Ligature braces for a perfect smile 

What is this system?

This name is given to bracket systems, the base of which is made of artificially grown sapphire crystals. At its core, the material is monocrystalline aluminum oxide.

Despite the “artificial” nature, this material does not cause allergies and is completely safe for the human body . It can be classified as ceramics. The difference between sapphire and ceramic braces is that polycrystalline aluminum oxide is used to produce the latter.

For crystallization (“crystal growing”), the starting material is exposed to very high temperatures – 2050°C. After special cutting and polishing, braces have the ability to transmit light . This is what makes them transparent and invisible after installation.

During the cutting process, each element is given a rounded shape, which allows the patient to practically not feel the foreign structure in the mouth, since it does not damage the mucous membrane .

Ormco self-ligating braces

The Damon ligature-free brace system is suitable for the treatment of clinical cases of mild, moderate and severe degrees of complexity. Passive self-ligation and gentle forces gently correct anterior and posterior tooth rotations and angulations on initial round arches. Full-slot rectangular arches implement the torque pattern inherent in the design of the bracket groove. To install elastics when treating distal, mesial, open or crossbites, the orthodontist can use removable hooks.

In 2020, Ormco offers a choice of four ligature-free devices: metal Damon Q/Q2 and ceramic Damon Clear/Clear2.

Non-ligature metal bracket system Damon Q in Russia since 2009. Orthodontists choose Damon Q because of the small size of the braces, ease of positioning on the teeth and predictability of treatment results. With one movement of a special tool, the doctor opens the patented SpinTek lid. The lid does not loosen over time and practically does not break. The process does not take much time and does not cause discomfort to the patient.

indoor and outdoor Damon Q

In 2020, Ormco introduced the world to the new Damon Q2 - the latest generation metal non-ligature braces with improved rotation control and increased subligature space. It has become more convenient to fix elastic and metal additional elements. To accurately position the bracket, the doctor focuses on the vertical line on the cover.

Damon Q2

Damon Q2 system

It is convenient for the patient to brush his teeth with small Damon Q2 metal braces with rounded corners without ligatures.

indoor and outdoor Damon Q2

Damon Q2 base

Damon Q/Q2 braces are made from high-strength 17-4 stainless steel. The design does not change its appearance and works stably throughout the treatment. To install the hooks, the doctor uses an additional vertical groove. The orthodontist attaches the intermaxillary rods to the hooks. To solve complex clinical problems, using hooks and an additional groove, the doctor creates multi-level biomechanics. When working with Damon Q, the doctor selects a torque for the anterior group of teeth, and soon the choice of torque will be available for the new Damon Q2.

On the polished surfaces of metal Damon Q of the first and second generation, biofilm forms more slowly, and parts of the bracket do not touch the marginal gingiva.

Damon Clear/Clear2 is made from polycrystalline aluminum oxide. The translucent material supports the load of the archwire as the teeth move. In Damon Clea 2, compared to the first generation models, the developer has improved the control of arc rotation and the design of the movable cover. The material is resistant to food dyes. Orthodontists often install Damon Clear2 aesthetic braces on the front group of teeth in the upper jaw in the smile zone from canine to canine.

Damon Clear

Ceramic ligature-free braces of the first and second generations are compatible with metal Damon Q/Q2 and with buccal tubes SnapLink, Accent Mini, Titanium. Damon Clear/Clear2 for the upper jaw is available with three torque options: standard, low and high.

indoor and outdoor Damon Clea

Device and principle of operation

Not only the device, but also the principle of operation of such systems are identical to classic braces made from other materials.

The system consists of three main elements:

1. The first is the braces themselves. They are miniature locks that have wings and a groove for the arc.
2. The arc is the main active component. After its installation (passed into the groove of each lock), the braces are connected into a single system.
3. Ligatures are small fasteners that help hold the archwire in the groove.

The principle of operation is based on the fact that the teeth in the jaw are fixed in such a way that they can slightly change their position. Moreover, the change is possible in any direction - towards neighboring teeth or around the central axis - if constant and prolonged slight pressure is applied to the tooth.

The arc is made of a material that has so-called shape memory - it tends to take its original position . It is she who produces this pressure, gradually changing the position of each desired tooth.

