Advance ortho /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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Advance ortho /certified fixed orthodontic courses by Indian dental academy

  1. 1. Advances inAdvances in OrthodonticsOrthodontics INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2.  Introduction  History of Orthodontics  Advances In Orthodontic MaterialsMaterials  BracketsBrackets  Arch wiresArch wires  Bonding materialsBonding materials  Alternative forceAlternative force delivery systemsdelivery systems  Recent Orthodontic AppliancesAppliances  BiomechanicalBiomechanical PrinciplesPrinciples  Changing EstheticEsthetic Concepts  Conclusion
  4. 4. INTRODUCTIONINTRODUCTION  Every generation of man, admires hishis own wisdom, skill, science, art &own wisdom, skill, science, art & progress;progress;
  5. 5.  It calls its ownown whatever it has learnt from men of former days, & counts the few improvementsthe few improvements which have had their birth in its own time as triumphs & distinctions which elevates it above the past.
  6. 6.  Advances in orthodontics has made possible a constant improvementconstant improvement in the quality of orthodontic treatment over a period of last two centuries, ultimately benefiting the patient.the patient.
  7. 7. An analysis of the various dimensions of orthodontic advancement reveals two important truths: 1.1. TheThe biologic problembiologic problem have remainedhave remained singularly unchanged.singularly unchanged. 2.2. Advancement inAdvancement in orthodontic materialorthodontic material and their cascading effect onand their cascading effect on appliance design and treatmentappliance design and treatment strategies has added new solution tostrategies has added new solution to old problems.old
  8. 8.  This area has been greatly taken advantage by the manufacturersthe manufacturers & the engineer orthodontist,the engineer orthodontist, who due to their basic knowledge of the materials have introduced newer and more efficient orthodontic appliances.
  9. 9.  Every important science must be correlated to another.  Similarly dentistry has borrowed from many different disciplines and specialties.  EngineeringEngineering is only one of them.
  10. 10.  The profession of dentistrydentistry itself, includes many disciplines, each important in its own right in the development and preservation of the portal that admits all food and sometimes the air that fuel the living body.
  11. 11.  The interests of dentistry, as the name implies, are centered on the teeth; but the teeth are an integral part of a much larger structure.
  12. 12. The ToothThe Tooth  Teeth exist in a dualdual environment,environment, partly inside the body and partly out.  The external part is called “crown”.“crown”.  The internal part consist of the “root”“root” and the supporting structures, thethe periodontal ligament.periodontal ligament. Crown Root PDL
  13. 13. Division in DentistryDivision in Dentistry Working division in dentistry is based on the area of their function, such as  Operative dentistry  Endodontics  Prosthodontics  Periodontics  Orthodontics  Oral
  14. 14. Operative dentistryOperative dentistry  Is responsible for the preservation of thepreservation of the crownscrowns of the teeth.  These are the working ends that are seen in the mouth, exposed to a wide variety of chemical,chemical, bacterial and mechanicalbacterial and mechanical hazards.hazards.
  15. 15. EndodonticsEndodontics  Endodontics treats thethe pulppulp (the living part of the tooth mostly by replacement) along with related diseases of the periapical tissues. Pulp
  16. 16. ProsthodonticsProsthodontics  Replaces missingmissing crowns,crowns, with or without support from remaining teeth.
  17. 17. PeriodonticsPeriodontics  Periodontics bridges the gap between the tooth and its environment.  The central responsibility is the periodontalthe periodontal membranemembrane that attaches tooth to bone.
  18. 18. OrthodonticsOrthodontics  Orthodontic therapy is accomplished by manipulating thethe external environmentexternal environment of the crown to stimulate changes in the internalthe internal environmentenvironment that will alter tooth positions.  He is concerned with the dental
  19. 19. Oral SurgeryOral Surgery  Most of you must be familiar with this branch of dentistry.
  20. 20. History of OrthodonticsHistory of Orthodontics
  21. 21.  Although we can hide our political and religious beliefs or our IQ with silence,silence,
  22. 22.  camouflage many physical shortcomings with clothing,clothing,
  23. 23.  we generally cannot hide our facialfacial appearance.appearance.
