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Bracket and wire orthodontics

Orthodontic therapy by brackets and wire, better known as fixed orthodontic treatment, has been used for teeth correction for a whole century. That fact speaks for the quality of the treatment. What has changed and evolved is the level of control of teeth spacing and the understanding of biomechanics and the movement of teeth that can be accomplished through this type of orthodontic treatment.

Safe to say that this type of orthodontic appliance gives the greatest control of teeth alignment, which means best and fastest results. A controlled and planned movement of teeth is the fastest orthodontic treatment.

How does bracket and wire orthodontics work?

The teeth have brackets which carry the information of the ideal position of teeth, glued to them. Then the brackets are connected by a wire arch. At the start of the treatment nickel-titanium wires are most often used due to their superelasticity in order to perform a rough leveling of teeth.

Because the superelastic wire has to be deformed to fit the slots of the brackets it wants to return to its original position. Due to this the elastic potential energy is transferred to the tooth which makes it move.

The wire then pulls the tooth along with it to the ideal position. Later a variety of other elastic elements (elastomer or wire) are used, which transfer the force and create teeth alignment.


Types of brackets by material of construction

The two most often types of brackets used in orthodontic treatment are metal and ceramic brackets.

Ceramic brackets

Ceramic brackets are divided into polycrystalline and monocrystalline (sapphire) brackets. Polycrystalline brackets are white, and monocrystalline brackets are see-through and are less conspicuous than polycrystalline ones. At our clinic we use sapphire, monocrystalline brackets for a complete see-through effect. Simply put, ceramic brackets are ideal for appropriate cases and cases of medium difficulty. In spite of that it is true that even heavier cases can be done using ceramic brackets with more effort and a longer duration of orthodontic treatment.


Metal brackets

Metal brackets are the gold standard in orthodontics which the fixed orthodontic treatment had from the very beginnings. They have by far the best mechanical properties, meaning they are resilient and don’t break during the orthodontic treatment. The wire arches that connect them slide through the body of the bracket very easily which means that the friction that may disrupt teeth alignment is reduced to a minimum. Metal brackets are also economically more affordable than other variants.

The almost only negative about metal brackets is their visibility. But, as orthodontic treatments become fashionable, often people, especially younger generations, choose metal brackets as a fashion accessory. Apart from this negative, metal brackets are superior by all criteria than all other, newer brackets. More modern isn’t necessarily always better, at least not in this case.

Today, metal brackets can be overlaid by gold or other noble materials which make them more fashionable or less conspicuous without losing their mechanical properties.


Types of brackets by construction.


Brackets are divided by construction into conventional and self-aligning. With conventional brackets the wire arch is tied to the bracket via elastic and wire elements. Since self-aligned brackets appeared after the conventional ones, companies that put them out into the market tried to show them as superior than conventional brackets. After serious and independent research was made, it was shown that self-aligning brackets have no advantages to conventional ones. Neither in terms of quality of results or the speed of the treatment. Again, the level of quality of the orthodontic treatment is exclusively down to the professional that is applying it.

Orthodontic treatment procedure


Step 1

Before the start of the treatment it is necessary to undergo and examination with an orthodontist who will, based on the examination and the x-ray of the jaw, give the patient a general plan of treatment and the options available


Step 2

The diagnostic procedures of taking impressions, photographing, taking additional x-rays if needed (LL craniogram, CBCT).


Step 3

The patient has the defined plan of treatment explained, the brackets and wires are applied to the teeth and the process of alignment starts. The brackets, wire arches and additional elements are continually adjusted at checkups through the entire duration of the treatment according to the treatment plan.


Step 4

After the end of the orthodontic treatment comes the retention phase. With the help of retainers worn by the patient we make the teeth stay in the correct position and stop their return to their original position. We use a fixed and mobile retainer whenever possible in order to have double protection.


The duration of the fixed brace orthodontic treatment

One of the most frequently asked questions our patients have is: “How long will I have to wear a fixed brace?”

The length of the treatment depends on multiple factors and is set on a case-by-case basis. Factors that influence the duration of treatment are the spacings between the teeth that they have to overcome in order to arrive at the correct alignment and the health of the teeth and bones.

An important factor is also the patient’s discipline, meaning adhering to the orthodontist’s instructions. On average the brace is worn during a period of one to three years.


Fixed brace orthodontics in adults

The opinion that fixed brace orthodontics with brackets and wire is meant purely for children and adolescents is completely wrong.

It is never too late to correct teeth alignment and to fix countless problems that come with overbite or underbite. If you’re an adult with misaligned teeth we can help you bring back complete functionality and esthetics to your smile.

More on that can be read on our blog.



Does wearing fixed braces hurt?

The fixed brace requires a certain adjustment period. There is a possibility that the patient will feel pressure, and, in some cases, during a shorter period, pain. This is completely normal and passes quickly. While the pain lasts, if it comes to pain at all, we recommend patients take painkillers as help. Every patient is different and reacts differently to pain and pressure, but it’s completely normal that you need to get used to wearing braces at the start of treatment.

How do I wash my teeth when wearing brackets and wire braces?

During brace treatment it is necessary to perform correct and regular oral hygiene. The worst thing that a patient can do is to disregard dental hygiene and allow the development of cavities or other diseases and so complicate and compromise the entire treatment. Teeth can be treated and fixed as well as whitened and sandblasted, but there is no reason not to take any available step to ensure the smooth duration of the orthodontic treatment, and dental hygiene is one of the most important aspects for it. It is important to use, besides a toothbrush and toothpaste, dental floss or interdental brushes. If you’re starting a brackets and wire treatment your orthodontist will give you any and all necessary information and instructions on correctly maintaining your oral cavity hygiene.