Self-ligating or ligature braces: differences, advantages and disadvantages

Self-ligating braces are one of the modern types of dental correction. They have some advantages over traditional ligature ones. In some cases, self-ligating braces are used when complex pathology is detected, as the only method of treating the dentition without first removing the incisors.

Such systems are among the most common methods used in orthodontics. At the same time, self-ligating devices have a higher cost, in contrast to ligature (classical) types of braces.

The advantages of self-ligating braces according to reviews from orthodontists:

• Such systems adapt the teeth naturally, without damaging them with excessive pressure, that is, the dentition is corrected naturally.
• The system allows you to leave healthy teeth intact. The device adapts them and makes it possible to save them without prior surgical intervention.
• The use of such a device reduces the number of doctor visits by two to three times.
• They are quite convenient for patients.

Special elastic rubber rings are used as fastenings in classic braces. In newer models, the fastenings are replaced with metal micro-locks.

The mechanism of bite correction using braces

Pathologies of occlusion can be congenital, caused by genetic predisposition or abnormalities of intrauterine development, or acquired, caused by bad habits or injuries to the dentofacial apparatus. The use of brace systems in corrective therapy makes it possible to effectively eliminate occlusion defects regardless of the reasons that gave rise to them.

The essence of the mechanism for correcting anomalies is based on the ability of teeth to move from their place under the influence of directed mechanical force. During the treatment process, the bone tissue in which the dental elements are located is thinned in the direction of the movement vector, and a new one is formed in the opposite direction. Thus, the calculated force pressure helps the tooth occupy a new place in the dental row.

The mechanical impact to achieve the goal of corrective therapy is created using bracket systems - non-removable orthodontic structures fixed to the surface of the tooth enamel.

Pros and cons of non-ligature systems

Many orthodontists and patients choose self-ligating appliances, which take up minimal space on the crown of the tooth, which greatly affects the appearance. The main positive qualities of braces systems:

1. Designs without ligatures are made of ceramics, plastic and artificially grown sapphire, which makes the device an aesthetic accessory, and not just a forced vestibular product that spoils the appearance.
2. The movement of teeth is carried out gradually, with the same force applied.
3. The sliding of the arch in the grooves occurs more smoothly due to the smooth polished surface of the bracket.
4. Braces without ligature systems bring less discomfort to patients and cause less severe pain.
5. The need for frequent visits to the orthodontist is minimized; consultation can usually be done in 8-12 weeks.
6. One of the most popular no-ligation systems is Damon, an American design characterized by a beautiful, modern design and comfortable wearing.

In some cases of simple pathologies, devices without ligatures can quickly correct the position of teeth. It is also possible to use them at the final stage of treatment - to consolidate the result obtained from the metal ligature structure. Materials for non-ligature products are resistant to staining with natural food dyes, which is an additional advantage.

Small disadvantages of products without ligatures:

• With their help, significant defects and abnormalities in the development of the jaw cannot be corrected.
• Less force when straightening teeth than in classic ligature devices.
• A high price, which is not always justified as a result of treatment.
• The effectiveness of the application depends on the qualifications of the orthodontist - even braces cannot always correct the bite.

Before using fixed orthodontic appliances, doctors often carry out preparations, which sometimes include removing a healthy tooth. This is necessary to create a free space, which is gradually filled by other teeth in the long process of alignment. Before installing a ligature-free structure, such preparation is not always carried out.

Design features of ligature braces

All bracket systems have the same design:

• bracket plates fixed to the teeth using a special adhesive composition;
• a power arc that has “shape memory” (tends to straighten out from a bent position);
• fastening elements that attach the arch to the bracket plates.

If the arch is fixed to the teeth using miniature clips, then such braces are called non-ligating or self-ligating braces. If the arch is attached using ligatures, then such orthodontic structures are called ligature. This is, as they say, a “classic of the genre.”

