Mauricio Berco, DDS, DMSc, FRCD(C)

Stephelynn DeLuca, DDS, DMSc, FRCD(C)

Specialists in Orthodontics & Dentofacial Orthopedics

 
 

Orthodontic appliances

Braces are the most common appliance used to correct orthodontic problems; however,  other appliances may be prescribed depending on your individual treatment needs.  Orthodontic appliances are designed to move teeth (orthodontics), modify facial growth (dentofacial orthopedics) or stabilize the results of active orthodontic treatment (retention).  Depending on their purpose, orthodontic appliances may be fixed in the mouth or removable. 

The following is a brief description of some of the orthodontic appliances utilized in our office.

 

APPLIANCES & PROCEDURES

Bite plate

A bite plate is a removable orthodontic appliance used to separate the jaws and facilitate certain tooth movements, including correction of deep bites (upper front teeth overlap the lower front teeth too much) or anterior crossbites (one or more upper front teeth sit behind the lower front teeth).

Braces

Braces, in combination with wires and bands, are the most common orthodontic appliance utilized and give the orthodontist three-dimensional control over tooth movement. 

Distalizer (Pendex / Pendulum / Distal jet)

Distalizing appliances are designed to push the upper posterior teeth back for bite correction where the upper teeth are positioned too far forward relative to the lower teeth.  Braces are then used to move the rest of the upper teeth back.

Elastics (rubber bands)

Orthodontic elastics are used to help move your teeth to the right position.  Elastics are worn from the hooks on certain brackets to help close space and better coordinate the upper and lower teeth.

Expander (rapid palatal expander or RPE)

Expanders are used to widen the upper jaw when the upper jaw is narrow relative to the lower jaw (maxillary constriction).  A posterior crossbite is often evident in these types of malocclusions.  Expansion creates room for unerupted or misaligned adult teeth and helps to coordinate the bite.

Facemask

A facemask is an orthopedic appliance.  It is used to prevent and correct underbite or class III malocclusions where the lower jaw is growing faster and longer than the upper jaw. 

Functional appliance

A functional appliance is an orthopedic appliance. It is used to treat overbite or class II malocclusions where the lower jaw is positioned disproportionately behind the upper jaw.

Habit appliance (tongue- or thumb-crib)

Habit appliances are used in early treatment to encourage the cessation of a detrimental oral habit such as thumb/finger sucking or tongue thrust.

Headgear

A headgear is an orthopedic appliance designed to pull the upper teeth back and restrain forward growth of the upper jaw.  They are used to correct class II malocclusion where the upper teeth and jaw are positioned too far forward relative to the lower jaw.

Invisalign

A series of clear, removable retainers gradually move teeth to their desired position without braces or wires

Retainers

Retainers are passive orthodontic appliances that help stabilize the teeth in their new corrected position after the completion of active orthodontic treatment.  They may be fixed or removable, with the type selected depending on your pre-treatment condition and preference.

Space maintainer (Lower lingual holding arch / Nance)

Space maintainers are used to hold space for unerupted adult teeth when baby teeth have been lost prematurely.  They can also help gain space during the transition from the primary to the permanent dentition.  This decreases the amount of crowding and reduces the need for extractions.

Spring aligners

Spring aligners are removable orthodontic appliances used to treat minor incisor crowding or rotations.

Temporary anchorage device (mini-implant or TAD)

A TAD is an immovable device that is temporarily fixed to the intraoral bone for the purpose of making certain tooth movements more predictable and easier to perform.

About treatment

Benefits of treatment

For children

For adults

Types of braces

Appliances & procedures

Results you can see

Adjunctive procedures

In some cases, orthodontics alone is not enough to achieve or maintain the desired results.  In such a case, Dr. Berco and Dr. DeLuca may refer you to the appropriate dental professional if they feel an interdisciplinary approach to your treatment will yield the best results.   If you may benefit from an adjunctive procedure, it will be discussed with you before treatment begins. 


Adjunctive periodontal procedures

Frenectomy - A frenectomy is a minor surgical procedure that removes or repositions a portion of the frenum when there is excessive or particularly thick tissue.  A frenectomy is most often performed for patients who have a gap (diastema) between their upper two front teeth that may be caused by the frenum.

Fiberotomy - A fiberotomy is a minor surgical procedure that releases tiny elastic fibers around teeth. For some patients, these fibers can cause teeth to rotate and relapse (return to their pre-treatment position), due to the “memory” in the elastic fibers.  Patients whose teeth had a high degree of rotation before orthodontic treatment may benefit from a fiberotomy to help retain their treatment results.

