Feste Zahnspange – Brackets für Kinder & Jugendliche
From traditional metal brackets to nearly invisible, self-ligating ceramic brackets: In Cologne, we treat children, teenagers, and adults with modern fixed braces—precisely, gently, and using braces made in our own master laboratory.
Eine feste Zahnspange (Multibracket-Apparatur) korrigiert Zahn- und Bissfehlstellungen präzise und zuverlässig. Kleine Brackets werden auf die Zähne geklebt und über einen Draht sanft bewegt – bei Kindern, Jugendlichen und Erwachsenen.
At our practice in Cologne, we treat patients with fixed braces, ranging from simple corrections to severe malocclusions. We determine which bracket system is best suited for each patient in advance through a thorough diagnostic evaluation.
Wie funktioniert eine feste Zahnspange?
Eine feste Zahnspange (Multibracketapparatur) bewegt die Zähne gezielt im Kieferknochen – ähnlich präzise wie ein Aligner-System (z. B. Invisalign). Die Brackets werden außen oder innen (Lingualtechnik) an den Zähnen befestigt. Außen sitzende Brackets gibt es aus Metall oder – weniger sichtbar – aus Keramik.
Modern braces are smaller and more comfortable than they used to be—but fixed braces remain essential for complex malocclusions.
Dr. Julia Steinmaier, Specialist in Orthodontics
Feste Zahnspange bei Kindern und Jugendlichen
Bei Kindern und Jugendlichen ist die feste Zahnspange häufig das Mittel der Wahl. Wenn sich die bleibenden Zähne im Durchbruch befinden und gleichzeitig Platz für diese benötigt wird, behandeln wir dieses für häufig mit festen Zahnspangen. Dasselbe gilt, wenn die oberen und unteren Zähne beim Zusammenbiss (Okklusion) nicht exakt ineinander passen. Häufig ist eine Alignerbehandlung ebenso möglich.
Feste Zahnspange / Klammer bei Erwachsenen
We can also fit fixed braces for adults whenalignertherapy is not a viable option. This includes the repositioning of tilted teeth or orthodontic treatment involving osseointegrated anchorage.
Comparison of the different bracket systems:
We use different systems with brackets in our orthodontic practice. What is the difference? Take a look at our comparison:
Treatment with Multibracket Appliances
Newly developed wire materials and brackets (e.g., the Damon bracket) allow for fast, gentle, and comfortable treatment with fixed braces. After the bracket is placed on the tooth, the tooth surface can be sealed.
Self-ligating brackets
The Damon system is one of the so-called passive self-ligating systems, the first generation of which was launched on the market by Ormco in 1996, and since then has constantly set new standards for the efficiency and quality of self-ligation.
In orthodontics, the term "ligation" refers to orthodontics the connection between the archwire and the bracket, which is created, for example, by elastic rubber bands or thin metal ligatures.
Self-ligating brackets for fixed braces
contain a small flap that can be closed to hold the bow in position. The use of elastics or ligatures can therefore be completely dispensed with. This greatly improves oral hygiene.
This method has decisive advantages: The locking flap allows the archwire to slide freely in the bracket, resulting in less friction and reduced effort compared to conventional brackets. Self-locating brackets therefore offer remarkable advantages over traditional fixed braces. The brackets are available in metal and ceramic.
For the patient this means
- Significantly shorter treatment time
- Significantly better oral hygiene capability
- High-quality results
- More biological forces on the teeth and therefore gentler treatment
- If there is a considerable lack of space, the removal of teeth can often be dispensed with.
In our practice, we exclusively use the highest quality materials from Ormco and American Orthodontics to achieve the best results with fixed braces with self-ligating brackets.