Either small plastic rings or thin metal wire made of medical steel are used as ligatures.

Plastic ligatures can be of various shades: transparent, silver, colored. Teenagers, as a rule, prefer rich colors. While wearing, the ligatures stretch, so the doctor periodically changes or tightens them.

Note: compliance with the prescribed frequency of visits to the clinic during the correction course is the key to the effectiveness of the process. Otherwise, the result may not be achieved.

Ligature braces are effective in treating both adults and adolescents.

Sapphire and plastic braces - what to choose?

In addition to metal and ceramic, there are sapphire and plastic non-ligature braces.

The first ones are transparent, so they are barely noticeable on the teeth. This is one of the most aesthetic braces. But sapphire systems are not as durable as metal ones, so they are not used to correct complex malocclusions.

Plastic braces are the most budget-friendly braces, but in terms of strength and durability they are inferior to any other. They wear out quickly: they are washed off, stained by drinks or food. They are almost invisible on the teeth, which is a plus. But most patients prefer to install more reliable structures.

Types of ligature systems

The main classification of braces is carried out depending on their positioning:

• those fixed on the outer side of the dental row are called vestibular;
• attached to the inner surface - lingual.

The material used to make orthodontic products also affects the type of bracket system:

• metal – bracket plates are made of a hypoallergenic metal alloy (cobalt, nickel or gold). Such designs are very reliable, efficient, affordable in cost, but their appearance is not aesthetically pleasing;
• ceramic - made of high-strength ceramics. Their color practically matches the shade of natural tooth enamel, so they have a high level of aesthetics. Cannot be used if excessive force pressure must be applied to correct defects (i.e., to correct severe pathologies). The price of such systems is significantly higher than similar metal products.

Non-ligature braces

The non-ligation brace system for correcting oral defects is preferred by most patients. Its principle of operation is the absence of fastening elements due to the special structure of the bracket itself. It has locks that are convenient for the dentist, securing the metal arc in the grooves. This device is more expensive, but has greater aesthetics. The self-ligating product has good performance in quickly correcting orthodontic defects, which is why dentists especially like it.

Indications and contraindications for installation

Any type of treatment should be prescribed exclusively by a specialist. Therefore, identifying indications and contraindications for correcting occlusion defects is a priority step, without which corrective therapy cannot be started.

Indications:

• Incorrect position of the jaws or individual teeth
• Tremas and diastemas (large distances between dental elements)
• Crowding of dental units
• Deep or crossbite

Contraindications:

• Periodontitis and periodontal disease
• Endocrine pathologies
• Severe cardiovascular diseases
• HIV;
• Tuberculosis
• Bone diseases (osteoporosis, osteomyelitis)
• Bleeding disorder
• Edentia (absence of many teeth)
• Oncology
• Mental illness

Important: An orthodontist identifies indications for starting corrective therapy with braces only after conducting a thorough hardware diagnosis. This is necessary to develop an adequate detailed treatment plan.

Which braces to choose - with or without ligatures?

Non-ligature braces look more aesthetically pleasing than classic ligature braces, reduce the number of visits to the orthodontist, correct the bite faster, move teeth more gently, and can be used for periodontal diseases. Thanks to the design of self-ligating systems, the process of their correction takes fifteen to twenty minutes. In addition, the absence of ligatures protects against pain that can occur if the orthodontist “tightens” the ligature.

The disadvantage of self-ligating structures is their high price. Apparently, for this reason, classic ligature systems are still very popular. They are especially often chosen by teenagers and young people, who, in addition to saving money, receive another bonus - the opportunity to experiment with the color of the ligatures, making their braces unique, emphasizing their individuality.

In general, when choosing an orthodontic system, doctors and patients are guided by two principles - the ability to effectively get rid of malocclusion pathology and the ability to pay for treatment. Both ligature and non-ligature constructions allow you to achieve the desired result.