  24. 24.  The face especially the mouth,the mouth, is visible in most social interactions.
  25. 25.  It has been argued that disfiguring mal- occlusion is aa physical handicapphysical handicap because it limits a person’s employment, career advancement, social stereotype, and marriage opportunities.
  26. 26.  “Treatment of the face is more than moving teeth or cutting and rearranging bones; it is even more than the sculpture of living tissues noted earlier, for it often involves serious alterations in the personality and social interactions” MoyersMoyers
  27. 27. Pierre Fauchard (1728)Pierre Fauchard (1728)  “Bandelette” plates used to “straighten” teeth by tying them to crude metal plates with brass or silver wire.
  28. 28.  Farrar’s appliance
  29. 29.  Dr Angle’s appliances, 1887 using cemented bands, retraction screws, soldered attachments
  30. 30.  Dr Angle’s E (expansion) arch appliance.
  31. 31. Advances in Brackets (design)Advances in Brackets (design) Ribbon archRibbon arch EdgewiseEdgewise BeggBegg Pin & TubePin & Tube Pre-AdjustedPre-Adjusted EdgewiseEdgewise
  32. 32. Advances in Brackets (design)Advances in Brackets (design) Ribbon archRibbon arch EdgewiseEdgewise BeggBegg Pin & TubePin & Tube Pre-AdjustedPre-Adjusted EdgewiseEdgewise
  33. 33. Advances in Brackets (design)Advances in Brackets (design) Ribbon archRibbon arch EdgewiseEdgewise BeggBegg Pin & TubePin & Tube Pre-AdjustedPre-Adjusted EdgewiseEdgewise
  34. 34. Advances in Brackets (design)Advances in Brackets (design) Ribbon archRibbon arch EdgewiseEdgewise BeggBegg Pin & TubePin & Tube Pre-AdjustedPre-Adjusted EdgewiseEdgewise
  35. 35. Advances in Brackets (design)Advances in Brackets (design) Ribbon archRibbon arch EdgewiseEdgewise BeggBegg Pin & TubePin & Tube Pre-AdjustedPre-Adjusted EdgewiseEdgewise
  36. 36. Advances inAdvances in Orthodontic MaterialsOrthodontic Materials BracketsBrackets Arch wiresArch wires Bonding materialsBonding materials Alternative force delivery systemsAlternative force delivery systems
  38. 38. BracketsBrackets  A door handle allows us to open or close a door.  Similarly a bracket acts as a handle to a tooth.  We can push, pull or rotate a tooth with the help of these attachments. BracketBracket Bonding materialBonding material Arch wireArch wire
  39. 39. Advances in Brackets (materials)Advances in Brackets (materials) Stainless SteelStainless Steel Allergic reaction to NickelAllergic reaction to Nickel PolycarbonatePolycarbonate EstheticsEsthetics Magnetic BracketsMagnetic Brackets TitaniumTitanium CeramicsCeramics Nickel free SSNickel free SS
  40. 40. Stainless Steel BracketsStainless Steel Brackets  Austenitic steel  AISI = 303, 304, 316, 316L & 317L (L = low carbon content)  AISI series 630 SS called as “precipitation hardening SS”, contains very low chromium and nickel.  Manufacturing techniques 1.1. MillingMilling 2.2. SinteringSintering 3.3. Metal injection mouldingMetal injection
  41. 41. Titanium BracketsTitanium Brackets  Current concept about heavy metalheavy metal poisoningpoisoning and their biologic effects led to banning the use of nickel releasing alloys in European countries.  Therefore, TitaniumTitanium based bracket were developed.
  42. 42. Ceramic BracketsCeramic Brackets  Demand for esthetics in treatment.  Modifications include: 1.1. Mini sized steel brackets,Mini sized steel brackets, 2.2. Lingual orthodonticsLingual orthodontics 3.3. Poly carbonate bracketsPoly carbonate brackets 4.4. Ceramic brackets (1987).Ceramic brackets (1987)
  43. 43.  With ceramic brackets, unlike traditional stainless steel braces, your smile will notwill not look 'metallic.'look 'metallic.' In addition, ceramic brackets are designed so that they won't stain or discolor over long periods of time.
