Hey assistants! There are 3 different types of ligation in orthodontics. Self Ligation, Elastic, And Metal Ligation. The three different types are explained below:
Self-ligation has been around since the 1930’s. Self-ligating brackets became more popular in the 80’s. The wire is placed inside a specialized door or clip with a special tool that locks the arch wire in place. Pros: Being self-ligating, brackets do not need elastic ligatures so they can be easily brushed. They are also less visible and are a great option for older teens and adults. Cons: Self-ligating brackets can be more expensive. They can also be difficult at the finishing stages of movement because the clips are loosely set on the self-ligating brackets as supposed to the elastic ligature which have a more tightening effect.
Elastic ligatures are different colored rubber bands that attach to the arch wire using a hemostat. For the patients, choosing a color every month makes going to the orthodontist something to look forward to. This option is a fun experience for the patient, adult, and children alike! Pros: The brackets used with elastic ligation tend to stick out less than a self-ligating bracket. Also, the wire grips better in the “detailing” stage of treatment. Cons: Plaque, plaque, plaque! Elastic ligatures are more difficult to keep clean and attract a lot more plaque than a bracket that uses self-ligation. You also have to see the patient every 4 to 6 weeks for an adjustment as the elastic ligatures lose their force.
Have you ever wondered where the term “Tightening” braces came from? Well, this is it. A steel ligature is tied on to an individual bracket with a hemostat to hold the arch wire in place. You twist the metal ligature on one side of the wire, forming a “pig tail” then clip it with a pin cutter. This way of ligation is still used today but elastic and self- ligation is definitely a more popular choice. A reason you might use a metal ligature tie is to try to move the tooth faster than what a conventional elastic tie would. You also use steel ligatures to hold spaces together after using a power chain.
As Orthodontic Assistants, you will run into new, different, and traditional ways of tying in brackets. Whichever technique you end up using remember to have a good chair side manner and always remember to be gentle and efficient.
Written by: Norma Abrica