Stages of installation on teeth

• Diagnostics

  A number of diagnostic studies are carried out - OPTG, TRG, CT to study the position of the roots of the teeth and the condition of the bone tissue. Next, the doctor takes impressions or conducts a computer scan of the oral cavity to calculate the displacement of the dentition.

• Oral preparation

  The damaged units are treated and hard and soft dental deposits are removed.

  Read also:  Malocclusion in a child: photos, causes, treatment

• Modeling

  Using impressions of a jaw model, the orthodontist draws up a treatment plan, predicts the results, and selects a system taking into account the wishes and financial capabilities of the patient.

• Attaching braces

  The doctor fixes the braces on the patient’s teeth, glues the plates, and secures the arch. Installation of plates is carried out directly or indirectly. In the first case, each lock is fixed to the tooth with an adhesive composition in turn; the procedure takes 1-1.5 hours for one jaw. With indirect fixation, all locks are transferred to the dentition from a silicone tray, which takes 30-40 minutes.

• Briefing

  The doctor gives the patient recommendations regarding lifestyle and oral care during bite correction, and draws up a plan of visits to regulate pressure or control.

Main disadvantages

These orthodontic devices have very few disadvantages compared to other types of braces.

Minuses:

1. The first and most significant of them is high cost. To a greater extent, the complexity of production and processing of each bracket and the need to use expensive equipment play a role here.
2. A fairly long period of bite correction with the help of these systems.
3. Despite the high strength of the base material, it is very fragile, forcing patients to treat the installed device very carefully.
4. They are practically not used to correct serious malocclusions.

Pros and cons of sapphire movements

The orthodontic device has a beautiful, unobtrusive design, so correction using artificial crystal material allows treatment without embarrassment about your appearance. Positive traits:

• The sapphire bracket system has a soft effect of the vestibular structure on the dentition and provides comfortable wearing without severe pain.
• The advantage is the gradual process of straightening the dentition.
• A special processing technology reduces friction and allows the arc to glide better.

Sapphire braces do have many advantages, but there are nuances that need to be discussed with your dentist, since not all cases can be treated with this material. Unfortunately, it has certain disadvantages:

1. High cost of the product.
2. The course of treatment takes a long period of time due to the weak force of tooth movement.
3. It is not used by doctors in complex cases of dental curvature and malocclusion.
4. Used to correct defects of the upper jaw.

There is a slight difficulty in installing sapphire braces - the transparent material is more difficult to position in the desired position, so this expensive product should be trusted only to professional orthodontists. The disadvantages of the ligature system also include the risk of staining or yellowing from various foods.

Manufacturers

These orthodontic appliances are made by different manufacturers.

Inspire ICE from Ormco

They take into account all the shortcomings of previous generations, so Inspire ICE are deservedly popular.

photo: before and after treatment

The special platform of each bracket has a special coating of microscopic zirconium balls , which, when applied with an adhesive, create maximum adhesion force to the tooth. At the same time, the properties of the coating make it easy to remove braces after treatment.

Damon Clear

This is a self-ligating passive system that has several advantages. In particular, this concerns the design. First of all, we should note the diamond shape and rounded edges, which increase wearing comfort. Using this system, there is no need for frequent visits to the dentist to activate the archwire.

photo: before and after

The groove is closed using a special patented Spin Tek mechanism, which allows the necessary manipulations (replacement of the arc) to be carried out quickly and without causing discomfort to the patient.

When opening the lock there is no pressure on the tooth. The attachment to the enamel surface is very strong and reliable , thanks to laser etching of the bracket base.

Miso

Also a non-ligature system, the difference of which is the free fixation of the arch without blocking it. This is achieved thanks to the presence of special sliding clamps in the design, which are similar in appearance to a valve.

This type of fixation simplifies the correction and allows you not to visit the orthodontist too often, and also facilitates care.

Radiance from American Orthodontics

The main advantage of this classic ligature system is the special base of each bracket, which has a patented name “Quad-Matte”.

Its peculiarity is that along the perimeter the attachment to the enamel is much weaker than in the central part. This ensures the safety of the enamel and ease of removal without damaging the teeth or using special tools.

