Ligatures for braces: reliable fixation and room for imagination

Publication date: June 01, 2022.

Date the information on this page was updated: January 21, 2022.

Orthodontic treatment does not end with the removal of braces, because immediately after removal, the bone tissue and ligaments will begin to return to their original position and move the teeth. To consolidate the result after removing braces, it is necessary to install retention structures that will hold the teeth in the correct position until the bone tissue is finally formed around the roots of the teeth.

• What are retainers?
• Fixed retainers
• Removable retainers and mouthguards
• Combined
• How do retainers work?
• How long should retainers be worn?
• The process of installing permanent retainers
• How to care for retainers?
• Which is better: mouthguards or retainers?
• Frequently asked questions about retainers
• What problems can arise with a retainer?
• Reviews about retainers

Fixed retainers

A permanent retainer is a wire arch made of medical steel, which is attached to the inside of the teeth with a special compound. This type of retainer is used most often, as they are completely invisible, cannot be felt in the mouth and do not oxidize. Fixed retainers can come off due to mechanical stress, such as chewing hard food. In this case, you should immediately visit the orthodontist and return the retainer to its place to prevent the teeth from moving.

Fixed retainers have many advantages: you can’t forget to put them on - they are always on your teeth, and they are absolutely invisible and do not interfere. The main feature of wearing a fixed structure is the need for careful home hygiene and professional cleaning every six months at the dentist, since plaque in hard-to-reach places around the retainer is more difficult to clean.

Pros and cons of ligature braces

These systems have their advantages and disadvantages, which the patient should be aware of before installation. Here are the advantages of these braces:

• Effectiveness: the use of ligatures allows you to reduce the period of wearing the system as a whole;
• a wide range of dental pathologies for which ligature braces are used;
• optimal cost - metal braces are especially affordable in price, although they do not look as aesthetically pleasing as ceramic or sapphire ones;
• the ability to change the system visually using rubber band ligatures of different colors.

Along with these undoubted advantages, ligature braces have their own characteristics:

• the need for constant correction: when installing elastic bands, you need to visit the orthodontist once a month to replace them;
• metal hard elements can cause some discomfort and long-term addiction;
• white or light-colored rubber bands can be stained by food; you will need to follow a certain diet.

But in general, despite some disadvantages, ligature braces provide good results in correcting malocclusion and are used more often than non-ligature or self-ligating braces. Let's consider this type of orthodontic structures.

Removable retainers and mouthguards

Removable retention structures come in two types:

1. Plastic plates with a metal arch that encircles the dentition;
2. Transparent mouth guards made of silicone.

After braces are removed, mouthguards or plates must be worn constantly, removed only during meals, brushing teeth, or public speaking. In the future, on the recommendation of a doctor, the time of wearing retention structures is reduced: they are removed at night and worn less during the day. Removable structures can be noticeable to others, and at first they affect diction and cause increased salivation. Typically, removable retainers are prescribed at the end of the retention period after fixed structures, but they can also be used independently throughout the entire retention period.

Plastic plates with metal arc

Silicone transparent mouth guard

Disadvantages of systems

Ligature braces have the following disadvantages:

• systems with metal ligatures are contraindicated for people with allergies to metals, oncology, epilepsy, or an implanted pacemaker;
• elastic fastening elements are subject to loss of elasticity, destruction and discoloration, and therefore must be replaced frequently;
• metal fixation parts can injure the tissues of the oral mucosa;
• hygienic care is difficult;
• the need for monthly system setup;
• impossibility of use for periodontal diseases.

Disadvantages of self-ligating systems:

• increased discomfort due to the large volume of the structure;
• relatively high cost.

How do retainers work?

Braces or aligners actively move teeth in the desired direction due to the traction of the arch and pressure on the dentition. A non-removable wire retainer does not put pressure on the teeth, but only holds them in the desired position, preventing them from moving apart. Removable aligners differ from aligners in that they are not used with attachments (activators of tooth movement), but exactly repeat the shape of the dentition and fit tightly to the teeth, fixing the dentition. Any retention structure does not move the teeth, but at the same time it should prevent the ligaments from relaxing and returning to their previous position until the bone tissue around is completely strengthened.

