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Tip edge /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. TIP EDGE CONCEPTS & APPLICATIONS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. INTRODUCTION  Improved bracket designs, materials & techniques  Evolution & hybridization of Past & Present technology  Integration of Begg, Edgewise & PEA— TipEdge www.indiandentalacademy.com
  • 3.  TipEdge – Convergent Technology with Divergent Philosophy  Overcomes disadvantages & retains advantages of Begg & Edgewise/PEA  Therefore, it has a cutting edge even over the most widely used system - PEA www.indiandentalacademy.com
  • 4. History  1915 – Ribbon Arch Appliance by E.H.Angle Enmasse movt. not possible 2nd order bends couldn’t be incorporated PM couldn’t be moved bodily www.indiandentalacademy.com
  • 5.  1928 – Edgewise Appliance by E.H.Angle No provision for pos’r space closure Restricts a-p correction of dental arches  1930’s – Strang incorporated loops in a/wire for opening & closing pos’r spaces www.indiandentalacademy.com
  • 6.  1933 – Begg Appliance by P.R.Begg Return to ribbon arch brackets Uncontrolled tipping 3 dimensional control inadequate  1960 – Uprighting spring by P.R.Begg www.indiandentalacademy.com
  • 7.  1958 – Edgewise bracket slots angulated by Reed Holdaway  1950’s– Torque incorporated in edgewise brackets by Ivan Lee  1961 – Jarabak Light Wire Appliance by Joseph R. Jarabak  1970’s-Fully preadjusted appliance by Lawrence F.Andrews Above & other refinements made major repositioning of teeth & jaws more difficult www.indiandentalacademy.com
  • 8.  Overview of the 2 major bracket systems has helped to define the Ideal Bracket Requirements Labially facing a/wire slot  Ease of ligation with elastomeric rings  Permit ltd. crown tipping  Root uprighting & torquing by auxiliaries  3 Dimensional control in finishing stage www.indiandentalacademy.com
  • 9.  1986 – A bracket system was developed that combined the previously mentioned characteristics  TipEdge Appliance & Differential Straight Arch Technique  By Peter Kesling with Andrew Hogg www.indiandentalacademy.com
  • 10.  Diagonally opposed corners were removed from PEA slot  Vertical slot was added  Bracket used with Differential Force Light Wire concept Rate of tooth movt. Can be varied by the amt. Of force acting /unit root surface area www.indiandentalacademy.com
  • 11. Advantage of Tip Edge over Edgewise.  Archwire slots open & close. Ease of archwire changes. Prevents undesirable couples on antr. teeth.  Diminished anchorage bends. Light forces are used – antr. teeth retracted by crown tipping. www.indiandentalacademy.com
  • 12.  Facilitates space opening & closing.  Enables correction of interarch malrelationships by making use of intermax. anchorage.  vertical control. Permit distal tipping of 6-8 teeth with no flexing of the wire, preventing elongation of incisors. www.indiandentalacademy.com
  • 13.  Easy bite opening as 0.016 wires with anchor bends are used. Torquing & uprighting by aux. forces. stability & molar control.  Does away with extraoral anchorage.  gingival & root morbidity. www.indiandentalacademy.com
  • 14. Adv. Of Tip Edge over Begg.  Horizontally facing slots facilitate archwire engagement esp. on rotated teeth.  Elastomeric ties acts as a cushion. patient comfort & bond failure.  In out compensations eliminate need for molar offsets. www.indiandentalacademy.com
  • 15.  Limited crown tipping & root uprighting. 20 - 25° of tip edge vs 60° of Begg brackets.  Programmed differential mechanics at work. Tip edge br. stops free crown tipping at a predetermined angle, antr. anchorage  mesial movt. of post teeth.  Better finishing due to greater 3 dimensional control.  Teaching & learning made easier due to similarity to edgewise br. www.indiandentalacademy.com
  • 16. Appliances: Tip Edge brackets. Molar tubes. Archwires. Elastics. Elastomerics. Elastomeric ties,  E-chains,  Tip – Edge rings. www.indiandentalacademy.com
  • 17. Auxiliaries.  Rotating springs.  Sidewinder or conv. uprighting spring.  Torque bars.  TRT.  Power pins.  Crimpable hooks.  Outrigger appliance. www.indiandentalacademy.com
  • 18. Tip Edge brackets. Modified preadjusted edgewise slot. ie., diagonally opposed corners removed. 0.022 x 0.028. Ltd. distal tipping of - 20° for all teeth mesial to the extn. site. - 25° for canines. Vertical slot – 0.020 x 0.020” – for aux. www.indiandentalacademy.com
  • 19.  Adv. Of vertical slot. wire bending. Aux. placed/ removed without removing archwire. Do not interfere with main mechanics of tip edge. Ensure long activation time of aux. www.indiandentalacademy.com
