Edge wise 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.

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Edge wise appliance /certified fixed orthodontic courses by Indian dental academy

  1. 1. EDGEWISE APPLIANCE www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. CONTENTS ► INTRODUCTION ► ANGLE’S PHILOSOPHY ► STANDARD EDGEWISE APPLIANCE ► EVOLUTION ► ATTATCHMENTS BRACKETS BUCCAL TUBES www.indiandentalacademy.com
  4. 4. ► BRACKET PLACEMENT ► BUCCAL TUBE PLACEMENT ► BRACKET ANGULATION www.indiandentalacademy.com
  5. 5. DR.EDWARD HARTLEY ANGLE ► The edgewise arch mechanism was the brain child of this master technician. ► By the time of Dr.Tweed,1930,with the introduction of milled brackets, S.S ligature wires it had evolved into a precision appliance, that demanded accurate fitting and placement of bands and attachments on teeth. www.indiandentalacademy.com
  6. 6. INTRODUCTION ► The edgewise arch mechanism/appliance was Dr Angle’s last and greatest contribution to orthodontics ,after almost a lifetime devoted to improvement of orthodontic appliances. ► Edgewise mechanism was designed to place teeth into Angle’s concept of line of occlusion: “the line with which in form and position according to type, the teeth must be in harmony if in normal occlusion.” www.indiandentalacademy.com
  7. 7. ANGLE’S PHILOSOPHY OF TREATMENT ► Based on the then prevalent assumption that, if cuspal interdigitation of teeth were made normal, stimulation by function would result in growth of basal bone structures. ► Little or no thought was given to the inclination of the mandibular incisor teeth or to normal mesiodistal relation of teeth and their respective jaw bases and head structures. ► It was assumed that function would take care of such matters. ► Extraction of teeth for orthodontic therapy wasn’t even an option . www.indiandentalacademy.com
  8. 8. ► E.H. Angle – Graduation 1878, experienced many technical problems and frustrations in treatment which irritated, motivated and inspired him to develop a standard appliance. His obsession for order motivated him to create the Angle System (1887) ► This ultimately resulted in the multi banded edgewise appliance 5yrs before his death. www.indiandentalacademy.com
  9. 9. EVOLUTION OF EDGEWISE APPLIANCE  ► ► ► ► ANGLE E-ARCH PIN & TUBE (1911) RIBBON ARCH APPLICANCE (1915) EDGEWISE APPLIANCE (1925) EVOLUTION OF EDGEWISE BRACKETS: 1) 2) 3) 4) 5) SINGLE WIDTH BRACKET SIAMESE BRACKET LEWIS BRACKET STIENER BRACKET BROUSSARD BRACKET www.indiandentalacademy.com
  10. 10. EDGEWISE APPLIANCE (1925) To overcome the deficiencies of his previous appliances, Angle changed the form of the bracket in the ribbon arch appliance - He placed the slot in the centre and oriented the slot from vertical to horizontal and inserted a rectangular wire rotated 900 to the orientation the wire had with the ribbon arch bracket (hence the name edgewise) ► Bracket wide mesio-distally ► Rectangular slot for rectangular archwire ► .022x.028 inch slot size, same size wire ► Archwire inserted in narrowest dimension -EDGEWISE ► brackets were referred to initially as "open face" or "tie brackets.“ ► ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Julwww.indiandentalacademy.com (26 - 37): Expanding horizons of edgewise arch wire slot - Kesling
  11. 11. Edgewise appliance www.indiandentalacademy.com
  12. 12. ► ► ► The high degree of control afforded by the edgewise bracket provides a sense of security. Each tooth is always under complete mesiodistal tip control. Teeth are restricted by the brackets, not only from tipping independently in undesired directions, but also from tipping in desired directions. Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Jul (26 - 37): Expanding horizons of edgewise arch wire slot - Keslin www.indiandentalacademy.com
  13. 13. THE STANDARD APPLIANCE USED BY ANGLE ► Basic components of the standard appliance used by Angle: Traction screw, jack screw, attachment tubes, band material ligature wire, arch wire, www.indiandentalacademy.com
  14. 14. ► Bands ► Obsolete wingless bracket ► Washers ► Staples ► Ligature wire www.indiandentalacademy.com
  15. 15. ► Unique feature  rectangular wire in rectangular slot  twisting / torquing forces could be imparted to control the axial inclination of teeth ► So possible to move teeth in all 3 planes of space with a single arch wire. www.indiandentalacademy.com
  16. 16. ► For rectangular wire to move teeth into the “line of occlusion”, it had to be shaped into normal arch form and given proper twist or torque for individual teeth. ► Angle recommended use of smaller diameter round archwires in the early stages of treatment. www.indiandentalacademy.com
  17. 17. ATTATCHMENTS ► BRACKETS ► BUCCAL TUBES ► LIGATURE TIE WIRE www.indiandentalacademy.com
  18. 18. EVOLUTION OF EDGEWISE BRACKETS Original bracket – ► soft gold , ► .022 x .028 inch slot ► Slot was readily deformed by the forces of occlusion. www.indiandentalacademy.com
  19. 19. 1)Single width brackets :► original bracket .050 inch wide & soldered to the gold band material ► archwire rests on bottom of bracket slot instead of the band ► ineffective for tooth rotation because of the narrow width ► Angle devised gold eyelets for rotation to be soldered on bands ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hocevar www.indiandentalacademy.com
  20. 20. DISADVANTAGE ► Repeated tying of the eyelets for rotation. ► Necessary to continue tying eyelets throughout treatment to prevent relapse. ► Tying rotation eyelets is time consuming. ► Ineffective. www.indiandentalacademy.com