How long should retainers be worn?

The duration of the retention period is on average 2 times longer than wearing braces, and patients who corrected their bite in adulthood - after 25-30 years, can wear retainers all their lives.

The length of time you wear retainers usually varies from person to person and depends on the following factors:

1. Age of the orthodontic patient. The younger a person is, the faster his ligaments and muscles are rebuilt, thereby fixing the teeth and bite in the correct position. For patients who received braces as teenagers, wearing retainers for 6 months to 2 years is sometimes sufficient.
2. Bad habits. People who smoke have poor blood supply and reduced immunity, so all processes of restructuring the position of teeth and healing are slower than in non-smokers.
3. Oral health. If the teeth and periodontal tissues are healthy, the fixation of the ligamentous apparatus occurs faster.
4. Complexity of the clinical case. The stronger the initial curvature of the teeth, the longer you need to wear a retainer.

The retention period must be carried out under the supervision of an orthodontist so that he monitors the condition of the bite. In any case, you should not stop wearing retainers without your doctor's approval, otherwise your teeth may become crooked again.

The process of installing permanent retainers

Retainers are installed after braces are removed on completely healthy teeth after professional hygiene. The patient may need to undergo oral sanitation after orthodontic treatment. While wearing braces, it is difficult to clean your teeth perfectly, and accumulated plaque can cause caries and tartar. Retainers cannot be installed on affected teeth, since another design in the mouth will again complicate hygiene and lead to a deterioration in the condition of the oral cavity. Also, during orthodontic treatment, the enamel may become thinner, so in addition to hygienic cleaning, teeth need fluoridation and mineralization.

After carrying out therapeutic and preventive measures, the orthodontist begins the laboratory stage of manufacturing retainers. An impression is taken from healthy teeth, according to which the retainer is given the necessary shape of the dentition.

Before the actual installation of the retainer, the teeth are etched with a special solution so that their surface becomes slightly rougher for better adhesion. In some cases, instead of etching the teeth, the teeth are prepared: a microgroove is drilled on the inside to fix the retainer. Once the teeth are prepared, the retainer is placed in the desired position and secured with composite material. The procedure is completed by grinding the material for the patient’s convenience.

The installation procedure takes 15-20 minutes and is absolutely painless. But in the first days of adaptation, the retainer can rub and reduce the clarity of diction.

How to care for retainers?

Retainers, like any structure in the mouth, without careful hygiene provoke the accumulation of bacteria, the appearance of plaque and caries.

1. You can brush your teeth with a regular toothbrush and toothpaste, but be careful when brushing the inside of your teeth if you have a permanent retainer;
2. If the retainer comes unstuck, you need to visit the orthodontist and return it to its place so that an orthodontic relapse does not occur;
3. For thorough hygiene when wearing fixed retainers, it is recommended to use a waterpik, brushes and dental floss to clean hard-to-reach places near the arch;
4. Removable retainers and mouth guards should be washed with disinfectants, soap, or brushed with toothpaste at least 2 times a day.
5. Mouthguards must be removed when eating and smoking and stored in special containers;
6. Mouthguards should not be washed with hot water because they will become deformed.
7. To strengthen the enamel, it is recommended to rinse the mouth with a fluoride solution.

After braces are removed and retainers are installed, you should periodically visit the orthodontist for follow-up examinations and the hygienist to maintain oral health. Only after the end of the retention period can orthodontic treatment be considered complete.

Features of non-ligature braces

The fastening of the power arc in this type of design is carried out using miniature locks or clips with grooves glued to the bracket plates. The arc is inserted into the grooves and snaps into place. The absence of blocking allows the arc to move freely in the grooves. This significantly reduces the feeling of discomfort when wearing. The forceful effect occurs naturally; the system itself ligates the process, which is why it is also called self-ligating.

Which is better: mouthguards or retainers?

