Adult Orthodontics

Clear Fixed Appliances

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Fixed appliance attachments (the brackets) can be made from tooth coloured ceramic materials in order to reduce their visual impact. Such appliances are commonly termed 'ceramic fixed appliances'. Conventional ceramic fixed appliances use small elastics to hold the wire into the bracket and self–ligating brackets use an integral clip mechanism that secures the wire into position. The small elastics used with conventional fixed appliances can discolour in–between visits particularly with foods containing bright colouring.

The wires used to align teeth are commonly termed 'arch wires'. These are made of metal (stainless steel or nickel–titanium) materials. They can be covered with tooth coloured coatings to make them less obvious. However, these coatings do have a tendency to decay between visits and may slow tooth movement.

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Metal Brackets

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Conventional metal fixed appliances can be self-ligating using an integral clip mechanism within the bracket in order to secure the archwire or use elastomers (small ‘rubber’ bands). Manufacturers have claimed many advantages to using self-ligation, however, few of these have been scientifically proven to this day. In our opinion the principal advantages of self–ligation include possibly more secure attachment between the archwire and bracket and less discolouration of appliances in between visits.

Many types of self-ligating appliances are available. These differ in having a different clip mechanism to secure the archwire. To date, there is no scientific evidence that one type of appliance is better than the other.

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Invisalign®

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Invisalign is a virtually invisible way to straighten teeth and improve the smile. It can be used for those conscious about the appearance of fixed appliances where simpler tooth movements are required. Invisalign uses a series of clear removable aligners that gradually move teeth to their desired position. A major advantage of Invisalign, apart from being almost invisible, is that the appliance can be removed for eating, tooth brushing and important social engagements.

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Lingual (Invisible) Orthodontic Appliances

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Lingual orthodontic appliances are a way of improving the smile for those conscious about having visible fixed appliances. These appliances are virtually invisible as they are attached to the back (lingual) surfaces of the teeth. The main disadvantages of this system, are the cost and potential discomfort against the tongue.

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Orthognathic Jaw Alignment Surgery

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Orthognathic surgery is a form of surgery used to align malposition jawbones. It can be used to reposition the upper and lower jawbones for a number of reasons:

  • The cosmetic correction of lower jaw retrusion or protrusion.
  • For the correction of asymmetry of the chin point
  • To improve chewing function where there is poor contact between the upper and lower teeth.
  • To improve the contact between the lips
  • To improve the stability of orthodontic treatment
  • To help reduce a double chin due to lower jaw retrusion
  • To improve obstructive sleep apnoea and snoring problems

Orthognathic surgery is commonly undertaken in combination with orthodontic treatment. A phase of orthodontic treatment is necessary before surgery in order to place the teeth into the correct position with respect to the individual jawbones such that when the jaw position has been corrected the teeth meet normally. This also helps to improve the stability of surgical results. A short phase of orthodontic treatment is often necessary following surgery in order to fine-tune the biting relationship.

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