Copy of selection of mbt appliance /certified fixed orthodontic courses by Indian dental academy


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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit ,or call

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Copy of selection of mbt appliance /certified fixed orthodontic courses by Indian dental academy

  1. 1. 11 FEATURES OF THE MBTFEATURES OF THE MBT VERSATILE+ APPLIANCEVERSATILE+ APPLIANCE 1.1. Design Features of MBTDesign Features of MBT Bracket SystemBracket System 2.2. The Versatility of the MBTThe Versatility of the MBT Bracket SystemBracket System INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. 22 Design FeaturesDesign Features 1.1. Range of bracketsRange of brackets  Size (standard, mid)Size (standard, mid)  Shape (rhomboidal)Shape (rhomboidal)  EstheticsEsthetics 1.1. In-out PrescriptionIn-out Prescription  Upper second premolarsUpper second premolars 1.1. Tip PrescriptionTip Prescription  Tip in anterior bracketsTip in anterior brackets  Tip in molar tubeTip in molar tube 1.1. Torque PrescriptionTorque Prescription  IncisorsIncisors  CaninesCanines  Upper molarsUpper molars  Lower premolars and molarsLower premolars and molars
  4. 4. 44 Range of bracketsRange of brackets 1.1. Standard size metal bracketsStandard size metal brackets  where control is the main requirementwhere control is the main requirement 1.1. Mid-size metal bracketsMid-size metal brackets  Give less control,Give less control,  but are useful for cases with smallbut are useful for cases with small teeth,teeth,  where there is poor oral hygiene, orwhere there is poor oral hygiene, or  where control needs are modestwhere control needs are modest 1.1. Esthetic bracketsEsthetic brackets  For older patients, where a metalFor older patients, where a metal appearance will not be acceptable.appearance will not be acceptable.
  5. 5. 55 Rhomboidal shapeRhomboidal shape  Rhomboidal shape reduces theRhomboidal shape reduces the bulk of each bracket andbulk of each bracket and coordinates perspective linescoordinates perspective lines through only two planes,through only two planes, thereby assisting accuracy ofthereby assisting accuracy of bracket placement.bracket placement. 8
  7. 7. 77 PastPast Roth once said :Roth once said :  ““the A-company’s SWA asthe A-company’s SWA as developed by L. Andrewsdeveloped by L. Andrews is truly ais truly a SWASWA from the stand point of afrom the stand point of a levellevel slot lineupslot lineup..  …… i.e. all the slots of the brackets arei.e. all the slots of the brackets are at the same height and level in allat the same height and level in all three dimensions when the teeth arethree dimensions when the teeth are in the correct positions”.in the correct positions”.
  8. 8. 88  This is accomplished by theThis is accomplished by the contours forcontours for torquetorque,, rotationsrotations andand in-outin-out being built into thebeing built into the base of the bracketsbase of the brackets”.”.  It isIt is physically impossiblephysically impossible toto achieve this slot lineup with anyachieve this slot lineup with any appliance that does not haveappliance that does not have the compound contoured basethe compound contoured base with torque in the base”.with torque in the base”.
  9. 9. 99 PresentPresent  During 1During 1stst & 2& 2ndnd generation PEAgeneration PEA brackets, technology was notbrackets, technology was not available to set bracket slots in theavailable to set bracket slots in the correct position relative to the facialcorrect position relative to the facial surfaces of the crowns ( i.e.surfaces of the crowns ( i.e. level slotlevel slot lineuplineup) without torque-in-base.) without torque-in-base.  With the introduction of CAD-CAM,With the introduction of CAD-CAM, however, the torque-in-base concepthowever, the torque-in-base concept has been given less importance.has been given less importance.
  10. 10. 1010  Modern bracket systems,Modern bracket systems, including the MBTincluding the MBTTMTM system,system, have been developed usinghave been developed using CAD-CAM.CAD-CAM.  However, at present this isHowever, at present this is available with theavailable with the Mid-Size MBTMid-Size MBT bracketsbrackets only.only.