Retention mouthguards and a non-removable retainer after orthodontic treatment are used in combination: a non-removable retainer from canine to fang is permanently placed on the teeth, the mouthguard is put on at night. After removing braces, we give patients 2 mouthguards: a night guard for all teeth in the upper dentition and a canine-to-canine safety mouthguard for the lower dentition, which is needed if the retainer breaks and there is no way to quickly make an appointment with an orthodontist. From the point of view of patient comfort, a non-removable retainer is more convenient than a mouth guard, since a week after installation, it is practically not felt in the mouth. And the mouth guards are quite bulky and it’s more difficult to get used to them.

Stages of treatment

Braces therapy takes place in three stages:

1. Elementary. Round arches with a maximum degree of elasticity and minimum thickness are used. The most effective at this stage are products made of titanium and nickel, due to their moderate action, resistance to deformation and shape memory.
2. Worker. The longest stage. Wires of rectangular cross-section are used to correct the shape and relationship of the jaw rows, and effectively move the roots and crowns of teeth.
3. Final. At the final stage of therapy, in order to form full contact between the bite of the upper and lower jaw and the final alignment of the teeth, it is recommended to use products with a square section.

On a note!

At different stages of treatment, different types of arches for braces are used.

Frequently asked questions about retainers:

Typically, patients who are thinking about installing braces learn about the need to wear a retainer during a consultation with an orthodontist. We have collected the most common questions that patients ask about the retention period.

How long to wear a retainer?

The minimum period for an adult patient is twice as long as the period of orthodontic treatment. Our recommended period is from 5 to 10 years, depending on the complexity of the case and the type of retention. Many patients do not feel the retainer on their teeth and quietly wear it all their lives.

Is it possible to do an MRI with a retainer?

Yes, an MRI can be done with a retainer, just like with braces, but due to the presence of metal in the mouth, there may be interference in the final image.

Do I need to change my permanent retainer?

If the retainer is not broken or unstuck, then there is no need to change it. To maintain good hygiene in the retainer area, use a single-tuft brush, brushes, dental floss, and regular professional hygiene.

Is there a warranty for the retainer?

In our clinic, the warranty on the retainer lasts 2 years. If during this time the retainer breaks or comes off, we will replace it absolutely free of charge.

Can teeth move apart if a retainer is installed?

If orthodontic treatment is completed correctly - the correct closure and position of the teeth is achieved, then with a permanent retainer, the teeth will remain in the correct position. If the retainer comes unstuck or breaks, you need to install it as quickly as possible, since even in a month your teeth can change position.

What problems can arise with a retainer?

The first thing a person who has a permanent retainer installed will face is getting used to it. At first, the retainer may rub your tongue, feel too big in your mouth, and interfere with clear diction. The retainer becomes invisible in the mouth after about a week.

The next task for a patient with a retainer is careful home hygiene, since food debris can get stuck in the spaces between the teeth and the retainer. For home cleaning, we recommend using a single-tuft brush, brushes, dental floss and irrigator.

The retainer may break or come off due to hard foods. In this case, you need to contact your doctor for a replacement.

If caries appears in the area of ​​the retainers on the teeth, then for treatment by a therapist, the retainer will need to be removed and then reinstalled.

What rules must be followed when wearing a ligature braces system?

If caring for non-ligature braces is quite simple, then when wearing ligatures, careful attention should be paid to oral hygiene. In addition, you must follow all the doctor’s recommendations so that the process does not take a long time and leads to the desired result:

• If you feel that the ligatures have loosened earlier than your scheduled visit to the clinic, do not wait, but visit a doctor and he will promptly replace them. Weak fixation in a certain place can worsen the results achieved.
• White or light-colored rubber bands quickly turn yellow from tobacco or some products and look unsightly. They can be removed during meals if the type of fastening allows it. If the pathology is complex and the elastic bands are applied in a complex cross pattern, then this should not be done.
• It is advisable to use not only toothbrushes, but also special brushes, as well as irrigators - this way you can clean the entire structure, even in inconvenient places, thoroughly removing food debris. During hygiene procedures, simple ligatures can also be removed periodically.

Before installing any braces, whether ligature or self-ligating, the condition of the teeth must be in perfect order: all dental diseases must be cured and professional cleaning must be carried out. Any braces systems are installed only in a completely healthy oral cavity.