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Materials in orthodontics /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......

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 www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. MATERALS IN ORTHODONTICS www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 2. IMPRESSION MATERIALS ACRYLIC MATREIAL –REMOVABLE PLATE BANDS BRACKETS CEMENTS ARCH WIRES BONDING MATERIALS ELASTICS MAGNETS IN ORTHODONTICS www.indiandentalacademy.com
  • 3. IMPRESSION MATERIAL ALGINATE composition type- fast & slow setting properties www.indiandentalacademy.com
  • 4. BAND MATERIAL STAINLESS STEEL PREFORMED FABRICATE Different sizes Preformed – according to diff. manufactures Fabricate- band material -150X0.005” 180x 0.005”www.indiandentalacademy.com
  • 5. S S BANDS Preformed www.indiandentalacademy.com
  • 6. BRACKETS GOLD STAINLESS STEEL CERAMIC(TOOTH COLOURED) TITANIUM www.indiandentalacademy.com
  • 7. STAINLESS STEEL BRACKET Pre-adjusted edgewise bracketwww.indiandentalacademy.com
  • 8. Beggs bracket – vertical slot www.indiandentalacademy.com
  • 9. Nickel sensitivity – titanium as an alternative to SS bracket Cutaneous sensitization to nickel develop from skin contact with any jewelry Most common in females www.indiandentalacademy.com
  • 10. CERAMIC BRACKET www.indiandentalacademy.com
  • 11. Introduced in late 1980s Advantage – tooth colored Disadvantage – 1. Staining and discoloration in patient who smoke & drink coffee more 2 .Poor dimensional stability 3 .Friction b/n plastic bracket and arch wire www.indiandentalacademy.com
  • 12. CEMENTS Cementing orthodontic bands ZINC PHOSPHATE GIC(LUTING) MODIFIED GIC-LIGHT CURE www.indiandentalacademy.com
  • 13. GIC www.indiandentalacademy.com
  • 14. For a patient visiting to orthodontists The only Medicine Will Be Forcewww.indiandentalacademy.com
  • 15. WIRES Composition Manufacturing & Heat Treatment Properties www.indiandentalacademy.com
  • 16. ARCH WIRES CLASSIFICATION 1] According to the material used : S.S Elgiloy Niti TMA 2] According to shape Round: 0.014 , 0.016 , 0.018 etc Rectangular : 0.016x0.16 ;0.016 x0.022 ; 0.017x0.025 3] According to the properties of springiness : Elastic / Springy Intermediate Rigid www.indiandentalacademy.com
  • 17. www.indiandentalacademy.com
  • 18. BASIC PROPERTIES OF ELASTIC MATERIAL STRESS – is internal distribution of load defined as force per unit area. STRAIN – is internal distortion produced by load defined as deflection per unit length. www.indiandentalacademy.com
  • 19. www.indiandentalacademy.com
  • 20. Orthodontic arch wires are like elastic material which shows typical force deflection curve Point of arbitrary clinical loading stiffness Range www.indiandentalacademy.com
  • 21. Orthodontic material properties STRENGTH STIFFNESS RANGE www.indiandentalacademy.com
  • 22. STRENGTH It is a force value that is a measure of the maximum possible load i.e., the greatest force that a wire can sustain or deliver, if it is loaded to the limit of the material. Strength measured in stress units i.e gm/cm2 www.indiandentalacademy.com
  • 23. STIFFNESS It is the rate of force delivery required for a unit activation . It is the measure of the force required to bend or otherwise deform the material to a definite distance. www.indiandentalacademy.com
  • 24. RANGE Range is defined as the distance that the wire will bend elastically before permanent deformation occurs. Range is usually determined from the 0.1% offset point on the force – deflection diagram. www.indiandentalacademy.com
  • 25. Strength,Stiffness and Range have an important relationship,i.e., Strength = Stiffness x Range www.indiandentalacademy.com
  • 26. www.indiandentalacademy.com
  • 27. Resilience –represents the energy storage capacity of the wire Formability- amount of permanent deformation that wire sustain before failing www.indiandentalacademy.com
  • 28. IDEAL WIRE MATERIAL FOR ORTHODONTIC PURPOSE IT SHOULD POSSESS High Strength Low Stiffness High Range High Formability www.indiandentalacademy.com
  • 29. The material should be Weldable or Solderable Low cost www.indiandentalacademy.com
  • 30. ORTHODONTIC ARCH WIRE MATERIAL PRECIOUS METAL ALLOYS STAINLESS STEEL COBALT-CHROMIUM ALLOYS(ELGILOY) NICKEL-TITANIUM (NiTi) ALLOYS BETA TITANIUM( TMA) COMPOSITE PLASTIC TOOTH COLORED WIRES www.indiandentalacademy.com