  44. 44. Classification of ceramic brackets  Crystal structure 1.1. Mono-crystallineMono-crystalline 2.2. Poly-crystallinePoly-crystalline  Materials 1.1. ZirconiaZirconia 2.2.
  45. 45. Lingual OrthodonticsLingual Orthodontics
  46. 46. Arch wiresArch wires  They generate the required forces and moments to bring about tooth movement.
  47. 47. Advances in Arch wiresAdvances in Arch wires Stainless Steel & Cobalt Chromium alloyStainless Steel & Cobalt Chromium alloy Better strength and Springiness with Corrosion ResistanceBetter strength and Springiness with Corrosion Resistance Nickel Titanium alloyNickel Titanium alloy Developed for the space programDeveloped for the space program 1.1. Shape memoryShape memory 2.2. Super elasticitySuper elasticity Beta TitaniumBeta Titanium alloyalloy (Titanium Molybdenum(Titanium Molybdenum alloy)alloy) Copper NiTi alloyCopper NiTi alloy Heat activated NiTi wiresHeat activated NiTi wires Precious alloyPrecious alloy Gold + Copper + Platinum + PalladiumGold + Copper + Platinum + Palladium Alfa TitaniumAlfa Titanium alloyalloy (Titanium + Aluminium(Titanium + Aluminium + Vanadium)+ Vanadium) Ion ImplantationIon Implantation To improve surfaceTo improve surface properties of the TMA wiresproperties of the TMA
  48. 48. Precious alloyPrecious alloy  Before the 1950s  Nothing else would tolerate intraoral conditions  But gold alone was too soft  Therefore used as alloy: GoldGold CopperCopper PlatinumPlatinum PalladiumPalladium
  49. 49. Stainless SteelStainless Steel  Increase in price of precious metals  Introduction to: Stainless Steel (18:8 ss)Stainless Steel (18:8 ss) Cobalt chromium alloyCobalt chromium alloy  Resistance to corrosion due to highhigh chromium content.chromium content.  Properties depends on 1.1. Cold workingCold working & 2.2. AnealingAnealing during
  50. 50. Nickel Titanium (NiTi) alloyNickel Titanium (NiTi) alloy  The 1st titanium alloy introduced in orthodontics = Nitinol (Nickel Titanium Naval Ordnance Laboratory)  It was developed for space program.  Properties: 1.1. Shape memoryShape memory 2.2. Super elasticitySuper elasticity 3.3. Superior spring backSuperior spring back 4.4. Light continuous forceLight continuous force 5.5. Long range of actionLong range of
  51. 51.  Types: Stabilized Martensitic NiTiStabilized Martensitic NiTi Active Austenitic NiTiActive Austenitic NiTi Thermally activated NiTiThermally activated NiTi Copper NiTiCopper NiTi Chinese NiTiChinese NiTi Japanese NiTiJapanese NiTi
  52. 52. Advances in Arch wiresAdvances in Arch wires Esthetic Arch wiresEsthetic Arch wires Composite Arch wiresComposite Arch wires (Optiflex)(Optiflex) Coated Arch wiresCoated Arch wires (elastomeric poly-tetra-fluor-(elastomeric poly-tetra-fluor- ethylene emulsion)ethylene emulsion)
  53. 53. Bonding MaterialsBonding Materials  The brackets are attached to a tooth surface with the help of bonding materials.
  54. 54. Advances in Arch wiresAdvances in Arch wires Composite ResinsComposite Resins Light cureLight cureChemical CureChemical Cure U.V.U.V. lightlight VisibleVisible lightlight LaserLaser curecure Single pasteSingle paste systemsystem Two pasteTwo paste systemsystem
  55. 55. Alternative force delivery systemsAlternative force delivery systems
  56. 56. Advances inAdvances in Orthodontic AppliancesOrthodontic Appliances
  57. 57. Removable appliancesRemovable appliances  Coffin Spring 1869  Bertoni expansion screw 2000
  58. 58.
  59. 59. Retention PlatesRetention Plates
  60. 60.
