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Orthodontic brackets part 1 /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 www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. Orthodontic brackets-part 1 INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Evolution of brackets (appliance) “All you can do is push ,pull ,or turn a tooth. “ Edward H Angle to Frederick Noyes Bracket- an attachment that serves to deliver the necessary tooth moving forces Bracket may be defined as an orthodontic attachment secured to a tooth for the purpose of engaging an arch wire .-Thurow www.indiandentalacademy.com
  • 3. www.indiandentalacademy.com
  • 4. Edward Hartley Angle www.indiandentalacademy.com
  • 5. Angle system A standard appliance must have five important properties1.Simple Patient Orthodontist 2.Stable 3.Efficiency Manufacturer/supplier 4.Delicate 5.Inconspicuous www.indiandentalacademy.com
  • 6. E Arch -1907 Basic E arch www.indiandentalacademy.com
  • 7. Ribbed E -arch www.indiandentalacademy.com
  • 8. E arch without threaded ends www.indiandentalacademy.com
  • 9. E arch with hooks www.indiandentalacademy.com
  • 10. Pin and tube-1910 www.indiandentalacademy.com
  • 11. The Ribbon Arch-1915 www.indiandentalacademy.com
  • 12. Edgewise Appliance      0.022*0.028 0.050 Inch wide Gold bracket Gold band Ligature tie www.indiandentalacademy.com
  • 13. Three dimensional control of tooth       First order bends Second order bends Third order bends In & out Tip torque www.indiandentalacademy.com
  • 14. Begg Appliance Dr P.R.Begg 1956   It utilizes 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 www.indiandentalacademy.com
  • 15. Lock pins  Safety lock pins  Hook lock pins  High hat pins www.indiandentalacademy.com
  • 16. Evolution of the edgewise brackets    Soldering gold eyelets- Angle Use of two brackets on a single tooth “Siamese twin brackets www.indiandentalacademy.com
  • 17. Twin brackets www.indiandentalacademy.com
  • 18. Tweed-Merrifield appliance     Double wide brackets on 6 anteriors Intermediate Single width brackets on Premolar bands Twin brackets on molars 0.022 tubes on second molars www.indiandentalacademy.com
  • 19. Twin brackets         ADVANTAGES Rotational control : mainly by deflection of arch wire Positive control DISADVANTAGES 10% play of arch wire Decreased amount of arch wire ,Inter bracket span & resiliency Closing loop arch wires Second order bends www.indiandentalacademy.com
  • 20. Lewis bracket  He soldered auxiliary rotation arm that abutted against the bracket itself and thus offered a lever arm to deflect arch wire and rotate the teeth www.indiandentalacademy.com
  • 21. Advantages of Lewis bracket Does not interfere with resiliency ,closing loops &second order bends  100% correction & over corrections  www.indiandentalacademy.com
  • 22. Curved Lewis bracket  1. 2. advantages Increase contact with band . Reduces trapping of the food. www.indiandentalacademy.com
  • 23. Vertical slot Lewis bracket Here further refinement was done by incorporating a 020 x020 vertical slot Use of up righting spring to correct axial inclination possible. www.indiandentalacademy.com
  • 24. Creekmore Uni Twin Bracket   Rationale –Twin bracket offered better rotational control which the single bracket could not match until the rotational wings were added Disadv-Badly rotated tooth www.indiandentalacademy.com
  • 25. Steiner bracket  This bracket incorporated flexible rotation arms and therefore did not rely entirely on the resiliency of arch wire for tooth rotation.  It uses a single width edgewise bracket and has the inherent advantage and disadvantage of the same  www.indiandentalacademy.com
  • 26. Broussard bracket    Was designed by “Grayford broussard” Modified edgewise bracket in which there is addition of 0.0185 x 0.046 slot –to accept 0.018 auxiliary wire special torque brackets.- 0,7˚,17˚,22˚ www.indiandentalacademy.com
  • 27. Burstone’s canine & 2 premolar brackets nd This consists of a basic .022 x .028 edgewise slot & additional .017 x . 025 vertical auxiliary tube for insertion of retraction assemblies. www.indiandentalacademy.com
  • 28. Changing concepts 1955-1970 1955 Acid etch by Buonocore  1965 Direct bonding by Newman  1970 bisGMA widely used for bonding  Complex wire bending skills needed for refined tooth movement in std E W  Begg technique used by uninformed ,unskilled & poorly trained operators  1972 six keys to normal occlusion Lawrence www.indiandentalacademy.com F.Andrews 
  • 29. www.indiandentalacademy.com
  • 30. Deltoid brackets Anthony B Viazis  Single type – poor rotational control  Twin bracketsreduced wire  Winged brackets –poor oral hygiene www.indiandentalacademy.com
  • 31. Deltoid brackets      Rotational control Sliding mechanics Reduced friction Orientation Torque control www.indiandentalacademy.com
  • 32. DUAL ENVIROMENT BRACKET Schudy 1990    Design was based on computer modeling Large outer slot - 0.040”-0.030” allows maximum arch wire flexibility in the initial phases of the treatment Smaller inner slot - 0.018” 0.016” accepts small rectangular wires for maximum control in the later stages of the treatment .www.indiandentalacademy.com
  • 33. Features of Edgewise Bracket www.indiandentalacademy.com
  • 34. Andrews classification 1. Non programmed appliance-a set of brackets designed the same for all tooth types ,relying totally on wire bending. 2. Partly programmed appliance- a set of brackets designed with some in built features ,but always require some wire bending Fully programmed appliance- a set of brackets designed to guide teeth directly to their goal positions with unbent wires. www.indiandentalacademy.com 3.