  • 31. PRECIOUS METAL ALLOYS Use routinely before 1950s Gold , platinum, palladium etc www.indiandentalacademy.com
  • 32. GOLD ALLOY WIRES The first wire introduced for orthodontic purpose was made of gold Gold arch wires were the ideal choice of arch wires with good bio-compatibility. www.indiandentalacademy.com
  • 33. Composition of many gold alloy wires corresponds to the type IV gold casting alloys They are also subjected to softening and hardening heat treatments. Crozat appliance was orignally made from gold in 1900s www.indiandentalacademy.com
  • 34. STAINLESS STEEL ALLOY Stainless steel wires began to replace gold wires in the 1930’s . Steels are iron – based alloys that usually contain less than 1.2% carbon. www.indiandentalacademy.com
  • 35. Silicon,phosphorous,sulphur, manganese, tantalum, and niobium may also be present in small amounts. The balance is iron. These alloys are often designated as American Iron and Steel Institute(AISI) Series 400 stainless steels. www.indiandentalacademy.com
  • 36. When 12-30% chromium is added to steel the alloy is commonly called STAINLESS STEEL. For orthodontic purpose 18:8 stainless steel is used ( 18% chromium and 8% nickel) www.indiandentalacademy.com
  • 37. S S replaces Gold wire because of its better strength and springiness Properties of steel wires controlled by amount of cold working and annealing Steel is soften- by annealing Harden –by cold working Fully annealed wire – making ligature wire. (dead soft wire) www.indiandentalacademy.com
  • 38. Ligature wire www.indiandentalacademy.com
  • 39. AUSTRALIAN ORTHODONTIC ARCHWIRE –stainless steel A. J. Wilcock of Victoria, Australia, produced the orthodontic archwire to meet Dr. Begg’s needs for use in Begg technique. The wire produced has certain unique characteristics different from usual stainless steel wires www.indiandentalacademy.com
  • 40. www.indiandentalacademy.com
  • 41. Grading and colour coding of Australian Orthodontic Arch wires REGULAR GRADE : White label REGULAR PLUS GRADE : Green Label SPECIAL GRADE : Black Label SPECIAL PLUS GRADE : Orange Label www.indiandentalacademy.com
  • 42. Each grade of wire is available in diameters of 0.010″, 0.012″, 0.014″, 0.016″, 0.018″, 0.020″, 0.022″. They are supplied in the form of spools or cut lengths of the wire. www.indiandentalacademy.com
  • 43. CLINICAL USE OF STAINLESS STEEL WIRE Orthodontic stainless steel is the most widely used alloy in orthodontics. Its application as Arch wires Auxillaries -springs Retainers Removable appliances Bands etc. www.indiandentalacademy.com
  • 44. www.indiandentalacademy.com
  • 45. www.indiandentalacademy.com
  • 46. The wires are available both in round as well as rectangular cross-sections. The Australian stainless steel wires described previously are used in the Begg’s technique as well as in the preadjusted edgewise technique www.indiandentalacademy.com
  • 47. MULTISTRANDED WIRES Twist flex- UNITEK Force 9 - ORMCO D-rect – ORMCO Respond – ORMCO www.indiandentalacademy.com
  • 48. Nickel Titanium Wires (NiTi) William F. Buehler in 1960’s invented Nitinol NOL (Naval Orddnance Laboratory) Ni – Nickel ti-titanium www.indiandentalacademy.com
  • 49. Andreasen G.F. and co- workers introduced the use of nickel-titanium alloys for orthodontic use in the 1970’s. www.indiandentalacademy.com
  • 50. COMPOSITION 55% nickel 45% titanium 1.6% cobalt also is added to obtain desirable properties. www.indiandentalacademy.com
  • 51. NiTi can exists in more than one form or crystal structure. MARTENSITIC FORM – exists at lower temperature AUSTENTIC FORM - at higher temperature www.indiandentalacademy.com
  • 52. PROPERTIES Shape Memory Super elasticity Both of these properties occur at low transition temperature b/n the martensitic and austenitic forms. www.indiandentalacademy.com
  • 53. Shape memory - This indicates that a material will return to its desired shape after being plastically deformed while in martensitic form. www.indiandentalacademy.com
  • 54. THERMOELASTICITY When alloy is cooled below transition temperature it deforms plastically, but when it is heated again the original shape is restored----this property called thermoelasticity. www.indiandentalacademy.com
