EVOLUTION OF BRACKETS.ppt
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About This Presentation
Brackets are the basic components of fixed orthodontic appliances. They act as an intermediary between the teeth and the active components of the appliance.
However, design of brackets is an important factor for efficient tooth movement and control of the complex force system .
Slide Content
EVOLUTION OF BRACKET
SYSTEM
DR NIVYA KRISHNA
POST GRADUATE STUDENT
DEPT OF ORTHODONTICS
MAR BASELIOS DENTAL COLLEGE
,KOTHAMANGALAM
1
SYSTEM
DR NIVYA KRISHNA
POST GRADUATE STUDENT
DEPT OF ORTHODONTICS
MAR BASELIOS DENTAL COLLEGE
,KOTHAMANGALAM
1
CONTENTS
INTRODUCTION.
HISTORY OF BRACKETS
CLASSIFICATION OF BRACKETS.
EVOLUTION OF BRACKET MATERIAL.
EVOLUTION OF FIXED APPLIANCES &
BRACKETS.
EDGEWISE APPLIANCES.
MODIFICATIONS OF EDGEWISE
APPLIANCE.
UNIVERSAL BRACKETS.
LIGHT WIRE EDGEWISE TECHNIQUE.
ANDREWS SYSTEM.
ROTH SYSTEM.
MBT.
VARI SIMPLEX DISCIPLINE.
DUAL ENVIRONMENTAL BRACKETS.
ORIGINAL BEGG SYSTEM.
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES.
MODERNIZED BEGG COMBINATION
SYSTEM.
2
INTRODUCTION.
HISTORY OF BRACKETS
CLASSIFICATION OF BRACKETS.
EVOLUTION OF BRACKET MATERIAL.
EVOLUTION OF FIXED APPLIANCES &
BRACKETS.
EDGEWISE APPLIANCES.
MODIFICATIONS OF EDGEWISE
APPLIANCE.
UNIVERSAL BRACKETS.
LIGHT WIRE EDGEWISE TECHNIQUE.
ANDREWS SYSTEM.
ROTH SYSTEM.
MBT.
VARI SIMPLEX DISCIPLINE.
DUAL ENVIRONMENTAL BRACKETS.
ORIGINAL BEGG SYSTEM.
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES.
MODERNIZED BEGG COMBINATION
SYSTEM.
2
THE BEDDTIOT APPLIANCE.
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF-LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT GENERATION
CONCLUSION.
BIBLIOGRAPHY.
3
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF-LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT GENERATION
CONCLUSION.
BIBLIOGRAPHY.
3
INTRODUCTION
Bracketsarethebasiccomponentsoffixedorthodonticappliances.Theyactas
anintermediarybetweentheteethandtheactivecomponentsoftheappliance.
However,designofbracketsisanimportantfactorforefficienttoothmovement
andcontrolofthecomplexforcesystem.
ThetermbracketcameintouseinorthodonticswhenDr.Angleintroducedthe
“Ribbonarchappliance”in1916.
Bracketmaybedefinedasanorthodonticattachmentsecuredtoatoothforthe
purposeofengaginganarchwire.(Thurow)
Itactsasahandlethattransmitstheforcefromthe
activecomponentstotheteethandservestodeliverthenecessarytoothmoving
forces.
Thus,Orthodonticbracketsprovidethemeanstotransfertheforceappliedbythe
activatedarchwiretothetooth.
4
Bracketsarethebasiccomponentsoffixedorthodonticappliances.Theyactas
anintermediarybetweentheteethandtheactivecomponentsoftheappliance.
However,designofbracketsisanimportantfactorforefficienttoothmovement
andcontrolofthecomplexforcesystem.
ThetermbracketcameintouseinorthodonticswhenDr.Angleintroducedthe
“Ribbonarchappliance”in1916.
Bracketmaybedefinedasanorthodonticattachmentsecuredtoatoothforthe
purposeofengaginganarchwire.(Thurow)
Itactsasahandlethattransmitstheforcefromthe
activecomponentstotheteethandservestodeliverthenecessarytoothmoving
forces.
Thus,Orthodonticbracketsprovidethemeanstotransfertheforceappliedbythe
activatedarchwiretothetooth.
4
HISTORY OF BRACKETS
Anglewasfirsttodesignanduseabracket-likeattachmentby
introducinghispinandtubeappliance.
Initially,softgoldwasusedformanufacturingbracketswhichwas
replacedbyrigidstainlesssteel.
Later,thisattachmentwasmodifiedandintroducedas
RibbonarchAppliance.
Finally,AngleintroducedtheEdgewiseappliancewhichwas
designedtoallowtheorthodontiststoplacetheteethintoAngle’s
conceptofthe“lineofocclusion”.
Withfewexceptions,thefixedapplianceusedincontemporary
orthodonticsisbasedonAngle’sdesignsfromtheearly20thcentury.
5
Anglewasfirsttodesignanduseabracket-likeattachmentby
introducinghispinandtubeappliance.
Initially,softgoldwasusedformanufacturingbracketswhichwas
replacedbyrigidstainlesssteel.
Later,thisattachmentwasmodifiedandintroducedas
RibbonarchAppliance.
Finally,AngleintroducedtheEdgewiseappliancewhichwas
designedtoallowtheorthodontiststoplacetheteethintoAngle’s
conceptofthe“lineofocclusion”.
Withfewexceptions,thefixedapplianceusedincontemporary
orthodonticsisbasedonAngle’sdesignsfromtheearly20thcentury.
5
Angle developed four major appliance system:
E-Arch.
Pin and tube.
Ribbon Arch Appliance.
Edgewise Appliance.
Overtheyears,bracketshaveundergonemanymodifications.
6
E-Arch.
Pin and tube.
Ribbon Arch Appliance.
Edgewise Appliance.
Overtheyears,bracketshaveundergonemanymodifications.
6
1728: Pierre Fauchard’sorthodontic appliance -Bandelette.
1849:DWINELLE:Jack Screw.
1889:John Farrar: Introduced concept of Lingual Removable Arch.
1905:E-ARCH.
1910:Pin and Tube.
1915:Ribbon Arch.
1928:Dr. Edward Angle: Edgewise Appliance.
1931: Dr. Spencer Atkin: Universal Appliance.
1933:Dr. Begg; Begg’s Bracket.
1952:Holdawayfirst used pre-adjusted brackets in order to reduce bending of archwires.
1952:Swain:IntroducedSiameseTwinBrackets.
7
1849:DWINELLE:Jack Screw.
1889:John Farrar: Introduced concept of Lingual Removable Arch.
1905:E-ARCH.
1910:Pin and Tube.
1915:Ribbon Arch.
1928:Dr. Edward Angle: Edgewise Appliance.
1931: Dr. Spencer Atkin: Universal Appliance.
1933:Dr. Begg; Begg’s Bracket.
1952:Holdawayfirst used pre-adjusted brackets in order to reduce bending of archwires.
1952:Swain:IntroducedSiameseTwinBrackets.
7
1960s:JarabakandFizzel:TwinEdgewiseBrackets.
Early1960s:IvanLeeintroducedpre-torquedbracketdesigninordertoeliminatecomplicated
torquingbendsusedinconventionaledgewisearchwire.
1967:Dr.JackPerlow:ModifiedEdgewiseBracket.
1968:Jarabakintroducedpre-angulatedandpre-torquedbracketsforupperanteriors.
1968:P.C.Keslingintroducedtip-edgebracket.
1970:Dr.H.L.Eirew:BracketusingUnitekAlastiKtierings.
8
Early1960s:IvanLeeintroducedpre-torquedbracketdesigninordertoeliminatecomplicated
torquingbendsusedinconventionaledgewisearchwire.
1967:Dr.JackPerlow:ModifiedEdgewiseBracket.
1968:Jarabakintroducedpre-angulatedandpre-torquedbracketsforupperanteriors.
1968:P.C.Keslingintroducedtip-edgebracket.
1970:Dr.H.L.Eirew:BracketusingUnitekAlastiKtierings.
8
1970:Dr.F.FSchudyandG.F.Schudy:BimetricSystemofedgewise.
1971:AndrewsintroducedSWA(StraightWireAppliance)Technique.
1972:Dr.Kameda:KamedanizedBeggBrackets.
1972:Wildman:EdgelockAppliance.
1975:Dr.Kurz:Near-conventionaledgewiseapproachtolingual
mechanics.
1976:ROTH:IntroducedmodifiedSWAtechnique.
9
1971:AndrewsintroducedSWA(StraightWireAppliance)Technique.
1972:Dr.Kameda:KamedanizedBeggBrackets.
1972:Wildman:EdgelockAppliance.
1975:Dr.Kurz:Near-conventionaledgewiseapproachtolingual
mechanics.
1976:ROTH:IntroducedmodifiedSWAtechnique.
9
1976:R.M.Rickettsusedpre-angulatedandpre-torquedbracketsandintroducedBioprogressive
Technique.
1976:Dr.CravenCurz–LingualStraightwireappliance.
1980:HerbertHanson:SPEEDAppliance.
1981:W.J.Thompson:CombinationAnchorageTechniqueorModernBegg.
1982:WilliamThompsondevelopedCombinationbracketsthatinvolvedverticalandhorizontal
slots.
1982:Dr.KinyaFujita:MushroomArch(LingualOrthodontics).
1983:Dr.R.G.Alexander:VariSimplexDiscipline.
10
Technique.
1976:Dr.CravenCurz–LingualStraightwireappliance.
1980:HerbertHanson:SPEEDAppliance.
1981:W.J.Thompson:CombinationAnchorageTechniqueorModernBegg.
1982:WilliamThompsondevelopedCombinationbracketsthatinvolvedverticalandhorizontal
slots.
1982:Dr.KinyaFujita:MushroomArch(LingualOrthodontics).
1983:Dr.R.G.Alexander:VariSimplexDiscipline.
10
1985:Dr.RichardHocevar:BEDDTIOTTechnique.
1989:ThomasCreekmore:LingualMechanicalAppliance(CONCEAL).
1990:Dual Environmental Bracket.
1991: Dr. V. P. Jayade : J-Bracket
1992:Kazuto et al, 1994: Friction Free Bracket.
1993:Irwin Fletcher: ACTIVA Appliance.
11
1989:ThomasCreekmore:LingualMechanicalAppliance(CONCEAL).
1990:Dual Environmental Bracket.
1991: Dr. V. P. Jayade : J-Bracket
1992:Kazuto et al, 1994: Friction Free Bracket.
1993:Irwin Fletcher: ACTIVA Appliance.
11
1996:Time Bracket.
1997:John C. Voudoris: Interactive Twin Bracket.
1997:Deva Devanthan and James Chudzynski:Nu-edge Bracket.
1998:Viazis : Viazis System.
12
1997:John C. Voudoris: Interactive Twin Bracket.
1997:Deva Devanthan and James Chudzynski:Nu-edge Bracket.
1998:Viazis : Viazis System.
12
CLASSIFICATION OF BRACKETS
ACCORDING TO THE TYPE OF SLOT .
ACCORDING TO THE MODE OF ATTACHMENT .
BASED ON THE MATERIAL USED .
BASED ON THE MORPHOLOGY OF THE BRACKET .
BASED ON THE TECHNIQUE FOR WHICH IT IS USED
13
ACCORDING TO THE TYPE OF SLOT .
ACCORDING TO THE MODE OF ATTACHMENT .
BASED ON THE MATERIAL USED .
BASED ON THE MORPHOLOGY OF THE BRACKET .
BASED ON THE TECHNIQUE FOR WHICH IT IS USED
13
ACCORDING TO THE TYPE OF SLOT :
Ribbon Arch brackets.
Edgewise brackets.
ACCORDING TO THE MODE OF ATTACHMENT :
Weldable brackets.
Bondable brackets.
A. with mesh and
B. with grooves
ACCORDING TO MATERIAL USED :
Metal Brackets
Stainless steel brackets.
Gold –coated brackets.
Platinum coated brackets.
Titanium brackets.
14
Ribbon Arch brackets.
Edgewise brackets.
ACCORDING TO THE MODE OF ATTACHMENT :
Weldable brackets.
Bondable brackets.
