Orthodontics
Orthodontic therapies in Florence with english speaking dentists
Orthodontics is a specialization of dentistry. It deals with the diagnosis, prevention and treatment of dental malpositions, more properly called malocclusions. In fact we often find ourselves in front of a bad occlusion when the match between the two arches is not correct. The incorrect contact between the lower and upper teeth leads to chewing problems but also postural, aesthetic, phonatory problems etc … ..
Orthodontics: the science of straightening crooked teeth?
Yes, but not only. Orthodontics treats malocclusions but also deals with craniofacial growth, and with functional problems of the entire dental and craniofacial system.
Why are the teeth crooked?
- Genetic factors The causes can be multiple: let’s start by saying that the genes that code for the bone bases are distinct from those that code for the teeth. So you can inherit, for example, a small arch from one parent and large teeth from the other, or the opposite because even an excess of space can represent an orthodontic problem.
- Factors related to growth During craniofacial growth, problems may occur that can block some sectors, resulting in a disproportion between the arches. Some teeth can come out too early or too late, caries trauma and other can interfere in obtaining a good occlusion. If not treated, these problems lead to significant alterations in the balance between the dental structure, bone, muscle and tendon structures. which can be responsible for headaches, postural imbalances, neck pain, impaired vision, speech and hearing. For this reason, we not only straighten our teeth but seek harmony and balance not only aesthetic but also functional in chewing, so that all the structures involved and restored lead to the overall well-being of the patient.
The dental clinics of Dr Gabriele Floria specialist in Orthodontics in Firenze and Pistoia boasts a great experience in the treatment of children and adults.
Safe environments, qualified personnel, high quality at affordable prices thanks to cutting-edge techniques, innovative tools such as CT, 3D printers and intraoral scanners.
The operating orthodontic specialists have developed a high level of specialization in the orthodontic sector, paying particular attention to the preventive diagnosis of jaw growth disorders as well as in the treatment of developmental defects of the dentition and malocclusions.
For over 30 years we have been dealing with the craniofacial growth of children and interceptive orthodontics always keeping in mind the teaching of our “maestro”: Prof. Isabella Tollaro who said that “the best appliance is the one that achieves the result with the least possible discomfort” for the patient. For this reason our attention is turned to the function that generates and maintains the craniofacial shape and not to the rapid and violent mechanical forcing.
Because we are aware that there is no stability of results over the years if not gaining step by step a slow but physiological change in the respiratory, masticatory and phonatory function.
Different Orthodontics: prevention, treatment and maintenance
There are many classifications of orthodontic therapies. One of the most important, however, concerns the moment of intervention because what we can do in the child by guiding growth we cannot do in the adult because the growth will be completed. However, even in adults we have craniofacial modifications, because time passes and our body changes and adapts continuously. The orthodontic therapy of children, adolescents and adults therefore have different needs and consequently characteristics to be analyzed.
Child orthodontic therapy
As we have already said, the priority in the orthodontic therapy of the child must be the craniofacial growth and not so much the position of the teeth as
these will not be definitive in terms of type, number and position. Therefore, mostly removable appliances able to restore a correct function of the growth structures are indicated.
We talk about interceptive orthodontics because it blocks a situation that would lead to a full-blown malocclusion.
Adolescent orthodontic therapy
The adolescent has a dental arch that is almost definitive in size, but sometimes needs a repositioning of the lower arch with respect to the upper one. In this case, both removable functional appliances and fixed appliances can be indicated, which we prefer lingual, so that they are of less discomfort for the patient. Adolescent age is very critical for the formation of the subject’s self-esteem, therefore interfering with unsightly fixed external devices on the smile, we believe it is something to be avoided. Lingual braces also have so many other advantages that they require a specific, more explanatory article. Learn more.
Adult orthodontic therapy
In adults, the dental arches are already shaped and positioned so our goal will be to give the teeth a correct position on these arches. For this reason, the most used device also in this case is the fixed lingual appliance, which is able to solve any malocclusion problems. When the situation requires it, we can avail ourselves of the help of a maxillofacial surgeon who, in close collaboration with the orthodontist, will perform orthognathic surgery to correct severe dysmorphism. In most cases this is not necessary and therefore orthodontic therapy is aimed at restoring the best aesthetics of the smile with a balanced and stable occlusion. The problems of adults are sometimes periodontal, surgical or prosthetic due to the loss of some teeth. This is why it is important to be able to count on a multi-specialist team, like ours, able to follow each phase of the therapy with the utmost specialization. Today we often hear about surgically guided orthodontic movement, the so-called corticotomies. This technique has many age-related limitations and its advantages in terms of speeding up treatment are in our humble opinion not such as to justify the patient’s suffering and post-surgery. We therefore limit this use only in cases where it is absolutely necessary.
Orthodontic appliances
Orthodontic treatment therefore aims to achieve a new position of the teeth that responds to aesthetic and functional needs. The orthodontic specialist is the one who plans the displacement of the teeth starting from an individual diagnosis (made through clinical, photographic and radiographic evaluation), on the basis of which the most suitable type of orthodontic equipment is selected to achieve the goal set with the as little discomfort as possible. Orthodontic therapy can be implemented because the teeth are suspended in the dental hollow by means of elastic fibers. The application of calibrated and continuous forces on the teeth causes resorption to be generated in the compression area and the apposition of new bone in the traction area. So the task of orthodontic appliances is to generate correct and calibrated forces.