Treatment of temporomandibular joint disordersTMD) with fixed braces
Bei Patienten mit Kiefergelenkerkrankungen (CMD) wird nach der orthopädischen Einstellung der funktionellen Kiefergelenkposition und der physiologischen Einstellung der Unterkieferlage häufig eine kieferorthopädische Behandlung mit einer festen Zahnspange (Multibracketapparatur) oder dem Invisalign-System notwendig. Mit Hilfe der festsitzenden Aufbisse wird die orthopädische Gelenkeinstellung fixiert und die Zähne in einzelnen Segmenten mit der Zahnklammer bewegt. Die festsitzenden Aufbisse werden nach und nach entfernt. Begleitend kann eine manualmedizinische oder osteopathische Behandlung durchgeführt werden.
Frequently asked questions / FAQ about fixed braces
Die feste Zahnspange ist eine bewährte und effektive Methode zur Korrektur von Zahnfehlstellungen. Sie besteht aus Brackets, die auf die Zähne aufgeklebt werden, und Drahtbögen, die die Zähne in die gewünschte Position bewegen.
The duration of treatment with fixed braces varies depending on the type and severity of the misalignment and can range from several months to several years.1 During treatment, the orthodontist must adjust the braces regularly to monitor progress and optimize the correction of the misalignment.
It is also important to maintain good oral hygiene during treatment and to avoid certain foods and habits that can damage the braces or affect the teeth. These include hard or sticky foods, chewing ice or biting nails.
Eine feste Zahnspange kann in vielen Fällen eine bessere Option sein als andere Korrekturmethoden wie Invisalign, insbesondere bei schwereren Zahnfehlstellungen. Ein erfahrener Kieferorthopäde kann die beste Behandlungsmethode empfehlen und eine individuelle Beratung bieten, um die bestmöglichen Ergebnisse zu erzielen.
According to studies, the average active treatment duration with fixed braces is approximately 20 months (range varies depending on the diagnosis).1
Tap a question to expand the answer.
Welche feste Zahnspange ist die beste?
There is no such thing as the “best” set of braces—which one is right depends on the diagnosis and treatment goal. The most common types are:
- Metal braces: durable, proven, and effective—but visible.
- Ceramic brackets: tooth-colored and less noticeable, but more fragile.
- Lingual braces: attached to the inside of the teeth and invisible from the outside, but more complicated and harder to clean.
- Self-ligating brackets: don't require rubber bands and often result in fewer appointments.
We'll discuss which option makes the most sense for you during our consultation.
Einen Überblick über alle Zahnspangen-Arten finden Sie hier: feste Zahnspange, lose Zahnspange und durchsichtige Zahnspange.
Wie viele Tage tut eine feste Zahnspange weh?
In the first few days after placement or adjustment, the teeth are often sensitive to pressure—this is normal and results from the pressure that moves the teeth. This may be accompanied by friction against the cheeks and lips. These symptoms usually subside within a few days, once the oral mucosa has adjusted. They can be alleviated by eating soft foods and, if necessary, taking a pain reliever such as ibuprofen or acetaminophen. If severe pain persists, you should have your braces checked.
Was ist besser eine feste oder lose Zahnspange?
Das hängt vom Befund ab. Eine feste Zahnspange – Brackets plus Drahtbögen, fest verklebt – eignet sich für stärkere Fehlstellungen und wird durchgehend getragen. Eine lose Zahnspange korrigiert leichtere Fehlstellungen oder hält nach der Behandlung als Retainer das Ergebnis; sie ist herausnehmbar. Oft werden beide kombiniert. Was passt, hängt von Schwere der Fehlstellung, Alter und individuellen Faktoren ab.
Was bringt eine feste Zahnspange?
Eine feste Zahnspange korrigiert Zahnfehlstellungen und Kieferanomalien zuverlässig. Der Nutzen:
- Function: Corrects overbite, underbite, crossbite, and open bite, as well as crowded teeth.
- Aesthetics: A symmetrical smile boosts self-confidence.
- Dental health: reduces the risk of gum disease, tooth decay, and tooth wear.
- Function: Improves chewing and speech, relieves pressure on the temporomandibular joint.
- Longevity: With proper aftercare, the results last a long time.
Treatment takes time, good oral hygiene, and regular checkups.