A. with mesh and
B. with grooves
ACCORDING TO MATERIAL USED :
Metal Brackets
Stainless steel brackets.
Gold –coated brackets.
Platinum coated brackets.
Titanium brackets.
14
Plastic Brackets
PolyCarbonate brackets
Poly urethane –composite bracket
Thermoplastic –polyurethane bracket.
Ceramic Brackets
Monocrystalline Alumina(Sapphire).
Polycrystalline Alumina.
Polycrystalline Zirconia (YPSZ).
15
PolyCarbonate brackets
Poly urethane –composite bracket
Thermoplastic –polyurethane bracket.
Ceramic Brackets
Monocrystalline Alumina(Sapphire).
Polycrystalline Alumina.
Polycrystalline Zirconia (YPSZ).
15
BASED ON THE TECHNIQUE FOR WHICH IT IS USED
Begglight wire appliance.
Edge wise appliance.
Straight wire appliance.
Tip Edge appliance.
Lingual force adjusted Edge wise appliance.
Varisimplex.
Butterfly system.
BASED ON THE MORPHOLOGY OF THE BRACKET
Siamese
Mini –twin
Single wing
Self ligating
16
Begglight wire appliance.
Edge wise appliance.
Straight wire appliance.
Tip Edge appliance.
Lingual force adjusted Edge wise appliance.
Varisimplex.
Butterfly system.
BASED ON THE MORPHOLOGY OF THE BRACKET
Siamese
Mini –twin
Single wing
Self ligating
16
EVOLUTION OF BRACKET MATERIAL
Initially soft gold was used to manufacture brackets but was soon
replaced by rigid stainless steel.
Later Plastics were introduced in late sixties followed by introduction of
Ceramics in mid eighties.
17
Initially soft gold was used to manufacture brackets but was soon
replaced by rigid stainless steel.
Later Plastics were introduced in late sixties followed by introduction of
Ceramics in mid eighties.
17
ANGLE’S ERA
Initially all attachments were made in noble metals and their alloys
-gold (75%)
-platinum
-iridium
-silver
In 1887 Angle tried replacing the noble metals with German silver (Cu, Ni, Zn) but
ultimately stainless steel replaced these materials.
18
Initially all attachments were made in noble metals and their alloys
-gold (75%)
-platinum
-iridium
-silver
In 1887 Angle tried replacing the noble metals with German silver (Cu, Ni, Zn) but
ultimately stainless steel replaced these materials.
18
METAL BRACKETS
Advantages of the metal brackets –
1.Excellent strength.
2.Reduced friction .
3.Smooth surface finish.
Disadvantages of the metal brackets –
1.Corrosion
2.Not biocompatible.
3.Unesthetic .
19
Advantages of the metal brackets –
1.Excellent strength.
2.Reduced friction .
3.Smooth surface finish.
Disadvantages of the metal brackets –
1.Corrosion
2.Not biocompatible.
3.Unesthetic .
19
GOLD BRACKETS
Advantages;
Biocompatible.
Disadvantages:
Pure gold is soft and cannot be used to make rigid brackets.
Deform under prolonged forces due to low hardness and
stiffness.
Poor Esthetics.
20
Advantages;
Biocompatible.
Disadvantages:
Pure gold is soft and cannot be used to make rigid brackets.
Deform under prolonged forces due to low hardness and
stiffness.
Poor Esthetics.
20
STAINLESS STEEL BRACKETS
Mainly austenitic steel used.
Advantages:
Smooth surfaced brackets with decreased friction.
Good Bond Strength.
Disadvantages:
Un-esthetic.
Corrosion of metal brackets: failure of joint during treatment.
21
Mainly austenitic steel used.
Advantages:
Smooth surfaced brackets with decreased friction.
Good Bond Strength.
Disadvantages:
Un-esthetic.
Corrosion of metal brackets: failure of joint during treatment.
21
PLASTIC BRACKETS
Introduction of new materials like polycarbonates and
polysulfones .
Advantage –
Esthetically acceptable when compared to steel.
Disadvantages-
1.Staining and discoloration.
2.Poor dimensional stability.
3.Undue friction between the bracket slot and the wire,
making sliding mechanics difficult.
4.Need for compatible bonding resin.
5.Cannot be re-cycled.
22
Tooth colored or clear brackets.
Introduction of new materials like polycarbonates and
polysulfones .
Advantage –
Esthetically acceptable when compared to steel.
Disadvantages-
1.Staining and discoloration.
2.Poor dimensional stability.
3.Undue friction between the bracket slot and the wire,
making sliding mechanics difficult.
4.Need for compatible bonding resin.
5.Cannot be re-cycled.
22
Tooth colored or clear brackets.
Plastic brackets
Silkon/SilkonPlus (American Orthodontics)
Elation (GAC)
Spirit MB (Ormco)
Composite bracket
Aesthetikline/Brilliant (Forestadent)
23
Silkon/SilkonPlus (American Orthodontics)
Elation (GAC)
Spirit MB (Ormco)
Composite bracket
Aesthetikline/Brilliant (Forestadent)
23
MAGNETIC BRACKETS
Produce minimum stress that occurred as a result of tooth movement.
When applied to tooth movement, initially the forces are light and once tooth starts moving,
the forces increase as the distance between magnets decreases.
Advantages:
Decreased treatment time.
Bone remodeling due to production of electro-current.
Painless.
Disadvantages:
Increased cost .
Magnetic force alone is insufficient to move teeth more than 3mm. Elastic chain must be
added.
24
Aluminum-Nickel-Cobalt magnets used.
Produce minimum stress that occurred as a result of tooth movement.
When applied to tooth movement, initially the forces are light and once tooth starts moving,
the forces increase as the distance between magnets decreases.
Advantages:
Decreased treatment time.
Bone remodeling due to production of electro-current.
Painless.
Disadvantages:
Increased cost .
Magnetic force alone is insufficient to move teeth more than 3mm. Elastic chain must be
added.
24
Aluminum-Nickel-Cobalt magnets used.
CERAMIC BRACKETS
These were introduced in early 1980’s
Zulauf’sbrackets:opaque and bulky .
Earlier ceramic brackets were made of alumina( Brittle)
Later Zirconia bracketswere introduced -
-Surface hardening treatment was done
-Lower Young’s modulus
-Higher overall strength
Disadvantage –
Increased coefficient of friction
25
These were introduced in early 1980’s
Zulauf’sbrackets:opaque and bulky .
Earlier ceramic brackets were made of alumina( Brittle)
Later Zirconia bracketswere introduced -
-Surface hardening treatment was done
-Lower Young’s modulus
-Higher overall strength
Disadvantage –
Increased coefficient of friction
25
Ceramic Brackets
Mystique/ In-ovation (GAC)
INVU (TP Orthodontics)
Clarity (3M Unitek)
Radiance (American Orthodontics)
Inspire Ice (Ormco)
Pure (Orthotech)
Signature (Rocky mountain)
26
Mystique/ In-ovation (GAC)
INVU (TP Orthodontics)
Clarity (3M Unitek)
Radiance (American Orthodontics)
Inspire Ice (Ormco)
Pure (Orthotech)
Signature (Rocky mountain)
26
Advantages of ceramic brackets over plastic-
1.Stain resistant.
2.Durable .
3.Good dimensional stability.
4.Custom moulded for individual teeth.
5.Allowed incorporation of the SWA
feature.
27
1.Stain resistant.
2.Durable .
3.Good dimensional stability.
4.Custom moulded for individual teeth.
5.Allowed incorporation of the SWA
feature.
27
Disadvantages
1.Fracture
2.Hardness: low
3.Bulkier
4.High friction
5.Enamel damage at the time of removal
28
1.Fracture
2.Hardness: low
3.Bulkier
4.High friction
5.Enamel damage at the time of removal
28
COMPOSITE BRACKET
Twoormorepolymers.
Thesehavepropertiesintermediatebetweenthoseoftheconstituents.
Materialsshouldbesochosenthatthepropertyofoneconstituentimprovesthe
deficientpropertyofothers.
29
Twoormorepolymers.
Thesehavepropertiesintermediatebetweenthoseoftheconstituents.
Materialsshouldbesochosenthatthepropertyofoneconstituentimprovesthe
deficientpropertyofothers.
29
30
TITANIUM BRACKETS
Alternative to stainless steel
-in patients who had sensitivity to Ni.
Advantages-
-Greatest Corrosion Resistance.
-Excellent biocompatibility.
-Small size
-Matte finish ,blends better
with the tooth.
-Low thermal conductivity
-No metallic taste.
.
REMATITAN BRACKETS
TITANIUM BRACKETS
Alternative to stainless steel
-in patients who had sensitivity to Ni.
Advantages-
-Greatest Corrosion Resistance.
-Excellent biocompatibility.
-Small size
-Matte finish ,blends better
with the tooth.
-Low thermal conductivity
-No metallic taste.
.
REMATITAN BRACKETS
Disadvantages –
-Difficult to fabricate.
-Not as esthetic as stainless steel.
-Fluoridated toothpastes corrode titanium
31
-Difficult to fabricate.
-Not as esthetic as stainless steel.
-Fluoridated toothpastes corrode titanium
31
EVOLUTION OF
FIXED APPLIANCES
&
BRACKETS
32
FIXED APPLIANCES
&
BRACKETS
32
33
PIERRE FAUCHARD’S ORTHODONTIC APPLIANCE(Bandellette) : 1728
DWINELLE’S JACK SCREW: 1849
PIERRE FAUCHARD’S ORTHODONTIC APPLIANCE(Bandellette) : 1728
DWINELLE’S JACK SCREW: 1849
34
ANGLE’S RETRACTION SCREW :1887
ANGLE’S RETRACTION SCREW :1887
ANGLE SYSTEM
35
A standard appliance must have five important properties-
1.Simple
2.Stable
3.Efficiency
4.Delicate
5.Inconspicuous
Patient Orthodontist
Manufacturer / supplier
35
A standard appliance must have five important properties-
1.Simple
2.Stable
3.Efficiency
4.Delicate
5.Inconspicuous
Patient Orthodontist
Manufacturer / supplier
E Arch -1905
36
Basic E arch
•Used for tipping tooth crowns into proper
alignment.
Disadvantage:
Provides no axial tooth control.
36
Basic E arch
•Used for tipping tooth crowns into proper
alignment.
Disadvantage:
Provides no axial tooth control.
Ribbed E –arch
37
37
E ARCH WITHOUT THREADED ENDS
38
38
E ARCH WITH HOOKS
39
39
PIN AND TUBE-1910
40
•Can precisely position each
tooth.
•Vertical Tube parallel to long axis
of tooth.
Disadvantages:
Limited mesio-distal crown
displacement.
40
•Can precisely position each
tooth.
•Vertical Tube parallel to long axis
of tooth.
Disadvantages:
Limited mesio-distal crown
displacement.
THE RIBBON ARCH-1915
41
41
42
•First appliance to provide three axis control of tooth movement.
•A Light-wire appliance.
•Widest cross-section: 0.9mm.
•Had vertical slot .
•Held in place by a lock-pin in each bracket with arch ends in molar
tubes.
Advantages:
•Rotations were obtained.
•Offered control over occluso-gingival movements.
Disadvantages:
•Difficult mesio-distal axial movement .
•Poor stabilization or anchorage for posterior teeth.
•First appliance to provide three axis control of tooth movement.
•A Light-wire appliance.
•Widest cross-section: 0.9mm.
•Had vertical slot .
•Held in place by a lock-pin in each bracket with arch ends in molar
tubes.
Advantages:
•Rotations were obtained.
•Offered control over occluso-gingival movements.
Disadvantages:
•Difficult mesio-distal axial movement .
•Poor stabilization or anchorage for posterior teeth.
EDGEWISE APPLIANCE & BRACKETS
43
EdgewiseAppliance:Itisafixed,multi-unitorthodonticapplianceusingarectangularlabial
archwireligatedtobracketscementedtoindividualteethortobandsencirclingtheteeth.
Socalledbecausethebracketismachinedsuchthattherectangulararchwireisinsertedwith
itslongcrosssectionhorizontalinsteadofverticalasintheribbonarchbracket.
