Accelerated braces treatment

Standard algorithm of orthodontic treatment

Orthodontic treatment with bracket systems has always consisted of 3 main steps, which are performed by the orthodontist in sequence:

1. Leveling
   Leveling – is the alignment of the tooth rows. In this stage, thin round arches with shape memory are used to align the teeth into a single tooth row: crowding, pronounced rotation and height discrepancies are eliminated. During the leveling phase, the bite is not corrected and other parameters of the teeth position (e.g. root position and inclination of the teeth) are not monitored.

2. Basic mechanics
   In the basic mechanics stage, rigid arches are placed, which fully control the position of the teeth and allow them to be moved predictably to correct the bite. At this stage, the use of additional orthodontic tools begins: bends on the arches, elastic chains, springs and elastics. Basic mechanics – this is the stage of large, complex tooth movements to create a proper functional bite.

3. Detailing
   This is the final stage of orthodontic treatment to create the aesthetics of the smile. Detailed curves are applied to the arches to improve the position of the teeth and create a more harmonious and personalized smile.

What is the concept of active leveling?

Many important movements during the leveling phase were previously prohibited – lightweight arches did not control tooth position well, resulting in unpredictable tooth movements and worsening the clinical picture.

With the advent of passive self-ligating brackets and the philosophy of weak forces, as well as the development of orthodontic thought and theoretical knowledge, it became possible to prevent unpredictable movements on thin arches and to perform the necessary tooth movements in the first stage of orthodontic treatment without waiting for the end of leveling.

The existing techniques for controlling tooth movement have been combined into a single concept of active leveling.

What has changed

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When working in the active leveling concept, orthodontic treatment consists of only two steps:

1. Active leveling = leveling + basic mechanics

2. Detailing

With active leveling, tooth movement is more active and the basic mechanics and bite correction phase begins from the very beginning of orthodontic treatment. This is why the active leveling concept is called the accelerated treatment concept. Starting the bite correction from the earliest possible stage reduces the overall duration of orthodontic treatment.

What are the features of active leveling?"

With active leveling techniques, you can make some tooth movements faster:

1. Active movement in case of heavy crowding from the first arcs.
   Previously, in other bracket systems, the friction of the arc against the bracket groove was quite strong, and the arc "jammed" in locks on teeth standing outside the dentition (dystopian). I had to connect these teeth to the system later on more rigid arcs. Passive self-ligation technology has significantly reduced friction, so you can connect a dystopian tooth and start moving immediately on thin arcs.

2. Correction of bite from the first visits with the help of early elastics (elastic bands between the jaws).
   In the outdated concept of elastics, the patient could only wear them at the stage of basic mechanics when using rigid arches. This delayed the onset of bite correction and increased the duration of treatment. In the concept of active leveling, an orthodontist can prescribe light elastics from the first visits and immediately begin bite correction.

3. Working with the shape of the dentition using early bends and preforming arches in width.
   At the beginning of orthodontic treatment, special light arcs with shape memory are used: NiTi or CuNiTi arcs (nickel-titanium or nickel-titanium with copper addition). Previously, such arches were installed in the oral cavity only straight, but in the concept of active leveling, an orthodontist can apply any necessary bends, expand or narrow the arc to improve control of dental movement. The technique of applying bends to nickel-titanium arcs differs from bends on rigid arcs. An orthodontist should have high manual skills and understand the features of arches with shape memory.