Wie viel kostet eine feste Zahnspange ohne Krankenkasse?
Without insurance coverage, the costs usually range from €3,000 to €8,000, depending on the diagnosis and type of braces. The exact amount depends on the type of braces, the duration of treatment, and the complexity of the case.
When do you get free braces?
Die gesetzlichen Krankenkassen übernehmen die Zahnspange bei Kindern und Jugendlichen bis 18 Jahren, wenn eine medizinische Notwendigkeit besteht – etwa bei einer ausgeprägten Fehlstellung von Zähnen oder Kiefer oder einer funktionellen Beeinträchtigung (eingestuft in den KIG-Stufen). Bezahlt wird die herkömmliche feste Zahnspange; ästhetische Alternativen wie Keramikbrackets kosten extra. Die Bedingungen unterscheiden sich je nach Kasse – wir prüfen mit Ihnen, ob eine Notwendigkeit vorliegt und welche Optionen es gibt.
Was kostet eine feste Zahnspange für Kinder bei der gesetzlichen Krankenkasse (z. B. AOK)?
For children and adolescents with a recognized need for treatment (KIG levels 3–5), public health insurance plans such as AOK generally cover the full cost of fixed braces. Below KIG level 3, treatment is usually paid for privately (approx. €3,000–8,000).
Can you pay for braces monthly?
Yes, you can often pay for braces in monthly installments through the dental practice. However, paying in installments may incur interest or fees—be sure to check the terms and conditions in advance.
Which braces are the cheapest?
Am günstigsten ist meist die herkömmliche feste Metallspange – bewährt und vergleichsweise preiswert. Unsichtbare Alternativen wie Invisalign oder Keramikbrackets kosten mehr. Die genauen Kosten hängen von Region, Praxis und Befund ab.
How long do teeth shift after braces?
After treatment, teeth tend to shift again—the extent of this shift depends on genetic predisposition, the type of treatment, and aftercare. That is why retainers (fixed or removable) are used to stabilize the results. They are usually worn for at least six months to a year initially, and often permanently. It is important to consistently follow the recommendations for retention.2
When are braces not possible?
In most cases, braces can be used at any age. However, in some situations, they are not recommended or are only appropriate after preliminary treatment:
- severe jaw abnormalities that require surgical correction
- insufficient bone or space for the teeth
- advanced gum disease or other serious dental problems
- severe allergy to the materials used in the brace
These factors do not automatically rule out treatment. Before beginning treatment, we thoroughly evaluate whether braces are appropriate and, if necessary, suggest alternatives.
How quickly do braces work?
How quickly treatment progresses depends on the initial findings, the type of braces, and the severity of the misalignment. The teeth begin to move slightly right from the start, but it takes time to see visible results. Depending on the case, treatment can last anywhere from a few months to several years, during which time the teeth are continuously subjected to gentle pressure. We monitor your progress regularly and keep you informed about the expected timeline.
Is it possible to shorten the treatment time for fixed braces?
The duration depends primarily on the findings and cannot be shortened at will. However, consistently attending follow-up appointments and maintaining good oral hygiene ensure that the treatment proceeds according to schedule without delays.
Classification system of orthodontic indication groups (KIG)
The classification system of orthodontic indication groups (KIG) is used in Germany to assess the need for orthodontic treatment based on findings.
Orthodontists use the system to classify tooth and jaw misalignments into five different categories. Depending on the category assigned, the treatment costs are covered by health insurance or offered as a private service.
The KIG system helps to ensure a clear structure in the treatment of misaligned teeth and jaws and to determine the corresponding benefit claims against the health insurance company.
Proper care of braces - Our care instructions
What do I have to consider with the new braces?
1.) Herausnehmbare Zahnspange/ Invisalign Schienen:
It is important that removable appliances are kept clean and stored correctly. This means that the appliance, just like the teeth, should be cleaned with a toothbrush and toothpaste or, if desired, with special cleaning tablets from the pharmacy or drugstore. The brace should always be kept outside the mouth in the brace box. If the braces are not stored carefully, they can bend or break and, in the worst case, no longer function properly.
