History of orthodontics

The presentation is about the history of orthodontics in details.

1. History of Orthodontics Dr.Ishfaq Ahmad BDS, BCS MS RESIDENT Department of Orthodontics and Dentofacial Orthopedics Dhaka Dental College

2. “Nobody can know much of a science unless he understands its history” Edward H Angle

3. Contents Introduction Ancient Origins Eighteenth Century Nineteenth Century Orthodontic Pioneers Of The Late 19 th Century The Professionalization Of Orthodontics In The Early 20th Century Women in orthodontics Post-war developments 21st century Conclusion

4. Introduction

5. Ever since Eve flashed Adam her first grin, we have been concerned about our smile.

6. Appliances for aligning teeth go as far back as the Egyptians even more ancient.

7. From evidence found in human skulls, crooked teeth have been around since the time of Neanderthal man (about 50,000 bc ), but it was not until about 3000 years ago that we had the first written record of attempts to correct crowded or protruding teeth.

8. Primitive (and surprisingly well-designed) orthodontic appliances have been found with Greek and Etruscan artifacts.

9. Archaeologists have discovered Egyptian mummies with crude metal bands wrapped around individual teeth. It is speculated that catgut was used to close the gaps

10. Ancient Origin The Etruscans The Ancient Greek The Romans

11. The Etruscans   The earliest evidence of appliances being used to straighten teeth is from around 1000 BC (Weinberger, 1934). The Etruscans, an ancient civilization predating the Romans, buried their dead with appliances that were used to maintain space and prevent collapse of the dentition (Guerini,1909).

12. The Ancient Greek Hippocrates (c460 BC–370 BC), considered to be one of the most exceptional figures in the history of medicine, published his ideas regarding the correction of tooth irregularities in 400 BC (Hippocrates,400BC).

13. The Romans Teeth bound with a gold wire, presumably an ancient precursor to modern ligature wire, have been found in a Roman tomb in Egypt ( Ruffer , 1921). The Romans saw teeth as precious—the first code of Roman law (450 BC) stated that ‘special penalties [would be exacted] for knocking out the teeth of an individual, either freeman or slave’.

14. Aulus Cornelius Celsus A great Roman philosopher and physician (c25 BC–c50 AD) recommended extracting deciduous teeth to allow the eruption of the permanent dentition in his medical encyclopedia De Medicina . In addition, Celsus was the first to record the use of finger pressure for the treatment of incorrectly positioned teeth and said that this finger pressure should be applied to new teeth every day to ensure correct tooth alignment.

15. Pliny the Elder Probably the first mechanical treatment was advocated by Pliny the Elder (ad 23-79), who suggested filing elongated teeth to bring them into proper alignment at chapter 49 named Remedies for Toothache in Naturalis Historia . This method remained in practice until the 1800s.

16. The Renaissance   The evidence suggests that no further developments were made until the 18th century. However, the European Renaissance of the 14th–17th centuries heralded scientists who studied dental anatomy, most notably the Italian Renaissance polymath Leonardo da Vinci (1452–1519). His drawings included detailed studies on body proportions and he used details such as lip–dental relationship, facial proportions and tooth size ratios in his paintings.  

17. A skull and arrangement of teeth in mouth sectioned by da Vinci.

18. Eighteenth century

19. Pierre Fauchard (1678-1761 ) Beginning in the 18th century, the leading country in the field of dentistry was France. This was due, in large measure, to the efforts of a single man Pierre Fauchard (1678-1761). He has been called the “Father ofOrthodontia .” He was the first to remove dentistry from the bonds of empiricism and put it on a scientific foundation. In 1728, he published the first general work on dentistry; a 2-volume opus entitled The Surgeon Dentist: A Treatise on the Teeth.

20. Pierre Fauchard He described methods of straightening teeth and devoted a chapter to the subject the first comprehensive discussion of orthodontic appliances in his book Le Chirurgien Dentiste ( Fauchard , 1728). He described the use of ligature wires to straighten teeth, as well as the first expansion appliance, known as a bandeau.