Pure by OrthoTechnology

They are distinguished by their neat shape, miniature size and fastening strength , which is ensured by applying powdered zirconium dioxide to the base of each element.

photo: treatment result

The installed system looks like a decoration, as it transmits not only natural daylight, but also neon. Because of this feature, it is suitable for active young people.

The best manufacturers of sapphire braces

There are several reliable manufacturers of high-quality braces systems that use synthetic sapphire crystals. First in the ranking of the best is Radiance (USA). The products are the perfect way to enhance your appearance with a fashion accessory thanks to the shiny finish that shimmers in the light. Radiance sapphire braces are recognized as the most transparent and aesthetic.

Inspire ice from Ormco has increased resistance to stress, which allows you to practically limit the consumption of solid foods. Sapphire clasps look especially attractive when paired with a light-colored arch that is not easily stained. The period of getting used to Inspire Ice is minimal, the design does not cause discomfort, but is not used for severe malocclusions.

Damon Clear is a popular clear model from Ormco, an American orthodontic products company. The braces do not interfere with speaking, are completely transparent, and have no ligatures.

Pure is an invention of the American brand “Ortho Technology”, which has been producing medical equipment for more than 20 years. The product has high aesthetic and quality characteristics, representing an expensive decoration for the treatment of simple types of dental curvature.

Ligature and non-ligature

Sapphire braces can be made in two types.

The classic case is when the system is equipped with ligatures to hold the arc - fastenings that are small elastic bands or thin wire rings. Rubber ligatures wear out quite quickly , so they have to be changed by your doctor.

Non-ligating braces are also called self-ligating braces. They are radically different from ligature ones in their structure. Each bracket is equipped with a lock that snaps into place and firmly secures the archwire , allowing it to slide. In this case, no additional fastenings are required, and the friction force will be much less.

Self-ligating systems are more expensive and in many cases more effective, as well as easier to use - there is no need to change the ligatures if they change color, become deformed or break.

However, they are not always better. The fact is that during the treatment process it may be necessary not only to replace the arc , but also the density of its fastening. When the contact with the walls of the groove is loose, this is a passive type of fastening, and if the arc is fastened very tightly, this is an active type.

Sometimes you need to change the force on your teeth. In the case of a classic ligature system, this is quite simple - the doctor can slightly loosen the fastenings , allowing the arc to slide freely or vice versa.

But self-ligating systems can be equipped with only one (passive or active) type of fixation. This may affect the duration of treatment, prolonging it.

Evolution of non-ligature constructions

Damon braces without ligatures appeared on the market in 1996. Since then, Ormco has been developing new models and improving clinical protocols for working with self-ligating constructs. As of 2020, doctors treated more than 50,000,000 clinical cases using Damon ligature-free systems. Let us remember how the concept of self-ligation appeared and developed.

Damon Q2 with orthodontic arch

In the 1930s, Dr. Jacob Stolzenberg developed the first metal, ligature-free Russell braces in New York City. The design consisted of a body and a removable screw. The screw was removed when replacing the arches. The doctor tightened the screw using a special screwdriver to control the position of the tooth roots on rectangular arches. With the screw loosened, the teeth moved body-wise in a given direction on round arches. An appointment with Dr. Stolzenberg took less time, and treatment was faster compared to correcting a bite using classic devices. The concept of passive self-ligation was ahead of its time and was further developed in the early 1970s.

In 1971, physician Jim Wildman developed a round metal Edgelok brace system with a lid that can be moved in the vestibular direction. The doctor pressed the lid with his finger, and the bracket groove turned into a tube. Dr. Wildman's invention was the first commercially successful self-ligating design.

Metal braces with an active type of ligation were created by Dr. Herbert Hanson from Canada in 1980. In the SPEED device, a curved spring clip gently acted on the archwire and partially controlled the movement of the teeth.

In 1996 and 1999, Dr. Dwight Damon introduced the Damon SL I and Damon SL II braces. The doctor equipped the double edgewise braces with a vestibular cap that closes the slot space. The difference was in the size of the structure and the position of the latch: in the first generation braces, the cover covered the ligature wings, and in the second generation braces, it was fixed between them.