ItwasintroducedbyEdwardAnglein1928.
Itofferscompletecontroloveraxialinclinationofallteethinalldirections.Thus,theappliance
controlshorizontaltoothmovementsofrootandcorrectsabnormalinclinationsofteeth.
Insteadofusinglockpins,thearchwirewasheldtoslotsusingligaturewire.
Both rectangular and round wires might be used for mesial or distal tipping but for bucco-
lingual tipping, rectangular wires are preferred.
43
EdgewiseAppliance:Itisafixed,multi-unitorthodonticapplianceusingarectangularlabial
archwireligatedtobracketscementedtoindividualteethortobandsencirclingtheteeth.
Socalledbecausethebracketismachinedsuchthattherectangulararchwireisinsertedwith
itslongcrosssectionhorizontalinsteadofverticalasintheribbonarchbracket.
ItwasintroducedbyEdwardAnglein1928.
Itofferscompletecontroloveraxialinclinationofallteethinalldirections.Thus,theappliance
controlshorizontaltoothmovementsofrootandcorrectsabnormalinclinationsofteeth.
Insteadofusinglockpins,thearchwirewasheldtoslotsusingligaturewire.
Both rectangular and round wires might be used for mesial or distal tipping but for bucco-
lingual tipping, rectangular wires are preferred.
EDGEWISE APPLIANCE
Slot=0.022”X0.028”
0.050 Inch wide
Gold bracket
Gold band
Ligature tie
44
ORIGINAL EDGEWISEATTACHMENTS
A. WINGLESS ANTERIOR BRACKET
B. PROTOTYPE OF PRESENT
EDGEWISE BRACKETS.
E. STAPLES.
G. WASHERS THAT CAN BE THREADED ON ARCH TO CONTROL SPACE.
Slot=0.022”X0.028”
0.050 Inch wide
Gold bracket
Gold band
Ligature tie
44
ORIGINAL EDGEWISEATTACHMENTS
A. WINGLESS ANTERIOR BRACKET
B. PROTOTYPE OF PRESENT
EDGEWISE BRACKETS.
E. STAPLES.
G. WASHERS THAT CAN BE THREADED ON ARCH TO CONTROL SPACE.
EDGEWISE BRACKETS
Theyareusedonthelabialorbuccalsurfacesofeverytooth(exceptlastmolar).
Thebracketshavehorizontalslotsforthearchwire,withupperandlowerwings
forligation.
Thearchwireistiedtothebracketbymeansofasoftligaturewirewiththe
wings.
45
Theyareusedonthelabialorbuccalsurfacesofeverytooth(exceptlastmolar).
Thebracketshavehorizontalslotsforthearchwire,withupperandlowerwings
forligation.
Thearchwireistiedtothebracketbymeansofasoftligaturewirewiththe
wings.
45
THREE DIMENSIONAL CONTROL OF
TOOTH
First order bends: In & Out.
Second order bends: Tip.
Third order bends: Torque.
46
TOOTH
First order bends: In & Out.
Second order bends: Tip.
Third order bends: Torque.
46
MODIFICATIONS
IN
ORIGINAL EDGEWISE
47
IN
ORIGINAL EDGEWISE
47
1.SINGLE WIDTH.
2.TWIN BRACKET.
3.REVERSE BASE CURVED TWIN.
4.LEWIS BRACKET.
5.ANTI TIP LEWIS BRACKET
6.VERTICAL SLOT LEWIS BRACKET.
7.CURVED BASE LEWIS BRACKET.
8.STEINER.
9.BROSSAURD.
48
2.TWIN BRACKET.
3.REVERSE BASE CURVED TWIN.
4.LEWIS BRACKET.
5.ANTI TIP LEWIS BRACKET
6.VERTICAL SLOT LEWIS BRACKET.
7.CURVED BASE LEWIS BRACKET.
8.STEINER.
9.BROSSAURD.
48
SINGLE WIDTH BRACKET
Angleadvisedsolderingofgoldeyeletswhichwereplacedonorthodonticbandtobringabout
toothrotation.
Ligaturewiresweretiedfromtheeyelettothearchwireandrotatedthetooth.
Disadvantage:
Therewasneedofrepeatedtyingofeyeletsthroughoutthetreatmentinordertoprevent
relapseofrotation.
49
Angleadvisedsolderingofgoldeyeletswhichwereplacedonorthodonticbandtobringabout
toothrotation.
Ligaturewiresweretiedfromtheeyelettothearchwireandrotatedthetooth.
Disadvantage:
Therewasneedofrepeatedtyingofeyeletsthroughoutthetreatmentinordertoprevent
relapseofrotation.
49
TWIN BRACKETS
Two edgewise brackets were joined together on the same base during manufacturing
process.
They were named as ‘Siamese Twin Brackets’by Dr. Brainerd Swain:1952.
Space between two brackets: 0.050”i.e. equal to the width of one bracket.
Advantage:
Ability to bring about rotation without using auxiliary eyelet ties.
Initially, could be used only on maxillary central incisors and molars.
Later four more designs were introduced so that they could be used on all the teeth.
50
Two edgewise brackets were joined together on the same base during manufacturing
process.
They were named as ‘Siamese Twin Brackets’by Dr. Brainerd Swain:1952.
Space between two brackets: 0.050”i.e. equal to the width of one bracket.
Advantage:
Ability to bring about rotation without using auxiliary eyelet ties.
Initially, could be used only on maxillary central incisors and molars.
Later four more designs were introduced so that they could be used on all the teeth.
50
TWIN BRACKETS
51
51
52
TWIN BRACKETS
ADVANTAGES
•Effective tooth rotation.
•Good control on axial inclination.
•Once the tooth is rotated, mere tying of bracket ligature wire would maintain the
tooth in its corrected position rather that re-tying the ligature, in order to prevent the
relapse.
•Frictional resistance is more and tendency for forward tipping is decreased.
DISADVANTAGES
•Loss of inter-bracket distance creates insufficient space of first and second order
bends.
•Decreased resiliency of wire between brackets.
TWIN BRACKETS
ADVANTAGES
•Effective tooth rotation.
•Good control on axial inclination.
•Once the tooth is rotated, mere tying of bracket ligature wire would maintain the
tooth in its corrected position rather that re-tying the ligature, in order to prevent the
relapse.
•Frictional resistance is more and tendency for forward tipping is decreased.
DISADVANTAGES
•Loss of inter-bracket distance creates insufficient space of first and second order
bends.
•Decreased resiliency of wire between brackets.
CURVED BASE TWIN BRACKETS
The base of twin bracket was curved to adapt to the curvatures of canines
and pre-molars.
53
The base of twin bracket was curved to adapt to the curvatures of canines
and pre-molars.
53
LEWIS BRACKET
He soldered auxiliary
rotation armthat abutted
against the bracket itself
and thus offered a lever
arm to deflect arch wire
and rotate the teeth
54
He soldered auxiliary
rotation armthat abutted
against the bracket itself
and thus offered a lever
arm to deflect arch wire
and rotate the teeth
54
LEWIS BRACKET
Advantages:
Does not interfere with resiliency ,closing loops &second order bends.
100% correction & over corrections.
Quick and easier method than twin brackets.
Disadvantage:
Less control of axial rotation than twin brackets.
55
Advantages:
Does not interfere with resiliency ,closing loops &second order bends.
100% correction & over corrections.
Quick and easier method than twin brackets.
Disadvantage:
Less control of axial rotation than twin brackets.
55
ANTI-TIP LEWIS BRACKET
It has notches or slots in the ends of the wings of brackets and therefore attach to a
wider area of contact.
Used mainly adjacent to extraction spaces and maxillary lateral incisors.
Advantages:
Control over axial inclination good.
Available in both large and short sizes to
accommodate small and big teeth.
56
It has notches or slots in the ends of the wings of brackets and therefore attach to a
wider area of contact.
Used mainly adjacent to extraction spaces and maxillary lateral incisors.
Advantages:
Control over axial inclination good.
Available in both large and short sizes to
accommodate small and big teeth.
56
CURVED WING LEWIS BRACKET
Therewascurvingofthebaseand
wingsofthebrackettoadaptto
caninesandpre-molars.
ADVANTAGES
1.Increasecontactwithband.
2.Reducestrappingofthefood.
57
Therewascurvingofthebaseand
wingsofthebrackettoadaptto
caninesandpre-molars.
ADVANTAGES
1.Increasecontactwithband.
2.Reducestrappingofthefood.
57
VERTICAL SLOT LEWIS BRACKET
Here further refinement was done by incorporating a .020 x .020 vertical slot.
Use of uprighting spring to correct axial inclination possible.
58
Here further refinement was done by incorporating a .020 x .020 vertical slot.
Use of uprighting spring to correct axial inclination possible.
58
BURSTONE SEGMENTAL ARCH
TECHNIQUE BRACKETS
He modified canine brackets by inserting a vertical tube for insertion of
retraction assemblies.
Molar and Second Pre-molar brackets were designed.
59
Edgewiseslot:.022x.028.
AuxiliaryVerticalTube:.017x.025vertical
auxiliarytube.
TECHNIQUE BRACKETS
He modified canine brackets by inserting a vertical tube for insertion of
retraction assemblies.
Molar and Second Pre-molar brackets were designed.
59
Edgewiseslot:.022x.028.
AuxiliaryVerticalTube:.017x.025vertical
auxiliarytube.
Thisbracketincorporatedflexiblerotationarmsandthereforedidnotrely
entirelyontheresiliencyofarchwirefortoothrotation.
Itusesasinglewidthedgewisebracketandhastheinherentadvantageand
disadvantageofthesame.
60
STEINER BRACKET
entirelyontheresiliencyofarchwirefortoothrotation.
Itusesasinglewidthedgewisebracketandhastheinherentadvantageand
disadvantageofthesame.
60
STEINER BRACKET
BROUSSARD BRACKET
Designedby“GrayfordBroussard”,1978.
Modifiededgewisebracketinwhichthereisadditionof
0.0185x0.046slot–toaccept0.018auxiliarywire
specialtorquebrackets.-0,7˚,17˚,22˚
Features –
-quick wing .
-vertical slot.
-round corners, smooth surface.
-horizontal slot.
-insert pin.
61
Designedby“GrayfordBroussard”,1978.
Modifiededgewisebracketinwhichthereisadditionof
0.0185x0.046slot–toaccept0.018auxiliarywire
specialtorquebrackets.-0,7˚,17˚,22˚
Features –
-quick wing .
-vertical slot.
-round corners, smooth surface.
-horizontal slot.
-insert pin.
61
THE UNIVERSAL BRACKET
DevelopedbyDr.SpencerR.Atkinson,1931.
Itisamulti-bandedappliancehavingbracketsandbuccaland
lingualsheathsasitsprincipalattachments.
IthasbeencalledUniversalsince,differenttechniquescan
beusedwithit.
Ithasbeendesignedtoproducetoothmovementinthe
threeplanesofspace.
Centralshafttoonarrowandshallow.
Appliancehasundergoneperiodicrefinementswithout
losingitsessentialfeatures.
62
DevelopedbyDr.SpencerR.Atkinson,1931.
Itisamulti-bandedappliancehavingbracketsandbuccaland
lingualsheathsasitsprincipalattachments.
IthasbeencalledUniversalsince,differenttechniquescan
beusedwithit.
Ithasbeendesignedtoproducetoothmovementinthe
threeplanesofspace.
Centralshafttoonarrowandshallow.
Appliancehasundergoneperiodicrefinementswithout
losingitsessentialfeatures.
62
Design-
-Vertical hollow shaft with two lateral welding tabs.
-Central shaft has two slot openings :
1.Horizontal –Opens labially at gingival third.
2.Vertical–opens incisally and extends gingivally
one third of the bracket height.
Gingival slot can only hold round wire (.008 -.016)
Incisal slot can hold single round, double round, twisted bundle of round, single
ribbon flat wire (.008x.020 up to .016x.028)
Wider mesiodistally and deeper buccolingually.
63
-Vertical hollow shaft with two lateral welding tabs.
-Central shaft has two slot openings :
1.Horizontal –Opens labially at gingival third.
2.Vertical–opens incisally and extends gingivally
one third of the bracket height.