21. Etienne Bourdet Fauchard’s bandeau was refined by Etienne Bourdet ( 1722-1789). He published The Dentist’s Art (1754), which, like Fauchard’s book, included a chapter dedicated to tooth alignment. His was the first record of recommending serial extraction (1757) and of extracting premolars to relieve crowding. He was also the first to practice “lingual orthodontics,” expanding the arch from the lingual. There followed a long line of lingual appliances, including the jackscrew, the expansion plate, and, closer to our time, the lingual arch.

22. John Hunter John Hunter (1728- 1793) made the greatest advances in dentistry of his time. An English anatomist and surgeon, Hunter took a particular interest in the anatomy of the teeth and jaws. His text, The Natural History of the Human Teeth (1771), presented the first clear statement of orthopedic principles. He was the first to describe normal occlusion to attempt to classify the teeth. He established the difference between teeth and bone. He was the first to describe the growth of the jaws, not as a hypothesis, but as a sound, scientific investigation. His findings have never been successfully challenged

23. Nineteenth century

24. Joseph Fox Joseph , a student of Hunter devoted 4 chapters of his book, The Natural History and Diseases of the Human Teeth (1814), to that topic. He was the first to classify malocclusion (1803). According to Weinberger, Fox “was the first to give explicit directions for correcting the irregularities” of teeth. He was particularly interested in the judicious removal of deciduous teeth, treatment timing, and the use of bite blocks to open the bite. His other appliances included an expansion arch and a chin cup (about 1802).

25. Joachim Lefoulon The term orthodontics was coined by Joachim Lefoulon , who used the word ‘ orthodontosie ’ in 1841 which roughly translates into orthodontia . He was also the first to combine a labial arch with a lingual arch.

26. Friedrich Christoph Kneisel He was the first to use plaster models to record malocclusion (1836). That same year, when he fitted his prognathic patient with a chin strap, he became the first to use a removable appliance. Very early appliances were made out of ivory with hickory wood pegs often used for tooth movement.

27. Orthodontic Pioneers Of The Late 19 th Century  

28. Norman W. Kingsley Norman W. Kingsley (1825-1896) was the first of those dental pioneers who made the last half of the 19 th century a period of great advancement. A splendid thinker and skilled artisan, he introduced several innovations, including occipital traction (1879). After 1850, the first texts that systematically described orthodontics appeared as Kingsley’s book, A Treatise on Oral Deformities (1880), the first to recommend that etiology, diagnosis, and treatment planning should be the foundations of practice. It was also the first to discuss cleft palate treatment in terms of orthodontics .

29. Amos Westcott Amos Westcott made the first reported effort to use a telescopic bar in the maxilla to correct a crossbite (1859). In the 1840s, he placed chincups on his Class III patients

30. C. R. Coffin C . R. Coffin, Kingsley’s student, reported on a new design for an expansion appliance, which still bears his name . He embedded spring-action piano wire, bent into the shape of “W,” into a vulcanite plate, separated the plate in the middle, and activated the spring so that its halves pressed the alveolar process to the outside.

31. John Nutting Farrar (1839-1913) The investigations of John Nutting Farrar (1839-1913, Fig 4) began the era of biologic tooth movement. His Treatise on Irregularities of the Teeth and Their Correction (1888) is considered the first great work devoted exclusively to orthodontics. For these reasons, he has been called the “Father of American Orthodontics.”

32. John Nutting Farrar In an 1876, he advocated specific limits for the movement of teeth and, in so doing, laid the foundation for “scientific” orthodontics. He was among the first (1850) to use occipital anchorage to retract anterior teeth. He recommended the bodily movement of teeth (1888). Based on animal studies, Farrar originated the theory of intermittent force and developed a screw to deliver this force in controlled.

