Braces are a common orthodontic treatment. While traditional braces primarily reposition teeth, orthodontic treatments can also influence jaw alignment and growth, especially in younger individuals.
Braces and Tooth Movement
Traditional braces apply continuous, gentle pressure to teeth, gradually shifting them into desired positions within the jawbone. The system involves brackets bonded to each tooth, an archwire threaded through them, and elastic bands or ligatures. The archwire exerts force, transmitting it through the brackets to the teeth, initiating movement.
Tooth movement occurs through bone remodeling. The periodontal ligament plays a key role. When pressure is applied, the ligament compresses, stimulating osteoclasts to resorb bone. Simultaneously, on the opposite side, osteoblasts deposit new bone. This coordinated breakdown and buildup allows the tooth to move through the jawbone while maintaining its support structure.
Non-Surgical Jaw Alignment
While fixed braces primarily move teeth, other orthodontic appliances can influence jaw position and growth without surgery, especially in growing patients. These methods guide jawbone development into a more harmonious relationship.
Palatal expanders widen a narrow upper jaw. They apply gentle, consistent force to the palate, allowing new bone to form in the widened space. This expansion creates more room for crowded teeth and corrects crossbites.
Other functional appliances, like the Herbst appliance or Twin Block, correct discrepancies between the upper and lower jaws by encouraging forward growth of the lower jaw. The Herbst appliance uses a telescoping mechanism to hold the lower jaw forward, promoting its growth and alignment. Twin Block appliances guide the lower jaw into a more advanced position when the patient bites down. These appliances are most effective in children and adolescents whose jawbones are still developing.
Elastics, or rubber bands, are also used with braces to apply force between the upper and lower arches. They help correct bite misalignments by influencing both tooth movement and subtle jaw positioning.
Surgical Jaw Correction
For severe skeletal discrepancies where non-surgical orthodontic methods are insufficient, orthognathic surgery may be necessary to reposition the jawbones. This procedure is typically reserved for adults or individuals whose growth has completed and whose jaw misalignment cannot be corrected by orthodontics alone.
The surgeon secures the repositioned jaw with small plates, screws, or wires. This often involves collaboration between the surgeon and an orthodontist, with orthodontic treatment preceding and following surgery to align teeth. Common surgical procedures include maxillary osteotomy for the upper jaw and mandibular osteotomy for the lower jaw, which can involve moving the jaw forward, backward, or rotating it to achieve proper alignment and facial balance.
Orthodontic Evaluation and Planning
Determining the appropriate treatment plan, whether tooth movement, non-surgical jaw alignment, or surgical intervention, begins with a comprehensive orthodontic evaluation. Orthodontists use diagnostic tools to assess tooth position and jawbone relationship.
These tools include digital X-rays, such as panoramic and cephalometric radiographs, providing detailed images of teeth, bones, and surrounding structures. Three-dimensional imaging techniques, like Cone Beam Computed Tomography (CBCT), offer an in-depth view of facial and dental anatomy for precise measurements and analysis.
Dental impressions, often digital scans, create models of the patient’s teeth and bite. A thorough clinical examination also contributes to diagnosis. By analyzing this information, the orthodontist distinguishes between dental problems (tooth position) and skeletal problems (jaw size and alignment). This assessment allows for a personalized treatment approach.