Gingival slot can only hold round wire (.008 -.016)
Incisal slot can hold single round, double round, twisted bundle of round, single
ribbon flat wire (.008x.020 up to .016x.028)
Wider mesiodistally and deeper buccolingually.
63
Combinationofverticalandhorizontalslotsprovidestheappliancewithfullcontrolinthree
planesofspace.
Incisalwire:
Rotations
Levelling
Torque
Guidingrailwhencoilspringsareusedatgingivallevel.
Gingivalwire:
M-Daxialinclinations
Guidewhenteetharemovedbodily
Fulcrumforlabio-lingualmovements
Leveling
64
planesofspace.
Incisalwire:
Rotations
Levelling
Torque
Guidingrailwhencoilspringsareusedatgingivallevel.
Gingivalwire:
M-Daxialinclinations
Guidewhenteetharemovedbodily
Fulcrumforlabio-lingualmovements
Leveling
64
To exert extra force, ‘Double action’type of
brackets can be used which have tabs or
wings between the occlusal and gingival
wire slots
Root Torquing type:Tabs extend outward to
allow extra ligation for excessive rotations
and provide extended leverage for mesio-
distal axial uprightingof teeth.
Two Curved brackets are used on maxillary
central incisors. In others, single curved
bracket is used.
65
brackets can be used which have tabs or
wings between the occlusal and gingival
wire slots
Root Torquing type:Tabs extend outward to
allow extra ligation for excessive rotations
and provide extended leverage for mesio-
distal axial uprightingof teeth.
Two Curved brackets are used on maxillary
central incisors. In others, single curved
bracket is used.
65
Double Molar Sheaths : Used on molars to receive ribbon arch wires .
Horizontal Lingual Sheaths: Used on lingual surfaces of molars to receive ribbon
arch wires.
66
Horizontal Lingual Sheaths: Used on lingual surfaces of molars to receive ribbon
arch wires.
66
Thus,byexertingdoubleactionandwithboththewires(in
occclusal&gingivalslots)actingalongwitheachother,the
UniversalBracketsbecomeafourdimensionalappliancethat
offer:
Toothmovementandguidanceinamesio-distalandbucco-
lingualaspects;
Rotationonitsaxisand
Movementinaverticalplane.
67
occclusal&gingivalslots)actingalongwitheachother,the
UniversalBracketsbecomeafourdimensionalappliancethat
offer:
Toothmovementandguidanceinamesio-distalandbucco-
lingualaspects;
Rotationonitsaxisand
Movementinaverticalplane.
67
LIGHT WIRE EDGEWISE TECHNIQUE
Jarabak and Fizzel: 1960.
It incorporated second and third order mechanics (tip and torque) in the
original edgewise appliance.
It controlled forces obtained from high deflection spring orthodontic
devices.
68
Jarabak and Fizzel: 1960.
It incorporated second and third order mechanics (tip and torque) in the
original edgewise appliance.
It controlled forces obtained from high deflection spring orthodontic
devices.
68
Itconsistsoftwoedgewisebrackets:
One;Long,cervicalwingtwinedgewisebracket.
Second:JarabakEdgewiseForceControlBracket:Long,edgewisebracketthatis
slottedverticallyatoneendandhorizontallyattheotherend.
HorizontalandVerticalbracketsareusedonlyonmaxillaryandmandibularanterior
teeth.
Advantages:
Exertsaccurateforcecontrolfortipping,rotationandbodilymovementofteeth.
Positiveaxialcontrolovercanineseliminatestheneedforuprightingmechanics.
69
One;Long,cervicalwingtwinedgewisebracket.
Second:JarabakEdgewiseForceControlBracket:Long,edgewisebracketthatis
slottedverticallyatoneendandhorizontallyattheotherend.
HorizontalandVerticalbracketsareusedonlyonmaxillaryandmandibularanterior
teeth.
Advantages:
Exertsaccurateforcecontrolfortipping,rotationandbodilymovementofteeth.
Positiveaxialcontrolovercanineseliminatestheneedforuprightingmechanics.
69
ANDREWS SYSTEM
ANDREWS-father of preadjusted bracket system
The original SWA was introduced byAndrewsin 1972and it had the
features of Siamese edgewise bracket.
Study of 120 non-orthodontic normal cases, 1972
1
st
generation of preadjusted brackets
He recommended a wide range of brackets.
-For extraction cases, canine brackets with anti-tip, anti-rotation, and
power arms for control space closure.
-Three sets of incisor brackets with varying degrees of torque for different
clinical situation.
ANDREWS-father of preadjusted bracket system
The original SWA was introduced byAndrewsin 1972and it had the
features of Siamese edgewise bracket.
Study of 120 non-orthodontic normal cases, 1972
1
st
generation of preadjusted brackets
He recommended a wide range of brackets.
-For extraction cases, canine brackets with anti-tip, anti-rotation, and
power arms for control space closure.
-Three sets of incisor brackets with varying degrees of torque for different
clinical situation.
SWA BRACKET
However, early results with Straight-wire Appliance were disappointing.
Traditional heavy edgewise forces continued to be used
WAGONWHEEL EFFECT
Tip is lost as torque is added(1:4)
Traditional heavy edgewise forces continued to be used
WAGONWHEEL EFFECT
Tip is lost as torque is added(1:4)
ROLLER COASTER EFFECT
Andrews described 3 system of brackets
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
75
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
75
Features of standard brackets
1.Slot siting feature
2.Convenience feature
3.Auxiliary feature
76
1.Slot siting feature
2.Convenience feature
3.Auxiliary feature
76
1)SlotsitingfeatureTheyaredescribedin3planesofspace.
a)Midtransverseplane:Themidtransverseplaneofslotandcrownshould
bethesame.
Toachievethis,thefollowingsitingfeaturesarerequired–
Feature1:Themidtransverseplanesoftheslot,stemandcrownmustbethe
same.
77
a)Midtransverseplane:Themidtransverseplaneofslotandcrownshould
bethesame.
Toachievethis,thefollowingsitingfeaturesarerequired–
Feature1:Themidtransverseplanesoftheslot,stemandcrownmustbethe
same.
77
Feature 2 :The base of the bracket for each tooth type must
have the same inclination as the facial plane of the crown at
the FA point.
78
have the same inclination as the facial plane of the crown at
the FA point.
78
Feature 3 :Each brackets inclined base must be contoured
occlusogingivallyto match the curvature of the crown.
79
occlusogingivallyto match the curvature of the crown.
79
b)MidSagittalplane:Themidsagittalplaneofeachslot
muchsuperimposeonafacialextensionofthecrownsmid
sagittalplane.
c)Midfrontalplane:Themidfrontalplaneofeachslot
mustsuperimposeonitscrown’sprominenceplane.
80
muchsuperimposeonafacialextensionofthecrownsmid
sagittalplane.
c)Midfrontalplane:Themidfrontalplaneofeachslot
mustsuperimposeonitscrown’sprominenceplane.
80
2) Convience feature :
These features make the appliance easier for the orthodontist to use and
sometimes more comfortable for the patient.
The gingival bases on posterior brackets are designed to extend laterally thus
facilitating ligation and eliminating gingival impingement.
81
These features make the appliance easier for the orthodontist to use and
sometimes more comfortable for the patient.
The gingival bases on posterior brackets are designed to extend laterally thus
facilitating ligation and eliminating gingival impingement.
81
Since the bases are inclined, the stem and the wings of mandibular
premolars and molars are directed more gingivally. This eliminates
occlusal interferences.
Identification : Fully programmed brackets are tooth types because they
are so much smaller than teeth, their differences are not always readily
visible without special markings.
82
premolars and molars are directed more gingivally. This eliminates
occlusal interferences.
Identification : Fully programmed brackets are tooth types because they
are so much smaller than teeth, their differences are not always readily
visible without special markings.
82
3)Auxiliaryfeatures:
Thesecontributetothebiologicaspectoftreatment
ForEg:
Powerarms
hooks
facebowtubes
utilitytubes
rotationwings.
83
Thesecontributetothebiologicaspectoftreatment
ForEg:
Powerarms
hooks
facebowtubes
utilitytubes
rotationwings.
83
ANDREWS SYSYEM
Andrews described 3 system of brackets
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
84
Andrews described 3 system of brackets
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
84
Translation/Extractionseries:
Translationisdefinedasuniformmotionofabodyinastraightline.Forsucha
movementtooccurtheforcemustbeappliedtotheobjectsCR.UnfortunatelyCR
oftoothisinrootsfromthestandardpointofphysics,bracketlocatedonthe
crownofatoothisinthewrongplacetobringabouttranslation.
Thebracketisocclusal/incisaltothetoothCR,sowhenaforceisapplied,tooth
insteadoftranslation,willtendtorotatearoundcenterofrotation.
Thuswhentheteethweretranslated,toovercomeproblemslikemesial/distaltip
androtationofteethadjacenttothesite,Andrewsintroducedthetranslation
seriesofbracketsin1972.
85
Translationisdefinedasuniformmotionofabodyinastraightline.Forsucha
movementtooccurtheforcemustbeappliedtotheobjectsCR.UnfortunatelyCR
oftoothisinrootsfromthestandardpointofphysics,bracketlocatedonthe
crownofatoothisinthewrongplacetobringabouttranslation.
Thebracketisocclusal/incisaltothetoothCR,sowhenaforceisapplied,tooth
insteadoftranslation,willtendtorotatearoundcenterofrotation.
Thuswhentheteethweretranslated,toovercomeproblemslikemesial/distaltip
androtationofteethadjacenttothesite,Andrewsintroducedthetranslation
seriesofbracketsin1972.
85
Thesebracketshadallqualitiesofstandardbracketsandsomeadditional
featureslike–
1)Counterrotation:
Thisfactorisbuiltbyrotationoftheslotarounditsverticalaxisinthe
directionithastobetranslated.
Foranefficienttransferofforcefromthebracketslottothecenterofthe
crownforrotation,themesialordistallengthofthebracketshouldbeequal
todistancefromtheslotpointtothetoothsverticalaxis.
<2mmMinimumtranslationbracket-2°
2-4mmMediumtranslationbracket-4°
>4mmMaximumtranslationbracket-6°
86
featureslike–
1)Counterrotation:
Thisfactorisbuiltbyrotationoftheslotarounditsverticalaxisinthe
directionithastobetranslated.
Foranefficienttransferofforcefromthebracketslottothecenterofthe
crownforrotation,themesialordistallengthofthebracketshouldbeequal
todistancefromtheslotpointtothetoothsverticalaxis.
<2mmMinimumtranslationbracket-2°
2-4mmMediumtranslationbracket-4°
>4mmMaximumtranslationbracket-6°
86
2)CounterMesiodistaltip:
Thiswasincorporatedtopreventthecrownfromrotatingwhentranslated.Itwas
donebyincreasingordecreasingtheangulationoftheslot.
Minimum translation 2°
Medium translation 3°
Maximum translation 4°
ThecounterMesiodistaltipofthebracketwillnotbesufficienttooppose
thetipoftheteethduringtranslation,becausethemesiodistalwidthofthe
bracketisnotequaltothedistancefromtheslotpointtotheCRoftooth.Thusa
gingivalextension(powerarm)isaddedfordeficientlengthofthebracket.
87
Thiswasincorporatedtopreventthecrownfromrotatingwhentranslated.Itwas
donebyincreasingordecreasingtheangulationoftheslot.
Minimum translation 2°
Medium translation 3°
Maximum translation 4°
ThecounterMesiodistaltipofthebracketwillnotbesufficienttooppose
thetipoftheteethduringtranslation,becausethemesiodistalwidthofthe
bracketisnotequaltothedistancefromtheslotpointtotheCRoftooth.Thusa
gingivalextension(powerarm)isaddedfordeficientlengthofthebracket.
87
Identification:
BracketsarecolourcodedbasedonQuadrants.
U–RightQuadrantBlackdotondistogingivalwing.
U–LeftQuadrantGreendotondistogingivalwing.
L–RightQuadrantReddotondistogingivalwing.
L–LeftQuadrantWhitedotondistogingivalwing.
Lowercentralandlateralbracketsdonothavecoloreddots,butinsteadare
bevelledocclusally.
