontist or the parents of the patient after receiving detailed instructions from the attending physician.
The changes that have occurred during treatment are persistent, and the teeth remain flat for the rest of their lives.
Varieties of modern braces for children and adults
There are several classifications of braces.By the type of placement of the device distinguish:
- vestibular( located on the outside of the teeth);
- lingual( fixed from the inside of the dentition).
According to the type of fastening of the orthodontic arc, the apparatuses are divided into:
- ligature( classical);
- is liquefied( self-ligating).
The following types of brackets are used for the materials used in manufacturing:
- metal( including gold);
- polymeric( plastic);
- combined( in particular - metal-ceramic).
Advantages and disadvantages of various bracket systems
Each of the types of devices has certain advantages and disadvantages, so it is impossible to unequivocally state which braces are better.Currently, most specialists prefer non-ligand systems, which are considered the most innovative and technically advanced.
A common disadvantage for vestibular braces is an aesthetic drawback, although, for example, the locks made of sapphire look very attractive.In addition, patients should observe some restrictions in the diet.In particular, you should completely eliminate the consumption of fast food, hard foods and beverages, which include artificial colors.
Non-removable devices somewhat complicate the process of cleaning teeth and make it impossible to use hygiene products such as flosses( dental floss).Also significantly increases the likelihood of developing the process of demineralization of enamel in the area of fastening the locks.Such complications as inflammation of the mucous membrane of the gums and the resorption of the bone tissue of the alveoli not provided for in the treatment plan are not ruled out.
Important: Orthodontic treatment is not the fastest process, and it will take at least a year to wear the device.When choosing braces for children and teenagers it is recommended to give preference to designs that have an original and attractive appearance.
Any patient, regardless of age, will certainly prefer an ugly metal bracket system that can serve as a real decoration.Having made your choice in favor of this or that material, try to find a specialist who specializes mainly on the type of braces you need.
The obvious advantage of metal structures is their relatively low cost, as well as a variety of models.The obvious drawback of the systems of nickel and titanium alloy or stainless steel is their visibility in the oral cavity.Children are offered metal braces, decorated with multi-colored ligatures, as well as devices with locks in the form of hearts and stars.
Plastic systems are more perfect from the point of view of aesthetics, but are characterized by less strength and the ability to change color under the influence of food dyes.But plastic can have different color solutions, so such systems are often offered to children and adolescents.
Ceramics are much stronger than polymers and, being competently matched in color, is not striking.The downside is the high price of ceramic bite correction systems.
Sapphire braces are almost transparent, but they are not cheap either.
Possible contraindications to the installation of braces for children
Contraindications to correction of bite through the braces are :
- low level of oral hygiene;
- presence of carious lesions of the teeth and complicated caries( before the installation of the systems complete sanation is necessary);
- gum disease( preliminary treatment of gingivitis is required);
- pathology of bone tissue( with osteoporosis, the effectiveness of treatment may be insufficient);
- mental illness( schizophrenia, dementia);
- blood diseases;
- some pathologies of the cardiovascular system;
- a number of endocrine diseases;
- malignant neoplasm.
Note: In children and adolescents with an excessively labile psyche, the process of adapting to braces may be difficult.Even for adult patients, getting used to non-removable devices is sometimes very difficult.In this regard, before taking the child to the dentist, it is recommended to get a consultation with a child psychologist in advance.The child needs to be explained that it is worthwhile to suffer some inconvenience in order to have beautiful even teeth in the future.
Withdrawal of brackets and subsequent treatment
After the braces are installed for children, the duration of treatment can be from 8 months to 1.5-2 years.This period depends on the severity of the defect of the dentition, age, and also on the general condition and individual characteristics of the organism of the young patient.
The efficiency of the treatment is determined by the attending physician on the basis of the examination data, instrumental research and analysis of the radiography data, allowing to assess the bone tissue condition of the alveoli of the problem areas of the dentition.
The last months of wearing systems are often the most difficult, because the child can not wait to get rid of a boring foreign object as quickly as possible.Braces are removed by means of a special tool - orthodontic forceps.
The removal process is painless, but it is associated with unpleasant sensations.On the surfaces of the teeth there is always material, with the help of which the staples were fixed.In order to restore the teeth to their natural appearance, the remains of the adhesive material are carefully ground, and the enamel is polished using special brushes and pastes with abrasive particles.
The most common problems with the removal of bracket systems occur if sapphire or ceramic structures have been installed.These materials are characterized by a sufficiently high degree of brittleness, therefore they crumble during the removal, and small fragments often remain glued to the surface of the tooth.The doctor should be very careful not to damage the enamel.
Even after the braces are removed, the treatment is not over.For the patient comes the retention period, during which he will have to wear the so-called.Retainers.
These devices can be removable or non-removable.They serve to fix the result achieved in the process of wearing braces.
Non-removable retainers are fixed on the lingual( or palatine) surface of the teeth of the frontal group( from the canine to the canine).
Removable devices, in fact, are rigid kapy.
The question of choosing the mode of use is strictly individual, but with complete abandonment of the containers or when they are worn irregularly, it is very likely that the teeth will return to their previous "abnormal" position.Replace these devices as needed.Immediate replacement is required if an incomplete fit of the retainer to the dentition is noted.
Children need to wear these accessories for the same amount of time during which they wore braces.For adolescents, the retention period is extended and may be( according to indications) up to 5 years.
Advice from an orthodontist when choosing bracket systems:
Vladimir Plisov, dentist