2.) Fixed braces:
With fixed braces, brackets or bands are bonded to the teeth and connected to an archwire. This can cause temporary tension after the brackets or new archwires have been fitted. This feeling of pressure usually starts in the evening and then subsides within the next three to four days. During this time, it is advisable to eat softer foods and avoid biting down hard. In principle, however, sticky or particularly hard foods should be avoided throughout the entire treatment period with fixed braces in order to prevent the brackets from coming loose. Sore spots may appear on the gums or inside of the cheeks. Covering them with dental wax usually provides relief, but here too, the mucous membrane needs a few days to get used to the new situation and form a kind of callus. However, if the symptoms do not improve, you should visit the dentist again.
Die Bestandteile der festsitzenden Zahnspange / Apparatur sind sehr empfindlich, und daher kann es zum Bruch des Bogens oder zum Ablösen von Brackets kommen. Bitte melden Sie sich in unserer Praxis, damit wir die feste Zahnspange wieder instand setzen können. Sollte der Bogen am hinteren Ende in die Backe stechen, können sie ihn auch einfach mit einer kleinen Zange kürzen. In jedem Fall sollten sie aber in der Praxis vorbeikommen, damit der Kieferorthopäde die verlorenen Bestandteile wieder ersetzen kann.
Care instructions for braces:
Festsitzende Zahnspangen erfordern eine besonders intensive Pflege. Diese ist schwieriger und zeitaufwendiger als ohne Brackets oder bei Invisalign-Behandlung. Eine gründliche Zahnreinigung nach jeder Mahlzeit ist mit einer festsitzenden Zahnspange jedoch unabdinglich, da sich im Umkreis der festsitzenden Elemente verstärkt bakterielle Plaque bilden kann, und dadurch ein erhöhtes Kariesrisiko besteht. Für die Pflege mit der festsitzenden Zahnspange empfehlen wir:
Oral B Indicator 35 Orthodontic
Oral B interdental set
Oral B Interspace (pharmacy)
Oral B Superfloss (50 threads)
Oral B Ortho (attachment for electric toothbrushes)
These special toothbrushes and dental floss enable cleaning of areas of the teeth that are difficult to reach and should definitely be part of your daily dental care routine when wearing fixed braces. In addition, additional care with mouthwash solutions is sometimes recommended.
Mit einer elektrischen Zahnbürste, z.B. Sonicare von Philips, ist eine optimale Reinigung der Zähne auch bei festsitzenden Zahnspangen oder bei der Behandlung mit dem Invisalign-System möglich. Ergänzend kann AirFloss (Philips) als Ersatz für Zahnseide für die Reinigung der Zahnzwischenräumre eingesetzt werden.
Palatal suture expansion (GNE)
The palatal expansion appliance is a fixed orthodontic appliance used for skeletal expansion of the upper jaw. It was first described in 1877 by Angell in the United States. Rediscovered after 1945 by Haas, Timms, and Derichsweiler, the palatal expansion appliance has since secured its irreplaceable place in orthodontics.
The braces are usually attached to the 1st molars and 1st premolars with bands. Today, the appliance can also be used as a plastic splint that covers all posterior teeth. The appliance is fitted with an expansion screw in the middle, with which the two halves of the upper jaw can be pushed apart by up to 10 millimetres in two to four weeks. New bone then reliably forms in the middle.
The palatal suture expansion technique is recommended for patients with an upper jaw that is too narrow. The widening achieved with this technique is skeletal, meaning it is caused by newly formed bone.
Die Gaumennaht-Erweiterung hat viele gesundheitliche Nebeneffekte, die alle auf der Verbesserung der Nasenatmung beruhen: weniger Erkältung, weniger Kieferhöhlenprobleme, Verbesserung der Belüftung des Innenohrs über die Eustachische Röhre mit Besserung von Ohrsymptomen, Verbesserung der Schlafqualität. Die Gaumennaht-Erweiterung ist häufig eine gute Vorbereitung einer folgenden Behandlung mit KFO- Geräten, dem Invisalign– System oder der festen Zahnspange.