  • 55. Thermodynamic –refers to the ability of an archwire to return to its intended shape once heated through its transition temperature. To be of clinical value, thermodynamic archwires must have a transition range close to mouth temperature. www.indiandentalacademy.com
  • 56. Andreasen introduced 0.019 inch thermal nitinol wire with a transition temperature range between 31° C and 45° C. www.indiandentalacademy.com
  • 57. Martensitic NiTi first marketed by Rocky Mountain & is now commercially available as M NiTi In later 1980s NiTi wires with an active austenitic grain structures (A NiTi) appeared- with property of superelasticity www.indiandentalacademy.com
  • 58. Super elasticity – This property can be produced by stress and not temperature difference. Therefore it is called as stress induced martensitic transformation www.indiandentalacademy.com
  • 59. A NiTi – force applied is not the same as force applied to activate it. i.e means unloading curve differs from its loading curve E.g Copper NiTi www.indiandentalacademy.com
  • 60. www.indiandentalacademy.com
  • 61. Type I Type II Type III Type IV advantage of cu- NiTi produced light continuous forces for long duration. Cu NiTi (copper NiTi) www.indiandentalacademy.com
  • 62. TYPE I wire –Af 150 generate very high forces TYPE II wire- A f270 generate highest force among all Uses- in pt with higher pain threshold normal periodontal health rapid tooth movement is required www.indiandentalacademy.com
  • 63. Type III Wire- Af 350 generate midrange force normal pain threshold patient generate light force use in normal or slightly compromised periodontal patient www.indiandentalacademy.com
  • 64. PROPERTIES OF COPPER NiTi WIRES 1. Copper Ni Ti generates a more constant force over long activation spans than other nickel titanium alloys and does so on a consistent basis, from archwire to archwire. www.indiandentalacademy.com
  • 65. For every small activations, Copper NiTi generates near constant force, unlike other nickel titanium alloys. Copper NiTi is more resistant to permanent deformation compared with other nickel titanium alloys; it exhibits better spring back characteristics. www.indiandentalacademy.com
  • 66. Type IV – Af 400 generate tooth driving force forces are intermittent use in pt who are sensitive to pain periodontal compromised cases www.indiandentalacademy.com
  • 67. Another wire called the Japanese Niti wire introduced by Fujio Miura is manufactured by a different process and demonstrates super elasticity. www.indiandentalacademy.com
  • 68. Another nickel titanium alloy introduced by Burstone developed by Dr Tien Hua Cheng called as Chinese Niti alloy exhibits superior spring back property when compared to Nitinol www.indiandentalacademy.com
  • 69. Due to little work hardening and presence of the parent phase which is austenite yielding better mechanical properties. www.indiandentalacademy.com
  • 70. CLINICAL USE OF NICKEL TITANIUM WIRES Nickel titanium wire can produce an uniform constant force which is delivered for a long period of time during the de-activation of the wire. www.indiandentalacademy.com
  • 71. Because of its superior spring back, superelasticity, shape memory, and its ability to produce light force for longer duration , NiTi is  ideal wire for initial levelling and aligning.  www.indiandentalacademy.com
  • 72. BEFORE AFTER ALIGNMENT www.indiandentalacademy.com
  • 73.  Rectangular NiTi allows full engagement of the bracket slot and give better torque control in the initial phase of treatment. Recently a NiTi palatal expander www.indiandentalacademy.com
  • 74. NiTi is also available in the form of coil springs. Used for distalisation of molars. www.indiandentalacademy.com
  • 75. Reverse curve NiTi, also known as Rocking chair NiTi helps in bite opening and when placed down helps in bite closure along with levelling and aligning. www.indiandentalacademy.com
  • 76. Cobalt Chrome alloy (Elgiloy) Developed during the 1950’s by the Elgiloy Corporation(Elgin, IL,USA). Manufactured for watch springs by Elgin watch company, hence the name Elgiloy. www.indiandentalacademy.com
  • 77. COMPOSITION 40% cobalt, 20% chromium, 15% nickel, 7% Molybdenum, 2% manganese, 0.16% carbon, 0.04% beryllium and 15.8% iron. www.indiandentalacademy.com
  • 78. Supplied in softer form and harden by heat treatment Heat treatment – increases the strength www.indiandentalacademy.com
