After Damon braces were introduced and the patent ended, more and more orthodontic companies began making braces that claim to be self-ligating, without giving much explanation as to what this means. Is this a good thing? How does this affect my treatment plan? Do I need self-ligating braces? If I do not get them, how will ligation, whatever that means, happen? Does it need to happen? These questions are the ones I wish to clear up in my article.
With standard braces, the archwire goes through the brackets but cannot slide in them; it is, essentially, trapped in there. In order to push or pull the brackets in a certain direction, extra pressure from outside the brackets needed to be exerted, and this is what ligation is about. It is a way to tie the archwire off so that it pulls or pushes the brackets in a set direction, without poking the patient’s mouth. Usually orthodontic elastics or rubber bands connect to the bracket perform this function. This is needed in certain orthodontic cases, and orthodontic elastics were quite capable of providing the necessary push or pull.
Self-Ligation And The Problem Of Elastics
The issues with elastic are that they are unaesthetic, unhygienic, and uncomfortable. They draw attention to the braces, as if braces were not visible enough by themselves. They are unhygienic because they provide more surface for bacteria, as well as food detritus and biofilm, to live on. They are reported as uncomfortable by people who wear them. But they are now unnecessary, because we now have self-ligating brackets.
Self-ligating brackets have a slide-through technology, meaning the archwire slides through them, exerting less pressure, and eliminating the need for elastics. The door or clip where the archwire enters can be adjusted to pretty much any angle, and so the bracket ligates itself. This way, orthodontic appliances do not need elastics anymore. The drawback? This technology is still quite a bit more expensive than the train tracks and elastics solutions, and are thus used less frequently. This will probably change in the future, as cheaper ways to produce self ligating brackets will be discovered and mass production will ensue.