Advances 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 formats.


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Advances in orthodontics /certified fixed orthodontic courses by Indian dental academy

  1. 1. Advances in Or thodontics INDIAN DENTAL ACADEMY  Leader in continuing dental education  www.indiandentalacademy.com
  2. 2.    Introduction History of Orthodontics Advances In Orthodontic Materials     Brackets Arch wires Bonding materials Alternative force delivery systems     Recent Orthodontic Appliances Biomechanical Principles Changing Esthetic Concepts Conclusion www.indiandentalacademy.com
  3. 3. INTRODUCTION
  4. 4. INTRODUCTION  Every generation of man, admires his own wisdom, skill, science, art & progress; www.indiandentalacademy.com
  5. 5.  It calls its own whatever it has learnt from men of former days, & counts the few improvements which have had their birth in its own time as triumphs & distinctions which elevates it above the past. www.indiandentalacademy.com
  6. 6.  Advances in orthodontics has made possible a constant improvement in the quality of orthodontic treatment over a period of last two centuries, ultimately benefiting the patient. www.indiandentalacademy.com
  7. 7. An analysis of the various dimensions of orthodontic advancement reveals two important truths: 1. 2. The biologic problem have remained singularly unchanged. Advancement in orthodontic material and their cascading effect on appliance design and treatment strategies has added new solution to www.indiandentalacademy.com old problems.
  8. 8.  This area has been greatly taken advantage by the manufacturers & the engineer orthodontist, who due to their basic knowledge of the materials have introduced newer and more efficient orthodontic appliances. www.indiandentalacademy.com
  9. 9.  Every important science must be correlated to another.  Similarly dentistry has borrowed from many different disciplines and specialties.  Engineering is only one of them. www.indiandentalacademy.com
  10. 10.  The profession of dentistry 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. www.indiandentalacademy.com
  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. www.indiandentalacademy.com
  12. 12. The Tooth    Teeth exist in a dual environment, partly inside the body and partly out. The external part is called “crown”. The internal part consist of the “root” and the supporting structures, the periodontal ligament. www.indiandentalacademy.com PDL Root Crown
  13. 13. Division in Dentistry Working division in dentistry is based on the area of their function, such as  Operative dentistry  Endodontics  Prosthodontics  Periodontics  Orthodontics  Oral Surgery www.indiandentalacademy.com
  14. 14. Operative dentistry   Is responsible for the preservation of the crowns of the teeth. These are the working ends that are seen in the mouth, exposed to a wide variety of chemical, bacterial and mechanical hazards. www.indiandentalacademy.com
  15. 15. Endodontics  Endodontics treats the pulp (the living part of the tooth mostly by replacement) along with related diseases of the periapical tissues. www.indiandentalacademy.com Pulp
  16. 16. Prosthodontics  Replaces missing crowns, with or without support from remaining teeth. www.indiandentalacademy.com
  17. 17. Periodontics   Periodontics bridges the gap between the tooth and its environment. The central responsibility is the periodontal membrane that attaches tooth to bone. www.indiandentalacademy.com
  18. 18. Orthodontics   Orthodontic therapy is accomplished by manipulating the external environment of the crown to stimulate changes in the internal environment that will alter tooth positions. He is concerned with www.indiandentalacademy.com the dental environment.
