Page 55 - DP Vol 20 No 4 HR

Fig 2a: Appliance framework for the Brava + appliance, Fig 2b: Indirect bonding tray with brackets incorporated in it

Fig 3: Different shapes of the vertical arms

The Brava+ system utilizes custom-designed, individual brackets The appliance framework has two main components: a horizontal
that control the movement of each tooth with precision. This innovative bar and distinct vertical extension arms for each tooth. The horizontal
method eliminates the need for traditional archwires, allowing for more bar runs along the gingival area, spanning from the second molars on
targeted adjustments. By focusing on each tooth’s unique alignment one side to the second molars on the other and is placed 0.5 mm away
needs, it enhances the overall efficiency of the orthodontic treatment from the palatal/lingual surface (Figure 2). Attached to this bar are the
and promotes a more comfortable experience for patients. 13 vertical extension arms, which engage each tooth individually. 13
However, specialized training may be required to handle various What sets the Brava appliance apart is the custom-designed vertical
clinical scenarios that may arise during treatment with the Brava arms, which come in a variety of complex shapes (Figure 3).These
appliance. The training covers a range of issues, including broken shapes are determined through Finite Element Analysis (FEA), a
brackets, damaged IM arms, misalignment of teeth, incorrect bracket process that calculates the precise magnitude and direction of the forces
positioning, bonding challenges, and optimal techniques for engaging needed for optimal tooth movement. The computer then designs the
13
IM arms with the brackets. (Refer to Table 1) NiTi arms with the necessary shape and rigidity to deliver the forces
effectively.
Appliance Design To address the varying force requirements of individual teeth, the
The Brava+ appliance is made up of a flexible Nickle Titanium (NiTi) vertical arms are engineered with varying rigidity. Anterior teeth,
alloy, which has shape memory as well as super elastic properties which require less force for movement, are equipped with less rigid
enabling it to return to its original shape after deformation and provide arms. In contrast, premolars, which need more force, have moderately
consistent, gentle force for effective orthodontic treatment. BRIUS® rigid arms, while molars, requiring the greatest force, are fitted with the
features low-profile lingual bracket from 2D Forestadent with a clip-on most rigid arms. This customized approach guarantees accurate and
design, which enhances both comfort and effectiveness. efficient tooth movement during the orthodontic treatment. 13

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Dental Practice I July-August 2024 I Vol 20 No 4 55