88
BracketsarecolourcodedbasedonQuadrants.
U–RightQuadrantBlackdotondistogingivalwing.
U–LeftQuadrantGreendotondistogingivalwing.
L–RightQuadrantReddotondistogingivalwing.
L–LeftQuadrantWhitedotondistogingivalwing.
Lowercentralandlateralbracketsdonothavecoloreddots,butinsteadare
bevelledocclusally.
88
89
Andrew’s prescription
Andrew’s prescription
PART 2
90
90
PART 2
CONTENTS
ROTH
MBT
TIP EDGE
ALEXANDER
DUAL ENVIRONMENTAL BRACKET
BEGG APPLIANCE
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES
.
MODERNIZED BEGG
COMBINATION SYSTEM
THE BEDDTIOT APPLIANCE.
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF-LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT
GENERATION
CONCLUSION.
BIBLIOGRAPHY.
91
CONTENTS
ROTH
MBT
TIP EDGE
ALEXANDER
DUAL ENVIRONMENTAL BRACKET
BEGG APPLIANCE
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES
.
MODERNIZED BEGG
COMBINATION SYSTEM
THE BEDDTIOT APPLIANCE.
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF-LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT
GENERATION
CONCLUSION.
BIBLIOGRAPHY.
91
ROTH PRESCRIPTION
It was introduced in early 1970’s after a five year clinical evaluation
of the Andrews Straight Wire Appliance
WORK OF ROTH
To avoid inventory difficulties of multiple bracket system,
ROTH recommended a single appliance system to manage
both extraction and non-extraction cases.
92
It was introduced in early 1970’s after a five year clinical evaluation
of the Andrews Straight Wire Appliance
WORK OF ROTH
To avoid inventory difficulties of multiple bracket system,
ROTH recommended a single appliance system to manage
both extraction and non-extraction cases.
92
Roth prescription
94
94
MBT SYSTEM
Rangeofbracket:Themodernorthodontistexpectstohave3mainbracket
systemavailabletomeettheneedsofatypicalcaseload.
Standardsizemetalbracketswherecontrolisthemainrequirement.
MidsizedbracketsGiveslesscontrol,usedonaveragesmallteeth.
Estheticbracketsneededforolderpatients,wheremetalappearanceisnot
acceptable.
Rhomboidalshape:
TheoriginalrectangularshapeisconvertedintoRhomboidalshapesothatthe
bulkofthebracketisreducedandallowsreferenceslinesinboththeHorizontal
andVerticalplanestherebyarrestingtheaccuracyofbracketplacement.
95
Rangeofbracket:Themodernorthodontistexpectstohave3mainbracket
systemavailabletomeettheneedsofatypicalcaseload.
Standardsizemetalbracketswherecontrolisthemainrequirement.
MidsizedbracketsGiveslesscontrol,usedonaveragesmallteeth.
Estheticbracketsneededforolderpatients,wheremetalappearanceisnot
acceptable.
Rhomboidalshape:
TheoriginalrectangularshapeisconvertedintoRhomboidalshapesothatthe
bulkofthebracketisreducedandallowsreferenceslinesinboththeHorizontal
andVerticalplanestherebyarrestingtheaccuracyofbracketplacement.
95
Standard
Midsize
esthetic
Midsize
esthetic
MBT SYSTEM
Work of Mclaughlin & Bennet between 1975 & 1993
Work of Mclaughlin & Bennet between 1975 & 1993
WORK OF MCLAUGHLIN,BENNET& TREVISI
BETWEEN 1997 & 2001
BETWEEN 1997 & 2001
99
100
101
MBT prescription
102
102
TIP EDGE
IntroducedbyPeterKesling,1988basedonhisexperienceswithdifferential
toothmovement
Bracketsdesignedtopromotedistalcrowntippingonallteethexceptthose
distaltotheextractionsite.
Theslotisprogrammedtobringaboutmesialordistalcrowntippingatthesame
timecontrolfinalcrowninclination.
However,thebracketexertsautomaticcontrolduetoitsslotdesignandalso
applicationofauniqueelastomerictip-edgering,
anuprightingspringandarectangulararchwire.
103
IntroducedbyPeterKesling,1988basedonhisexperienceswithdifferential
toothmovement
Bracketsdesignedtopromotedistalcrowntippingonallteethexceptthose
distaltotheextractionsite.
Theslotisprogrammedtobringaboutmesialordistalcrowntippingatthesame
timecontrolfinalcrowninclination.
However,thebracketexertsautomaticcontrolduetoitsslotdesignandalso
applicationofauniqueelastomerictip-edgering,
anuprightingspringandarectangulararchwire.
103
BASIC DESIGN
It has aunique arch wire slot: Bevelled diagonally opposed corners of the
conventional edgewise archwire slot.
-slot size is .022 x.028
-lateral extensions or wings
-vertical slot .020 x.020
-deep grooves
104
TS: TIPPING SURFACE
US: UPRIGHTING SURFACE
CR: CENTRAL RIDGES
It has aunique arch wire slot: Bevelled diagonally opposed corners of the
conventional edgewise archwire slot.
-slot size is .022 x.028
-lateral extensions or wings
-vertical slot .020 x.020
-deep grooves
104
TS: TIPPING SURFACE
US: UPRIGHTING SURFACE
CR: CENTRAL RIDGES
AdvantagesofTip-EdgeBrackets
Canstopfreedistaltippingofcanines.
Providesautomaticmesio-distaltipcontrol.
Absenceofparallelsurfacesinarchwireslotreducestheactionofundesired
mesialordistalroottorquingforcesduringoverbitecorrection.
Permitsretractionofbothdentalarches,whereverrequired(ClassIbimaxillary
malocclusion).
Permitsclosureofextractionspaces.
Theuniqueslotcanstopmesialordistalcrowntippingatapre-determined
inclinationandthus,increasetheanchoragepotentialofteeth.
Theslotmayalsofunctionasshockabsorbertohighlevelsoftorqueandmesio-
distaluprightingforces
105
Canstopfreedistaltippingofcanines.
Providesautomaticmesio-distaltipcontrol.
Absenceofparallelsurfacesinarchwireslotreducestheactionofundesired
mesialordistalroottorquingforcesduringoverbitecorrection.
Permitsretractionofbothdentalarches,whereverrequired(ClassIbimaxillary
malocclusion).
Permitsclosureofextractionspaces.
Theuniqueslotcanstopmesialordistalcrowntippingatapre-determined
inclinationandthus,increasetheanchoragepotentialofteeth.
Theslotmayalsofunctionasshockabsorbertohighlevelsoftorqueandmesio-
distaluprightingforces
105
Tippingsurfaceslimitdegreeofinitialcrowntipping;uprighting
surfacescontrolfinaltipandtorque.
106
surfacescontrolfinaltipandtorque.
106
Molar tubes –
.036 round gingival tube.
.022 x .028 occlusal tube.
They are available with –
1.Extraction and non extraction kits.
2.Torque in base/ face.
3.Over rotation bracket.
4.Positioning jigs .
5.Tip edge rings.
107
.036 round gingival tube.
.022 x .028 occlusal tube.
They are available with –
1.Extraction and non extraction kits.
2.Torque in base/ face.
3.Over rotation bracket.
4.Positioning jigs .
5.Tip edge rings.
107
108
TIP EDGE BRACKETS FOR DIFFERENT TEETH
TIP EDGE BRACKETS FOR DIFFERENT TEETH
THE ALEXANDER DISCIPLINE
(VARI SIMPLEX DISCIPLINE)
This system is based on Edgewise philosophy that was developed by
Dr. R.G. Alexander.
VARIrefers to the variety of bracket types used whereas
SIMPLEXrelates to the kiss principle (keep it simple, sir)
PHILOSOPHY OF THE VARI’S SIMPLEX DISCIPLINE:
Thesizesandshapesoftheteethespeciallythemesiodistalwidthandcurvatures
influencetheappropriateinterbracketwidth.
Thebracketsshouldbeselectedsothattheywillprovidefordentalrotationand
archlevelingwithoutthenecessityoftimeconsumingverticalsprings,multiloopsor
extraarchwires.
109
(VARI SIMPLEX DISCIPLINE)
This system is based on Edgewise philosophy that was developed by
Dr. R.G. Alexander.
VARIrefers to the variety of bracket types used whereas
SIMPLEXrelates to the kiss principle (keep it simple, sir)
PHILOSOPHY OF THE VARI’S SIMPLEX DISCIPLINE:
Thesizesandshapesoftheteethespeciallythemesiodistalwidthandcurvatures
influencetheappropriateinterbracketwidth.
Thebracketsshouldbeselectedsothattheywillprovidefordentalrotationand
archlevelingwithoutthenecessityoftimeconsumingverticalsprings,multiloopsor
extraarchwires.
109
Bracket Selection
Specificbrackettypesareassociatedwithspecificteeth.
TwinBrackets:Flatandlargesurfaceofmaxillarycentralandlaterals
allowsfullarchwireengagementinthetwinbracket.
LangBrackets:IntroducedbyHowardLand
Usedonlargeroundsurfacedteethlocatedatthecornersofthearch,
themaxillaryandmandibularcuspids.
Thelangbracketisconstructedinthediamondform,butitisasingle
bracketwithflatrotationalcontrolwings,eachcontaininga
mandibularhole.Theholeincreasetheflexibilityofthewingandcould
beusedforligation.
LewisBracket:RedesignedLewisbracketareusedonround
surfacedteethnotlocatedatthecornersofthearches.(Maxillary
andMandibularbicuspids)aswellassmall,flatsurfacedteeth
(mandibularincisors).
110
Specificbrackettypesareassociatedwithspecificteeth.
TwinBrackets:Flatandlargesurfaceofmaxillarycentralandlaterals
allowsfullarchwireengagementinthetwinbracket.
LangBrackets:IntroducedbyHowardLand
Usedonlargeroundsurfacedteethlocatedatthecornersofthearch,
themaxillaryandmandibularcuspids.
Thelangbracketisconstructedinthediamondform,butitisasingle
bracketwithflatrotationalcontrolwings,eachcontaininga
mandibularhole.Theholeincreasetheflexibilityofthewingandcould
beusedforligation.
LewisBracket:RedesignedLewisbracketareusedonround
surfacedteethnotlocatedatthecornersofthearches.(Maxillary
andMandibularbicuspids)aswellassmall,flatsurfacedteeth
(mandibularincisors).
110
DUAL ENVIRONMENTAL BRACKET
Introducedin1990.
Anewbracketwasdesignedtocapitalizeonthecomputermodelingthat
demonstratedtheadvantagesofsmallwiresandgreaterintra-bracketspace.
Thisnewbrackethasalargerouterslot,formaximumarchwireflexibilityin
theinitialphase,andasmallinnerslotthatacceptssmallrectangularwires
formaximumcontrollaterinthetreatment.
Theouterslotmeasures0.040”fortwinbracketsand0.030”forsingle
brackets.
Theinnerslotcanbeeither0.016”or0.018”.
111
Introducedin1990.
Anewbracketwasdesignedtocapitalizeonthecomputermodelingthat
demonstratedtheadvantagesofsmallwiresandgreaterintra-bracketspace.
Thisnewbrackethasalargerouterslot,formaximumarchwireflexibilityin
theinitialphase,andasmallinnerslotthatacceptssmallrectangularwires
formaximumcontrollaterinthetreatment.
Theouterslotmeasures0.040”fortwinbracketsand0.030”forsingle
brackets.
Theinnerslotcanbeeither0.016”or0.018”.
111
Advantages:
Fasterlevelingofarcheswithfewerarchchanges.
Thelargeposteriorintrabracketspaceallowslessfrictionwithworkingarches,
permittingtheteethtomovemoreeasilybothverticallyandhorizontally.
Easiertorquingofteethwithlessdiscomfort.
Theworkingarchisnotcloselyheldintheposteriorbrackets;itflexeswithinthe
slotandactsasashockabsorbertopreventstrainonthewirefromchewing.
112
Fasterlevelingofarcheswithfewerarchchanges.
Thelargeposteriorintrabracketspaceallowslessfrictionwithworkingarches,
permittingtheteethtomovemoreeasilybothverticallyandhorizontally.