Stages of corrective therapy

Correcting anomalies of the dental system is a long and painstaking process consisting of several stages:

• visual and hardware diagnostics: computed tomography, teleradiography,
• rendering a verdict, making a diagnosis, determining indications and contraindications;
• development of a treatment plan;
• oral hygiene: treatment of teeth and gums, professional cleaning;
• taking individual measurements (casts or scanning), making a model, drawing up an estimate;
• production of braces;
• installation of a brace system for a patient;
• wearing the device with periodic system adjustments. The duration depends on the severity of the specific clinical case and is determined by the orthodontist;
• removal of braces and installation of a removable or non-removable retainer. The duration of retention also depends on the individual characteristics of the clinical case.

Specialist comment: the retention stage is very important for consolidating the achieved results. Failure to follow the recommendations of the attending orthodontist may invalidate the results of therapy, and everything will return to its previous position.

Stages of orthodontic treatment

1. Leveling stage. Nickel-titanium arches of circular cross-section tilt the teeth in the direction of the forces, begin to correct the rotation and angulation of the teeth, and the correct shape of the dentition is formed.
2. Basic mechanics stage. On rectangular nickel-titanium, TMA or steel arches, the teeth are moved body-wise into the position of correct occlusion. The correct position is controlled in three planes: torque, angulation and rotation. If necessary, the orthodontist installs miniscrews and additional elements: springs, bite braces, buttons, intermaxillary elastics.
3. Retention period. To stabilize the treatment results, the doctor fixes a metal retainer on the lingual surface of the incisors and canines of the upper and lower jaw. In addition to the permanent retainer, the patient wears a retention mouth guard at night.

orthodontic retainer

Installation of ligature bracket system

The procedure for fixing the device takes about one and a half hours. What does the doctor do:

• washes the enamel, then thoroughly etches it with a special substance designed for better adhesion of the bracket plates to the surface of the enamel;
• applies an adhesive composition to the areas of future fixation of the plates;
• glues the plates and removes excess adhesive solution;
• threads a power arc into the grooves of the bracket plates;
• fixes the arch with ligatures.

Duration of treatment with self-ligating braces

Self-ligating systems are more modern and comfortable designs for the patient and doctor. Thanks to soft forces and the involvement of the muscular system, teeth straightening occurs faster, more physiologically and is more easily detailed. On average, treatment time with such systems is 20% less than with ligature systems, that is, 1.5-2.5 years. At the same time, fewer visits to the orthodontist are required, since there are no ligatures that require regular replacement.

The Confidence Aesthetic Orthodontics Clinic works with Damon Q and Clear self-ligating braces. According to reviews from our patients, these are the most comfortable systems to care for and wear, with impressive results.

Features of the adaptation period

The patient should be prepared to experience discomfort for several days or weeks (depending on the threshold of sensitivity):

• rubbing of the mucous membranes of the lips and cheeks;
• violation of diction;
• discomfort when eating.

Expert advice for minimizing discomfort:

• to prevent chafing, you can use special wax (sold in pharmacies);
• for minor pain, you should rinse your mouth 3-4 times a day with saline solution (1 tsp per glass of warm water). The procedure cannot be performed if there are wounds and abrasions in the mouth. In this case, it is better to use a soda solution in the same concentration;
• In case of severe pain, you need to take a tablet of any painkiller. Note: strictly follow the dosage indicated in the instructions for the medicine;
• In the first days after installing braces, cancel intense physical training. Yoga exercises will help during this period;
• learn to chop food with a knife, exclude excessively hard or sticky foods (dried, dried) from your diet. During the first few days, the products can be ground in a blender.

Attention: if the pain is severe and does not go away within several days, then you should definitely consult your doctor.