Damon 3 non-ligature aesthetic braces are a combination of a plastic body with a metal groove. The reliability of passive self-ligation and the aesthetic advantages of the material made this model the first in popularity among combined structures.

What arcs are used?

Unfortunately, there are no transparent arches that have the qualities necessary for braces. a classic metal arc is inserted into sapphire systems . It is a little noticeable during a conversation, but does not create the effect of “metal staples”.

In such systems, to maximize their aesthetics, you can use metal arches that have a white coating of a material similar to Teflon.

In this case, the braces become completely invisible. The only drawback of such arches is that the aesthetic coating can gradually wear off due to strong friction.

Peculiarities

Ligature braces are very common in dentistry. It is with these designs that most malocclusion pathologies can be corrected.

What is a ligature? A ligature is a metal or elastic rubber ring with which braces are attached to the arch. It can be varied in color: transparent, colored, silver (when using metal ligatures), white, and so on.

With the help of ligatures, teeth are straightened quite slowly and with minimal friction.

Elastic ligatures can stretch and must be replaced during orthodontic treatment. But each time you can change the color, adding a new twist to your smile.

In addition to braces, leveling arches and ligatures, ligature brace systems can also use additional elements in the form of rings, springs, rods, elastic chains, and so on.

Which systems are better and how do they differ?

At the moment, most orthodontists agree that to correct significant malocclusions, the ideal option is to install a metal brace system.

This is due to its reliability, maximum strength and the ability to use large forces to move teeth. However, it has one significant drawback - the metal on the outer surface of the teeth stands out and spoils the impression of a smile.

As opposed to metal, special ceramics and artificially grown sapphire crystals began to be used in orthodontics. Both of these materials are less durable than metal, but are strong enough to perform their functions .

The option of sapphire artificial crystals is most preferable for those for whom the aesthetic side of the issue is very important, since transparency and high light transmittance make them invisible.

Ceramic braces have properties similar to sapphire ones, but have a matte tint , which will be noticeable on white enamel. The strength of ceramics is almost the same as that of a transparent crystal. In addition, both materials do not stain during wear and retain their ideal appearance throughout the entire treatment period.

Popular metal models - cheap

Structures can be made from various materials. The cost of treatment depends on them. Most often, patients choose metal structures, since this material is distinguished by its reliability and low price. Metal structures help correct bite even in the most difficult clinical cases.

Metal

Their main disadvantage is their lack of aesthetics, but this is compensated by their efficiency and durability. Today, such structures can be installed even for patients with allergies, since only hypoallergenic alloys are used in their manufacture.

Let's introduce popular self-ligating, non-ligating systems made of metal.

Damon 3MX. It is one of the most effective. The design has no sharp corners, so the process of getting used to it is as quick and comfortable as possible.

Damon 3MX

Damon Q. Can be used to treat complex cases, including distal, mesial occlusion and dental dystopia. They are customized individually for the patient and allow you to avoid tooth extraction, reducing the treatment period by 20%.

Damon Q

Smart Clip. Their feature is a unique patented snap mechanism. It allows you to control the arc strength, providing maximum therapeutic effects.

Smart Clip

In-ovation R is compact. The latches have an additional impact on the arc, and this shortens the treatment period.

In-ovation R

A self-ligating metal brace system can cause irritation on the gums and mucous membranes, just like any other model, if the patient’s oral hygiene is poor. It differs only in lower cost and better visibility for others.

Installation

Installation always takes place in several stages.

• Diagnostics. At the very beginning, the doctor conducts a complete diagnosis not only of the type of anomaly, but also of the entire oral cavity. Possible treatment options (for example, installation of a ligature or self-ligating system) are discussed with the patient. A visual examination is carried out, as well as detailed studies - orthopantomogram, photographs, etc.
• Preparation. Since the installation of sapphire braces can only be carried out on healthy teeth, the oral cavity is sanitized - all problems are eliminated (treatment of caries, other diseases) and professional hygiene is carried out.
• Taking impressions. Before making it, the doctor must take an impression of both jaws of the patient. This is necessary for making a working model and precise fitting of braces.
• Ordering braces and waiting for them to be made. The wait is inevitable, since in each case the installation is carried out purely individually - the location and shape of the bracket is determined for each tooth.
• Installation. In order to install braces, one visit is enough, but it requires from 1.5 to 3 hours of time spent in the dentist’s chair. The doctor secures each brace separately and only after that installs the arch

Cost of installing Ormco braces systems

The cost of installing Ormco braces varies from 100,000 to 200 thousand. The cost is quite reasonable for most clients, in addition, there are flexible installment systems that allow patients to purchase the necessary procedure, get healthy teeth, and, at the same time, pay the full amount if possible.