  • 79. TYPES OF CHROME COBALT ALLOY WIRES Blue(soft) elgiloy : bent easily with finger pressure pliers. Heat treatment of blue elgiloy increases its resistance to deformation. www.indiandentalacademy.com
  • 80. Yellow elgiloy : Relatively ductile and more resilient than blue elgiloy. Further increase in its resilience and spring performance can be achieved by heat www.indiandentalacademy.com
  • 81. Green elgiloy : More resilient than yellow elgiloy and can be shaped with pliers before heat treatment. Red elgiloy : Most resilient of elgiloy wires, with high spring qualities, . Heat treatment makes it extremely resilient. www.indiandentalacademy.com
  • 82. β – TITANIUM – TITANIUM MOLYBDENUM ALLOY OR T.M.A. high temperature” form of titanium alloy became available. At temperature above 1625°F pure titanium rearranges into a body centered cubic lattice (B.C.C.), referred to as ‘Beta’ phase. www.indiandentalacademy.com
  • 83. Addition of elements as molybdenum or columbium, a titanium based alloy can maintain its beta structure even when cooled to room temperature. Such alloys are referred as beta stabilized titanium. www.indiandentalacademy.com
  • 84. High temp Ti – Beta phase Molybdenum + Ti –TMA i.e in low temp maintain beta phase www.indiandentalacademy.com
  • 85. PROPERTIES TMA Excellent formability] Reduced load/deflection Excellent resiliency www.indiandentalacademy.com
  • 86. Elastics Made up of latex Separator E chain module www.indiandentalacademy.com
  • 87. www.indiandentalacademy.com
  • 88. www.indiandentalacademy.com
  • 89. www.indiandentalacademy.com
  • 90. www.indiandentalacademy.com
  • 91. CLINICAL USE choice for utility arches.- INTRUSION www.indiandentalacademy.com
  • 92. TOOTH COLOURED ORTHODONTIC WIRES current generation are built of composite plastics, Optiflex WIRE Made of clear optical fibre, it comprises of three layers. CV NiTi WIRES www.indiandentalacademy.com
  • 93. Indirect bonding www.indiandentalacademy.com
  • 94. Indirect bonding SILVERMAN AND COHEN – 1972 MMA and UV light activated unfilled BISGMA MMA was applied to the plastic bracket base on the patient’s model BISGMA –intermediary adhesive between the patients etched enamel & pre set adhesive on the bracket base www.indiandentalacademy.com
  • 95. Indirect bonding Updated technique – 1974 by same authors Used perforated metal bracket bases and only one adhesive- BISGMA[ UV light activated] Increased operator working time as polymerization did not occur www.indiandentalacademy.com
  • 96. INDIRECT BONDING ADVANTAGES Accurate bracket placement Decreasing the chair side time Avoiding band fitting on the posterior teeth Eliminating the need for separators Improved ability to bond the posteriors Improved patient comfort and hygiene www.indiandentalacademy.com
  • 97. INDIRECT BONDING Disadvantages Technique sensitive Additional set of impressions need to be taken Posterior attachments more likely to fail if the patient chews on hard food www.indiandentalacademy.com
  • 98. Indirect bonding techniques Thomas technique Silicon transfer tray Double sealant technique Moin & Dogon technique Indirect method – Anoop Sondhi Indirect bonding for light cured composites www.indiandentalacademy.com
  • 99. Indirect bonding Moin & Dogon technique AJO 1977 Pour impression in stone A drop of sticky wax is placed on teeth surfaces of cast Brackets are warmed over flame and set on the cast www.indiandentalacademy.com
  • 100. Indirect bonding - Moin & Dogon technique Impression made with polyether material Tray separated from cast but brackets remain in situ Bracket is removed from the cast &warmed to remove residual wax They are placed into the impression www.indiandentalacademy.com
  • 101. Teeth are pumiced,etched & isolated Enamel surface is sealed with mixture of universal & catalyst sealant bracket base is covered with the adhesive tray is seated Indirect bonding - Moin & Dogon technique www.indiandentalacademy.com
  • 102. Indirect bonding - Moin & Dogon technique Use of sticky wax-corrections can easily &readily be made until optimal bracket alignment is obtained Previously used Adhesive tape - bracket displacement Bonding resin – cleaning of bracket base prior to bonding difficult and time consuming www.indiandentalacademy.com