  11. 11. 1111 Adv. of CAD-CAM:Adv. of CAD-CAM:  To create correct relationshipTo create correct relationship between the midpoint on thebetween the midpoint on the tooth & the slot basetooth & the slot base (as with(as with traditional torque-in-base)traditional torque-in-base) &&  Flexibility of design in relationFlexibility of design in relation to:-to:-  brackets strengthbrackets strength  depth of tie wing &depth of tie wing &  labio-lingual profile of bracket.labio-lingual profile of bracket.
  13. 13. 1313 IN-OUT SPECIFICATIONIN-OUT SPECIFICATION  For second premolar:For second premolar:  AnAn alternative bracketalternative bracket which is 0.5mmwhich is 0.5mm thicker than normal is helpful inthicker than normal is helpful in obtaining good alignment of marginalobtaining good alignment of marginal ridges in cases with small upper secondridges in cases with small upper second premolars.premolars.  Rest of the teeth:Rest of the teeth:  Original SWA in-out specification wasOriginal SWA in-out specification was used.used.
  15. 15. 1515 Upper and Lower Anterior TipUpper and Lower Anterior Tip  Anterior Tip measurements in SWAAnterior Tip measurements in SWA are greater than non-orthodonticare greater than non-orthodontic normals.normals.  This was presumably done toThis was presumably done to control thecontrol the ““wagon wheelwagon wheel”” effect thateffect that torque places on anterior crown tip.torque places on anterior crown tip.  Note:Note:  As palatal root torque is added to theAs palatal root torque is added to the anterior segment, mesial crown tip isanterior segment, mesial crown tip is reduced.reduced.
  16. 16. 1616 Advantage of reduced anterior tip:Advantage of reduced anterior tip: 1.1. Reduced tip value of cuspids avoidsReduced tip value of cuspids avoids the problem ofthe problem of cuspid and bicuspidcuspid and bicuspid rootsroots that finish in close proximity.that finish in close proximity. 2.2. It also reduces the need forIt also reduces the need for anchorageanchorage control.control. 3.3. Since the value is identical to normalSince the value is identical to normal values, there isvalues, there is no compromise inno compromise in idealideal static occlusionstatic occlusion.. 4.4. And if the condyles are in centricAnd if the condyles are in centric relation, there isrelation, there is no compromise inno compromise in idealideal functional occlusionfunctional occlusion asas described by Roth.described by
  17. 17. 1717 Clinical pointClinical point (Tip visualization)(Tip visualization)
  18. 18. Tip in the Molar tubesTip in the Molar tubes  When usingWhen using 5/-9° brackets5/-9° brackets (tip = +5°) in(tip = +5°) in the upper molars it is necessary tothe upper molars it is necessary to placeplace the bands at 5° to the buccalthe bands at 5° to the buccal cusps,cusps, in order to get the bracket wingsin order to get the bracket wings parallel to the buccal groove of theparallel to the buccal groove of the tooth.tooth.  BandsBands do not fit welldo not fit well in this position andin this position and it is difficult to routinely place them init is difficult to routinely place them in this way.this way.  It is preferable therefore to useIt is preferable therefore to use 0/-9°0/-9° bracketsbrackets (tip = - 5°) and place the molar(tip = - 5°) and place the molar bandsbands parallel with buccal cuspparallel with buccal cusp of theof the molarsmolars 1818
  19. 19. 1919  If molar tubes are placedIf molar tubes are placed parallel to the buccal cuspsparallel to the buccal cusps ofof the molars athe molars a 00° tip bracket° tip bracket willwill deliverdeliver   5° of tip for the uppers and5° of tip for the uppers and  2° of tip for the lowers.2° of tip for the lowers.