In rare cases, there may be possible side effects such as slight loosening of the teeth, a feeling of pressure and possibly pain in the head area as well as reddened or slightly inflamed gums.
The palatal expansion is a fixed brace
The palatal expansion is a fixed brace
Distalizer according to Carrière
The Carrière Distalizer is an absolutely passive appliance that only becomes active through the use of Class II elastics. The nickel-free appliance is applied to the lateral tooth area, leaving the visible front area largely free.
A transparent retaining splint in combination with small buttons in the opposing jaw provides the anchoring point for the elastic rubber bands. The joint, the key component of the distalizer, enables targeted distalization of the canine and simultaneous distalization and derotation of the molar.
Wir wenden den Distalizer bei einer Klasse II-Verzahnung gerne vor einer Invisalign-Behandlung an.
Patient example
Anchoring technique orthodontics
Very difficult tooth movements have become possible thanks to an anchorage that is attached to the bone. Anchoring means that we get the support we need to move a tooth from this point.
Example cases
Intrusion eines elongierten Molaren mit Minischrauben und Invisalign
Die folgenden Bilder zeigen die Intrusion eines verlängerten oberen Molaren durch eine Invisalign-Behandlung in Kombination mit Miniimplantaten und Gummizügen. Das Setzen von zwei kleinen Schrauben bukkal und palatinal des zu intrudierenden Zahnes ermöglicht einen optimalen Angriffspunkt für die Invisalign Schienen und die zusätzliche Kraftkomponente durch die Gummizüge. Durch die Behandlung konnte eine optimale Ausgangssituation für die implantologische Versorgung des Gegenkiefers erfolgen.
Gegenüberstellung vor der Intrusion und nach der Behandlung mit dem Invisalign-System und Minischraube. Implantologische Versorgung durch Dr. Schuppan
Positioner
Once the brackets and bands have been removed, the phase of fine-tuning and retention begins. The teeth’s alignment is not yet fully stabilized, so a device called a “positioner” can be used to fine-tune it and bring the teeth into their ideal position.
To this end, the laboratory . Individual teeth or groups of teeth are removed from the plaster model and repositioned individually in the ideal alignment of the dental arches. The positioners are then manufactured using a special deep-drawing technique based on this ideal arch.
, Studies, and Further Reading
Sources:
Tsichlaki, A., Chin, S.Y., Pandis, N., & Fleming, P.S., 2016. How long does treatment with fixed orthodontic appliances last? A systematic review. Am J Orthod Dentofacial Orthop, 149(3), pp. 308–318. https://doi.org/10.1016/j.ajodo.2015.09.020
Martin, C., Littlewood, S.J., Millett, D.T., Doubleday, B., Bearn, D., Worthington, H.V., & Limones, A., 2023. Retention procedures for stabilizing tooth position after treatment with orthodontic braces. Cochrane Database of Systematic Reviews, (5):CD002283. https://doi.org/10.1002/14651858.CD002283.pub5
Chen, S.S., Greenlee, G.M., Kim, J., Smith, C.L., & Huang, G.J., 2010. Systematic review of self-ligating brackets. Am J Orthod Dentofacial Orthop, 137(6), pp. 726.e1–726.e18; discussion 726–7. https://doi.org/10.1016/j.ajodo.2009.11.009
Fleming, P.S., Dibiase, A.T., Sarri, G., & Lee, R.T., 2009. Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial. Angle Orthod, 79(1), pp. 46–50. https://doi.org/10.2319/121007-579.1
Rosvall, M.D., Fields, H.W., Ziuchkovski, J., Rosenstiel, S.F., & Johnston, W.M., 2009. Attractiveness, acceptability, and value of orthodontic appliances. Am J Orthod Dentofacial Orthop, 135(3), pp. 276.e1–12; discussion 276–7. https://doi.org/10.1016/j.ajodo.2008.09.020
O’Brien, K., Wright, J., Conboy, F., Appelbe, P., Bearn, D., Caldwell, S., Harrison, J., Hussain, J., Lewis, D., Littlewood, S., Mandall, N., Morris, T., Murray, A., Oskouei, M., Rudge, S., Sandler, J., Thiruvenkatachari, B., Walsh, T., & Turbill, E., 2009. Prospective, multicenter study of the effectiveness of orthodontic/orthognathic surgery care in the United Kingdom. Am J Orthod Dentofacial Orthop, 135(6), pp. 709–714. https://doi.org/10.1016/j.ajodo.2007.10.043.