Easiertorquingofteethwithlessdiscomfort.
Theworkingarchisnotcloselyheldintheposteriorbrackets;itflexeswithinthe
slotandactsasashockabsorbertopreventstrainonthewirefromchewing.
112
MODERN BEGG’S
TECHNIQUE.
113
TECHNIQUE.
113
BEGG APPLIANCE
It utilized the ribbon arch type
brackets and was manufactured to
accept 016’ round wire
Wire was held in position with the
lock pins .020 x .045 slot.
114
Dr P.R.Begg ,1956.
It utilized the ribbon arch type
brackets and was manufactured to
accept 016’ round wire
Wire was held in position with the
lock pins .020 x .045 slot.
114
Dr P.R.Begg ,1956.
REFINED BEGG
Brackets used are TP-256-00,
With a depth of .020 and Height of .045
Molar tubes–
Round molar tubes .036 and 6 mm length.
Oval tubes .072 x .024 and 5mm length.
Combination tube (TP Lab)
They consist of a round gingival tube of .036 and 6.2 mm length.
Rectangular .025 x .018 -5.5mm long
115
Brackets used are TP-256-00,
With a depth of .020 and Height of .045
Molar tubes–
Round molar tubes .036 and 6 mm length.
Oval tubes .072 x .024 and 5mm length.
Combination tube (TP Lab)
They consist of a round gingival tube of .036 and 6.2 mm length.
Rectangular .025 x .018 -5.5mm long
115
BUILT IN ADJUSTMENTS
Anti rotational brackets
Built in torque.
Additional round tubes and pins used in Refined Begg
116
Anti rotational brackets
Built in torque.
Additional round tubes and pins used in Refined Begg
116
KAMEDANIZED BEGG
IntroducedbyDrAkira
Kameda,1983.
Heintroducedtorquingand
reversetorquingbracketsin
1983
Ribbonarchbuccaltubein
1986.
117
IntroducedbyDrAkira
Kameda,1983.
Heintroducedtorquingand
reversetorquingbracketsin
1983
Ribbonarchbuccaltubein
1986.
117
In 1983 , he introduced torquing and reverse torquing brackets .Built in torque
adjustments is obtained by raising the incisal or gingival edge of the bracket base
away from the tooth surface.
Advantage of using round buccal tube with a round wire .But it had its own pitfalls-
Free tooth movement is possible ,but anchor molars tend to roll in.
Correcting lingually inclined molars is difficult.
Directing the forces of anchorage bends and bite opening bends is difficult.
118
adjustments is obtained by raising the incisal or gingival edge of the bracket base
away from the tooth surface.
Advantage of using round buccal tube with a round wire .But it had its own pitfalls-
Free tooth movement is possible ,but anchor molars tend to roll in.
Correcting lingually inclined molars is difficult.
Directing the forces of anchorage bends and bite opening bends is difficult.
118
TO OVERCOME THIS PROBLEM KAMEDA INTRODUCED –
RIBBON ARCH BUCCAL TUBES -1986
119
RIBBON ARCH BUCCAL TUBES -1986
119
RIBBON ARCH BUCCAL TUBES -1986
In 1992 JIOS –mentioned that efforts are going on to develop a new type of
KB bracket with a built in T-Pin.Also labiolingual thickness of these KB
brackets are same as non torque brackets, regardless of the 10 ˚ or 20˚built
in torque.
120
TORQUE REGULAR Reverse T
In 1992 JIOS –mentioned that efforts are going on to develop a new type of
KB bracket with a built in T-Pin.Also labiolingual thickness of these KB
brackets are same as non torque brackets, regardless of the 10 ˚ or 20˚built
in torque.
120
TORQUE REGULAR Reverse T
MODERNIZED BEGG-COMBINATION TECHNIQUE:
WILLIAM J. THOMPSON: 1981.
Therationalebehindthisapproachwastodevelopa
techniqueandabracketsystemthatusestheadvantagesofboth
BeggandStraightwireatthesametimeminimizingthe
disadvantages.
Tounderstandtherationalebehindthedevelopmentofthis
appliance,onemustunderstandtheadvantagesanddisadvantages
ofboththeBeggandStraightWireApplianceSystems.
121
WILLIAM J. THOMPSON: 1981.
Therationalebehindthisapproachwastodevelopa
techniqueandabracketsystemthatusestheadvantagesofboth
BeggandStraightwireatthesametimeminimizingthe
disadvantages.
Tounderstandtherationalebehindthedevelopmentofthis
appliance,onemustunderstandtheadvantagesanddisadvantages
ofboththeBeggandStraightWireApplianceSystems.
121
TheBeggapplianceisrapidinearlytreatmentbutbecomesmorecumbersomeinthe
finishingstages.Thestraightwiresystemispronetocomplicationsinearlyperiodsof
treatmentbutisefficientinthefinalfinishingadjustments.
Anappliancethatcapturestheadvantagesofbothsystemsandreducesthe
disadvantagesofbothisthecombinationbracket.
Thenewapplianceenablestheorthodontisttocombineboththetippingandbodily
movementprinciplesofmechanics.
Thedualcapabilityoftheapplianceisduetothecombinationdesigninwhichthe
lowerthirdofthebracketisatype256Beggbracketandtheuppertwothirdsofthe
bracketisa.018”x.025”straightwireslotwithin-outpositioningandpre-angulated
andpre-torqued.
122
finishingstages.Thestraightwiresystemispronetocomplicationsinearlyperiodsof
treatmentbutisefficientinthefinalfinishingadjustments.
Anappliancethatcapturestheadvantagesofbothsystemsandreducesthe
disadvantagesofbothisthecombinationbracket.
Thenewapplianceenablestheorthodontisttocombineboththetippingandbodily
movementprinciplesofmechanics.
Thedualcapabilityoftheapplianceisduetothecombinationdesigninwhichthe
lowerthirdofthebracketisatype256Beggbracketandtheuppertwothirdsofthe
bracketisa.018”x.025”straightwireslotwithin-outpositioningandpre-angulated
andpre-torqued.
122
BEDDTIOTStandsforBeggEdgewiseDiagnosisDeterminedTotally
IndividualizedOrthodonticTechnique.
Thesebracketsarenarrow,single-width(0.050inchor1.3mm)edgewise
bracketswith0.022inchx0.028inchhorizontalarchwireslots.
Onthelingualsideofthebracketisa0.020x0.020inchverticalslot.
Exceptfortorque,thebracketsareallidentical.Therefore,theyare
interchangeable.
Thebracketsaresmallinalldimensionstoensureoptimalappearanceand
minimallipandcheekirritation.Thisalsolessensocclusalinterference,enamel
surfaceinvolvedinbonding,andproblemswithgingivalproximityandoral
hygiene.
.
123
THE BEDDTIOT APPLIANCE
RICHARD HOCEVAR: 1985
IndividualizedOrthodonticTechnique.
Thesebracketsarenarrow,single-width(0.050inchor1.3mm)edgewise
bracketswith0.022inchx0.028inchhorizontalarchwireslots.
Onthelingualsideofthebracketisa0.020x0.020inchverticalslot.
Exceptfortorque,thebracketsareallidentical.Therefore,theyare
interchangeable.
Thebracketsaresmallinalldimensionstoensureoptimalappearanceand
minimallipandcheekirritation.Thisalsolessensocclusalinterference,enamel
surfaceinvolvedinbonding,andproblemswithgingivalproximityandoral
hygiene.
.
123
THE BEDDTIOT APPLIANCE
RICHARD HOCEVAR: 1985
Theverticalcanaccommodateligatures,elastichooks,rotationdevices,and
variousotherauxiliaries.
Thebasicbuccaltubesareconventional4.5mmlong,0.022x0.028inch
"edgewise"tubeswith25°lingualcrowntorqueforlowerand10°forupper
firstmolars.
Anadditionalrectangulartube(outertube)iscarrieddiagonallyacrossthe
buccalsurfaceofthebasictube,itsmesialendpointinggingivally.Theouter
tubecrossestheinnertubeatanangleofapproximately15°andissomewhat
gingivaltotheinnertube.
124
variousotherauxiliaries.
Thebasicbuccaltubesareconventional4.5mmlong,0.022x0.028inch
"edgewise"tubeswith25°lingualcrowntorqueforlowerand10°forupper
firstmolars.
Anadditionalrectangulartube(outertube)iscarrieddiagonallyacrossthe
buccalsurfaceofthebasictube,itsmesialendpointinggingivally.Theouter
tubecrossestheinnertubeatanangleofapproximately15°andissomewhat
gingivaltotheinnertube.
124
COMBINATION ANCHORAGE TECHNIQUE
(CAT) BRACKETS:
WILLIAM J. THOMPSON: 1988
TheCATbracketiscomfortableandestheticallypleasingtothepatient.
Ithasa.022”x.035”gingivalorribbonarchslotandeithera.018”x.025”
or.022”x.028”straightwireedgewiseslot.
Anenclosedverticalslotisalsoincorporatedintothebracketforusewithup
rightingandrotatingsprings,elasticorsurgicalfixationhooksandfor
attachmentoftandemordoublearchwires.
Allbracketsareidentifiedbycolorcodingdotsatthedisto-gingivalaspect.
Maxillarybracketsareredandmandibularbracketsareblue.
Molarattachmentsnowhaveconvertibledoubletubestofacilitateextending
thestraightwireintosecondmolartubes.
125
(CAT) BRACKETS:
WILLIAM J. THOMPSON: 1988
TheCATbracketiscomfortableandestheticallypleasingtothepatient.
Ithasa.022”x.035”gingivalorribbonarchslotandeithera.018”x.025”
or.022”x.028”straightwireedgewiseslot.
Anenclosedverticalslotisalsoincorporatedintothebracketforusewithup
rightingandrotatingsprings,elasticorsurgicalfixationhooksandfor
attachmentoftandemordoublearchwires.
Allbracketsareidentifiedbycolorcodingdotsatthedisto-gingivalaspect.
Maxillarybracketsareredandmandibularbracketsareblue.
Molarattachmentsnowhaveconvertibledoubletubestofacilitateextending
thestraightwireintosecondmolartubes.
125
BEGG-RIBBON ARCH COMBINATION SYSTEM (BRACS):
NIKHIL S. VASHI
TheBegg-RibbonArchCombinationSystemisanappliancethatcombinesthe
advantagesofBeggappliancelikerapidbiteopening,useoflighttippingforcesfor
retractionwiththoseofEdgewiseandpreadjustedapplianceslikeprecisefinishing
andtotalcontrolovertoothmovements.
Thebrackethasonegingivalribbon-wiseslot(.018”x.027”)forroundand
rectangulararchwiresandtwoverticalslotsforlockpinsandligaturewires.
Italsohasanincisalslot(.020”x.020”)forligaturewireorelasticmodules.This
slotcanalsobeusedforastabilizingarchwireifneeded.
126
NIKHIL S. VASHI
TheBegg-RibbonArchCombinationSystemisanappliancethatcombinesthe
advantagesofBeggappliancelikerapidbiteopening,useoflighttippingforcesfor
retractionwiththoseofEdgewiseandpreadjustedapplianceslikeprecisefinishing
andtotalcontrolovertoothmovements.
Thebrackethasonegingivalribbon-wiseslot(.018”x.027”)forroundand
rectangulararchwiresandtwoverticalslotsforlockpinsandligaturewires.
Italsohasanincisalslot(.020”x.020”)forligaturewireorelasticmodules.This
slotcanalsobeusedforastabilizingarchwireifneeded.
126
Themolartubeisrectangularribbonwiseforribbonarch.Itisplacedata6
degreeoffsetfordistalrotationtoachievebettermolarcontrol.
Thebracketdesignissuchthatitwouldallowfreetipping,controlled
tippingorbodilytranslationofteethasrequired.
127
degreeoffsetfordistalrotationtoachievebettermolarcontrol.
Thebracketdesignissuchthatitwouldallowfreetipping,controlled
tippingorbodilytranslationofteethasrequired.
127
Advantages-
Rapid differential movements of teeth with better control and less friction.
Helps in proper finishing of the case.
Need for patient co-operation is minimal.
