What is orthodontics?
Orthodontics is a speciality of dentistry that deals with the correction of the teeth and jaws that are positioned incorrectly.
Crooked and incorrectly positioned teeth not only detract from your appearance, but they are also harder to clean, therefore having an increased risk of tooth decay and periodontal disease. In addition, dental malposition can cause an overload on the mastication and temporomandibular joint (TMJ) muscles, resulting in headaches, chewing and neck pain.
How do braces work?
During the mixed dentition stage, where both baby (milk) and adult teeth are present, removable orthodontic appliances are often used in order to direct the growth of the jaws that are still in development (orthopaedic effect).
Once the permanent (adult) teeth are established, fixed devices are more commonly used, with bands and brackets that are attached to the teeth using a special glue. The teeth are connected using a steel or nickel-titanium wire that exerts a light force on the roots of the teeth, causing them to move in an orderly manner.
Dental malposition problems are becoming increasingly common, with more than 20% of the population having some deviation in their bite (malocclusion). In accordance with the diagnosis, your orthodontist or dentist will determine if you need orthodontic treatment and develop a treatment plan tailored to your needs. If you have any of the following conditions it is likely that you will need orthodontic treatment:
- CROWDING: Lack of space leads to the teeth being mounted on each other.
- DIASTEMA: The separation between one or more teeth is excessive.
- DEVIATIONS OF THE MIDLINE: The midpoint of the upper and lower dental arches do not match up.
- CLASS II MALOCCLUSION: Also known as an overbite, where your upper teeth stick out past your lower teeth.
- CLASS III MALOCCLUSION: Also known as an underbite, where your lower teeth stick out past your upper teeth.
- OPEN BITE: The maxillary arch teeth fail to close completely with the mandibular teeth.
1. I’ve been told it hurts, is it true?
2. Can I lead a normal life?
- The new technology that we offer (passive self-ligating brackets and low friction) use mild force to move the teeth rather than conventional techniques that use more force (more pain).
- Do not interfere with your normal activities (talking, chewing,….)
- You will be able to continue your professional activities, and your social relationships will not be affected.
- Consider that today there are many adults who wear braces.
3. Is the treatment stable?
- Eat with care, no hard foods, and avoid biting with the front teeth.
- Brush your teeth and gums thoroughly.
- If you play contact sports, we recommend that you protect your teeth with a wax overlay or with a silicone mouth guard.
4. I have been told that they can stain the teeth.
- According to many years of research and experience in orthodontics, it seems that only 10% of patients experience changes in the finished position of the teeth and/or jaws.
- All those patients that wear a retainer for the rest of their lives are less likely to suffer changes in their teeth.
- We therefore recommend the use of fixed wire retainers or removable retainers to enjoy a safe and healthy smile for life.
- The decalcification of enamel only occurs in those patients who neglect their hygiene during the orthodontic treatment. The braces retain a lot of food and it is important to follow the instructions and advice that the clinic gives you.
The latest in Orthodontics
Clínica Kranion is a pioneer in High-Tech Orthodontics:
1. Orthodontics using lingual orthodontic braces
which are stuck on the inside of the teeth, not being visible when the patient is talking or chewing.
2. Orthodontics via the invisible Invisalign ® system,
which uses mouldable plastic (aligners) that are placed over the teeth and are inconspicuous due to being transparent.
3. Cosmetic gingival sculpting
that allows us to reduce or streamline the amount of gum that shows when smiling, thus achieving more pleasing dental aesthetics.
4. Micro screws and miniplates:
- Those patients that show their gums when smiling, can benefit from a new diode laser system that allows the gum to be trimmed (gingivectomy) with great precision and painlessly.
- We apply a local anaesthetic gel and remove the excess gum, this way we can increase the size of the front teeth and reduce the amount of gum when smiling.
One of the main difficulties in the daily practice of orthodontistry , when dealing with dental anomalies, is finding a source of anchorage. In order to move the teeth, it is necessary to have a rigid and stable base to act as support to carry out the orthodontic forces. This support is what we call the anchor. Normally, the orthodontist uses a dental anchor building on a block of teeth. However, when there are big malocclusions, the dental anchor is insufficient and thus a bone anchor is needed (or skeletal anchorage) through placing micro screws or miniplates in the bones base, being in most cases, a safe and efficient alternative for achieving tooth movement.
5. Reducing treatment time by almost 50% (approximately 1 year) using:
- Low-friction orthodontics through self-ligating braces, made of titanium alloys with low elastic modulus, and memory as used in the aerospace industry.
- Indirect bonding, which allows us to stick the brackets at the optimum point of the crown of each tooth, resulting in a more effective tooth movement.
Accelerated orthodontics in 3-8 months, through the application of cortical incisions in the bone at the base of the teeth.
7. Combined treatment of orthodontics and orthognathic surgery.
Orthognathic surgery corrects facial skeletal disorders caused by abnormal growth of the maxilla and / or jaw. An alteration in the shape of position of the jaws mean that the teeth are misaligned and there is a bad fit or occlusion between them. For this reason, treatment of orthognathic surgery is often combined with orthodontic treatment.
Currently, the techniques of maxillofacial surgery can reduce the operating times of these interventions and accelerate recovery, due to surgery being minimally invasive inside the mouth and without visible scars. Physiotherapy rehabilitation through lymphatic drainage, massage and exercise therapy will encourage a speedy recovery.
The vast majority of cases require joint planning between the maxillofacial surgeon and the orthodontist. The teeth naturally in these cases become cluttered and suffer what is known as teeth crowding. The work of the orthodontist, fundamental in order to organise the teeth in the jawbone, along with surgical correction, where the surgeon places the bones in their correct position, allows us to achieve facial harmony and a correct arrangement of the teeth.
ESometimes, complementary cosmetic procedures are performed (chin surgery, rhinoplasty, liposuction, Bichat’s fat pad, malar osteotomy, canthoplasty..) to further enhance some parts of the face and thus optimise the aesthetic results.
It is important to know that the orthognathic surgical procedures are usually performed with general anaesthesia and can last from 30 minutes to 2 hours depending on the type of surgery. When surgery is completed the patient remains in the recovery room for another hour, before being transferred to their room.
Some examples of combined treatments of orthodontics and orthognathic surgery are:
- Small lower jaw: Here we are talking about a class II malocclusion, when the upper teeth protrude past the lower teeth, also known as an overbite. This may be because there is a short anteroposterior jaw, which is more noticeable if you look at the patient’s profile. Surgery to move forward the jaw will make the profile more natural and give due prominence to the patient’s face.
- Small upper jaw: Here we are talking about a class III malocclusion where the upper teeth are lagging behind the lower, also known as an underbite. Normally this alteration affects both jaws in varying proportions: the upper one is deficient and the lower is excessive – protruding jaw. Surgical treatment usually consists of moving the upper jaw and / or retracting the lower.
- Narrow upper jaw: A narrow palate causes the upper jaw to have a V shape resulting in the incisors showing too much when smiling. Correcting the width of the palate has a very positive impact on the face and on the patient’s smile. If the narrowness is excessive, surgery is necessary to expand the palate.
- Facial asymmetry: When there is uneven growth of the craniofacial skeleton on both sides of the face, this causes facial asymmetry. This asymmetry tends to affect, due to the compensation mechanisms generated, other parts of the face, requiring surgery of the jaws to centre the face.