Pandis, N., Walsh, T., Polychronopoulou, A., Katsaros, C., & Eliades, T., 2013. Split-mouth designs in orthodontics: an overview with applications to orthodontic clinical trials. Eur J Orthod, 35(6), pp. 783–789. https://doi.org/10.1093/ejo/cjs108.
Papageorgiou, S.N., Gölz, L., Jäger, A., Eliades, T., & Bourauel, C., 2016. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci, 124(2), pp. 105–118. https://doi.org/10.1111/eos.12250.
Scott, P., Sherriff, M., Dibiase, A.T., & Cobourne, M.T., 2008. Perception of discomfort during initial orthodontic tooth alignment using a self-ligating or conventional bracket system: a randomized clinical trial. Eur J Orthod, 30(3), pp. 227–232. https://doi.org/10.1093/ejo/cjm131.
Khambay, B., Millett, D., & McHugh, S., 2004. Evaluation of methods of archwire ligation on frictional resistance. Eur J Orthod, 26(3), pp. 327–332. https://doi.org/10.1093/ejo/26.3.327.
Fleming, P.S., DiBiase, A.T., & Lee, R.T., 2010. Randomized clinical trial of the effectiveness of orthodontic treatment using self-ligating and conventional fixed orthodontic appliances. Am J Orthod Dentofacial Orthop, 137(6), pp. 738–742. https://doi.org/10.1016/j.ajodo.2009.06.023.
Kalra, A., Jaggi, N., Bansal, M., Goel, S., Medsinge, S.V., Abraham, R., & Jasoria, G., 2013. Comparison of the rate of canine retraction into a recent extraction site with and without gingival fiberotomy: a clinical study. J Contemp Dent Pract, 14(3), pp. 419–426. https://doi.org/10.5005/jp-journals-10024-1338.
Angolkar, P.V., Kapila, S., Duncanson, M.G. Jr., & Nanda, R.S., 1990. Evaluation of friction between ceramic brackets and orthodontic wires made of four alloys. Am J Orthod Dentofacial Orthop, 98(6), pp. 499–506. https://doi.org/10.1016/0889-5406(90)70015-5.
Reicheneder, C. A., Gedrange, T., Berrisch, S., Proff, P., Baumert, U., Faltermeier, A., & Muessig, D. (2008). Conventionally ligated versus self-ligating metal brackets—a comparative study. European Journal of Orthodontics, 30(6), 654–660. https://doi.org/10.1093/ejo/cjn053
Proffit, W.R., Fields, H., Larson, B., & Sarver, D.M., 2018. Contemporary Orthodontics. 6th ed. ISBN: 9780323543873.
Having an urgent problem with your braces?
Is a wire poking you, did you lose a bracket, or did your retainer come loose? On our page “First Aid for Braces Problems,” you’ll find quick self-help tips—and a clear answer on when you should call us.
Feste Zahnspange in Köln?
Schedule a no-obligation consultation about fixed braces at JUST KFO Dr. Steinmaier & Associates in Cologne.
Mon–Thu 8:00 a.m.–12:30 p.m. & 1:30 p.m.–6:00 p.m. · Fri 8:00 a.m.–12:30 p.m. & 1:30 p.m.–4:00 p.m.