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Refinement vs. Replacement Brava

When is it time to consider a refinement Brava vs. a replacement?

On occasion a Brava independent mover may break creating the need to replace that Brava. Under certain circumstances, a refinement may be the better choice. Here's what to consider: 

  • The current Brava has been engaged 4-6 months.
  • Tooth movement has stopped, indicating the Brava is fully expressed.
  • For staged cases, if Stage 1 has failed, proceed to Stage 2 provided that Stage 1 has been engaged for 4–6 months and appears to be fully expressed. If Stage 2 fails after 4–6 months of engagement, consider a refinement rather than replacing the Brava appliance.

Once the Brava appliance has been fully expressed, a replacement will not produce additional tooth movement and will function only as a retainer. Replacement of the Brava appliance is appropriate only if breakage occurs while it is still actively facilitating tooth movement.