Orthodontics

The orthodontic word comes from the Greek "orthos" - the simple and the "odous" - the tooth. The first orthodontic appliances appeared in the 18th century, but the orthodontic bloom and its popularity increased with start of using modern fixed appliances.

This field of dentistry, also known as dentofacial orthopedics, is a broader concept that deals primarily with the diagnosis, prevention and treatment of malpositioned teeth and the jaws . It not only allows you to "straighten" incorrectly positioned teeth but in many cases also improves facial features.

In most cases, the appropriate time for the first orthodontic visit is the beginning of the period of mixed dentition, ie about 6 years of age.

At this time, the first permanent molars (sixes) erupt and the replacement of dentition starts.

Only a dozen or so percent of malignant anomalies are recorded in genes. Therefore, if you come early enough for an orthodontic visit, you can recognize and eliminate many factors that can lead to malocclusion, thereby reducing or eliminating some potential orthodontic problems in the future.

Some of the abnormalities, which in childhood can be cured by simple methods, require much more complicated, invasive and expensive methods in adulthood.

The timing of treatment depends on the type of malocclusion, oral conditions, and any other urgent medical needs for conservative dentistry, oral surgery or periodontics. Some bite defects require early treatment, during the period of mixed and even dairy teeth; treatment of others is best carried out during the growth spurt, others after the end of growth.

All tooth decay, inflammation of the gums and other oral problems must be cured before the orthodontic treatment. It is also necessary to maintain very good oral hygiene . For children, appropriate co-operation is required so that planned treatment can be effective.

It is not advisable to professionally fluorinate the teeth before the permanent appliance is bondd, as this weakens the bonding of the adhesive to the teeth enamel.

What happens at the first orthodontic visit?

At the first orthodontic visit, the orthodontist will ask you about your medical history, paying particular attention to your expectations and carry out a thorough examination of your face, the jaws and the teeth. It is followed by radiographs (X-ray examination) and impressions (moulds) of the teeth. 

Second appointment - Treatment plan:

After analyzing diagnostic records, orthodontist will formulate and discuss with you a customized treatment plan, including types of appliances to be used, the need for auxiliary devices, and the type of appliances that maintains the effects of the treatment. In some cases, there are two possible ways of treatment and the final decision belongs to the patient. You can choose a type of braces (metal or aesthetic). Treatment time and cost are discussed at this appointment. It also gives you the opportunity to ask any questions you may have.  

Bonding the fixed appliance:

Once the enamel is properly prepared, brackets are bonded to the teeth. Orthodontist will show you how to clean your teeth during orthodontic treatment. The visit takes about an hour.

Scheduling appointments:

Fixed appaliance must be activated by the orthodontist every 4-8 weeks (depending on the type of appliance and the stage of treatment). In the final phase of treatment, X-ray is  taken to check the alignment of the root of the teeth.

Debonding:

After achieving the intended purpose of treatment, the fixed appliance is removed, teeth are cleaned and polished and patient gets the retention appliances.  Final impressions and photographies are taken. In some cases, the orthodontist bonds fixed retainer to the inner surface of  the anterior teeth.

Retention:

In the first 3-4 months after removal of fixed appliances the retainers must be worn full-time, then the time is shortened and the appliance is worn only at night.Control visits are aimed at checking the stability of the treatment or the activation of the retainers. They are much less frequent than visits during active treatment.

In the simplest way, orthodontic appliances can be divided into removable and fixed. Removable applaiances, also called movable ones, are usually made of acrylic and wire components. The device is performed individually for the patient by a technician using plaster models of the teeth, when designed by orthodontist.  

These types of appliances are used mainly in children. The ability to insert and remove a patient's own device is both an advantage and a drawback. The advantages include easier maintenance of oral hygiene, resulting in a low risk of dental caries. The disadvantage - the need for very good patient cooperation to achieve the expected effects of treatment and the fact that not all malocclusion can be cured completely with removable appliances.

Fixed appliances consist of brackets and bands bonded to the teeth, wires and other items. They help to move teeth in the direction planned by the doctor.

These types of appliances allow for very precise movements of the teeth, and their advantage is that they can also be used in adult patients treatment.

Braces, which are fixed to the teeth, are made of metal (steel, possibly titanium for nickel allergy) or aesthetic materials (porcelain, sapphire). The average duration of active treatment with fixed appliances is about 2 years.

In some cases this time may be prolonged, in the case of simple defects slightly shortened. The condition for starting the treatment is strong patient motivation and ideal oral hygiene because during orthodontic therapy it's more difficult to brush the teeth, which can predispose to the appearance of caries around brackets.

The last but definitely the most important phase of orthodontic treatment is  retention. It is the period after the end of active treatment when the patient wears special retainers . The position of the teeth in the initial period after removal of the fixed appliance is unstable, so it should be "held" in the new position until the reconstruction of bone and gums tissues and adaptation of the muscles to the new situation. Different malocclusions have different  predisposition to recurrence, in some cases, retention must be very long and even life. If there is a good patient cooperation the achieved therapeutic effect can be stable for a very long  time.

However, it is important to distinguish the recurrence of the defect from the appearance of new abnormalities or age-related changes after treatment. As with aging of the skin and other tissues of our body, there may also be changes in the teeth that sometimes need to be accepted.

Patients who are looking for discreet, invisible treatment can choose treatment with invisible aligners that move the teeth step by step into the good position. Treatment begins with consultation with orthodontist and getting orthodontic records.  After the data analysis, the doctor presents the proposed treatment plan, which includes the number of necessary steps (sets of aligners), estimated time and cost of treatment, and possibly limitations of this method. It is possible to see the final effect of treatment on a specially prepared plaster model of teeth set in new positions (setup). Impressions are made on monthly visits to make a new set of aligners. These type of appliance should be worn around the clock, except for meals. Due to the fact that they are almost invisible, they can be worn even by patients who, for various reasons, cannot afford treatment with a visible fixed appliance. In some cases, the entire treatment may end more quickly than with fixed appliances. At the end of active treatment it is necessary to maintain the teeth in new positions (retention) to prevent recurrence of the malocclusion. The retention period usually is twice as much as the active treatment. 

Fixed appliance – metal brackets1500 zł
Fixed appliance aesthetic braces2500 zł
Fixed appliance (aesthetic on 6 front, metal on side)2000 zł
Fixed retainer as the only retention350 zł
Fixed retainer as an additional retention100 zł
Schwarz appliance600 zł
Aparat płytowy ze śrubą trójkierunkową600 zł
Activator700 zł
Twin-block1000 zł
TPA300 zł
Lingual arch300 zł
Nance300 zł
Pendulum / Pendex550 zł
Quad-helix/Bi-helix500 zł
Hyrax800 zł
TAD/miniscrew500 zł
Clear Aligner – 1 set/ 1 arch700 zł

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