Mobile or removable appliance
They are appliances that the patient can put on and take off by himself following the advice of the orthodontic specialist. They are made of various materials: silicone, rubber, metal, acrylic resin and can incorporate metal portions (screws and hooks). It is difficult to say how much it should be worn because the choice of the most suitable device is very wide, but the collaboration required is almost always at least 15 hours a day. It must not create pain or other discomfort although it may at certain times make itself felt due to the corrective action it is carrying out. In the first few days it causes an increase in salivation which then ceases with use. The appliance must be kept clean by brushing it every day and regularly using special pads to clean orthodontic appliances. Do not use other methods to clean or disinfect the device as it could be damaged.
Fixed orthodontic appliance
It is formed by a metal arc that connects to small metal plates or other material (plastic or ceramic) glued to the teeth. If they are glued on the outside, on the visible side we talk about a fixed vestibular or traditional appliance while if they are glued on the inside, the one in contact with the tongue is called a fixed lingual appliance. This last device, in addition to being invisible, is more efficient and is less likely to descale than the traditional one. The metal arches, which are made of various alloys (nickel-titanium, stainless steel, beta-titanium etc …), are progressively replaced during treatment by the orthodontist, exerting the necessary traction to move the teeth. They are called fixed appliances because they can only be removed by the orthodontist and not by the patient who would risk damaging the tooth with improper operations. Its main components are:
- brackets: platelets glued to the external or internal surface of the teeth;
- bands: metal rings that are positioned around the molars (today the most modern techniques no longer use them because they are annoying when they pass between one tooth and the other and because they are technologically overcome by tailor-made attachments)
- orthodontic arches: they are inserted into the brackets and are the active component of the appliance, they allow the realization of the programmed dental movements and the best techniques make them model and individualize by special robots.
- elastic modules: allow the wire to remain inside the bracket;
- intermaxillary elastics: they join the two arches and have various functions, they help to obtain a good dental gear
- springs: they are used to widen or close the spaces between the teeth
- orthodontic elastics: in most cases they are used to improve the occlusion, either by moving the teeth vertically or by forcing the position of the jaw to a new position
- separator elastics: they are small elastics that were positioned when the bands were used to create a space between the teeth and facilitate the passage into the interdental space
How long should a fixed appliance be worn?
It starts from a few months to get to a few years, everything is in relation to the problem to be solved which can be dental, dento-alveolar or basal. The fastest and most efficient orthodontic appliance is the individualized lingual one because it acts close to the center of resistance of the tooth and is therefore able to translate it more efficiently. The collaboration of the patient also plays an important role because keeping the mouth clean, brushing the teeth after each meal, prevents inflammation that creates slowdown processes in the bone metabolism responsible for dental displacement. Furthermore, following the instructions on wearing accessory devices makes treatment faster. Other orthodontic appliances, just to name a few, are:
- Functional appliances (Twin Block, Frankel, Carriere Motion, Bionator etc …)
- Rapid palate expander
- Pendulum
- Delaire mask
- Delaire petite
- Lingual arch
Interceptive Orthodontics
It is sometimes necessary to program orthodontic therapy in two phases. The first phase defined as Interceptive (or Phase I) aims at correcting the disharmonies of the bone bases in a transverse direction (narrow arches, lack of space) and in an
antero-posterior direction (mandible set back or advanced with respect to the upper arch).
Lingual orthodontics
Lingual Orthodontics is a technique to apply the orthodontic brackets on the lingual tooth surface such that the appliance is not visible.
Invisible orthodontic appliances
This treatment consists of a series of nearly invisible, removable aligners that you change every two weeks for the next set of aligners.
Natural orthodontics
Sometimes we notice joint problems in mouths with perfectly aligned teeth, or difficulty of maintaining a valid occlusion over time, perhaps as a result of years of orthodontic treatment.
Is orthodontics really necessary?
Orthodontics goes beyond the simple straightening of the teeth, it has not only aesthetic purposes, but its main purpose is to restore the functions of the entire stomatognathic system.
So it not only straightens crooked teeth but also and above all treats craniofacial growth by restoring a correct bone relationship between the jaws and the dental arches, essential for a correct masticatory, phonatory and aesthetic function.
At what age should you have your first orthodontic visit?
Five or six years is on average the right age to identify any malocclusions and intervene with the most appropriate interceptive orthodontic therapy.
Who to rely on?
Just as we turn to the specialist in pediatrics for medical problems of children, to the specialist in gynecology for gynecological problems, so it is logical to do for orthodontic problems. The orthodontic specialist (this is the precise term) has completed a post-graduate university course of at least three years.
Obviously the specialization does not guarantee competence in itself but at least you will know that for three years after graduation he studied and took exams on the subject.
Then evaluate the reputation of the individual professional in your community, but also ask to see cases similar to yours already covered when you visit.
How to check who has a university specialization and who defines himself as a specialist in a self-referential way?
The national site of the board of medical doctors and dentist allows one-click search and verification.