  • 20. Tip & Torque values similar to PEA brackets. In Cl III non – surgical cases, torque ed.  U/ CI - + 22°.  U/LI - + 17° Similar tip & torque values for 1st & 2nd PM for each arch. Torque of L/ PM - -20°. Brackets can be switched from L to R for clockwise or counterclockwise movt. www.indiandentalacademy.com
  • 21. Identifying features. O on uppers. on lowers. / on PM’s. Available in single, twin versions. Deep groves in U/CI brackets – torque bar. Lateral extensions – provide rotational control & accept archwire easily. www.indiandentalacademy.com
  • 22. Molar tube. 3 types. Round molar tube with torquing flap. .036 x.250 After bite opening, retraction & major torquing, flap is folded for finishing with edgewise archwire. www.indiandentalacademy.com
  • 23.  Combination round & rectangular tube. Gingival round tube – 0.036 x 0.250 During bite opening lessens distortion. Occlusal rect. tube – 0.022x 0.028” , 5.5mm. Same used on PM brackets. Permits levelling before or after space closure. www.indiandentalacademy.com
  • 24.  Combination rectangular & flat oval tube with converting flaps. When 2nd molars are anchor teeth. Provide max. molar control as they erupt. Converting flaps create 0.036 round tubes. Rect. tube same dimensions. www.indiandentalacademy.com
  • 25.  Archwires Initial a/wire .016 round,high tensile, non-relaxing AJW wire Necessary for adequate molar control & incisor intrusion Moderate to Severe crowding cases Loops bent into .016 wire Sectional .016 or .018 coaxial wire Sectional .014 or .016 Niti www.indiandentalacademy.com
  • 26.  Intermediate a/wire With the conclusion of Stage 1, wire ceases to source of tooth moving forces Assumes role of retainers Heavier .020’’ or .022” wire used during Space closure and Root uprighting & torquing stages www.indiandentalacademy.com
  • 27.  Final a/wire Rectangular wire - .0215’’x .028’’ Used for finishing Expresses torque in molars After uprighting & when retained with tipedge rings, Full expression of tip & torque in all other teeth www.indiandentalacademy.com
  • 28.  Auxiliaries Power Pins Ideal for engagement of elastics/elastomerics Eliminates need for bracket with integral hooks Optional – inserted or removed from vertical slot at any time with a/wire & ligature in place Low profile head with 15 degree inclination Labially when inserted gingivally Lingually when inserted incisally Can be used on both sides of the arch www.indiandentalacademy.com
  • 29.  Bilevel Pins Capture auxiliary behind tie-wings Eg. Open coil spring threaded over .016 Sswire Torquing auxiliary www.indiandentalacademy.com
  • 30.  Rotating Springs Same as those used in Begg technique Easy means rotating teeth without removing a/wire Fabricated in .014 SS Preformed ones available in Clockwise & Counterclockwise versions www.indiandentalacademy.com
  • 31.  Uprighting Springs Permits individual tooth uprighting without a/wire modifications 2 types – Standard Sidewinder Both fabricated in .014’’ & available in CW & CCW Standard US – Activation coil rests on tip of bracket www.indiandentalacademy.com
  • 32.  Sidewinder US Coil rests on labial surface of bracket More Aesthetic & Hygienic Inserted from gingival or incisal Bracket must be ligated with O ring On finishing with rectangular wire , Changes role from uprighting to torquing www.indiandentalacademy.com
  • 33.  Torquing Auxiliaries – Conventional torq. aux. Torque bar Torque bar Commonly employed .022’’x.018’’ curved Niti sectional wire with 30 degree torque Virtually invisible – Placed lingual to a/wire in deep grooves of incisor brackets Can’t be used in ceramic brackets Both aux. used with round wire www.indiandentalacademy.com
  • 34.  Outrigger Appliance Encourages elastic wear Threaded over a/wire without IMH Features 2 elastic hooks that Extend labially - elastics not worn Swing incisally - elastics are worn Serves as uncomfortable but not painful reminder www.indiandentalacademy.com
  • 35.  Elastics & Elastomerics Intermax. & intramax. elastics, power chains, elastomeric ties, etc. Tipedge rings Designed for use with tipedge brackets Lingually facing lugs wedge between a/wire & bracket converting Tipedge  PEA With rectangular wires, 3 dimensional control possible Strap across ring enhances wedging force Creates flexible edgewise bracket Locking haemostats are used for placing it www.indiandentalacademy.com
  • 36. Technique  Divided into 3 Stages  Redn of Stage 1 objectives Increase in Stage 2 objectives No change in Stage 3 objectives  Stage 1 Only stage in which tooth moving forces are generated by a/wires All obj. to be addressed simultaneously www.indiandentalacademy.com