  19. 19. Oral Surgery  Most of you must be familiar with this branch of dentistry. www.indiandentalacademy.com
  20. 20. History of Orthodontics
  21. 21.  Although we can hide our political and religious beliefs or our IQ with silence, www.indiandentalacademy.com
  22. 22.  camouflage many physical shortcomings with clothing, www.indiandentalacademy.com
  23. 23.  we generally appearance. cannot hide www.indiandentalacademy.com our facial
  24. 24.  The face especially the mouth, is visible in most social interactions. www.indiandentalacademy.com
  25. 25.  It has been argued that disfiguring malocclusion is a physical handicap because it limits a person’s employment, career advancement, social stereotype, and marriage opportunities. www.indiandentalacademy.com
  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” Moyers www.indiandentalacademy.com
  27. 27. Pierre Fauchard (1728)  “Bandelette” plates used to “straighten” teeth by tying them to crude metal plates with brass or silver wire. www.indiandentalacademy.com
  28. 28.  Farrar’s appliance www.indiandentalacademy.com
  29. 29.  Dr Angle’s appliances, 1887 using cemented bands, retraction screws, soldered attachments www.indiandentalacademy.com
  30. 30.  Dr Angle’s E (expansion) arch appliance. www.indiandentalacademy.com
  31. 31. Advances in Brackets (design) Pin & Tube Ribbon arch Edgewise Begg Pre-Adjusted Edgewise www.indiandentalacademy.com
  32. 32. Advances in Brackets (design) Pin & Tube Ribbon arch Edgewise Begg Pre-Adjusted Edgewise www.indiandentalacademy.com
  33. 33. Advances in Brackets (design) Pin & Tube Ribbon arch Edgewise Begg Pre-Adjusted Edgewise www.indiandentalacademy.com
  34. 34. Advances in Brackets (design) Pin & Tube Ribbon arch Edgewise Begg Pre-Adjusted Edgewise www.indiandentalacademy.com
  35. 35. Advances in Brackets (design) Pin & Tube Ribbon arch Edgewise Begg Pre-Adjusted Edgewise www.indiandentalacademy.com
  36. 36. Advances in Orthodontic Materials Brackets  Arch wires  Bonding materials Alternative force delivery systems  
  37. 37. ORTHODONTIC BRACKETS www.indiandentalacademy.com
  38. 38. Brackets    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. Bracket Arch wire www.indiandentalacademy.com Bonding material
  39. 39. Advances in Brackets (materials) Stainless Steel Esthetics Allergic reaction to Nickel Polycarbonate Titanium Nickel free SS www.indiandentalacademy.com Magnetic Brackets Ceramics
  40. 40. Stainless 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. 2. 3. Milling Sintering Metal injection moulding www.indiandentalacademy.com
  41. 41. Titanium Brackets   Current concept about heavy metal poisoning and their biologic effects led to banning the use of nickel releasing alloys in European countries. Therefore, Titanium based bracket were developed. www.indiandentalacademy.com
  42. 42. Ceramic Brackets  Demand for esthetics in treatment.  Modifications include: 1. 2. 3. 4. Mini sized steel brackets, Lingual orthodontics Poly carbonate brackets Ceramic www.indiandentalacademy.com brackets (1987).
  43. 43.  With ceramic brackets, unlike traditional stainless steel braces, your smile will not look 'metallic.' In addition, ceramic brackets are designed so that they won't stain or discolor over long periods of time. www.indiandentalacademy.com
  44. 44. Classification of ceramic brackets  Crystal structure 1. 2.  Mono-crystalline Poly-crystalline Materials 1. 2. Zirconia Alumina www.indiandentalacademy.com
  45. 45. Lingual Orthodontics www.indiandentalacademy.com
  46. 46. Arch wires  They generate the required forces and moments to bring about tooth movement. www.indiandentalacademy.com
  47. 47. Advances in Arch wires Precious alloy Gold + Copper + Platinum + Palladium Stainless Steel & Cobalt Chromium alloy Better strength and Springiness with Corrosion Resistance Nickel Titanium alloy Developed for the space program 1. Shape memory 2. Super elasticity Copper NiTi alloy Heat activated NiTi wires Beta Titanium alloy Alfa Titanium alloy (Titanium Molybdenum alloy) (Titanium + Aluminium + Vanadium) Ion Implantation To improve surface www.indiandentalacademy.com properties of the TMA wires
  48. 48. Precious alloy     Before the 1950s Nothing else would tolerate intraoral conditions But gold alone was too soft Therefore used as alloy: Gold Copper Platinum Palladium www.indiandentalacademy.com
  49. 49. Stainless Steel   Increase in price of precious metals Introduction to: Stainless Steel (18:8 ss) Cobalt chromium alloy   Resistance to corrosion due to high chromium content. Properties depends on 1. 2. Cold working & www.indiandentalacademy.com Anealing during manufacturing.