  21. 21. Additional Incisor TorqueAdditional Incisor Torque  In most of the cases, it isIn most of the cases, it is necessary to achieve palatalnecessary to achieve palatal root torque for theroot torque for the upperupper incisors and labial root torqueincisors and labial root torque for the lower incisors.for the lower incisors.  Increasing the torque values inIncreasing the torque values in these bracketsthese brackets reduces thereduces the amount of wire bendingamount of wire bending at laterat later stages.stages. 2121
  22. 22. 2222 Torque visualizationTorque visualization
  23. 23. Upper Canine TorqueUpper Canine Torque  The prescription on the canineThe prescription on the canine brackets have been reducedbrackets have been reduced and currentlyand currently 0° canine brackets0° canine brackets are used so that the canineare used so that the canine roots are keptroots are kept in cancellousin cancellous bonebone while retracting, whichwhile retracting, which offers lesser resistance.offers lesser resistance. 12323
  24. 24. 2424 Lower Canine TorqueLower Canine Torque
  25. 25. 2525 Upper Molar TorqueUpper Molar Torque  The upper molars, on the otherThe upper molars, on the other hand, frequently show excessivehand, frequently show excessive buccal crown torque with palatalbuccal crown torque with palatal cuspscusps “hanging down”“hanging down” which createswhich creates centric, balancing side and workingcentric, balancing side and working side interferences.side interferences.  For this reason it is preferable toFor this reason it is preferable to use -14° of buccal root torque inuse -14° of buccal root torque in these teeth, as opposed to only -9°these teeth, as opposed to only -9° of buccal root torque in SWA.of buccal root torque in SWA.
  26. 26. 2626 Lower Premolar & MolarLower Premolar & Molar TorqueTorque  Many orthodontic cases demonstrateMany orthodontic cases demonstrate narrowing in the maxillary archnarrowing in the maxillary arch withwith lower posterior segments that arelower posterior segments that are compensated toward the lingual. Thesecompensated toward the lingual. These cases benefit from buccal uprighting ofcases benefit from buccal uprighting of the lower posterior segment.the lower posterior segment. Therefore, the lingual crown torque isTherefore, the lingual crown torque is reducedreduced by  5°5° in the lower premolars, byin the lower premolars, by  10°10° in the lower first molars,in the lower first molars, && byby  25°25° in the lower second the lower second
  27. 27. 2727 Lower posterior torqueLower posterior torque  It has been consistentlyIt has been consistently observed that lower secondobserved that lower second molars with -35° of torquemolars with -35° of torque consistentlyconsistently “roll in”“roll in” lingually.lingually.
  28. 28. 2828 Torque in the BaseTorque in the Base VSVS Torque in the FaseTorque in the Fase
  29. 29. 2929
  30. 30. 3030 FEATURES OF THE MBTFEATURES OF THE MBT VERSATILE+ APPLIANCEVERSATILE+ APPLIANCE 1. Design Features of MBT Bracket System 2.2. The Versatility of the MBTThe Versatility of the MBT Bracket SystemBracket System
  31. 31. 3131 Aspects of VersatilityAspects of Versatility 1.1. Palatally placed upper lateral incisors (-Palatally placed upper lateral incisors (- 10 )10 ) 2.2. Three Torque options forThree Torque options for  Upper canines (-7,0,+7).Upper canines (-7,0,+7).  Lower canines (-6,0,+6).Lower canines (-6,0,+6). 1.1. Interchangeable brackets –Interchangeable brackets –(same tip and(same tip and torque)torque)  Lower incisor bracketsLower incisor brackets  Upper premolar bracketsUpper premolar brackets 1.1. Finishing to a Class II molar relationshipFinishing to a Class II molar relationship  Use of second molar tubes for the upper first andUse of second molar tubes for the upper first and second molars of the opposite side.second molars of the opposite side. 1.1. In non-HG casesIn non-HG cases  Use of upper second molar tubes on first molars.Use of upper second molar tubes on first molars. Explained later
  32. 32. 3232 Palatally Displaced UpperPalatally Displaced Upper Lateral IncisorsLateral Incisors  During alignment stage, it isDuring alignment stage, it is necessary to create enough space.necessary to create enough space. 1 3 1 1
  33. 33. 3333  Lateral incisor is moved gently into the space created using .016 HANT 17°
  34. 34. 3434  Extra torque is required to act onExtra torque is required to act on lateral incisor to align its root.lateral incisor to align its root. 17°1010°°
  35. 35. 3535  Lateral incisor bracket is rotatedLateral incisor bracket is rotated 180° which changes the torque from180° which changes the torque from +10° to –10°+10° to –10° 1 3 1 11 2 12
  36. 36. 3636 Interchangeable lowerInterchangeable lower incisor bracketsincisor brackets Interchangeable
  37. 37. 3737 Interchangeable upper premolar brackets
  38. 38. 3838 In non-HG casesIn non-HG cases  Use of upperUse of upper second molar tubes on first molarssecond molar tubes on first molars
  39. 39. 3939 Finishing to a Class II molarFinishing to a Class II molar relationshiprelationship  Use of second molar tubes for theUse of second molar tubes for the upper first and second molars of the opposite side.upper first and second molars of the opposite side. ..
