Orthodontics is the practice of straightening teeth and relieving malocclusion. Orthodontics mainly studies the etiological mechanism of malocclusion, diagnosis and analysis and its prevention and treatment, orthodontics can achieve the effect of beautiful teeth.
The English name of orthodontics comes from a combination of three Greek roots, which mean "teeth", "orthodontics", "discipline", that is, what we call "Orthodontics".
Basic introduction Western medical name: Orthodontics English name: Orthodontics Other name: Orthodontics Affiliated departments: Pentaclinic - Stomatology Infectious: Non-infectious Academic foundation, orthodontic treatment, timing, age limit, process, time, precautions, indications, orthodontic methods, functional brackets, movable brackets, fixed brackets, contraindications, complications, misunderstandings, Academic foundation 1 The plasticity of the jawbone: The jawbone, especially the alveolar bone, is one of the most active parts of the human skeleton. The modification of jawbone includes two processes of proliferation and resorption, which is an important physiological feature of jawbone and the basis of orthodontic treatment, so the change of jawbone in the process of orthodontic treatment is mainly a physiological process of the balance between bone-breaking and bone-forming. 2, the compression resistance of the dental bone, in the same orthodontic force conditions often only alveolar bone resorption, but no or only a small amount of resorption of the dental bone. 3, the stability of the periodontal membrane environment, orthodontic treatment is completed after maintenance, periodontal width, periodontal membrane and alveolar bone as well as the line of the bone can be restored to normal. Orthodontic treatment Orthodontic treatment mainly uses various orthodontic devices to adjust the coordination between facial bones, teeth, nerves and muscles of the jaw and face, that is, to adjust the abnormal relationship between the upper and lower jaws, between the upper and lower teeth, between the teeth and the jaws, and between the nerves and muscles connecting them, and the ultimate goal of orthodontic treatment is to achieve the balance of the oral and maxillofacial system, stability and aesthetics. The treatment of malocclusion mainly relies on the use of orthodontic appliances inside or outside the mouth to apply appropriate "biological forces" on the teeth, alveolar bone and jawbone to make them move physiologically, so as to correct malocclusion. Timing There are some malocclusions that need to be treated at an early age (3 to 6 years old), such as those caused by bad habits such as "bunion" or lip-biting and finger-sucking, in order to avoid adverse effects on the jaw and face during growth and development. The rest of the malocclusion should be consulted and examined by an orthodontist when the permanent teeth begin to erupt (8 to 10 years old). This is because the process of eruption of permanent teeth in children can be observed early and regularly, and problems can be detected and solved in a timely manner. The optimal age for most orthodontic treatments is 12-16 years old, and some orthodontists refer to this age as the "golden age" for orthodontic treatment. The optimal time for orthodontic treatment has different considerations according to different age groups: 1. Teething period (3~5 years old). The purpose of orthodontic treatment is mainly to promote the normal development of children's maxillofacial, this period is mainly aimed at the milk teeth inverse (alveolar) (i.e., periosteum), mandibular protrusion, posterior teeth inverse (alveolar) and other malocclusion (alveolar) deformity that impede the normal development of the maxillofacial, and timely correction of the stretching of the tongue, biting the lip and other bad habits affecting the normal function of the oral cavity, to prevent the malocclusion (alveolar) deformity from further occurrences. 2. Teething period (girls: 8-10 years old, boys: 9-12 years old). Localized malocclusion that occurs in this period is generally not necessary to be corrected in a hurry, but for bad habits such as lip biting, tongue stretching, forward extension of the lower jaw, or abnormal facial shape, anterior antomandibular, functional mandibular retraction, and abnormalities such as intermandibular relationship, it is often necessary to go to the hospital in a timely manner to find orthodontic specialists for examination, to determine whether it is a dental, functional or bony malocclusion, to clarify the treatment plan. 3, permanent teeth period (girls: 11-14 ~ years old, boys: 13-15 ~ years old). 