  21. 21. 2)Twin brackets:- two brackets on one base -“Siamese twin brackets” by Swain - space between two brackets was .050 inch (equal to width of one bracket ) - Available in different widths:► Extra wide ► Standard ► Intermediate ► Junior www.indiandentalacademy.com
  22. 22. Twin brackets www.indiandentalacademy.com
  23. 23. ADVANTAGE ► ability to effect tooth rotations without using auxiliary rotation ties. www.indiandentalacademy.com
  24. 24. 3)Curved base twin bracket:► curved bases to confirm to the curvatures of the canines & premolars www.indiandentalacademy.com
  25. 25. ADVANTAGE ► Offers a positive control (greater axial inclination control) www.indiandentalacademy.com
  26. 26. DISADVANTAGE ► increased width decreases the inter bracket span (i.e. length of archwire between brackets), thus decreasing the resiliency. ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hoceva www.indiandentalacademy.com
  27. 27. 4)Lewis bracket:► Developed by Lewis in 1950. ► To overcome the problem of efficient tooth rotation. ► He soldered auxillary rotation arms that abutted against the bracket itself, thus, offered a lever arm to deflect the archwire & rotate the tooth. ► One piece bracket with integral rotation wings www.indiandentalacademy.com
  28. 28. ADVANTAGE ► These wings do not interfere with occlusogingival deflections of archwire & do not decrease the interbracket span ► 100% of the desired tooth rotation is possible. www.indiandentalacademy.com
  29. 29. 5)Curved base Lewis bracket:► Curved base confirms to the canine, premolar surface ► Types:- Long Short www.indiandentalacademy.com
  30. 30. ADVANTAGE ► Wings lie close to the tooth throughout their length ,so less trapping of food ► Increases the surface area www.indiandentalacademy.com
  31. 31. 6)Vertical slot Lewis bracket :► ► Incorporation of .020 x .020 inch vertical slot Possible to use uprighting spring to correct axial inclinations if needed www.indiandentalacademy.com
  32. 32. ADVANTAGE 1) complete rotational control 2) do not reduce the interbracket span www.indiandentalacademy.com
  33. 33. 7) Steiner bracket :► ► ► Given by Cecil C Steiner in 1931 Incorporated flexible rotation arms & so did not rely on the resiliency of the archwire for tooth rotation Introduced tie wings for ease of ligation www.indiandentalacademy.com
  34. 34. ADVANTAGE ► Easy to tie ► Quite efficient for tooth rotation www.indiandentalacademy.com
  35. 35. DISADVANTAGE ► Once permanent deformation of the arms has occurred, complete rotation will not be effective unless the arms are adjusted to their original positions. www.indiandentalacademy.com
  36. 36. 8)Broussard bracket:► ► Designed by Garford Broussard for use in the Broussard technique Addition of a 0.0185 x 0.046 inch vertical slot to accept a doubled 0.018 inch auxillary wire www.indiandentalacademy.com
  37. 37. EVOLUTION OF EDGEWISE BUCCAL TUBE ► ► ► ► 1)Original buccal tube was a piece of .022x .028 inch gold or nickel silver tubing soldered to the molar band Length –3/16 or ¼ inch Buccal tube is for the insertion and stabilisation of the archwire. Notched distal ends - to facilitate a tie back ligature www.indiandentalacademy.com
  38. 38. Hook – gingival to buccal tubes, soldered on the bands for placement of elastics Inconel tube - gold buccal tubes were discarded - is preattatched to the curved and contoured welding flange. www.indiandentalacademy.com
  39. 39. 2)Combination buccal tubes ► Incorporates a round tube for insertion of a face bow ► Posses sufficient rigidity to resist deformation from the forces of occlusion. ► Fairly close tolerances must be maintained between archwire & tube for effective transmission of torque to the tooth www.indiandentalacademy.com
  40. 40. 3)Triple buccal tube ► additional rectangular tube for auxillary sectional & base archwire www.indiandentalacademy.com
  41. 41. LIGATURE TIE WIRE ► Used to attatch archwire to the bracket. ► Dead soft .009 or .010 inch stainless steel ligature wire is used. www.indiandentalacademy.com
  42. 42. BRACKET & TUBE PLACEMENT ► Angle - “goal of correct bracket & tube placement is to produce an ideal occlusion at the end of treatment with flat, straight, ideal archwires ► Brackets were soldered to band strips with the slot parallel to the band strip. ► General rule was to place band strip with the brackets parallel to the long axis of the teeth. www.indiandentalacademy.com
  43. 43. ► Posterior brackets were angulated to produce desired tooth movements www.indiandentalacademy.com
  44. 44. ► Holdaway (1952) described three uses for bracket angulation a) as an aid in paralleling roots adjacent to extraction spaces b) as a method of setting up posterior anchorage units into tipped back or anchorage prepared positions c) as a means of obtaining correct axial inclinations or artistic positioning www.indiandentalacademy.com
  45. 45. REFERENCES  Orthodontics Current Principles and Techniques - Thomas Graber , Robert Vanarsdall  Contemporary Orthodontics - William R. Proffit  Orthodontics Principles and Practice T.M.Graber www.indiandentalacademy.com
  46. 46. REFERENCES ► Orthodontics Current Principles and Techniques – Thomas Graber , Brainerd F. Swain. ► AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hoceva ► AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1988 Jul (26 - 37): Expanding horizons of edgewise arch wire slot - Keslin www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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