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When a patient enters a Orthodontic clinic He/She is confused whether to go for metal braces or ceramic braces? Orthodontic treatment is generally considered a cosmetic treatment as this is the primary reason behind patient visiting a Orthodontist. But the choice of braces should be more dependent on the longetivity, comfort and ease of treatment in addition to cost to both the patient and the Orthodontist.
Based on my personal experience i would prefer metal braces over ceramic for the following reasons :-
1. Cost effective : metal braces are far cost effective than ceramic braces. approx difference would range from Rs.10,000 - 20,000.
2. Longetivity :- although ceramic braces have a very good tooth to bracket bond strength but they lack marginal strength(i.e. they break from corners because of load). so in this regard they have a lesser life than metal for this reason they have to be changed which ultimately leads to higher cost.
3. Friction :- we all know friction tend to slow down a object. Friction between a ceramic bracket and wire is much higher than that of a metal bracket due to which the movement is slower, ultimately resulting in longer duration for treatment. although now a days various brackets are available in market that have a ceramic bracket with metal slot but there overall efficiency is still lacking somewhere.
4. Comfort - Metal has strength in thin sheets also, but ceramic requires bulk. So the profile that is thickness of ceramic bracket is much higher than that of a metal bracket. more the thickness more is the discomfort for the patient as it takes space between soft tissue (lips, cheek) and hard tissue (teeth). so in this regard metal brackets are more comfortable. now a days various bracket system is available that have low profile metal brackets.
5. Aesthetics :- anyone opt to ceramic braces due to aesthetic concern but they are not completely invisible. and in addition the coating over ceramic wire and ligatures gets removed after sometime leading to a unaesthetic look.
6. Repair :- in any case if a bracket breaks it has to be replaced. Replacement of ceramic bracket is higher than a metal bracket.
7. Enamel damage :- as discussed earlier ceramic brackets have a higher tooth to bracket bond strength they tend to chip off enamel at the time of debonding(removal of bracket).
so it can be concluded that metal brackets have a lot of advantages over ceramic bracket. it lacks in aesthetics only. but if we measure all benefits and drawbacks one will always go for metal brackets. as aesthetics is a smaller concern. protection of tooth is a greater concern.
all the things mentioned above are a result of my personal experience. opinions may vary. criticism is always welcome.
Dr.Kapil Saroha
BDS,MDS (Orthodontics and dentofacial orthopaedics)


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