12 years old or so, permanent teeth began to form, at this time, once the teeth appear teeth will not automatically disappear, can only be corrected through the treatment of orthodontist specialists, this is the best period of children's orthodontic correction of dental irregularities, the best results, a variety of All kinds of irregularities can be treated by orthodontists. Age Limitations Adults have more limitations when it comes to receiving comprehensive orthodontic treatment than children. If the bite problem is caused by a maldevelopment of the upper and lower jaws, it will have to be cured by orthodontic treatment because the adult's face and skeleton are already well established. Only a combination of orthodontic and maxillofacial surgical procedures can correct deviations in adult jaw development. Functional braces used in correcting skeletal developmental deviations in the jaws of children are generally not successful in adults. As society develops and the population demands a better quality of life, more and more adults are seeking orthodontic treatment to improve their smiles, correct their bite or correct other problems caused by injury, disease or prolonged neglect of oral care. Today's society places greater emphasis on personal image and health, and having a pleasant smile and straight teeth] can give you a boost of confidence. A healthy, beautiful smile can boost self-confidence at any age. Healthy teeth can be moved at any age. However, because adults are not as metabolically active as younger patients, and because the oral environment is more complex than that of younger patients, the difficulty of orthodontic treatment and the time required for it will increase to some extent. Of course, because the facial bones of adults are no longer growing, some serious malocclusion problems cannot be corrected with braces alone, and sometimes require the use of maxillofacial surgery in conjunction with orthodontic treatment. The Process The process of orthodontic treatment is actually a mutual cooperation between the doctor and the orthodontist to align the uneven teeth through brackets. Orthodontic process can be divided into these stages: 1, consultation: including pre-treatment clinical examination, collection of diagnostic information (such as plaster casts, facial appearance and intra-oral photographs of the teeth, facial and dental X-ray examination, etc.), diagnosis and analysis of the medical records, the preparation of the treatment plan, the patient's explanation and discussion. 2, the start of orthodontic treatment: to determine the orthodontic treatment plan, and to determine the treatment plan, the patient's explanation of the treatment plan and discussion. 2, start orthodontic treatment: after determining the treatment plan, the doctor will choose the appropriate brackets according to the patient's condition and requirements, and carry out the corresponding adjustment, bonding and force. Orthodontic treatment of the teeth that is the beginning of the treatment, and then generally about 1 month follow-up, the specific time is determined by the doctor according to the needs of the treatment, each follow-up will also be necessary for the treatment of the examination and records. 3. Maintenance: Wear a retainer after orthodontic treatment. Generally speaking, you need to wear a retainer all day long for the first year after the treatment, and then gradually reduce the time of wearing the retainer according to the doctor's recommendation. Failure to wear the retainer may lead to recurrence of malocclusion. Since malocclusion varies from person to person, the details of orthodontic treatment depend on the degree of malocclusion. In addition, the complexity of the orthodontic process also depends on the experience of the orthodontist and the cooperation of the patient. In short, for orthodontists, as long as they cooperate well with the doctor during the orthodontic process, they can achieve ideal orthodontic results. Time The course of orthodontic treatment is usually around two years, but the time required for treatment may increase or decrease depending on the age, severity, and response of the teeth to treatment of each patient. As long as you can work well with your orthodontist, follow up on time, maintain healthy oral hygiene, and protect your aligners from damage, the efficiency of orthodontic treatment can be greatly improved. Don't think that you can get rid of the problem once and for all after you put on the brackets. When you are having orthodontic treatment, you have to pay attention to your diet and oral maintenance. Improper diet and oral maintenance habits may affect the time needed for the treatment and the final result at the end of the treatment. The brackets of orthodontic braces are attached to the surface of the teeth with a special bonding agent, and then the archwires are fixed to them to apply a certain amount of force in order to achieve the purpose of orthodontic treatment. Therefore, the brackets themselves need to meet the characteristics of both easy to put on and easy to take off. At the same time, the archwire needs to have the ability to generate the appropriate force to withstand a certain amount of chewing. Since they are appliances to be removed at a later date, the aligners cannot be so tightly fitted to the teeth that we can eat with impunity, and the thin archwires cannot withstand excessive biting forces. Therefore, during orthodontic treatment, we should eat less of: (1) Foods that are too hard, such as ice, nuts, hard cookies, sugar cane, hard candies, crabs, lobster shells, etc., and we should also give up bad habits such as biting pens and fingernails; (2) Foods that are too sticky, such as milk sugar, maltose, and some cookies and other foods. (3) Foods that are too big, such as apples and pears, should be cut into small slices before eating. Of course, in order to avoid dental caries, the intake of sweets should be minimized during orthodontic treatment, and less carbonated drinks should be consumed. After each meal, the mouth should be thoroughly cleaned using the correct brushing method, supplemented by flossing and gap brushes and other oral cleansing products, in order to avoid demineralization of tooth enamel, dental caries, gingivitis or other complications. Indications 1. Patients with crowded teeth: the performance of the teeth in and out, unattractive, not easy to clean, susceptible to dental caries, easy to form dental calculus, leading to periodontal disease. 