Topics on this page:
	Fixed Appliances
	Risse-Method: Biofunctional-Fixed
	MEAW-Method by Prof. Sato
	Retention

Fixed Appliances

Fixed appliances cannot be removed by the patient - they include braces ( brackets made of metal, acrylic or ceramic), which are bonded to the teeth, bands (which are like a ring around a tooth) and wires (Abb 1a, 1b).

They function mechanically like a stretched spring. The dosage of the forces is important to avoid damage to teeth and roots.

The transmission of the force happens from the wire via the bracketslot to the tooth. The smaller the bracketslot the thinner the wire the gentler the forces.

Tooth movement takes place through pressure on the tooth which causes bone resorption on one side and bone apposition on the other side. It is normal during treatment that the teeth are mobile. After movement is finished the teeth are retained and they stabilise again.

In the beginning you have to get used to a fixed appliance. Wire or braces can cause sore spots on the oral mucosa; chewing can be uncomfortable.

After an inconvenient initial phase most patients have no problems at all, braces and wires are part of the mouth.

It is indispensable to brush the teeth regularly and thoroughly because food and plaque collects around the braces and therefore the patient has a higher risk for decay.

Furthermore it is very important to keep the appointments, otherwise there will be a delay in treatment time.

Fig.1a: fixed appliances, metall brackets	Fig. 1b: fixed appliances, ceramic brackets

Risse-Method: Biofunctional-Fixed

This is a new treatment method named after Dr.Georg Risse, Münster, Germany.
This method is in Biofunctional Orthopedics the up-to-date and most advanced treatment concept using complete new knowledge from physics, anatomy , general medicine……

With this method thinner wires are used causing less trouble; the wires are individually designed and give a very good control over toothmovement; this method meets the demands for lighter forces and up to date doctrines which have been made for many years by acknowledged institutions ( Council of Education, USA 2003) .

Teeth are moved smoother and individually more precise and it is possible to treat pain of the head-, face- jawjoint- and shoulder area ( Costen-Syndrom).

Fig. 2a: Example of a biofunctional-fixed appliance with individually designed wires.	Fig. 2b: Example of a biofunctional- fixed appliance with individually designed wires.

Fig. 3: Metal bracket

To work with lighter forces we use for example a 0.014x 0.020inch 14times braided wire; all wires are designed individually for the patient ( pict. 2a, 2b); industrially preformed wires are not used. The height of the slot is 0.016 inch only.

MEAW Method by Prof. Sadao Sato

In especially difficult cases we use the MEAW-Technik (multiloop edgewise archwire) by Prof. Sato. With this technique it is possible to treat some patients with fixed appliances only who would otherwise need orthodontics and orthognatic surgery due to the malpositioned jaws (Fig.5a, 5b).

Abb .5a: befor treatment	Abb. 5b: 7 month after der MEAW treatment

Durch das Arbeiten an bzw. der Beeinflussung der Neigung der Bissebene kommt es zu einer Neupositionierung der Unterkiefers. Dies erfordert eine ständige Beachtung der Bisshöhe und der Achsenneigung der Zähne. Nur der Multiloop-Draht (Abb. 5a, 5b)ermöglicht uns die dreidimensionale Arbeitsweise, wobei die Zähne wie bei einer „Einzelradaufhängung“ gesteuert werden können, wodurch es zu einer Anpassung (Adaptation) des Unterkiefers an den Oberkiefer kommt. Dadurch können auch Kiefergelenksbeschwerden auf Grund einer Fehlbißlage behandelt bzw. vermieden werden.

Trotz Platzmangel im Bereich der Vorderzähne werden die Backenzähne nicht entfernt, da die ersten Backenzähne (Vierer) wichtig sind für die Steuerung des Unterkiefers beim Kauen. Der Platzmangel wird durch das Aufrichten der hinteren Zähne nach hinten und durch das Aufdehnen der Zahnbögen zur Seite aufgelöst. Das unerwünschte Vorkippen der

Abb. 5a: Multiloop-Draht	Abb. 5b: Multiloop-Draht

Retention

After the fixed appliance follows the retention period to keep the treatment result.

For retention removable plates which are worn during the night are often used, sometimes wires are bonded to the lingual surface of the teeth ( pict. 6a, 6b). Period of time and method of retention depend on the original malocclusion of the teeth.

Fig. 6a: Retention device	Fig.6b: Retention device