Nowadays in the day-to-day life of dental clinics, we encounter more and more patients with particular needs and demands regarding the treatment that they will obtain. These patients have different concerns and motivations, and it is important that as professionals we are able to understand them, this way we can offer the treatment that best suits each case. This particularly applies to orthodontics, where you have several types of brackets that can be used for the different types of treatments. Each of these brackets has different characteristics and is better adapted to a particular type of treatment. This is why we have written this article highlighting the various kinds of brackets according to patients' wants and needs.
The best brackets in terms of durability:
Considering solely the durability of the brackets, without any doubt, the best ones are metal brackets, as they are virtually unbreakable and require very little maintenance. This is one of the factors that makes metal brackets the most commonly used in children's orthodontics. However, sapphire and ceramic brackets are already very close to metal brackets in terms of durability, and this should not be a critical factor when deciding on one or the other. Very far from all of the above mentioned are the plastic brackets and resin brackets which are much more delicate. This can cause them to fracture in the middle of treatment, causing discomfort to the patient and consuming a lot of orthodontist time in changes and repairs.
The best brackets in terms of aesthetics:
In the aesthetic section, the winners are the sapphire brackets, as they are practically transparent. In addition to this, these brackets, made of a material similar to glass, do not stain with the passage of time, and maintain their aesthetics all the way throughout the treatment. Sapphire brackets are comparable in aesthetics to other solutions such as "Invisalign", and which should be used in conjunction with aesthetic arche wires (white) if the intent is for the treatment to go as unnoticed as possible. After these, we find the ceramic brackets, which have a similar aesthetic to sapphire at the beginning of the treatment, but if the patient is not very careful with his hygiene and consumes a lot liquids such as coffee, tea, etc... the braces may end up darkening with time. Finally, there are metal brackets, which should be reserved for treatments where aesthetics are not the greatest concern for the patient.
The best brackets in terms of adhesion:
Metal brackets are the ones that best adhere to the tooth surface. This is another reason why they are the undisputed kings in children's orthodontics, as it is more difficult to remove them. Even so, modern ceramic and sapphire brackets have surfaces treated to obtain greater roughness in the bonding area.
The best brackets in terms of patient comfort:
At the beginning of an orthodontic treatment, it is normal for the patient to feel a certain discomfort, as we have introduced a foreign body into the mouth to which he must become accustomed to. There are no major differences in patient comfort depending on the material of the bracket. If anything, we should take into account the quality of the bracket in this aspect, since higher-quality brackets will have edges that are better polished such that they will rub as little as possible with the patient's mouth.
The best brackets in terms of oral hygiene:
It is advisable to insist that the patient maintains a good oral hygiene with any type of bracket. However, metal brackets are somewhat more permissive in this regard because their dark color hides the ligature from turning a little yellow. With ceramic brackets and sapphire brackets we should be much more thorough in cleaning, however, as it will be much more noticeable as soon as the transparent plastic bond begins to yellow.
The best braces in terms of price:
For orthodontic treatments where price is a critical factor, metal brackets are the clear winners. However, though there are very cheap metal brackets, it is crucial to ensure that they are of a minimum quality and have all the certificates to be marketed in the European Union. Ceramic brackets are somewhat more expensive, and last but not least, sapphire brackets, which should be reserved for treatments where aesthetics is an important factor.
The best brackets in terms of speed of treatment:
If we are looking to speed up the treatment, design should be a minimal factor in choosing the material. In this regard, low friction self-ligating brackets are clear winners and can accelerate treatment in several weeks. Self-ligating brackets are usually metal though self-ligating ceramic brackets are also available. These types of brackets are somewhat more expensive than conventional brackets, but by reducing treatment time, they save patient visits and time for the professional, so they are often worth using.
As we said at the beginning of the article, the type of bracket to be used will depend on the treatment and the patient's peculiarities. That's why it's important to know all the types so that we can offer the patient alternatives and use them when it suits us best.
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