Eliminates the need for heavy elastics.
Reduced the treatment duration.
128
Rapid differential movements of teeth with better control and less friction.
Helps in proper finishing of the case.
Need for patient co-operation is minimal.
Eliminates the need for heavy elastics.
Reduced the treatment duration.
128
‘J’ BRACKET-A NEW DESIGN OF BEGG (COMBINATION) BRACKET
The‘J’bracketwasintroducedbyDr.V.P.Jayadein1991.Thisbracketattemptsto
harnesstheadvantagesofboththeribbonarchandedgewisebracketsatthe
sametimeeliminatingtheirdisadvantages.
AdvantagesofMultipleSlotBracketsoverSingleSlotBrackets:
Acombinationbracketwithmorethanoneslotismuchmoreefficientthana
singleslotbracketbecausemanyofourtreatmentrequirementsarediametrically
opposite
Theyofferthepossibilityofapplyingforcestotheteethatdifferentareaseg.One
canapplycrown-tippingforcesclosertotheincisalmarginandrootmovingforces
closertothecervicalmarginofthecrowns.
Switchingslotshelpsinalteringorreinforcinganchorage.
Segmentalwires,whichoffergreaterversatilityinforcedistributioncanbeused
whenevernecessary.
Tandemwirescanalsobeused
129
The‘J’bracketwasintroducedbyDr.V.P.Jayadein1991.Thisbracketattemptsto
harnesstheadvantagesofboththeribbonarchandedgewisebracketsatthe
sametimeeliminatingtheirdisadvantages.
AdvantagesofMultipleSlotBracketsoverSingleSlotBrackets:
Acombinationbracketwithmorethanoneslotismuchmoreefficientthana
singleslotbracketbecausemanyofourtreatmentrequirementsarediametrically
opposite
Theyofferthepossibilityofapplyingforcestotheteethatdifferentareaseg.One
canapplycrown-tippingforcesclosertotheincisalmarginandrootmovingforces
closertothecervicalmarginofthecrowns.
Switchingslotshelpsinalteringorreinforcinganchorage.
Segmentalwires,whichoffergreaterversatilityinforcedistributioncanbeused
whenevernecessary.
Tandemwirescanalsobeused
129
Twin slot arrangement also has its peculiar disadvantages:
They drastically reduce mesiodistal tipping due to increased width
They reduce the inter-bracket wire span which reduces the working range of the inter-bracket
section of the wire
Net effect of the changed orientation of the slots:
Permits adequate mesio-distal crown tipping but restricts excessive crown tipping
Affords good rotational control
Allows to fully utilize the torquing abilities of rectangular wires
130
They drastically reduce mesiodistal tipping due to increased width
They reduce the inter-bracket wire span which reduces the working range of the inter-bracket
section of the wire
Net effect of the changed orientation of the slots:
Permits adequate mesio-distal crown tipping but restricts excessive crown tipping
Affords good rotational control
Allows to fully utilize the torquing abilities of rectangular wires
130
SELF-LIGATING BRACKETS
131
131
RUSSELL ATTACHMENT
The first self-ligating bracket, the Russell attachment, was developed by
Dr. Jacob Stolzenberg in 1935.
Design–
-A flat-head screw seated snugly in a circular ,threaded opening in the
face of the bracket.
-The horizontal screw could be loosened or tightened .
132
The first self-ligating bracket, the Russell attachment, was developed by
Dr. Jacob Stolzenberg in 1935.
Design–
-A flat-head screw seated snugly in a circular ,threaded opening in the
face of the bracket.
-The horizontal screw could be loosened or tightened .
132
EDGELOCK BRACKET
1971-Dr Jim Wildman.
This was the first “passive” self-ligating bracket
Design –
-Bracket had a round body with a rigid labial sliding cap
-A special tool was used to move the slide occlusally to facilitate arch wire
insertion.
133
1971-Dr Jim Wildman.
This was the first “passive” self-ligating bracket
Design –
-Bracket had a round body with a rigid labial sliding cap
-A special tool was used to move the slide occlusally to facilitate arch wire
insertion.
133
MOBIL-LOCK BRACKET
About 2 years later, in 1973, Dr. Franz Sanderintroduced the Mobil-lock
bracket.
Design-
-Semi circular labial disc .
-A special tool was used to rotate the disc into its closed or open position
134
About 2 years later, in 1973, Dr. Franz Sanderintroduced the Mobil-lock
bracket.
Design-
-Semi circular labial disc .
-A special tool was used to rotate the disc into its closed or open position
134
SPEED BRACKET
“Speed” bracket introduced by Dr Herbert Hanson in 1976
and became available in the market in 1980.
Stands for-
S -Spring loaded
P -Precision
E -Edgewise
E -Energy
D -Delivery
135
“Speed” bracket introduced by Dr Herbert Hanson in 1976
and became available in the market in 1980.
Stands for-
S -Spring loaded
P -Precision
E -Edgewise
E -Energy
D -Delivery
135
Bracket Design-
Consists of a narrow single width bracket body.
Multislottedwith 3 horizontal slots:
1.Arch wire slot
2.Auxiliary slot
3.Spring retainer slot
136
Consists of a narrow single width bracket body.
Multislottedwith 3 horizontal slots:
1.Arch wire slot
2.Auxiliary slot
3.Spring retainer slot
136
Curved, flexible “Super-Elastic Spring Clip”
that wraps occluso-gingivally around the
bracket body.
Opens and closes in a vertical manner.
Labial arm of the spring clip forms the
flexible fourth wall.
137
that wraps occluso-gingivally around the
bracket body.
Opens and closes in a vertical manner.
Labial arm of the spring clip forms the
flexible fourth wall.
137
TheSpeedApplianceFunction-
Thehighlyresilientspringclipcontrolstoothmovementinallthethree
planesofspace
RotationalControl:
Onarchwireengagement,thespringclipisactivatedbydisplacementfrom
therestingposition
-Rotational correction is achieved through torsional component of the
deflection.
-Deflection creates a rotational couple consisting of a fulcrum and spring clip
force.
138
Thehighlyresilientspringclipcontrolstoothmovementinallthethree
planesofspace
RotationalControl:
Onarchwireengagement,thespringclipisactivatedbydisplacementfrom
therestingposition
-Rotational correction is achieved through torsional component of the
deflection.
-Deflection creates a rotational couple consisting of a fulcrum and spring clip
force.
138
Tipcontrol:
Tipcorrectionisachievedthroughthelabialdeflectionandsubsequent
returnofthespringcliptoitsrestingposition.
139
Tipcorrectionisachievedthroughthelabialdeflectionandsubsequent
returnofthespringcliptoitsrestingposition.
139
TorqueControl:
Residesincombinationofthemechanicalactionofthearch
wireintheslotwithconstantforceapplicationfromthespring
clip.
140
Residesincombinationofthemechanicalactionofthearch
wireintheslotwithconstantforceapplicationfromthespring
clip.
140
Further enhanced with the use of beveled SPEED arch wires.
Helps the operator in saving as much as 5 minutes per arch wire
change .
Offers full control even with the most undersized arch wires.
141
Helps the operator in saving as much as 5 minutes per arch wire
change .
Offers full control even with the most undersized arch wires.
141
ACTIVA
In 1986, Dr. Erwin Pletcherintroduced the Activabracket
Had an inflexible curved arm that rotated occluso-gingivally around the cylindrical
bracket body.
Arm could be moved into a “slot-open” or “slot-closed” position with finger
pressure alone
Drawbacks:
1.Ease with which patients could open the bracket.
2.Large mesiodistal width
142
In 1986, Dr. Erwin Pletcherintroduced the Activabracket
Had an inflexible curved arm that rotated occluso-gingivally around the cylindrical
bracket body.
Arm could be moved into a “slot-open” or “slot-closed” position with finger
pressure alone
Drawbacks:
1.Ease with which patients could open the bracket.
2.Large mesiodistal width
142
TIME BRACKET
In1995,DrWolfgangHeiserintroducedtheTime
bracket.
Design-
Rigid,curvedarmthatwrapsocclusogingivally
aroundthelabialaspectofthebracketbody
Aspecialinstrumentisusedtopivotthearm
gingivallyintotheslotopenpositionorocclusally
intotheslotclosedposition.
Stiffnessofthebracketarmpreventsinteraction
withthearchwire.
143
In1995,DrWolfgangHeiserintroducedtheTime
bracket.
Design-
Rigid,curvedarmthatwrapsocclusogingivally
aroundthelabialaspectofthebracketbody
Aspecialinstrumentisusedtopivotthearm
gingivallyintotheslotopenpositionorocclusally
intotheslotclosedposition.
Stiffnessofthebracketarmpreventsinteraction
withthearchwire.
143
TWIN LOCK BRACKET
TheTwinLockbracketwasintroducedbyDr.JimWildman,in1998.
Ithadaflat,rectangularslide,housedbetweenthetiewingsofan
edgewisetwinbracket.
Theslideisopenedocclusallywithauniversalscaler.
144
TheTwinLockbracketwasintroducedbyDr.JimWildman,in1998.
Ithadaflat,rectangularslide,housedbetweenthetiewingsofan
edgewisetwinbracket.
Theslideisopenedocclusallywithauniversalscaler.
144
DAMON SL I AND DAMON SL II
Between1996and1999,Dr.DwightDamonintroducedtheDamonSLIand
DamonSLIIbrackets
Thebasicdifferenceisthatthefirsthadalabialcoverthatstraddledthetiewings,
whilethesecondincorporatesaflat,rectangularslidebetweenthetiewings.
Slide moves incisally on the maxillary and gingivally on the mandibular brackets.
Special opening and closing pliers are required.
145
Between1996and1999,Dr.DwightDamonintroducedtheDamonSLIand
DamonSLIIbrackets
Thebasicdifferenceisthatthefirsthadalabialcoverthatstraddledthetiewings,
whilethesecondincorporatesaflat,rectangularslidebetweenthetiewings.
Slide moves incisally on the maxillary and gingivally on the mandibular brackets.
Special opening and closing pliers are required.
145
IN-OVATION BRACKET
Introduced in year 2000.
►Itisaself-ligatingbracketsystemconsistingofatwinbracketfor
rotationalcontrolandhasan“active”clipforseatingarchwire.
►Thebracketdesignnotonlycombinesalltheimportantfeaturesofan
effectiveself-ligatingsystem,itgoesevenfurthertoprovidethehighest
levelofversatility,functionandcomfort
Advantages:
►Shorter office visits.
►Shorter overall treatment time.
►Use of lighter forces.
►Increased patient comfort.
146
Introduced in year 2000.
►Itisaself-ligatingbracketsystemconsistingofatwinbracketfor
rotationalcontrolandhasan“active”clipforseatingarchwire.
►Thebracketdesignnotonlycombinesalltheimportantfeaturesofan
effectiveself-ligatingsystem,itgoesevenfurthertoprovidethehighest
levelofversatility,functionandcomfort
Advantages:
►Shorter office visits.
►Shorter overall treatment time.
►Use of lighter forces.
►Increased patient comfort.
146
Four full tie wings.
Slot blocker.
Horizontal V Slot .
Compound contoured base.
Torque in base .
147
Slot blocker.
Horizontal V Slot .
Compound contoured base.
Torque in base .
147
Recent advances in self ligating
brackets
Damon 3 brackets (2004)
Smart clip( 2004)
Damon 3MX brackets (2005)
Smart clarity SL
bracket(2007)
Discovery brackets(2007)
Damon Q (2009)
Smart clip SL3 (2009)
Harmony lingual self-ligating
bracket system (2011)
Sensation active ceramic
self-ligating bracket(2012)
BioQuick self-ligating bracket
(2014)
Carriere SLX self-ligating
bracket system (2014)
Empower 2(2016)
In-Ovation X (2017)
148
brackets
Damon 3 brackets (2004)
Smart clip( 2004)
Damon 3MX brackets (2005)
Smart clarity SL
bracket(2007)
Discovery brackets(2007)
Damon Q (2009)
Smart clip SL3 (2009)
Harmony lingual self-ligating
bracket system (2011)
Sensation active ceramic
self-ligating bracket(2012)
BioQuick self-ligating bracket
(2014)
Carriere SLX self-ligating
bracket system (2014)
Empower 2(2016)
In-Ovation X (2017)
148
Brackets Used in Lingual
Orthodontics
149
Orthodontics
149
Lingual Light Wire Technique
StephenFPaige–Aug,1982
Fujitaconfirmedthatorthodontictreatmentwithbracketsplacedonthe
lingualispossible.