2. Anterior anti-maxillary (dental), also known as "Baodi", manifested as the lower front teeth biting on the outside of the upper front teeth, some people only teeth anti-maxillary; some people are not only teeth anti-maxillary, facial bone deformity, known as bony anti-maxillary, manifested as the lack of development of the maxillary bone (backward shrinkage), the lower jaw is overdeveloped (anterior protrusion), resulting in the middle of the face is sunken, the side of the face is crescent-shaped, affecting aesthetics The crescent shape affects aesthetics and function. 3. Interdental gap patients, manifested as excessive gaps between teeth. 4. Deep coverage: also known as "bristling teeth", some of them are only manifested as upper front teeth protruding or lower front teeth inverted; some of them are skeletal deformities. Some of these people have upper front teeth and upper dental beds protruding forward excessively, while the chin is shrinking behind the upper lip, or there is no chin form. 5. Bimaxillary protrusion, or upper and lower anterior teeth protrude forward, resulting in lip protrusion, lips can only be closed with force, open lip and teeth patients. 6. Posterior teeth inversion (malocclusion), locking (malocclusion): affect the chewing function, long-term may lead to upper and lower jaw distortion deformity. 7. Patients with deep overbite (overbite of the front teeth): the lower front teeth are invisible when biting; some of them are accompanied by skeletal deformity, which is manifested as the shortness of the lower part. This deformity is easy to bite the upper gums, but also easy to lead to periodontitis diseases of the front teeth and facial joint diseases. Orthodontic Methods With the increasing improvement of stomatology technology and patients' demand for orthodontic treatment, orthodontic treatment has also developed from movable brackets, buccal fixed brackets, to ceramic brackets, self-locking brackets, lingual invisible brackets, and non-bracketed invisible brackets and other orthodontic materials and methods. The treatment options are provided to meet the requirements of different practitioners and patients in terms of efficacy, aesthetics and comfort. Functional Brackets The main feature of functional brackets is that the orthodontic force of the brackets is mainly derived from the patient's oral-mandibular system muscle force, or the long-lasting and gentle orthodontic force. The majority of functional brackets are removable brackets, such as Twin-block, Frankel brackets, etc. However, some functional brackets are fixed brackets, such as Forsus, Herbst, etc. Compared to removable brackets, fixed brackets are more effective. Compared to removable braces, fixed braces have the advantage of not relying on the patient's cooperation, which ensures a certain degree of efficacy. Forsus Fixed Function Braces Removable Brackets Removable brackets consist of retaining device rings, inter-neighbor hooks, abutments, orthodontic springs and so on. The patient can take off and put on by himself. Now mostly used to break the oral bad habits, orthodontic treatment of some simple error (malocclusion) deformity or as a fixed orthodontic auxiliary device, the scope of application is more limited. Fixed Brackets Metal Brackets Metal Brackets refers to the adhesive bonding of the brackets to the buccal side of the teeth, through the orthodontic arch wire and the orthodontic brackets on the teeth to exert force to straighten the teeth. These brackets cannot be removed by the patient. The most widely used metal braces in the world are Straight wire braces (Straighire appliances), which are used by the most doctors and have the widest range of applications, and therefore have better orthodontic function in all aspects. Self-ligating brackets Self-ligating brackets are the most advanced buccal fixed brackets, which, compared with traditional non-self-ligating brackets, can significantly reduce discomfort during orthodontic treatment, extend the time between follow-up appointments, shorten the time spent on intra-oral manipulation during the visit, and make it easier to clean and maintain oral hygiene. In addition, self-ligating brackets can also reduce the resistance when teeth move, helping teeth to be leveled and aligned more quickly. The self-ligating design of various brands on the market varies, and the double-clamp self-ligating brackets also have an automatic protection function, which automatically releases the archwire when the orthodontic force is too great, avoiding tooth damage and apical resorption, thus better protecting the health of teeth and periodontium. Self-ligating brackets are available in both metal and ceramic materials, both of which have the above features. Ceramic