Page 56 - DP Vol 20 No 4 HR

ORTHODONTIC SECTION

Biomechanics
In the Brava appliance system, force optimization
is achieved through finite element analysis. This
method ensures that the Independent Movers™
anchorage bar exerts force closer to the center of
resistance, as opposed to the labial straight wire.
The design of the Independent Movers™ helps
to prevent round tipping by evenly distributing
and balancing the force across the anchorage bar.
Unlike conventional methods, where spacing is
typically managed after the leveling and alignment
and torque adjustments are made after placing a
large rectangular archwire in the bracket slot, the
Brava appliance addresses both spacing and torque
from the very start of the treatment .
10
Once the Brava appliance is engaged with the
brackets, it precisely delivers the necessary forces to
move each tooth through all three planes of space—
transverse, sagittal, and antero-posterior. These
movements guide the teeth from their initial pre-
Table 1: Pros and Cons of Brava Appliance
treatment positions to their final, optimal positions.
The final alignment of the teeth is determined by
the orthodontist during the virtual setup phase
of the case, ensuring a customized and accurate
treatment plan. 14

TREATMENT PLANNING
Pre-treatment records including intraoral and
extraoral photographs, orthopantomogram (OPG),
lateral cephalometric radiograph, cone-beam
computed tomography (CBCT), an intraoral scan,
and a full mouth series of X-rays are uploaded on
the Brius portal. 10
BRIUS® utilizes individualized prescriptions
through virtual setups for each patient requiring
treatment. The system uses Brius case planner
Fig 4: Orthodontic treatment workflow with the BRIUS®
software to accurately plan how each individual
Fig 5: tooth will be positioned in the patient’s mouth.
Extraoral photographs This technology enables both the orthodontist and
(a) Frontal view the patient to visualize and adjust the expected
(b) Frontal smile view
(c) Profile view treatment outcomes. While similar aligning
(d) Oblique view software is already available to orthodontists,
(e) Oblique smile view BRIUS® stands out by incorporating Finite Element
Analyses (FEA) once the virtual setup is complete.
13
FEA compute the exact magnitude and direction
of force vectors needed to move each tooth into
its final position. This approach ensures accurate
force delivery, abolishing the need for subjective
adjustments or manual intervention from the
practitioner. (Figure 4)
10
BRIUS® minimizes the burden of the practitioner
by employing a specialized manufacturing process
to create a single appliance designed to deliver all
necessary movements. The use of shape memory
NiTi ensures that the appliance retains its original

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