Anobviousdisadvantagetothelingualapplianceisthedifficultyofinsertion
andremovalofarchwires.
150
StephenFPaige–Aug,1982
Fujitaconfirmedthatorthodontictreatmentwithbracketsplacedonthe
lingualispossible.
Anobviousdisadvantagetothelingualapplianceisthedifficultyofinsertion
andremovalofarchwires.
150
Bracket Design Criteria:
1.Interbracketdistanceisreducedonthelingual.Therefore,the
bracketmustbedesignedtobeasnarrowaspossiblemesiodistally.
2.Mesiodistalrootcontrolbecomesmoredifficult–verticalslotforarch
auxiliaries.
3.Topographyofthelingualsurfacesofthemaxillaryandmandibular
anteriorteethvaryagreatdeal.
151
1.Interbracketdistanceisreducedonthelingual.Therefore,the
bracketmustbedesignedtobeasnarrowaspossiblemesiodistally.
2.Mesiodistalrootcontrolbecomesmoredifficult–verticalslotforarch
auxiliaries.
3.Topographyofthelingualsurfacesofthemaxillaryandmandibular
anteriorteethvaryagreatdeal.
151
ArchwireDesign
Archwiresofapprox..002"
smallerdiameter.
Generalshapeofthe
archwiresresemblesthe
mushroomshape.
152
Archwiresofapprox..002"
smallerdiameter.
Generalshapeofthe
archwiresresemblesthe
mushroomshape.
152
Molar Tube Design
-Ovaltubewithmesiogingivalhook.
-Increasespatientcomfort,allowsmolarcontrol,andwill
acceptaribbonarch
153
-Ovaltubewithmesiogingivalhook.
-Increasespatientcomfort,allowsmolarcontrol,andwill
acceptaribbonarch
153
Lingual BeggLight Wire Technique
PeterKYen,Nov1986.
DevelopedatechniquethatusesregularBegglabialbrackets.
TP256-500mini-meshlowerincisorlabialbrackets,areusedforboth
upperandlowerincisors.
Upperlateralincisorlabialbracketsareadaptedtothecuspids,andthe
curveduppercuspidlabialbracketstothebicuspids.
.036”tubewithamesio-gingivalhook.
Themushroom-shapedarchwireshouldhavehorizontalloopsdistalto
thecuspids.
154
PeterKYen,Nov1986.
DevelopedatechniquethatusesregularBegglabialbrackets.
TP256-500mini-meshlowerincisorlabialbrackets,areusedforboth
upperandlowerincisors.
Upperlateralincisorlabialbracketsareadaptedtothecuspids,andthe
curveduppercuspidlabialbracketstothebicuspids.
.036”tubewithamesio-gingivalhook.
Themushroom-shapedarchwireshouldhavehorizontalloopsdistalto
thecuspids.
154
CONCEAL SYSTEM
Aug1989-ThomasCreekmore.
DevelopedbyUnitekCorp.
Anacceptablelingualorthodonticappliancesystemmust
includethefollowingkeyelements-
◦Itshouldalignteethfromthelingualsideasefficientlyasfromthe
labialside.
◦Ameansofpositioningbracketspreciselytocreatea“near”SWAon
thelingualside.
155
Aug1989-ThomasCreekmore.
DevelopedbyUnitekCorp.
Anacceptablelingualorthodonticappliancesystemmust
includethefollowingkeyelements-
◦Itshouldalignteethfromthelingualsideasefficientlyasfromthe
labialside.
◦Ameansofpositioningbracketspreciselytocreatea“near”SWAon
thelingualside.
155
Thefoundationofthedesignistheopeningofthewireslottotheocclusal
aspectratherthantothelingualaspect.
156
aspectratherthantothelingualaspect.
156
Decreaseininterbracketdistanceonthe
lingualsidenecessitatestheuseofsmaller
archwires.Hence,slotsizeis.016”x.022”.
AnteriorbracketshaveaYconfiguration
withasingletiewingprojectinggingivally
andtwintiewingsprojectingocclusally
157
lingualsidenecessitatestheuseofsmaller
archwires.Hence,slotsizeis.016”x.022”.
AnteriorbracketshaveaYconfiguration
withasingletiewingprojectinggingivally
andtwintiewingsprojectingocclusally
157
Friction Free Bracket
Kazutoetal,1994.
Basicideaofthedesignwastoreducefrictionbetweenthe
bracketslotandthearchwire.
LigaturedoesnotpressagainstthearchwireintheFFbracket
158
Kazutoetal,1994.
Basicideaofthedesignwastoreducefrictionbetweenthe
bracketslotandthearchwire.
LigaturedoesnotpressagainstthearchwireintheFFbracket
158
Recent advances in lingual brackets
Fujita lingual Bracket(Forstadent)
Stealth Brackets (American orthodontics)
Philippe self ligating lingual bracket -Massimo Ronchinin 1994
Kelly Bracket
Kurz lingual bracket
In –ovation l bracket (GAC)
Braces(Incognito)
159
Fujita lingual Bracket(Forstadent)
Stealth Brackets (American orthodontics)
Philippe self ligating lingual bracket -Massimo Ronchinin 1994
Kelly Bracket
Kurz lingual bracket
In –ovation l bracket (GAC)
Braces(Incognito)
159
Straight Wire: The Next Generation
IntroducedbyCreekmoreandRandyin1993.
Frequently,anticipatedresultsarenotachievedbyusingpreadjusted
appliancesandstraightwires.
There are at least five reasons –
1.Inaccurate bracket placements
2.Variations in tooth structure
3.Variations in antero-posterior and vertical jaw relationsrequire
variations in the position of the maxillary and mandibular incisors
4.Need for overcorrection
160
IntroducedbyCreekmoreandRandyin1993.
Frequently,anticipatedresultsarenotachievedbyusingpreadjusted
appliancesandstraightwires.
There are at least five reasons –
1.Inaccurate bracket placements
2.Variations in tooth structure
3.Variations in antero-posterior and vertical jaw relationsrequire
variations in the position of the maxillary and mandibular incisors
4.Need for overcorrection
160
5. Mechanical deficiencies of the edgewise appliance
a. Force application away from C
Res.
b.Playbetweenarchwireandslot
c.Forcediminution.
161
a. Force application away from C
Res.
b.Playbetweenarchwireandslot
c.Forcediminution.
161
THE SLOT MACHINE
ThomasCreekmorehasdesignedtheslotmachineinsuchawayforplacementof
bothconventionalandlingualbracketsdirectlyontothemalocclusionmodel
Eachtoothwillbedesignatedwithspecifictipandtorquevalue.
Thebracketslotisorientedtothemachine.
Theplacementofbracketshavingeitherhorizontalorverticalaccessarchwire
slotsisdonebytheslotmachine
162
ThomasCreekmorehasdesignedtheslotmachineinsuchawayforplacementof
bothconventionalandlingualbracketsdirectlyontothemalocclusionmodel
Eachtoothwillbedesignatedwithspecifictipandtorquevalue.
Thebracketslotisorientedtothemachine.
Theplacementofbracketshavingeitherhorizontalorverticalaccessarchwire
slotsisdonebytheslotmachine
162
CONCLUSION
Understandinganduseofhistoricevolutionofbracketsaidinbetterunderstandingof
present-dayBracketsandpredicttheirfuturedevelopments.
Presently,fivebracketshavewithstoodthetestoftime:
a.)StandardEdgewiseBracketb.)Pre-adjustedEdgewiseBracketc.)Beggd.)
CombinationEdgewiseorModernBegge.)TipEdge.
Today’spreferencesaretowardspre-adjusted,machined,fourcomponenttwin
bracketswithroundedformsandcertainaidingfeaturesliketorque,in-and–outsand
counter-rotationfeatures.
Thus,withneweraprecisionbracketsareevolvingthatinvolveefficientforce
distributiontothetoothtobringaboutdifferenttoothmovementsinlesstime
163
Understandinganduseofhistoricevolutionofbracketsaidinbetterunderstandingof
present-dayBracketsandpredicttheirfuturedevelopments.
Presently,fivebracketshavewithstoodthetestoftime:
a.)StandardEdgewiseBracketb.)Pre-adjustedEdgewiseBracketc.)Beggd.)
CombinationEdgewiseorModernBegge.)TipEdge.
Today’spreferencesaretowardspre-adjusted,machined,fourcomponenttwin
bracketswithroundedformsandcertainaidingfeaturesliketorque,in-and–outsand
counter-rotationfeatures.
Thus,withneweraprecisionbracketsareevolvingthatinvolveefficientforce
distributiontothetoothtobringaboutdifferenttoothmovementsinlesstime
163
BIBLIOGRAPHY
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Philadelphia,Saunders,1995:535-539.
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5. GraberandSwain:BiomechanicalPrinciplesandReactions:OrthodonticcurrentPrinciplesand
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2,Mosby,1993:385-391,410-414.
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:140-144.
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Techniques,Edn3,C.V.Mosby,1985:456-460,676-687.
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(94):26-37.
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therapy, J Clin Orthod, 1983, 17 (1): 99-115.
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19. Alexander: The Vari Simplex Design: Part 1-Concept and Appliance Design; J Clin Orthod,
1983, 17 (6) : 380-392.
20. Stephen H. Paige: The lingual Light Wire Technique; J Clin Orthod, 1982, 16 (2) : 534-544.
21. Broussard, Shia: The Broussard Hook and Eye Clasp Fixed-Removable Appliance; J Clin Orthod,
1978, 12 (6): 412-420.
22. Jorge Fastlicht: The Universal Appliance Today-Part 1; J Clin Orthod, 1969, 3 (1) : 582-589.
23. Swain and Ackerman: An Evaluation of Begg Technique; Am J Orthod, 1969 ( ) : 122-141.166
therapy, J Clin Orthod, 1983, 17 (1): 99-115.
17. Milton Rabine: The Rationale of Begg Therapy; J Clin Orthod, 1968, 2 (9) : 338-341.
18. Wofgang Heiser: TIME: A New Orthodontic Therapy; J Clin Orthod, 1998, 32 ( 1): 44-53.
19. Alexander: The Vari Simplex Design: Part 1-Concept and Appliance Design; J Clin Orthod,
1983, 17 (6) : 380-392.
20. Stephen H. Paige: The lingual Light Wire Technique; J Clin Orthod, 1982, 16 (2) : 534-544.
21. Broussard, Shia: The Broussard Hook and Eye Clasp Fixed-Removable Appliance; J Clin Orthod,
1978, 12 (6): 412-420.
22. Jorge Fastlicht: The Universal Appliance Today-Part 1; J Clin Orthod, 1969, 3 (1) : 582-589.
23. Swain and Ackerman: An Evaluation of Begg Technique; Am J Orthod, 1969 ( ) : 122-141.166
24. Thompson: Combination Anchorage Technique: An Update of Current Mechanics; Am J
Orthod Dentofac Orthop, 1988, 93 (5) : 363-379.
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1987, 92 (1): 50-69.
26. Harradine: The clinical use of Activa self-ligating bracket; Am J. Orthod Dentofac Orthop,
1996, 109 (3) : 319-328.
27. RH Roth: The Straight Wire Appliance: 17 yrs later; J Clin Orthod, 1987, 24 (2 ) : 632-642.
167
Orthod Dentofac Orthop, 1988, 93 (5) : 363-379.
25. Hocevar: BEDDTIOT: Introduction to Clinical Applications; Am J. Orthod Dentofac Orthop,
1987, 92 (1): 50-69.
26. Harradine: The clinical use of Activa self-ligating bracket; Am J. Orthod Dentofac Orthop,
1996, 109 (3) : 319-328.
27. RH Roth: The Straight Wire Appliance: 17 yrs later; J Clin Orthod, 1987, 24 (2 ) : 632-642.
167
168
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