self-ligating brackets are very close in color to the teeth and are more aesthetically pleasing than metal self-ligating brackets. Ceramic Brackets Ceramic material is close to the color of natural teeth, and it is better hidden when it is stuck on the teeth, so that the orthodontic process can be completed quietly. Therefore, it is favored by adults and patients with high aesthetic requirements, and has become one of the indispensable materials for orthodontic treatment. However, the strength of ceramic material is weak, easy to fracture in the process of treatment or removal, affecting the treatment results. And the color is easy to cause staining and discoloration due to patients' poor oral hygiene and maintenance habits, which used to be its main problem. However, with the birth of a new generation of microcrystalline ceramic materials, these former shortcomings have now been overcome. Under the premise of ensuring overall strength, today's high-end ceramic bracket materials are smaller in size, stronger, and less prone to staining, discoloration, and easy to remove. Lingual Invisible Brackets Lingual Invisible Brackets is a relatively advanced orthodontic technology that has emerged internationally in recent years, which is to install the brackets on the lingual side of the teeth to carry out orthodontic treatment, and no orthodontic traces can be seen on the appearance. The lingual side orthodontic technology began to appear in Japan and the United States as early as the 1970s, and after many years of theoretical research and technical perfection, it has become a system of its own and is widely used in Japan and the United States. Lingual invisible braces technology is relatively mature in Europe, America and Japan, etc., which requires higher requirements for the operation of physicians and is technically more difficult. Invisible Brackets Invisible Brackets is a technology that customizes a series of transparent brackets to complete the entire orthodontic treatment through 3D computer technology. Compared with the traditional orthodontic methods, Invisible Brackets can be freely removed, so it has obvious advantages in oral cleanliness, comfort and aesthetics. However, Invisible Brackets requires a high degree of cooperation from the patients (daily wearing time needs to be more than 22 hours), and if the patients are unable to wear them according to the time requirements, the treatment course will be extended and the treatment effect will be greatly reduced. Therefore, there is still a certain gap between fixed orthodontic appliances and fixed orthodontic appliances in terms of treatment results and treatment indications. Invisible Brackets Contraindications Patients with periodontal disease, poor oral hygiene habits or patients with caries. Systemic diseases such as hyperthyroidism, diabetes, tuberculosis, mental illness, etc. are generally not suitable for orthodontic treatment, severe malnutrition and pregnant women are also not suitable for orthodontic. Complications 1, enamel demineralization and caries: orthodontic process due to the oral cavity more than a number of orthodontic devices, so if you still follow the usual cleaning habits will miss many places that are not easy to clean, resulting in irreversible demineralization of the surface of the teeth (tooth surface becomes chalky), serious caries may also occur (worm teeth). 2, periodontal tissue damage: tooth movement and periodontal tissue reconstruction need to follow a certain biological force, incorrect orthodontic force may cause permanent damage to periodontal tissue. 3, root resorption: orthodontic treatment involves slow reconstruction of the alveolar bone around the tooth root, in the process of the alveolar bone around the bone and osteoblast activity, so the root of the tooth root more or less will occur to a certain extent of root resorption. The degree of resorption often increases depending on the distance the tooth needs to be moved, but generally speaking, the degree of root resorption does not have an effect on the stability of the tooth as long as the correct biological forces are followed to apply force to the tooth. However, due to the existence of individual differences, in rare cases, the root of the tooth may have specific resorption, which in turn causes the tooth to loosen or fall out. 4, mucosal ulcers: In the early stage of orthodontic treatment, mucosal ulcers sometimes occur after contact with orthodontic brackets. In the treatment, sometimes ulcers will also occur because of the ligature wire or the end of the arch wire ***. But generally after a period of adaptation are able to relieve themselves. 5, orthodontic pain and tooth loosening: under normal circumstances, each tooth has a certain degree of physiological mobility in order to buffer the pressure of chewing, to prevent teeth from being traumatized. When doing orthodontic treatment, teeth loosening increased, which is a normal reaction. However, this side effect of orthodontic treatment is reversible. Alveolar bone and periodontium need to be reconstructed when the teeth are to be moved, mainly because the teeth are anchored in the alveolar bone by the periodontium, which makes the teeth looser. However, after the teeth have been straightened to their normal position and stopped moving, the teeth will be able to reattach to the periodontium through their own restorative ability and become stable, and no permanent damage will occur. Therefore, if clinically found that the degree of looseness of the teeth is too large, should suspend the force, let it recover for a period of time to continue to increase the force. 