33. Calvin S. Case (1847-1923) He was the first to use (about 1893), along with Henry Baker, Class II elastics and was the first to attempt bodily movement. He was also the first to use light wires (.016 and .018 in). Case advocated extraction to correct facial deformities . In so doing, he incurred the wrath of Angle and his disciples. Case’s(1911 )paper provoked an acrimonious debate that came to be known as the “Great Extraction Debate.” Case used headgears for cleft patients and others. Because of his modesty and Angle’s forcefulness and charisma, Case’s accomplishments were slow to be recognized, but he is now considered one of the “Big Four” in orthodontics.

34. Edward H. Angle (1855-1930 ) The most dominant, dynamic, and influential figure in orthodontics was Edward H. Angle (1855-1930). He is regarded as the “Father of Modern Orthodontics .” Probably no other man in dentistry did more to foster this branch of dental science as a specialty, causing its separation from general practice and advocating it as a recognized and distinct science. His address at the Ninth International Medical Congress in Washington, DC (1887), calling for the separation of orthodontics from dentistry, was the beginning of a new era of dentistry. He founded (1900) the first postgraduate school of orthodontics (Angle School of Orthodontia). He also founded the first orthodontic journal, The American Orthodontist , in 1907,

35. Angle’s classification Angle’s classification, published in Dental Cosmos (1899), remains the most widely accepted classification of malocclusions. Based on the relationship of the maxillary to the mandibular first molars, it provided the first orderly means of characterizing malocclusions, and its universal acceptance by the dental profession is a testament to its practical simplicity.

36. Angle’s Appliances Angle held 37 patents; his most noteworthy appliances are the E-arch (1900), the pin-and-tube appliance (1910), the ribbon arch (1916), and the edgewise appliance (1925 ). Angle organized the first orthodontic society (1900), the American Society of Orthodontists (now the American Association of Orthodontists),19 and became its first president.

37. Anna Hopkins (1872-1957) About 1908, Angle married his longtime secretary, Anna Hopkins (1872-1957). “ Mother Angle” became secretary of the American Society of Orthodontists, a founding coeditor of the Angle Orthodontist, and honorary chair of the Angle Society executive committee.

38. THE PROFESSIONALIZATION OF ORTHODONTICS IN THE EARLY 20TH CENTURY

39. Benno Lischer Benno Lischer (1876-1959), was once turned away from admission to Angle’s school became a leading figure in the specialty. He wrote Elements of Orthodontia (1909), Principles and Methods of Orthodontics (1912), and Time to Tell (1955). He was the first to use the term cephalometrics (1922); he championed the term orthodontics in place of orthodontia ; and he coined mesiocclusion , distocclusion , and neutrocclusion , promoting their use in lieu of Angle’s Classes I, II, and III.

40. John V. Mershon John V. Mershon (1867-1953; Angle School, 1908) was head of orthodontics at the University of Pennsylvania from 1916 to 1925. When he took over the newly formed graduate department, he tried to present orthodontics from the biologic rather than the mechanical viewpoint. His study of the relapse phenomenon led to his memorable quote, “You can move teeth to where you think they belong; nature will place them where they will best adapt themselves to the rest of the organism .”  

41. Spencer R. Atkinson Spencer R. Atkinson (1886-1970; Angle School, 1920) who was Orthodontist, teacher, inventor, innovator, anatomist, and skilled photographer, was originally a children’s dentist. Atkinson’s interest in the growth and development of the head led to a collection of some 1400 skulls that are now housed at the University of the Pacific School of Dentistry. He originated the term key ridge .

42. Holly Broadbent The introduction of the cephalometer by Holly Broadbent in 1931 was another important milestone that placed orthodontic research on a scientific foundation.  Broadbent’s original work on the “face of the normal child” and Brody’s classic research “on the growth pattern of the human head from the third month to the eighth year of life” were among the earliest contributions. These were followed by the research of Down’s “Variations in Facial Relationships,” the work of Thompson in “Functional Analysis of Occlusion,” Wylie’s “Assessment of Anterior-Posterior Dysplasia,” and the work of Margolis’ “Basic Facial Pattern and Its Application in Clinical Orthodontics.”

