Braces
Our orthodontists carry out treatment with braces using the bidimensional technique developed by Professor Anthony Gianelly. Anthony Gianelly trained in orthodontics at Harvard University and went on to a career as a professor at Boston University. There he was appointed head of the Department of Orthodontics and developed the bidimensional technique of orthodontic treatment. For many years he taught this technique to students at Boston University and carried out research. He has many publications that examine the results of orthodontic treatment with this technique and compare them with other well-known techniques. The conclusions of these studies show that the bidimensional technique gives the best results for controlling the torque of the front teeth (their forward inclination) and anchorage during orthodontic tooth movement. Gianelly brackets are conventional brackets with different slot sizes (the opening for the archwire) for the front and side teeth. The molars are also moved with brackets. We do not use bands at our clinic! The brackets hold the archwire in place with small elastic ties or wire ligatures. Dr Ivanova-Koycheva trained in the bidimensional technique with Professor Mauro Cozzani, a student and close friend of Professor Gianelly. The brackets we mainly use to treat our orthodontic cases are Bidimensional Gianelly brackets by American Orthodontics. These brackets, used with this specific technique, together with our in-depth knowledge, are the reason for our patients' amazing smiles.
The Damon system
The Damon system is another American bracket system, with several variants in bracket design and function. These are passive self-ligating braces – brackets that hold the archwire without pressing on it. The proven advantages of self-ligating braces are faster initial correction of the position of the teeth and less discomfort for the patient, because lighter forces are applied to the teeth. Other advantages relate to correcting the bite with elastics – the teeth slide along the archwire with less resistance than with conventional braces, so correction with elastics is faster. Bear in mind that overall treatment time is not shorter with these braces than with others, and whether teeth need to be removed in some treatments depends on the type of case, not on the type of braces. At our clinic we use Damon® self-ligating braces.
Bracket adhesive
We use 3M Transbond bracket adhesive, which offers excellent bond strength and transparency. Our aim is that once we bond the brackets, they stay on until we remove them at the end of treatment. Bear in mind that the adhesive bonds to the tooth strongly enough to withstand chewing forces, but we still need to be able to remove the brackets, so the adhesive cannot be "stronger".
Clear aligner treatment
Aligner treatment at our clinic is carried out with in-house aligners. What does this mean?
In-house aligners are produced using 3D technology. The process starts with taking a digital impression of the patient's teeth using the latest Medit intraoral scanner. The STL files are imported, and the aligners are planned with American software. The orthodontist has full control over the movements planned in the software, just as when treating with braces. The dental models are printed on a latest-generation SLA 3D printer by Formlabs, and the aligners are made from a thermoforming material by the Italian orthodontic company Leone. This material does not contain hazardous substances such as Bisphenol A (BPA).
Like all the world-famous aligner companies, our aligners use attachments. These are small bumps that our orthodontists place on the patient's teeth at the start of treatment. The attachments are made from GC's injectable material, which combines a strong bond to the tooth, easy placement and removal, and a chameleon effect that blends with the colour of the tooth. This makes the attachments unnoticeable. These composite bumps increase the force the aligner applies to a specific part of the tooth and expand the possibilities of aligner treatment by more than 80%. This makes aligners a suitable appliance for treatment in most situations.
The main advantages of using in-house aligners are:
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Speed of making new aligners – new aligners can be made within a few days rather than weeks.
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Control over tooth movements – just as with braces, tooth movement with aligners is fully controlled by the treating orthodontist. With most aligner companies, tooth movements are planned by technicians who understand more about software than about teeth.
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The option of further corrections until the desired result is achieved.
Our appliances
Additional treatment appliances (expansion appliances) are made by our partners at the Pcheli Dent dental laboratory. It is the only laboratory in Bulgaria with a fully digital process for making orthodontic and prosthetic appliances. They make appliances with band-free technology, which makes fitting and working with the appliance much easier, and they hold a patent for the manufacturing method.
The reason we do not use bands either with braces or with appliances is that bands are placed around the back teeth, and this encourages food to get trapped, the teeth to decay and the gums in the area to become inflamed. Fitting bands in the patient's mouth takes several visits and causes considerable discomfort, so, like many orthodontists around the world, we reject this practice.
We make MSE appliances with mini-screws for expanding the upper jaw in adult patients together with our partners at the Ortosan laboratory in Madrid, Spain.
Mini-screws
Mini-screws are an indispensable aid in orthodontics for anchorage and for moving large groups of teeth. They are placed in the mouth temporarily, which is why they are called temporary anchorage devices. We use mini-screws from GTC and Hubit.
Carriere Appliance – a distalisation appliance
One of the most common ways of making room to align the teeth is to move them backwards, using the space of the wisdom teeth. For this movement, we use the Carriere appliance.
The appliance is a metal or ceramic arm that is fixed on each side to two teeth – the 3rd and the 6th tooth. It can be used in the upper or lower jaw, on one side or both sides, depending on the problem. The Carriere appliance is named after its creator, Dr Luis Carrière, who won the international Design Award Delta Gold 2009 for his distalisation appliance. We use this appliance because over time it has convinced us of its effectiveness, we have studied the scientific publications on it to date, and we can offer shorter treatment times through fast correction of the bite.
See cases treated with Carriere Motion – before and after
Our equipment
Intraoral scanner
We use the latest-generation Medit i700, with the highest level of accuracy for scanning the teeth – 10.9µ! The digital impression is the impression of the future. It allows us to do things that were unthinkable only a few years ago, such as simulating orthodontic treatment! It lets us create a digital patient record and communicate quickly and easily with the laboratory (including our partner laboratory in Spain), and it is essential for making aligners. An accurate impression without shrinkage or distortion allows precise appliances to be made, including retainers.
3D printer
Our aligners are printed on American Formlabs Form 4B and Form 3 SLA 3D printers, which give outstanding precision for the orthodontic models for retainers or aligners. This gives us great freedom in orthodontic treatment to offer the latest treatment methods from around the world without making our patients' treatment unnecessarily expensive.
Dental laser
We use the laser in our practice for:
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In-office laser teeth whitening;
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Gum trimming;
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Healing mouth sores caused by orthodontic appliances;
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Treating mouth ulcers (aphthae) and gum inflammation;
Woodpecker polishing system
The polishing system can clean away any surface deposits on the teeth and in the spaces between them caused by smoking, staining foods and drinks, and medicines. Polishing is done with a soda powder; the delicate 40µm particles do not damage tooth enamel.
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Removal of plaque and staining;
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Timely prevention of tooth decay and periodontal disease;
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Preparing teeth for in-office and home teeth whitening;
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Preparing teeth for fluoride treatment;
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Preparing the mouth for dental treatment and for fitting braces;
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Removing stains after braces are taken off;