  40. 40. 4040 Factors Which Govern theFactors Which Govern the Selection of Canine Brackets:-Selection of Canine Brackets:- 1.1. Arch formArch form 2.2. Canine prominenceCanine prominence 3.3. Extraction decisionExtraction decision 4.4. OverbiteOverbite 5.5. Rapid palatal expansion casesRapid palatal expansion cases 6.6. Agenesis of upper lateral incisorAgenesis of upper lateral incisor
  41. 41. 4141 Why Torque options for theWhy Torque options for the canines :canines :  Effective torque control of the upperEffective torque control of the upper canines is necessary, because theycanines is necessary, because they are key elements in a mutuallyare key elements in a mutually protected occlusion.protected occlusion.  The inefficiency of the PEA inThe inefficiency of the PEA in delivering torque is evident whendelivering torque is evident when working with canines (longest rootsworking with canines (longest roots in the human dentition).in the human dentition).  The MBT philosophy usedThe MBT philosophy used twotwo typetype of canine brackets (in each arch) toof canine brackets (in each arch) to provideprovide three possible torque optionsthree possible torque options (in each arch).(in each arch)
  42. 42. 4242 1. Arch form1. Arch form  Well developed arches:Well developed arches: (not requiring substantial tooth movement)(not requiring substantial tooth movement)  -7-7°° upper caninesupper canines  -6-6°° lower canineslower canines  Ovoid or tapered arch form:Ovoid or tapered arch form:  00°° for upper caninesfor upper canines  00°° for lower caninesfor lower canines  Narrow tapered arch form:Narrow tapered arch form:  +7+7°° upper caninesupper canines  +6+6°° lower canineslower canines
  43. 43. 4343 2. Canine prominence2. Canine prominence  Prominent canines orProminent canines or  Gingival recession present:Gingival recession present:  upper canines = 0upper canines = 0°° or +7or +7°° torquetorque  lower canines = +6lower canines = +6°° torquetorque
  44. 44. 4444 3. Extraction decision3. Extraction decision  In premolar extraction cases orIn premolar extraction cases or  In cases where there isIn cases where there is considerable canine tip to beconsiderable canine tip to be corrected:corrected:  00°° torquetorque As they tend to maintain the canineAs they tend to maintain the canine roots in cancellous bone, therebyroots in cancellous bone, thereby making tip control of the jcaninemaking tip control of the jcanine roots easier.roots easier.
  45. 45. 4545 4. Overbite4. Overbite  In class II/2 cases andIn class II/2 cases and  Other deep bite situationsOther deep bite situations  Lower canine = 0Lower canine = 0°° or +6or +6°° torquetorque There is often a requirement toThere is often a requirement to move the lower canine crownsmove the lower canine crowns labially, but to maintain the rootslabially, but to maintain the roots centered in the bone.centered in the bone.
  46. 46. 4646 5. Rapid palatal expansion5. Rapid palatal expansion casescases  Widening of the upper archWidening of the upper arch creates a secondary widening increates a secondary widening in the lower arch = torque changesthe lower arch = torque changes among lower teeth.among lower teeth.  lower canine = 0lower canine = 0°° or +6or +6°° torquetorque Recommended to assist thisRecommended to assist this favorable change.favorable change.
  47. 47. 4747 6. Agenesis of upper lateral6. Agenesis of upper lateral incisorincisor  If to close the spaces of missingIf to close the spaces of missing lateral incisors with caninelateral incisors with canine mesialization:mesialization:  Canine bracket = +7Canine bracket = +7°° torquetorque
  48. 48. 4848 Thank youThank you For more details please visitFor more details please visit