Gingivoplasty - A gingivoplasty is a minor surgical procedure used to remove or sculpt gingival (gum) tissue.  This procedure can be performed to remove excess (hyperplastic) gum tissue, to correct a “gummy” smile or to balance uneven gum heights. 

Extractions

The majority of orthodontic patients do not require extractions to correct their malocclusion (bad bite); however, in certain cases the removal of permanent teeth can improve oral health, function, and even dental-facial esthetics!  In all cases, if Dr. Berco and Dr. DeLuca feel that extractions would be in your best interest they will discuss this with you in detail before treatment is started.


Situations which may warrant extractions include:

  1. •Excessive crowding

  2. •Excessive protrusion of the teeth - for healthy teeth and gums the teeth should sit upright over their supporting bone

  3. •Excessive overjet - when the top teeth sit ahead of the bottom teeth upper teeth may be extracted to bring the top and bottom teeth into proper alignment

  4. •Lip incompetence or protrusive lips - extraction of teeth may enhance facial appearance when the lips fail to contact when biting down or appear protrusive when at rest



Call today to schedule your complimentary consultation with

Dr. Berco & Dr. DeLuca!

Separators (spacers)

Separators are elastic rings designed to gently push your back teeth apart so that orthodontic bands can be placed around your teeth next visit.   A band is a stainless steel ring that encircles your back tooth and is a common component of many fixed orthodontic appliances.

  1. A. Ligature - small elastic or twisted wire tie that holds the archwire to each bracket.  Elastic ligatures come in a variety of colours and can be changed at each appointment.

  2. B.Archwire - made of biocompatible stainless steel or NiTi material, the archwire creates force to move teeth to their proper position

  3. C.Brackets - bonded directly to the teeth, brackets along with ligatures hold the archwire in place. 

  4. D.Band - a stainless steel ring that encircles your back tooth.  It is a common component of braces and many other fixed orthodontic appliances.

  5. E.Elastics - Elastics (rubber bands) are worn from hooks on certain brackets or bands to help move teeth towards their final corrected position.

Banded RPE

Bonded RPE

Treatment stages with RPE

A. At placement of expander    B. At completion of expansion    C. After braces

Essix (clear) retainerTypes_of_braces.html
Hawley retainerTypes_of_braces.html

Fixed retainer

Before frenectomy

After frenectomy

Before IPR

After IPR

Treatment with a TAD to close space

Appliance and procedure photos on this page courtesy of the American Association of Orthodontists

Interproximal Reduction (slenderizing, enamel reduction, reproximation, selective reduction)

Interproximal reduction is the mechanical removal of a small amount of outer tooth surface, called enamel, between select teeth.  The space created by this procedure is used to straighten teeth and improve your bite in conjunction with fixed or removable appliance therapy.  It may also be used to reshape oddly shaped teeth.  It is a safe and effective procedure preformed chairside by your orthodontist.  When preformed correctly, interproximal reduction can help achieve a more attractive smile and contribute to long-term stability of your bite after braces are removed.

Orthognathic surgery

Orthodontics in conjunction with orthognathic surgery is utilized when ones malocclusion is due to not only the position of the teeth, but also the alignment of the jaws.  In such cases, orthodontics is used to align the teeth and a surgical procedure performed by an oral surgeon is used to move the jaws into a more favourable position.  Orthognathic surgery can also be used along with orthodontics to address certain cases of temporomandibular joint disorders (jaw pain), sleep apnea and acquired or congenital deformities such as cleft lip and palate.

Skeletal problems often addressed with surgery include:

  1. •Protruded upper or lower jaw - the upper or lower jaw sticks out too far

  2. •Retruded chin - the chin appears position too far back

  3. •Narrow upper jaw - the back teeth sit inside the lower back teeth.  Surgically assisted palatal expansion may be utilized to increase the width of the upper jaw allowing the upper and lower teeth to fit together properly.

  4. •Gummy smile - too much gum tissue is observed above the upper front teeth

  5. •Lip incompetence or elongated face- the lips to not contact when the lips are relaxed or the lower face appears long

  6. •Asymmetry - the chin is not in line with the center of the face

  7. •Cleft palate - an congenital condition caused by improper fusion of the palate

Benefits of orthognathic surgery include:

  1. •Improved function, including the ability to bite, chew and speak

  2. •improved dental and facial esthetics

  3. •Improved self-esteem and self-confidence

  4. •Improved dental health