Vestibular and lingual apparatus

Orthodontists install braces in the oral cavity in two ways: on the vestibular (visible) and lingual (in contact with the tongue) side of the dentition. With the lingual type of fixation, aesthetic indicators are higher, but the period of adaptation to internal braces is more difficult. Patients with lingual devices do not experience psychological discomfort: the devices are almost invisible to others. The cost of invisible structures is higher compared to traditional vestibular systems.

lingual braces STb

Hygienic care

The bracket design has many areas that are very difficult to clean from food debris and plaque. Therefore, hygienic care for them requires special attention and patience. Special devices are used for cleaning (in addition to a regular toothbrush and paste):

• V-shaped brushes;
• brushes of different sizes and bristle angles;
• dental floss (floss);
• irrigator is a device for cleaning hard-to-reach places between teeth and orthodontic elements. The principle of operation is based on the controlled supply of a stream of water (or solution) under pressure.

You should clean your mouth while wearing braces twice a day. Ideally, after every meal. But, if this is not possible, then you need to rinse your mouth thoroughly after eating.

How to properly care for ligature braces so that the dream of perfect teeth becomes a reality?

The care is basic, but the outcome of treatment depends on compliance with these rules:

• the patient must have a minimum set of care products (special brush, irrigator, brushes, rinses, paste);
• brush your teeth not only in the morning and in the evening, but also every time after eating - it is important to thoroughly clean out leftover food, because it is they that provoke the formation of pathogenic flora. When wearing braces, it is important to maintain healthy teeth so as not to have to deal with the treatment of caries and pulpitis;
• In case of any defect in the braces system (if the arch has come off, the lock has come loose, the ligature is damaged, etc.), you must contact your dentist. Under no circumstances should you do this yourself.

Diet restrictions

To prevent braces from breaking or changing the vector of force, you need to reconsider your diet. Orthodontists recommend:

• hard vegetables and fruits must be grated or crushed in a brander before use;
• You cannot bite seeds, chew gum, eat nuts, dried apricots and other dried fruits;
• Avoid consuming very hot or extremely cold foods and drinks;
• limit the intake of food and drinks containing artificial or natural colors (tea, coffee, red wine, soda, berries, etc.).

Important: failure to follow the recommendations given by a specialist may result in system failure. In this case, the device will need to be repaired, which will lead to an increase in the correction period and an increase in the cost of treatment.

Diet while wearing braces

The main rule for all patients is strict compliance with the doctor’s requirements. Even the most durable metal structures will not be able to withstand the consumption of solid foods, not to mention ceramics. Regardless of the type of design used, care must always be taken.

To prevent the possibility of damage to the braces, experts recommend refraining from consuming the following foods:

• Firm fruits and vegetables. This includes apples, pears, carrots, nuts and much more. Solid foods can damage the structure of the braces, which will undermine the entire treatment process.
• Chewing gum and other products with a viscous consistency. Such food products will simply get stuck in the brace system.
• Foods and drinks that are too hot or cold. In case of sudden temperature changes, the bracket arch can be significantly damaged.
• Products containing dyes. Here, the possibility of damage to the structure itself is excluded, but the appearance of the product will be spoiled. This especially applies to plastic elements. You should refrain not only from food with dyes, but also from smoking.

If you are careful, the structure will remain intact throughout the entire treatment process.

Prices for ceramic braces in 2022

The cost of treatment consists of various factors - the choice of the manufacturer of the orthodontic system, the level of the clinic and the complexity of the bite pathology. One of the best systems is Clarity Advanced ceramic braces; the average cost of installation on both jaws is 175,000 rubles. Also on the list of leaders is the Damon 3 model, which stimulates the physiological processes of teeth. The price of this system is similar. The Clarity SL brand is also popular - these ceramic braces are reliable, do not stain and look as aesthetically pleasing as possible. The price is about 185,000 rubles.

It is also necessary to remember about arch correction sessions; the price of a visit varies from 2000 to 3000 rubles. You need to visit a doctor every month. Removal is paid separately, and if the ceramic bracket comes off, you need to order a new one, for which you also have to pay extra.

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