6, pulpal reaction: in the early stage of orthodontic treatment, the pulp produces a mild, temporary inflammatory reaction, manifested in the first few days of the patient's pain or discomfort at home, but experiments have proved that this effect is of no clinical significance. This is one of the side effects of orthodontics, but it is temporary. Myths Myth 1: Only young children can receive orthodontic treatment There is no age limit for orthodontic treatment. Of course, adolescents have a fast metabolism and adaptability, and orthodontics takes a relatively short period of time. But this in no way means that orthodontics is limited to minors. Adult patients are perfectly capable of receiving orthodontic treatment as long as the periodontal condition of the teeth themselves allows it. Myth 2: Orthodontically corrected teeth are prone to loosening and falling out in old age. This myth confuses orthodontics with periodontal disease. Loose teeth are mainly due to the oral environment is not well maintained, the plaque around the teeth due to eating is not cleaned in a timely manner, and the minerals in the saliva further role in the formation of tartar, with the passage of time slowly build up, infection of the tissues around it resulting in periodontitis. The tissues surrounding the teeth such as the alveolar bone resorbs due to periodontitis, and the area of the tooth root surrounded by the alveolar bone decreases with the resorption of the alveolar bone, and finally loosening and loss of teeth occurs. Undeniably, the teeth in the orthodontic process due to the force and alveolar bone remodeling, the degree of loosening will increase, but when the end of orthodontic treatment, the teeth are no longer under the force of their own recovery, as long as good maintenance of the oral environment, to avoid the occurrence of periodontitis, there is no tooth loosening in the future to fall out of the problem. Myth 3: Orthodontics requires tooth extraction, which will affect your health. Orthodontic tooth extraction is a very common and mature treatment, and tooth extraction will not cause any negative impact on the patient's function and health. It should be said that tooth extraction treatment is to harmonize the inconsistency between the amount of teeth and the amount of bone. In the absence of obvious maxillary and mandibular bony disorders, the production of malocclusion is traced to the result of insufficient space in the alveolar bone to accommodate all the existing teeth, and the extraction treatment not only makes the amount of teeth and the amount of bone match better, but also makes the results of the treatment more stable. In addition, the Oriental face is characterized by a less straight nose, more protruding lips, and a less developed chin than the Western race, so in order to achieve a better face shape, many patients (60%) need to be extracted for orthodontic treatment. Myth 4: Orthodontic treatment takes a long time and costs a lot of money, while porcelain crowns are a short, once-and-for-all procedure. Teeth are different from machines; tooth movement itself is a physiological process, and the speed of treatment is limited by normal physiology. Adult orthodontic treatment usually takes one and a half to two years. Although the porcelain crown treatment course is short, but the denture is after all a denture, abraded tooth tissue can not be regenerated, and the maintenance and long-term prognosis (generally recommended porcelain crowns five to ten years to replace a time) can not be ignored, not as some doctors advertised as a lifelong restorations. There are many unscrupulous practitioners who have stolen the concept of porcelain crowns and come up with the so-called 7-day rapid correction of cosmetic crowns. In fact, there is no such thing as cosmetic crowns under the sun, which is neither a term used by professionals nor a thing done by professional doctors. Such organizations take advantage of the patient's eagerness to see the results of the psychological, reckless, and a large number of healthy dental tissues are abraded, and then crowns are placed on them, which is called cosmetic crowns. In reality, the patient will have to deal with unrecoverable teeth and traumatized periodontal tissues for many long years to come. There is no such thing as fast orthodontics; tooth movement is a scientific, slow process. Professional treatment, in order to ensure the effectiveness of treatment at the same time, but also to maintain the health of the teeth and periodontal tissue Myth 5: brackets are not beautiful, affecting work and life. Modern orthodontic technology is highly developed, there are more and more types of brackets, according to different aesthetic needs, there are many orthodontic options, including ceramic brackets, lingual brackets and invisible brackets without brackets, etc., can achieve varying degrees of aesthetic effect, after a period of time to adapt to the work and life has little impact.