REMOVABLE APPLIANCES
A simple way to a healthy smile. Benefit from the expertise of specialists, undergo treatment with a removable appliance, and smile without self-consciousness!
A removable appliance is one that the patient inserts and removes themselves, wearing it for a specific number of hours per day as prescribed by the orthodontist. It can be fabricated for a single arch, e.g., the maxilla (upper jaw) or mandible (lower jaw), for both arches, or it can be a biaxillary (two-arch) appliance, often referred to as a block appliance, which engages both arches simultaneously.
It is typically made of acrylic, often available in various colors, and incorporates retentive components (clasps), as well as labial bows, screws, and springs. These elements are designed to perform specific tasks, such as expanding the dental arch, tipping or inclining a tooth or group of teeth, moving a tooth along the dental arch (e.g., into a space created by an extracted tooth), or altering the mutual relationship of the jaws (e.g., advancing the mandible when it is positioned posteriorly, typically with a biaxillary appliance).
The most important advantages of removable appliances include:
However, their disadvantages include the fact that with low patient compliance, treatment duration is prolonged, and a lack of visible positive treatment effects can be discouraging for both the patient and their parents/guardians. Furthermore, these appliances are not effective in treating all types of malocclusion; they are primarily much less precise than fixed appliances and can also be less comfortable, potentially restricting tongue space.
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They should be worn as instructed by the orthodontist, typically for approx. 4 hours during the day – while doing homework, watching television, playing computer games, or performing household chores – and throughout the night while sleeping.
Do not eat while wearing the appliance.
It should be cleaned with a toothbrush and toothpaste, just like your teeth.
Additionally, to prevent calculus (tartar) buildup, which can be particularly detrimental to the screw mechanism, specialized descaling agents designed for this purpose should be used. If the appliance incorporates an expansion screw, the designated individual (e.g., parent or guardian) must activate it at the frequency prescribed by the orthodontist, for example, once a week, every 10 days, or every two weeks. The screw is activated using a special key, which is inserted into the hole in the central pin. It should be turned in the direction indicated by the arrow embedded in the acrylic (from the tail towards the head of the arrow) until resistance is met, completing one full turn. It is important not to tamper with the screw by turning it back and forth.
The appliance should be stored dry in its designated case; otherwise, it may become damaged.
Regular attendance at follow-up appointments scheduled by the orthodontist, e.g., every 6 weeks, is necessary. If the appliance is worn for the recommended number of hours, is properly seated and fits snugly, and the screw is activated systematically, then after each activation, the patient will feel increased pressure on the teeth, which typically subsides after 1 or 2 days.
However, if the appliance is worn for fewer hours than recommended, e.g., only at night, then after activation, it may be found that the appliance cannot be inserted, keeps falling out, or, if it can be inserted, the pressure on the teeth is unbearable. In such a case, the screw must be reversed (turned back), the appliance worn for a few days, and then reactivated. This situation may occur, for example, during an illness. The frequency of screw activation must be appropriate for the duration of wear. An appliance worn for fewer hours than recommended should be activated less frequently. However, this will prolong the treatment duration. Achieving a satisfactory orthodontic treatment result does not mean the patient can immediately stop wearing the appliance. It must still be worn without screw activation for a period equal to at least half the duration of active treatment to prevent relapse (the malocclusion from returning).
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