Ormco braces have always been popular due to their ease of installation and painlessness.
In addition, there is a huge variety of braces and these Ormco braces are no exception. Ormco Moscow braces allow patients to get the maximum benefit from the design; as a rule, in order to consult a doctor, it is necessary to visit him once every six months, clean him, and also monitor him during wear to maintain hygiene and prolong service life. The optimal time to wear Ormco braces is from two to five years, depending on the curvature of the bite.

Who is it prescribed to?

Such orthodontic appliances are prescribed to patients who have relatively simple problems with the position of their teeth:

• malocclusion;
• spaces between teeth;
• torsion.

It is also important that people who may have allergic reactions to other materials can undergo treatment using such systems.

In this case, the age and gender of the patient (from 14 years old) do not matter. However, you should note that sapphire models are more suitable for patients with white tooth enamel . In the case of a natural yellowish color, aesthetics decreases, since the appliance becomes more noticeable on yellow teeth.

Comparison and differences from systems made from other materials - which ones are better to use?

An orthodontist will help you choose the right device; he will advise which braces are better - sapphire, ceramic or metal in your particular case. The doctor takes into account the degree of malocclusion, the possible timing of treatment, your wishes regarding aesthetics, convenience, and cost of the product.

If the displacement of the teeth is insignificant, and aesthetics are not an issue, the doctor will recommend metal structures - the course of treatment will be shorter and cost less. If aesthetics is as important to the patient as cost, the orthodontist will suggest a combined system. If comfort and a “Hollywood” smile are important to the patient, sapphire products are suitable for him.

How are they different from ceramic

The price difference between ceramic and sapphire braces is small. Ceramic structures cost 104,000 rubles, a total of 22,500-24,000 rubles. cheaper. But such devices are suitable in case of a yellowish tint of enamel, because... will stand out on perfectly white teeth. Over time, they become darker, accumulate plaque faster, and can change color under the influence of alkaline and acidic foods, food dyes. And polished sapphires repel plaque and remain transparent throughout the entire treatment period.

Ceramic braces are less durable than sapphire braces and are more likely to break and come off.

What is the difference with metal

Metal structures cost less - from 82,500 to 90,000 rubles. This is their only advantage. Minuses:

• bulky;
• take about 2 weeks to get used to;
• violate diction;
• clearly visible on the teeth;
• require frequent visits to the doctor;
• accumulate plaque and food debris;
• more difficult to clean.

We recommend installing ceramics and metal in combined systems in the area of ​​chewing teeth to reduce the cost of treatment while maintaining aesthetics.

Rules of care

Despite the fact that sapphire braces do not change color while worn and are quite durable, there are still certain care rules that experts advise to adhere to.

1. Be sure to brush your teeth every morning and evening.
2. Use an additional toothbrush – a mono-beam one.
3. Use dental brushes and, if possible, an irrigator.
4. Avoid eating hard and very hard foods – nuts and other things.
5. Be sure to visit a doctor according to the schedule for preventive examinations and replacement of arches.

Damon Clear 2 sapphire braces - eliminate almost any malocclusion

It is believed that non-metallic systems increase the duration of orthodontic treatment and cope only with minor curvatures. But this is a mistaken opinion. Damon Clear 2 eliminates almost any dental deformation and does it faster than classic devices. New generation self-ligating systems without ligatures (thin wires used to secure arches) - this simplifies teeth cleaning. In Damon Clear 2, the arch is attached to the groove with a special latch that slides freely inside the bracket. This technology minimizes the friction force between the arch and the groove, speeds up treatment, and reduces the number of visits to the orthodontist by 2-3 times.

Levin Dmitry Valerievich

Chief physician, Ph.D.