Hybrid Appliances

WHAT ARE HYBRID APPLIANCES?

Hybrid appliances in a very general sense are just two different orthodontic appliances used in conjunction (at the same time) or serially (one after the other).  This scenario tends to be fairly common in orthodontics.  A common situation will find an orthodontist doing expansion as well as aligning teeth (braces and expander).  Another orthodontist will correct a front-to-back bite discrepancy with an appliance like a Herbst or Mara before lining up the teeth with braces or Invisalign.  Sometimes an orthodontist will treat the lower teeth with Invisalign while tackling the bite using a Carriere appliance.  

The basic idea is that you tackle one problem either before you tackle another problem (sometimes concurrently).

BRACES OR ALIGNERS - THAT IS THE QUESTION???

Quite often patients want to know which is better braces or aligners?  The answer to the question may be braces in certain circumstances and aligners in others.  Each clinical scenario dictates its own priorities.  

Sometimes the answer to the question, "which is better braces or aligners" is...

YES

Yes, both braces AND aligners are best.  Braces are best to tackle the really hard things that aligners don't do as well and aligners are best to handle the movements that they excel at.  Feel free to insert your favorite "with our powers combined - we are Captain Planet" quote, here.  In this type of scenario, an orthodontist will ask a patient (typically an adult) if they can see themselves wearing braces for 6-9 months before switching to aligners.  If the answer to that question is "yes, doc, I think I could manage it if I only had to wear braces for 9 months and then switch to aligners for the remainder of my treatment", then that patient may well be a candidate for a hybrid-appliance treatment (braces AND aligners).

WAIT A MINUTE - BRACES AND ALIGNERS - DOESN'T THAT COST MORE?

Simple answer.  Yes - absolutely.  The more complex answer is that a combination of braces and aligners incorporates both physical appliances and you would expect that to cover the lab/material costs for both that there would be a price increase.  

Another way to view this price increase is to think, "how much would I pay to get done with treatment around 6 months sooner"?  If your treatment is relatively complex and you can come up with a monetary value that you would pay to speed up your treatment, then you may be a candidate for this type of treatment.  Quite often a combination of two appliances applied at the proper time is both faster and more effective.  Here, the appliance (braces) better suited to handling large alignment corrections, front-to-back bite corrections, and large vertical corrections tackles those problems.  Next the appliance best suited to subtle and delicate finishing tasks handles those problems (aligners). 

Please don't misunderstand I'm not saying that you cannot handle both sets of tasks with either appliance but this is a bit like an Olympian who could change size and shape at will.  For the shot-put the Olympian would put on bulk and throw the shot an incredible distance.  For the marathon, the shape-shifting Olympian would become lean and wiry and suddenly chew through 26 miles without even breaking a sweat.  The analogy breaks down a bit as we're dealing with inanimate objects and not humans but if you think of the appliances each handling the task they were best suited to, you can see how a gold-medal result is within your grasp!

HYBRID-APPLIANCE SUMMARY

Not every scenario would benefit from a hybrid-appliance approach.  Sometimes a patient can select one or the other appliance and be just fine.  The differences between the aligners or braces they chose and the combination-appliance may be negligible (1-2 months longer in treatment).  Sometimes a patient won't trust themselves with aligners ("I snack too much") or they wouldn't be caught dead in braces as an adult.  In those scenarios clear lines have been drawn and this treatment alternative may not even be worth mentioning.  In other scenarios, this hybrid-appliance approach can shave off around half a year in treatment.  The question for patients who would benefit from this approach is, "what's your time worth to you?"