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The fixed appliance

Fixed appliances are the most common and most effective way of straightening teeth, that is, correcting orthodontic anomalies. 

The term "fixed appliance" refers to small brackets that are glued to your teeth at the front and are connected with a wire all the way. Once they are applied to your teeth, they cannot be removed until the end of treatment, and the wires are changed from the thinnest to the thickest. 

The wire is used to create tension that pulls the teeth in the given direction, based on the therapy plan and, in time, places them in the desired plane so they confront to a properly shaped arch.

About the procedure

Brackets today meet high aesthetic criteria so they are barely noticeable. By developing new orthodontic materials and techniques, fixed appliances have become considerably more comfortable to wear, and the number of checkups at the orthodontist during treatment has also decreased.

The best period for orthodontic treatment with fixed appliances in children is from 12 to 14 years, in special cases even earlier.

However, there is an increasing number of adult patients who opt for orthodontic therapy with a fixed device, among other things, to create good foundations for further prosthetic or implant reconstruction. Patients doing orthodontic treatment also often use corrective jaw surgery.

Also, with fixed appliances as the most common solution, there is also Invisalign, an innovative transparent appliance, that is, invisible splints that  straighten your teeth.

It is an orthognathic surgery that by moving one and / or both jaws can have wonderful results, both functional and aesthetic. There is no age limit for adult patients.

Fixed appliances are synonymous with orthodontics and have been giving excellent results for years, creating beautiful smiles. The treatment is very individual and depends on your specific needs. On average, the therapy is expected to last up to two years. Your orthodontist will give you detailed information about this.

The fixed appliance

We distinguish between fixed appliances that are located on the outside of the teeth (labial) and those that are on the inside of the teeth (lingual), and which are absolutely invisible.

There are several types of brackets with regard to material. Metal brackets are the most common and, in many cases, the best solution for more severe cases, as they ensure precision of movement.

On the other hand, there are aesthetic brackets that can be plastic, ceramic and of monocrystalline ceramics, also called sapphires. The plastic ones are not aesthetically pleasing because they age with time. Ceramic bracelets are aesthetically pleasing because they are mostly in milky colors, that is, they can be adapted to the color of the teeth, which makes them very imperceptible.

Sapphire brackets are transparent and seemingly 'disappear' on the surface of the enamel, making them the most common choice in adult patients. There are also 24-carat gold brackets.

The latest brackets, which use a special technique, are the so-called self-ligating brackets, or self-locking brackets. Among the most famous and of best quality are certainly Damon brackets, which we also offer, and which are among the most common ones among our patients.

The fixed appliance

With these brackets, in contrast to conventional ones, there is a piston that closes the wire inside the bracket, as a kind of door, which allows the orthodontist to connect the wire into the slot without ligatures, which greatly simplifies the process. It produces less friction, less pain and less force, which is important for healthy gums and the bone through which the tooth travels during a functional shift.

This decreases the number of checkups and the time spent in the clinic. They are simpler, more comfortable and better for both the patient and the orthodontist.

It is important to keep in mind that the brackets are the tools of your orthodontist and that it is their knowledge and experience of working with a particular system that is more important than the lock itself.

Am I a candidate?

After the majority of baby teeth have fallen out, uneven teeth, a bad bite and gaps between teeth lead the patient to the orthodontist because the anomalies will not, in most cases, be solved by themselves. When an orthodontic problem is not treated, in time the problem gets even worse.

Orthodontic therapy can be successful at any age - adults especially value therapy because of a nice smile that gives them confidence and is advantageous in many ways.

It is important to note that each tooth movement is simpler and faster  in a young patient. Likewise, if there are any anomalies you did not prevent in your youth - you must treat them in old age.

Orthodontic anomalies are most commonly divided into:

  • compression anomalies
  • open bite
  • crossbite
  • congenital Anomalies (clefts)
  • KL II / 2 (overbite), KL II / 1
  • anomalies of the progenitor complex
  • anomalies in the number of teeth, tooth shape, tooth position, tooth denseness, median diastemas, premature extraction, trauma, affected teeth, retained teeth, ankylosed teeth, and the like.