  • 37.  Objectives Alignement of ant’r teeth Open/Close ant’r bite Correction of over/underjets Overcorrction of rotated teeth Correction of molar relation & pos’r crossbite started; need not be completed before going to Stage 2 www.indiandentalacademy.com
  • 38.  Bite opening mechanics Most important goal of Stage 1 Allows for full expression of mand. growth in correction of Class II MO .016’’ high tensile wire with bite opening bends PM not bracketed & engaged in Stage 1 Space preserved for pm in non-extn trt Plastic tubing from canine to molar Molar stops www.indiandentalacademy.com
  • 39.  If bite is open or edge to edge Max a/wire is made straight Mand a/wire is given mild anchor bends  Proper use of Class II elastics in conjunction with high tensile wire will open the severest deep bite  Elastics to be worn 24hrs/day www.indiandentalacademy.com
  • 40.  Correction of Over/Under jets Use of Class II/III elastics If bite is edge to edge & space is available Over/Under jet corrected by Class I elastics with in the faulty arch Eliminates molar extrusion www.indiandentalacademy.com
  • 41.  Alignement of ant’r teeth Extn trt Mild crowding cases Tying e-ligature from canine to a/wire Moderate to severe crowding cases Coaxial or Niti aligning aux Nonextn trt Crowding is corrected by looped a/wire www.indiandentalacademy.com
  • 42.  Correction of rotations By rotation springs Achieved in 6 weeks Over corrected rotations held by Over rotation brackets in incisors Offset bonding in pm & canines www.indiandentalacademy.com
  • 43.  Stage 2  Shortest of three stages  Objectives Pos’r space closure Correct/maintain dental midlines Correct pos’r crossbites Achieve Class I molar relation Over rotate severely rotated pm’s Level anchor molars if tipped distally Maintain all Stage 1 corrections www.indiandentalacademy.com
  • 44.  Mechanics & A/wire  .022 round wire for max control  Mild bite opening sweeps in U&L/wires  Mild to moderate anchorage situations A/wire engaged in rectangular tube  Max anchorage situations A/wire inserted in large diameter round tube www.indiandentalacademy.com
  • 45.  Automatic canine rotational control Canine rotation doesn’t occur during retraction Cause pressure is applied at their contact pts. with LI  Braking Mechanics Employed when abundant space is available to prevent over retraction Side winder springs Heavy horizontal forces Smaller rooted ant’r teeth become a large anchor unit & pos’r teeth move mesially www.indiandentalacademy.com
  • 46.  Stage 3 Longest stage of DSAT 9-12 months in extn trt 6 months in non-extn trt Objectives Achieve final axial inclination Maintain all corrections www.indiandentalacademy.com
  • 47.  Mesiodistal uprighting & labiolingual torquing- Forces generated by aux Uprighting is self limiting i.e. further uprighting stops as each tooth reaches its desired m-d inclination Torquing is self limiting only in conjunction with rectangular wires www.indiandentalacademy.com
  • 48.  A/wires .020’’/.022’’ round wire .0215’’x.028’’ rectangular wire Round wire approach Stage 2 wire used Simplifies trt Indications Severe a-p skeletal discrepancies When there is no need for molar torquing & labiolingual repositioning of canines & LI www.indiandentalacademy.com
  • 49.  Mild bite opening sweeps placed  Max a/wire passive  Mand a/wire expanded 1-2 mm  Molar offsets placed to eliminate Horizontal play Facilitates rectangular wire engagement  A/wire ends are cinched www.indiandentalacademy.com
  • 50.  Rectangular wire approach More vertical & horizontal control If engaged prior to uprighting effective molar torquing occurs cause inter bracket span is 100% Indicated when full expression of torque is needed  Combination approach www.indiandentalacademy.com
  • 51. CONCLUSION  Conventional edgewise slots provide multi- directional tooth control throughout trt, when actually such control is required only during finishing  PEA slots compound this problem.  Majority of edgewwise orthodontist have come to accept these problems as facts of orthodontic life, yet these are only facts of the slot itself. www.indiandentalacademy.com
  • 52.  Solution to all these problems is a tip edge archwire slot, because orthodontist now have an edgewise type bracket that provides all the advantages to be gained by free crown tipping as well as the final luxury of achieving predetermined tip & torque angles for all teeth.  There fore tooth are treated more kindly than with any other bracket wire combination. www.indiandentalacademy.com
  • 53. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com