  • 35. Design shortcomings of Non programmed bracket 1. 2. 3. 4. 5. 6. Bracket base perpendicular to bracket stem. Bracket bases are not contoured. Slots are not angulated Bracket stem are of equal faciolingual thickness. Maxillary molar offset is not built in. Bracket sitting techniques are unsatisfactory. www.indiandentalacademy.com
  • 36. Perpendicular base & stem   www.indiandentalacademy.com Inclinations Occlusogingi val levels
  • 37. Non contoured bases Occlusogingival Mesiodistal www.indiandentalacademy.com
  • 38. Slots are not angulated www.indiandentalacademy.com
  • 39. Bracket stem are of equal faciolingual thickness. www.indiandentalacademy.com
  • 40. Maxillary molar offset is not built in www.indiandentalacademy.com
  • 41. Bracket sitting techniques are unsatisfactory. Tweed recommends sitting brackets in specified number of millimeters from the incisal edge. Holdaway advocates that the bracket sitting should altered according to the malocclusion According to Jarabak bracket sites for inclination should be determined by the shape of the crown. Saltzman recommends except for the maxillary www.indiandentalacademy.com lateral incisor ,brackets should be located in
  • 42. Wire bending  Primary Wire bending  1st  ,2nd & 3rd order bends Secondary Wire bending  Slot irregularities  Side effects  Human errors  Tertiary Wire bending  Loops ,&stops www.indiandentalacademy.com
  • 43. Partly programmed appliance Bracket angulation -Reed Holdaway 1958  Bracket slot angulation  www.indiandentalacademy.com
  • 44. Torqued brackets • Ivan Lee suggested torquing of slots • Torque in base • Torque in face www.indiandentalacademy.com
  • 45.    Raised base upper lateral brackets Angulated molar brackets/tubes Jarabak combined 2 features www.indiandentalacademy.com
  • 46. Fully programmed appliance  The Straight Wire Appliance - Slot-siting feature - - Convenience feature - Auxiliary feature www.indiandentalacademy.com
  • 47. Feature 1- mid transverse planes of the slot stem and crown must be the same www.indiandentalacademy.com
  • 48.  Feature 2-base of the bracket for each tooth type must have same inclination as the facial plane of the crown www.indiandentalacademy.com
  • 49.  Feature 3-each bracket inclined base must be contoured o-g www.indiandentalacademy.com
  • 50.  Feature 4- mid sagittal plane of the slot stem and crown must be same www.indiandentalacademy.com
  • 51. Feature 5 -the plane of the bracket base at its base point must be identical to the facial plane of the crown at the FA point. www.indiandentalacademy.com
  • 52.  Feature 6 - base should match the m-d contour of the tooth. www.indiandentalacademy.com
  • 53.  Feature 7 - the vertical component should be parallel to one another. www.indiandentalacademy.com
  • 54.  Feature 8 – all slots point must have same distance between them and the crown embrasure line. www.indiandentalacademy.com
  • 55. Convenience features 1. The gingival tie wings of the post Brackets extend farther laterally . www.indiandentalacademy.com
  • 56.  Base are inclined www.indiandentalacademy.com
  • 57. Facial surface of the incisor and canine brackets are designed to parallel their bases. www.indiandentalacademy.com
  • 58. In mandibular brackets the tie wings are designed with least amount occlusofacial prominence Bracket identification www.indiandentalacademy.com
  • 59. Auxiliary feature - Power arms Hooks Face bow tubes Utility tubes Rotational wings www.indiandentalacademy.com
  • 60. The Straight Wire Appliance Slot-siting feature Convenience feature Auxiliary feature  www.indiandentalacademy.com