  61. 61. Functional AppliancesFunctional Appliances
  62. 62. Fixed Functional AppliancesFixed Functional Appliances
  63. 63. Extra-oral anchorageExtra-oral anchorage
  64. 64. Biomechanical Approach to GrowthBiomechanical Approach to Growth PrinciplesPrinciples  Orthodontic problems are the result of mechanical forces, and their correction depends on mechanical forces.  The force systems in the face can form or deform, and their conscious control is a continuing challenge in orthodontics.
  65. 65.  Altering the balance of forces can arrest or reverse progressive deformities during growth, and it can correct many of their effects even in the adult.
  66. 66. Traditional use of Biomechanical ConceptTraditional use of Biomechanical Concept
  67. 67.
  68. 68. Chinese FootChinese Foot
  69. 69.
  70. 70. Lip –Tongue-cheek SystemLip –Tongue-cheek System
  71. 71. Functional DeviationFunctional Deviation (Maxillary Constriction)(Maxillary Constriction)
  72. 72. Environmental (Habits or Trauma)Environmental (Habits or Trauma)
  73. 73. Muscle DysfunctionMuscle Dysfunction  Loss of part of musculature (unknown cause or birth injury or damage to the motor nerve).
  74. 74. Muscle WeaknessMuscle Weakness  Muscular dystrophy / Cerebral palsy / Muscle weakness syndromes.
  75. 75. Functions of the JawsFunctions of the Jaws
  76. 76. Mechanical Principles in Jaws FunctioningMechanical Principles in Jaws Functioning
  77. 77.  Thus understanding of the fundamentals of mechanics must be the starting point for understanding orthodontics.
  78. 78.  The principles of force analysis are the basic tools of the mechanical engineer, & their application is universal.
  79. 79.  In applying them to oral environment, one combines engineering with dentistry, which requires a mixed terminology that is partly foreign to each discipline: BIOLOGY + MECHANICS ________________________ BIO-MECHANICS
  80. 80.  Today we are about to enter a new era where the genetic coding is becoming part of daily diagnostic tool. May be tomorrow we have to approach dentofacial problems by means of genetic alterations.
  81. 81. Bioengineered Human of FutureBioengineered Human of Future
  82. 82. CONCLUSIONCONCLUSION  Hope you have become familiar with the variety of problems, their correct diagnosis and the best treatment solution possible.  Every case is a challenge requiring versatile thinking and imagination rather than opting for a dogmatic conventional cook book approach .
  83. 83.  Our profession is at cross roads now. We are at a critical point in history where we should make conscious decisions which will determine the way the future unfolds.
  84. 84.  We should make a sincere effort to lay an enduring foundation for a robust and a lasting co-operation between the specialitiesbetween the specialities for the sake of providing excellent care for ourexcellent care for our patients.patients.
  85. 85.  We should be open to criticisms and update ourselves. We should be careful not to get entangled in dogmatic philosophies and treatment approaches.
  86. 86. QuickTimeMovie
  87. 87. So! Where are we?So! Where are we?
  88. 88.  Let us work together to usher in a new era of integrated multidisciplinary treatment philosophy.
  89. 89.  I would like to leave you with an inspirational saying ““Coming together is a beginningComing together is a beginning Keeping together is progressKeeping together is progress Growing together is success”.Growing together is success”.
  90. 90. Let’s Begin, Progress & Succeed!Let’s Begin, Progress & Succeed!
  91. 91. Thank You !Thank You !
  92. 92. Golden Proportions (Divine Proportion)Golden Proportions (Divine Proportion) Rickett’s 1982
  93. 93. Bracket positioning simulation & Computerized wire bending
  94. 94. CAD/CAM FabricationCAD/CAM Fabrication of occlusal splint for orthognathic surgeryof occlusal splint for orthognathic surgery  Laser scanning of the cast  Image of cast on monitor
  95. 95.  Images of study casts and facial skeleton combined for simulation
  96. 96.  Sagittal split ramus osteotomy simulated on a 3-D image
  97. 97.  Contact areas of occlusal splint drawn from computer image of study cast  Finished 3d image of occlusal splint
  98. 98.  Occlusal splint polymerized by Laser Lithography UnitLaser Lithography Unit
  99. 99. Thank you For more details please visit