How do you prepare?

Orthodontic diagnostics
After the first consultations with an orthodontist, when the need for therapy is established, an appointment for diagnostic procedures is scheduled at an orthodontic office.

One of the most important segments of therapy is certainly the orthodontic diagnostics that precede the therapy and are crucial to the success of the therapy and are the basis for further action.

Thorough diagnosis can anticipate and avoid problems that may arise during therapy. The treatment plan is defined on the basis of the following data that is collected:

- dental and medical history
- analysis of study models with previously gathered prints and bite records
- orthopantomogrphic analysis
- acephalometric analysis (latero-lateral and / or antero-posterior)
- clinical photographic set (intraoral and extraoral photos)
- smile analysis
- functional analysis
- CBCT and / or joint MR

During the procedure

The first phase is the active phase of the therapy.

After fixing the fixed appliance, very thin wires are put in both jaws.

It is essential for the wire to exert a small force on the tooth in order to maintain healthy gums.

During therapy, your orthodontist will change the wires according to your therapy plan in order to direct the teeth in the right direction.

In some cases, coil springs and small rubber bands, hooks, knobs, mini screws and other auxiliary parts that can help in the straightening process are also used.

Checkups take place every 6 to 10 weeks, depending on the system of the brackets and the plan of therapy. Mostly, ten checkups are needed, depending on the severity of the anomaly.

During checkups wires and auxiliary parts are changed. After the straightening, i.e. teeth leveling in both jaws, it is necessary to check the bite and establish a proper function. Then the patients wear the rubbers they put and remove themselves.

When both the patient and the orthodontist are satisfied with the final outcome of the therapy, the appliance is removed and the second part of the therapy starts.

The fixed appliance

The second phase is called the retention phase.

After removing the appliance and polishing the tooth, the imprint for the retainer is taken.
The retainer keeps the new, corrected smile so that the muscles don't go back to the initial state, i.e. so that the teeth don't move to the original position.

It can be fixed in the form of a thin knit wire glued to the inside of the upper 4 or bottom 6 teeth, and / or can be a mobile, so-called essix retainer that is like a transparent plastic foil mandatorily covering all the teeth in both jaws.

They are planned depending on the severity of the anomaly. This phase of therapy is lifelong.



During the therapy with a fixed appliance, it is necessary to pay attention to the food that is consumed.

Hard foods such as snacks and hard, crunchy bread require extra caution when eating, and you should completely avoid foods such as caramels, chewing gums or hard candy, as these can break the connection between the teeth and the brackets, and can later lead to the brackets falling out.

When new brackets are glued, the therapy goes one step back.

The mandatory orthodontic recommendation is to maintain good dental hygiene. Teeth should be brushed after each meal or at least washed out with water. Dental floss will come in handy for cleaning the food around the brackets and the wires.

An interdental toothbrush also facilitates cleaning around the brackets, but not between the teeth.

In orthodontic therapy, cleaning between the teeth with an interdental brush, especially the front teeth, is prohibited because the aggressive metal part causes gum withdrawal.Moreover, it leaves black holes between teeth after orthodontic therapy.A much better alternative is a dental shower used after brushing, before bedtime.

If hygiene is not impeccable, there is an increased prevalence of caries and / or enamel demineralization caused by the therapy.

During therapy, it is forbidden to use a mouthwash because some can cause tooth decay due to difficulty brushing.

During orthodontic therapy it is important not to do  a regular head MRI so that you do not have to remove the brackets.
You must not be allergic to nickel, and you must not have osteoporosis or acute periodontitis.



By the end of the month, make an appointment for a specialist orthodontic checkup with a top expert at a promotional price of only 150 kuna.

Make an appointment today by email at info@bagatin.hr or call us at +385 1 46 10 225.

You can find out about the price of a fixed apparatus at Polyclinic Bagatin, and about payment options in our price list.

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