43. Charles Tweed and Raymond Begg  The extraction of teeth (typically the bicuspids) to achieve occlusal stability and periodontal health was reintroduced into American orthodontics during the 1930s by Charles Tweed and simultaneously into the United Kingdom (Australia) by Raymond Begg .

44. Lawrence F. Andrews Dr. Andrews was one of the first orthodontist to clarify the importance of addressing both facial and dental harmony from the beginning of treatment to achieve the best facial form and head and neck function for each patient. Dr.

45. Andrews stated that, for the maxillomandibular complex to be in harmony (i.e., to have all elements in alignment) with the overall face, the following must be present: Element I: Proper arch shape and positioning of the maxillary and mandibular teeth (roots) over the basal bone Element II: Proper horizontal ( sagittal ) projection of the maxilla Element III: Proper width of the maxillary and mandibular arches Element IV: Proper vertical height of the maxilla Element V: Proper prominence (shape) of the chin (i.e., pogonion prominence) Element VI: Establishment of the  Six Keys to Optimal Occlusion He studied each of these Six Elements and defined both qualitatively and quantitatively how the orthodontist and the surgeon can work together to achieve these objectives for each patient.

46. Women in orthodontics

47. Pioneers   Guilhermena G. Mendell (d. 1946; Angle School, 1902) was the first woman graduate and the first woman instructor at the Angle School (1902 ). She later taught at the Pasadena school and practiced with her husband, Harvey Stallard (1888- 1974), a pioneer in gnathology . Josephine M. Abelson (1901-1987; Dewey School, 1923) was the first femaledirector of the Dewey School clinic (Fig 1). She married Sidney E. Riesner (1900-79), a pioneer in radiography and temporomandibular joint treatment. Both Mendell and Abelson influenced their husbands to study orthodontics .

48. Pioneers Other early 20th-century pioneer women included Gertrude Locke (1869-), a founding member of the American Society of Orthodontists (ASO) (1901); Jane G. Bunker (Angle School, 1904), founding member, European Orthodontic Society (1907) and the Eastern Association of Graduates of the Angle School of Orthodontia (1909); Genette Harbour (1865-1936; Angle School, 1911), first woman orthodontist in Los Angeles (1911) and founding member, Pacific Coast Society of Orthodontists (1913); Eda B. Schlencker , the first woman to be certified by the American Board of Orthodontics (ABO) (1933).

49. Post-war developments

50. Direct Bonding The concept of directly bonding brackets to the surface of the teeth was first described by Newman in 1965 and meant that brackets could be fitted to teeth without metal bands for the first time .

51. Self- ligating brackets Self- ligating brackets were first proposed by Alexander Wildman (1972). Self- ligating systems have risen in popularity with the introduction of the Damon bracket (Damon, 1998).

52. 21st century

53. 3D computer imaging The adoption of 3D computer imaging in orthodontics has been the most fundamental development of the 21st century. As well as using the technology to plan treatment and create virtual study models, computeraided design and computer-aided manufacture can be used to design and create custom-made brackets to make appliances more comfortable and enable more accurate results .

54. Ceramic Brackets With the aim of making appliances less visible, ceramic, tooth- coloured brackets have been developed in recent years.

55. Invisalign Invisalign  aligners are the clear alternative to metal  braces  for adults and teens. These clear aligners are the virtually invisible way to improve your smile.

56. Lingual braces Lingual braces  are one of the many types of the fixed orthodontic treatment appliances available to patients needing orthodontics. They involve attaching the orthodontic brackets on the inner sides of the teeth. The main advantage of lingual braces is their near invisibility compared to the standard braces, which are attached on the buccal sides of the  tooth  Lingual braces were invented by Craven Kurz  in 1976

57. Conclusion

58. After more than 3,000 years of advancements, orthodontic appliances have come a long way and have developed quickly over the last two centuries to become the appliances we know today. The increased use of digital technology means that this progress should continue for years to come. Let’s Recap With A N ice V ideo