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Orthodontic braces: types of appliances and treatment plans

Fixed braces remain the reference for many treatments. Several types exist; the treatment plan itself depends on age and on the problem to be corrected.

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How do fixed braces work?

Small attachments (brackets) are bonded to each tooth, and a metal archwire runs through their slots. As it returns to its shape, the wire pulls the teeth towards the planned position. Elastics, springs or small anchorage screws complete the appliance for precise movements.

The types of brackets

  • Metal brackets: stainless steel, small and sturdy; the most widely used, particularly in teenagers.
  • Ceramic brackets: translucent or tooth-coloured, more discreet; slightly bulkier and more fragile.
  • Self-ligating brackets: a built-in clip holds the wire, with no elastic ligature; less friction and sometimes longer intervals between adjustment visits (for example the Damon system).
  • Lingual brackets: bonded to the inner surface of the teeth, hence invisible; often custom-made (for example Incognito or WIN), they require the tongue and speech to adapt at first.

Brands differ in bracket design, manufacturing precision and the associated archwires. The choice of appliance is made by the orthodontist according to the movements required and your priorities: discretion, comfort, budget.

The main treatment plans

In children: interceptive treatment

Between about six and eleven years of age, simple appliances (plates, expanders, functional trainers) correct a jaw discrepancy or guide tooth eruption while taking advantage of growth. A second phase with braces may follow in adolescence.

In teenagers: comprehensive fixed treatment

With all the permanent teeth present, the appliance aligns the teeth and corrects the bite. Ceramic brackets or clear aligners are possible when discretion matters.

In adults

Treatment is possible at any age, provided the gums and bone are healthy; periodontitis is treated first. Aligners, lingual or ceramic brackets meet the constraints of professional life.

Before a prosthesis or an implant

Targeted orthodontic treatment sometimes prepares the mouth: uprighting a tilted molar, opening or closing a space, moving a tooth up or down to recreate bone and gum before an implant.

Combined orthodontic and surgical treatment

When the discrepancy comes from the jaws themselves rather than from the teeth, orthodontics is combined with orthognathic surgery, to which we devote an article.

Retention

Whatever the appliance, the result is maintained by a retainer: a custom-made bonded wire, a night-time tray or both. It is a stage of the treatment, not an option.

At the practice

Treatments are carried out by Docteur Alison Cohen, specialist orthodontist, and Docteur Margaux Rioual. The choice of appliance is discussed at the first consultation, after the examination and radiographs.

Sources

Related care

Gouttière transparente posée sur les dents (animation)Orthodontics Soin dentaire chez un enfantPaediatric dentistry

Further reading

Illustration : contention parodontalePeriodontal splinting: fibre-glass splint or Memotain wire?When teeth become loose after periodontitis, or when an alignment needs to be maintained, a bonded retainer links them together. At the practice we use two devices: the fibre-glass splint and the custom-made Memotain wire. Empreinte optique : la praticienne montre à la patiente son modèle 3D sur l'écran du scanner intra-oralDigital impressions: the 3Shape TRIOS scanner in practiceAt the practice, impressions are taken with a 3Shape TRIOS intraoral scanner, without paste or trays. Here is how it works and what it brings to your care. Aligneurs transparents (animation)Clear aligners: Invisalign and the other aligner systemsClear aligners move teeth with a series of custom-made trays. Several brands exist; at the practice, our orthodontists work with Invisalign, the original system, which has the longest clinical track record. Salle de radiologie panoramique et cone beamOrthognathic surgery: when is it necessary and how?Some discrepancies do not come from the teeth but from the jaws. Once growth is complete, orthodontics alone cannot correct them: orthognathic surgery repositions the jaws, in coordination with the orthodontic treatment.