Based on The British Society of Orthodontics, Orthodontic is a knowledge that learn about developmental and growth of jaw, face, body that can affected to teeth position. Orthodontic treatment is a long-term procedure that aims to obtain good occlusion without tooth rotation and diastema. Orthodontic treatment aims to fixed oral health, oral function, and self-appearance. On evidence-based shows that malocclusion and dental malposition caused negative impact to oral health particularly in condition of periodontal ligament. Orthodontic care is a dental treatment that currently popular in the community both in children, teenager, and adults. In general, they come with desire to even out the arrangement of teeth so is that is more attractive and harmonious to support appearance and self-confidence. Orthodontics treatment can be applied either in removable orthodontics or fixed orthodontics
Removable Orthodontics
Removable orthodontics appliances are one of the kinds of devices that are commonly used for treat malocclusion expected to achieve the correct arrangement of teeth regular and harmonious facial appearance. Removable orthodontics appliance is a device that its use can be installed and removed by patients, have ability to care, functional tool, and affects orofacial muscles and development of dental alveolar.
Removable orthodontic is indicated only for tipping movements where the dental abnormalities that occur are not too complex which only involve the deviated position of the teeth in the jaw arch while the jaw is still in normal condition. This appliance can only be used by patients over the age of 16 years old, the use of removable orthodontics can be used in class I skeletal malocclusions, individual repositioning, bucco-lingual malposition with mandibular displacement, and can be used to close the extraction space. Contraindications to the use of removable orthodontics are when there is a marked malocclusion, abnormal apical position, requires bodily movement, lack or excess of large space (>3 mm), vertical direction abnormalities, and requires repair of the tooth relation between the jaw.
Consideration of the use of removable orthodontic appliances can be considered based on the advantages and disadvantages it has. The advantage of using a removable orthodontic appliance is that it allows the user to maintain good oral hygiene during orthodontic treatment because this appliance can be removed and installed by the patient independently. The manufacture of this tool can be done in the laboratory, so that visiting times are more efficient, this tool is much better aesthetically, the cost of treatment using removable orthodontics also tends to be cheaper and requires less cost for smelling the appliance.
Besides the advantages, the use of removable orthodontics requires a high level of cooperation from the patient and it is expected that the patient has the skills to install and remove the appliance independently. This appliance increases the risk of loss of the appliance or the appliance may break which results in undesired directional movement of the teeth. This tool also cannot be used in cases that require tooth extraction, because this tool is not able to cover a large enough space. This deficiency can be taken into account in the selection of tools used for orthodontic treatment.
Fixed Orthodontic
Fixed orthodontic appliance is an orthodontic appliance that is firmly attached to the tooth surface which consists of an active component and a passive component with a high maintenance capability with a very large and better chance of success. Fixed orthodontic appliances are able to provide tipping movements, rotational movements, bodily movements, torque movements, vertical movements in the form of intrusions and extrusions.
The use of fixed orthodontic appliances is avoided for patient who are uncooperative in maintaining oral hygiene and cannot make regular visits for bracket replacement. The use of fixed orthodontics is also contraindicated for patients with systemic diseases such as diabetes mellitus.
Consideration of the use of fixed orthodontics can be through the advantages and disadvantages it has. Advantages The use of fixed orthodontics tends to reduce problems with retention that trigger multiple and simultaneous movements, fixed appliances also do not require patient skills in their treatment, patients can choose bracket variations that match the desired color, treatment time using fixed orthodontics is much shorter, on fixed orthodontic appliances there is no acrylic material that can trigger allergies in some patients, the treatment results on this tool are much better.
Disadvantages of fixed orthodontics are that this tool is very complicated so that its installation requires high skills of a dentist, treatment costs tend to be more expensive because more tools are needed, oral hygiene care is complicated because the device is permanently installed, if there is damage it will be difficult to repair.
Consideration of Treatment
Consideration of the decision to use orthodontic appliances depends on the needs of the patient. If the patient has severe dental abnormalities, the use of fixed orthodontics is highly recommended. Meanwhile, if the patient has complaints of dental abnormalities that are not too severe and the patient can be invited to cooperate, then removable orthodontic appliances can be used. The decision to plan treatment is influenced by the benefits to the patient, which are balanced by the risks of using the device used. Fixed or removable orthodontic treatment has risks and complications such as root resorption, gingival recession, periodontal tissue damage, poor oral hygiene, increased risk of caries, gingival inflammation, and temporomandibular joint disorders. Supportive examinations such as OPG (Orthopantomography) radiographic examination are needed to evaluate the readiness of the teeth for the treatment plan to be carried out.
Personally, the writer chooses the use of fixed orthodontic rather than removable orthodontic based on two and half years treatment. The result is very clear even non-dentist person can figure it out easily. The use of orthodontic treatment can boost the confidence of the writer’s and fixed oral problems such malocclusion, space loss, and overjet.