  • 61. Translation problems Counter buccolingual tip Counter mesiodistal tip Counter rotation www.indiandentalacademy.com
  • 62. Translation brackets 1. 2. 3. Minimum translation brackets –requiring a translation of 2 mm or less Medium translation brackets – requiring a translation of more than 2mm but less than 4 mm Maximum translation brackets -requiring a translation of more than 4 mm. www.indiandentalacademy.com
  • 63. Vari Simplex Discipline Alexander-1978 Factors defining the bracket system-Type of bracket -Placement positions -Angulations -Torque -In /out compensations www.indiandentalacademy.com
  • 64. Lang bracket-cuspids It was invented by Dr Howard Lang  single bracket with a flat rotational control wing -each wing has a circular hole . - Wedge shape in profile  www.indiandentalacademy.com
  • 65. Vari Simplex Discipline  Lewis brackets-Bicuspids & lower incisors Twin brackets with convertible sheath-1st molars Bracket positioning –X  Tip –0 all posteriors(-6 lower 1st molar)  Torque-negative with lower incisors (-5) -3˚ torque on maxillary cuspid No torque in the second molar tube      In out –thick for upper laterals & lower incisors www.indiandentalacademy.com
  • 66. Roth Prescription   “Five year clinical evaluation of the Andrews Straight Wire Appliance 1976 Inventory – Tip canine upper 11-13,lower 5-7  Anchorage loss – Tip posteriors upper 0 ,lower-1  Over correction – Torque increased with upper incisors by 5 www.indiandentalacademy.com
  • 67. MBT  McLaughlin &Bennett 1975-1993 – Bracket positioning – ,lacebacks, & bendbacks for anchorage control – leveling with light arch wires , – sliding mechanics with 0.019/0.025 steel wires – Ovoid arch wire www.indiandentalacademy.com
  • 68. MBT Versatile+  Additional tip in upper anteriors caused – Anchorage strain ( 8-11-13 canine) – Bite deepening – Upper canine root apex close to premolars  Overall increase in upper anterior torque  Three torque options for canines 7,0,-7  Square ,ovoid &tapered arch form www.indiandentalacademy.com
  • 69. Slot size 0.022 / 0.018?       0.022 Angle used gold wires SS wire being rigid applies excessive force lower wire in larger slot torque lost 0.018 slot ideal when sliding is not needed Alexander-0.18 for ease of placement & patient comfort MBT 0.022 slot – Reduces treatment forces(opening stages) – Working wire is.019/.025 works well with sliding mechanics – .018slot working wire .017 has greater deflection & www.indiandentalacademy.com shows binding
  • 70. Begg today    Conventional Begg Modified Begg Refined Begg www.indiandentalacademy.com
  • 71. Kamedanized Begg introduced by Dr Akira Kameda  He introduced torquing and reverse torquing brackets In 1983  Ribbon arch buccal tube in 1986.  efforts are going on to develop a new type of KB bracket with a built in T-Pin. www.indiandentalacademy.com 
  • 72. Refined Begg Anti rotational brackets . Pins used in Refined Begg www.indiandentalacademy.com
  • 73. References      Orthodontics- current principles & technique-Graber &Swain Orthodontics- current principles & technique-Graber & Vanarsdall Straight wire –The concept &appliance – Andrews The Alexander discipline –contemporary concepts &philosophies -Wick Alexander Atlas of Orthodontics- principles & clinical applications –Viazis www.indiandentalacademy.com
  • 74. References      Begg orthodontic theory &techniqueBegg & Kesling Refined Begg for modern times -Dr V P Jayade Systemized orthodontic treatment -McLaughlin ,Bennett & Trevisi New vistas in orthodontics –Kesling K B technique its theory & practiceJIOS1992Dr Akira Kameda www.indiandentalacademy.com
  • 75. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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