  • 103. Indirect bonding – ANOOP SONDHI AJO 1999 NEW INDIRECT BONDING MATERIAL 3 M UNITEK / SONDHI RAPID SET Unique features Increased viscosity - silica fillers[5%] Quick set time – 30 secs Decreases the time needed for holding the bonding tray Completely cured 2 min allowing rapid removal of the tray www.indiandentalacademy.com
  • 104. Indirect bonding – ANOOP SONDHI Alginate impressions made working models poured in stone www.indiandentalacademy.com
  • 105. Indirect bonding – ANOOP SONDHI APC brackets used and positioned over the teeth excess adhesive removed www.indiandentalacademy.com
  • 106. Indirect bonding – ANOOP SONDHI Bracket positions checked Models are placed in the TRIAD curing unit 10 minutes www.indiandentalacademy.com
  • 107. Indirect bonding – ANOOP SONDHI Block the undercuts Construct tray with bioplast material [1mm] thick overlayered with bioacryl www.indiandentalacademy.com
  • 108. Indirect bonding – ANOOP SONDHI Excess tray material is trimmed off with scalpel Trays placed in the TRIAD unit to ensure that uncured resin is cured www.indiandentalacademy.com
  • 109. Indirect bonding – ANOOP SONDHI Prepare patient Pumice , Etch & isolate Tray can be sectioned if there is severe crowding www.indiandentalacademy.com
  • 110. Indirect bonding – ANOOP SONDHI Small amounts of resin A and B are poured into the wells Resin A – tooth surface Resin B – resin pads in the tray www.indiandentalacademy.com
  • 111. Indirect bonding – ANOOP SONDHI Seat the tray over the teeth Hold with uniform pressure for 30 seconds Leave the tray on for another 2 minutes to ensure complete polymerization www.indiandentalacademy.com
  • 112. not really a bracket placement device Rather it orients the arch wire slot of the bracket relative to the facial surface Accomplished by holding the archwire slot stationary while manipulating each tooth to any tip angle , torque, rotation & height . The slot machine & indirect bonding www.indiandentalacademy.com
  • 113. [ Orientation templates & rotation guides] www.indiandentalacademy.com
  • 114. SEALING Sealer / Primer / Intermediate resin Low viscosity resin which is applied prior to bonding .  Necessary to achieve proper bond strength  Improve resistance to microleakage  Both reasons  Not needed at all www.indiandentalacademy.com
  • 115. Chemically cured Sealant Light cured Ceen & Gwinnett Found Light cured sealant Chemically cured Protect enamel Polymerize poorly adjacent to bracket Have low resistance from discoloration towww.indiandentalacademy.com
  • 116. Evaluation of sealant in orthodontic bonding Wei Nanwang etal AJO 1991 Evaluated the Tensile bond strength with and without use of sealant They found no statistically significant difference in the bond strength of the two evaluated groups www.indiandentalacademy.com
  • 117. However the use of sealant May offer extra protection to enamel during debonding As chances of enamel surface detachment with out use sealant was greater. www.indiandentalacademy.com
  • 118. Self Etch Primer Unique characteristic of some bonding system is that they combine the Etchant + Primer into single product Saves time Cost efficient www.indiandentalacademy.com
  • 119. Self Etch Primer Prompt L Pop Transbond self etch primer Liquid begins to etch as soon as it is applied www.indiandentalacademy.com
  • 120. Etchant Primer When two hydroxide ions are converted hydrogen ions are released www.indiandentalacademy.com
  • 121. Procedure For Self Etch Teeth are pumiced Self etch primer gently swirled on to each enamel surface for 2 to 5 secs As pH rises , etchant is converted to primer Primer is thinned with burst of air No rinsing with water Bracket then bonded in usual way. www.indiandentalacademy.com
  • 122. Conclusion- No significant difference in bond strength between the two groups. 10 min delay in bonding after application of self etch primer might not be deleterious for adhesion www.indiandentalacademy.com
  • 123. Hydrophilic Primer ( MIP ) Bond failure – Moisture contamination When etched enamel is wet most porosities get plugged – Penetration of resin impaired Second molars – Access difficult Hydrophilic primer (HEMA & Maleic acid) dissolved in acetone – 3M Unitek ( Transbond MIP ) www.indiandentalacademy.com
  • 124. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com