Orthodontic treatment is the alignment of teeth done through the application of forces onto the tooth. Brackets are fixed to the crown of the tooth with dental cement and the excess is removed. Arch wires are then passed through these brackets, which help in applying controlled forces. Accessory components play a huge role in treatment, especially elastics and springs. These devices have different indications and are placed according to the needs of the patient.
The root of the tooth is held in place by the periodontal ligament – a group of specialised fibres which surround the tooth and these attach from the cementum to the lamina dura in bone. The periodontal ligament fibres run in all directions and play an important role is the distribution of forces between teeth and alveolar bone, acting as a shock absorber when strong forces are exerted.
Orthodontic forces work in the manner that when a force is applied via a bracket or wire, the PDL fibres are stressed. Two distinct sides form, a compression side where there is a release of cells called osteoclasts which resorb the bone there to allow the tooth socket to shift on that edge. The other end, called the tension side causes the release of osteoblasts which are bone forming cells and fill up the empty space created. This cascade of events is called bone remodelling as a break down and formation of bone occurs simultaneously. The balance occurring however, causes the tooth to shift in a healthy way which isn’t detrimental or too strong on the tooth. Light, continuous forces extended over a period of time are recommended for tooth movement.
Careful discussion and treatment planning with the dentist is important prior to treatment. Dr. Pancko, an excellent orthodontist at Wilmington Orthodontic Centre will help you in creating the smile you want.