  50. 50. Nickel Titanium (NiTi) alloy    The 1st titanium alloy introduced in orthodontics = Nitinol (Nickel Titanium Naval Ordnance Laboratory) It was developed for space program. Properties: 1. 2. 3. 4. 5. Shape memory Super elasticity Superior spring back Light continuous force www.indiandentalacademy.com Long range of action
  51. 51.  Types: Stabilized Martensitic NiTi Active Austenitic NiTi Thermally activated NiTi Copper NiTi Chinese NiTi Japanese NiTi www.indiandentalacademy.com
  52. 52. Advances in Arch wires Esthetic Arch wires Coated Arch wires Composite Arch wires (elastomeric poly-tetra-fluorethylene emulsion) (Optiflex) www.indiandentalacademy.com
  53. 53. Bonding Materials  The brackets are attached to a tooth surface with the help of bonding materials. www.indiandentalacademy.com
  54. 54. Advances in Arch wires Composite Resins Chemical Cure Single paste system Two paste system Light cure U.V. light www.indiandentalacademy.com Visible light Laser cure
  55. 55. Alternative force delivery systems www.indiandentalacademy.com
  56. 56. Advances in Orthodontic Appliances
  57. 57. Removable appliances  Coffin Spring 1869  Bertoni expansion screw 2000 www.indiandentalacademy.com
  58. 58. www.indiandentalacademy.com
  59. 59. Retention Plates www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
  61. 61. Functional Appliances www.indiandentalacademy.com
  62. 62. Fixed Functional Appliances www.indiandentalacademy.com
  63. 63. Extra-oral anchorage www.indiandentalacademy.com
  64. 64. Biomechanical Approach to Growth Principles  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. www.indiandentalacademy.com
  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. www.indiandentalacademy.com
  66. 66. Traditional use of Biomechanical Concept www.indiandentalacademy.com
  67. 67. www.indiandentalacademy.com
  68. 68. Chinese Foot www.indiandentalacademy.com
  69. 69. www.indiandentalacademy.com
  70. 70. Lip –Tongue-cheek System www.indiandentalacademy.com
  71. 71. Functional Deviation (Maxillary Constriction) www.indiandentalacademy.com
  72. 72. Environmental (Habits or Trauma) www.indiandentalacademy.com
  73. 73. Muscle Dysfunction  Loss of part of musculature (unknown cause or birth injury or damage to the motor nerve). www.indiandentalacademy.com
  74. 74. Muscle Weakness  Muscular dystrophy / Cerebral palsy / Muscle weakness syndromes. www.indiandentalacademy.com
  75. 75. Functions of the Jaws www.indiandentalacademy.com
  76. 76. Mechanical Principles in Jaws Functioning www.indiandentalacademy.com
  77. 77.  Thus understanding of the fundamentals of mechanics must be the starting point for understanding orthodontics. www.indiandentalacademy.com
  78. 78.  The principles of force analysis are the basic tools of the mechanical engineer, & their application is universal. www.indiandentalacademy.com
  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 ________________________ www.indiandentalacademy.com 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. www.indiandentalacademy.com
  81. 81. Bioengineered Human of Future www.indiandentalacademy.com
  82. 82. CONCLUSION   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 . www.indiandentalacademy.com
  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. www.indiandentalacademy.com
  84. 84.  We should make a sincere effort to lay an enduring foundation for a robust and a lasting co-operation between the specialities for the sake of providing excellent care for our patients. www.indiandentalacademy.com
  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. www.indiandentalacademy.com
  86. 86.  Let us work together to usher in a new era of integrated multidisciplinary treatment philosophy. www.indiandentalacademy.com
  87. 87.  I would like to leave you with an inspirational saying “Coming together is a beginning Keeping together is progress Growing together is success”. www.indiandentalacademy.com
  88. 88. T hank You !
  89. 89. Golden Proportions (Divine Proportion) www.indiandentalacademy.com Rickett’s 1982
  90. 90. Bracket positioning simulation & Computerized wire bending www.indiandentalacademy.com
  91. 91. CAD/CAM Fabrication of occlusal splint for orthognathic surgery  Laser scanning of the cast  Image of cast on monitor www.indiandentalacademy.com
  92. 92.  Images of study casts and facial skeleton combined for simulation www.indiandentalacademy.com
  93. 93.  Sagittal split ramus osteotomy simulated on a 3-D image www.indiandentalacademy.com
  94. 94.  Contact areas of occlusal splint drawn from computer image of study cast  Finished 3d image of occlusal splint www.indiandentalacademy.com
  95. 95.  Occlusal splint polymerized by Laser Lithography Unit www.indiandentalacademy.com
  96. 96. Thank you www.indiandentalacademy.com  Leader in continuing dental education  www.indiandentalacademy.com

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