COSMETIC ORTHODONTICS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiand...
What is Aesthetics?
Aesthetics is purely and simply
the science of expression,expression
being itself so defined as to be ...
How Far Have We Gone?
In Aesthetics!!
In Orthodontics!!!
We have gone as far as developing
materials which are tooth color...
1. Brackets
2. Wires
3. Rings or Chains
4. Auxiliaries
TOGETHER IN A HARMONY BETWEEN

“ function and esthetics ”
www.india...
HISTORICAL PRESPECTIVE

FIXED APPLIANCES INTRODUCED IN 1800’s

BANDING OF ANTERIOR &POSTERIOR TEETH

BONDING OF ANTERIOR A...
REDUCTION OF BRACKET SIZES

CERAMIC /COMPOSITE BRACKETS

COMPOSITE ARCHWIRES

LINGUAL ORTHODONTICS

INVISALIGN SYSTEM
www....
ANTERIOR BAND1NG :

www.indiandentalacademy.com
TWIN BRACKETS

MINI-TWIN BRACKETS

www.indiandentalacademy.com
DESIGN VARIATIONS

www.indiandentalacademy.com
TOOTH COLOURED BRACKETS
1. PLASTIC BRACKETS
introduced by NEUMAN (1969)
Acrylic, nylon, epoxies, polysulphones, polycarbon...
ADVANTAGES
1.Nontoxic
2.Easy fabrication
3.Good abrasion resistance
4.Good impact strength
5.No bad odour /distaste

DISAD...
2.CERAMIC BRACKETS
Introduced by MICHEAL SWARTZ (1987)
 FULL CERAMIC BRACKETS
 CERAMIC BRACKETS WITH METAL INSERTS

www....
Full ceramic brackets

With metal inserts

www.indiandentalacademy.com
 MONOCRYSTALLINE /POLYCRYSTALLINE ALUMINA
( 2100`C )

 ZIRCONIA (1000`C )

------Made of 3D inorganic molecules

Extreme...
BONDING OF CERAMIC BRACKETS TO ENAMEL:

1. Mechanical retention via indentation / undercuts
in base.
2. Chemical bonding w...
DISADVANTAGES
1. BRACKET FAILURE
* Fracture of brackets
* Friction within bracket slots
* Tooth wear on bracket contact

2...
CASE SELECTION CRITERIA
Ceramic brackets are contraindicated in
1.Deep bite cases
2.Bruxism patients
3.Large restorations
...
3.COMPOSITE BRACKETS
A Composite is a multiphase material brought about by
combining materials that differ in composition ...
COMPOSITION
Manufactured by ‘INJECTION MOLDING TECHNIQUE’.
COMPOSITE PRECURSOR
-Plasma treated high strength Polyethylene ...
ADVANTAGES
1.SUPERIOR IMPACT RESISTANCE
2.INCREASED COMPRESSIVE STRENGTH
3.FATIGUE RESISTANCE
4.RESISTANCE TO DISCOLORATIO...
ARCH WIRES-COSMETIC ADVANCES
1. Arch wires with plastic tubing coating
2. Marsenol
3. Lee-white
4. Composite archwires
5. ...
ARCH WIRES WITH PLASTIC TUBING COATING :
Earliest to be introduced

Stainless steel arch wires were coated with plastics
D...
MARSENOL:
E.T.E COATED NICKEL TITANIUM
It exhibits all the characteristics of NiTi . The coating is
adherent and is flexib...
COMPOSITE ARCH WIRES:
Made of S-2 glass fibres and acrylic resin.
Manufactured by 1. Photopulstration
2. Electromagnetic r...
‘OPTIFLEX’ ARCH WIRES
Designed by Dr. Taloss
Composite of ceramic fiber-plastic-nylon.
Made of 3 layers:
1. Silicon dioxid...
www.indiandentalacademy.com
ADVANTAGES
 Highly esthetic
 Stain resistant
 Light continuous force
 Greater flexibility and resiliency
 Low frictio...
FIBRE REINFORCED COMPOSITE
Made of S GLASS FIBRES in a matrix of THERMOSET BIS-GMA
Available as –1.Rope type
2.Woven strip...
USES:
1.Retainers
2.After initial aligning can replace main arch wire
3. Any attachments can be directly bonded
www.indian...
www.indiandentalacademy.com
LINGUAL ORTHODONTICS
“INVISIBLE BRACES”

www.indiandentalacademy.com
CASE SELECTION CRITERIA
NON EXTRACTION CASES
1.Cl.I , Deep bite , mild crowding
2Cl..I , Deep bite , generalized spacing
3...
ADVANTAGES
1. Totally invisible

2. Facial surfaces are not damaged
3. Lip contour not distorted
DISADVANTAGES

1. Decreas...
CASE REPORT

PRETREATMENT

www.indiandentalacademy.com
DURING TREATMENT

www.indiandentalacademy.com
POST TREATMENT

www.indiandentalacademy.com
INVISALIGN
The invisible way to align teeth without braces,
using a series of clear removable aligners

ADVANTAGES


Invi...
The Technology Behind Invisalign
Invisalign is a high-volume, customized manufacturing
process by advanced computer techno...
A computerized movie - called ClinCheck- depicting
the movement of the teeth from the beginning to the final
position is c...
CASE REPORT
BEFORE

AFTER

www.indiandentalacademy.com
RETAINERS
QCM RETAINER

ESSIX RETAINER

FRC RETAINER

www.indiandentalacademy.com
AUXILIARIES
Easy to tie ligatures

Elastomeric modules

Rotation wedges

www.indiandentalacademy.com
CONCLUSION
“An orthodontic patient smile is
no more a metallic smile”
It’s in our hands to keep in pace with the
recent ad...
Brackets

Auxiliaries
Wires

www.indiandentalacademy.com
ACKNOWLEDGEMENT
PRINCIPAL :

Dr. E . Munirathnam Naidu M.D.S
VICE PRINCIPAL AND HEAD OF THE DEPARTMENT:

Dr. P. Jaya Kumar...
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com
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Cosmetic orthodontics1 /certified fixed orthodontic courses by Indian dental academy

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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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Cosmetic orthodontics1 /certified fixed orthodontic courses by Indian dental academy

  1. 1. COSMETIC ORTHODONTICS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. What is Aesthetics? Aesthetics is purely and simply the science of expression,expression being itself so defined as to be Identical with every form of Appreciation,Intuition or Imaginative Synthesis. “HENFREY” www.indiandentalacademy.com
  3. 3. How Far Have We Gone? In Aesthetics!! In Orthodontics!!! We have gone as far as developing materials which are tooth colored or (Invisible)in.. www.indiandentalacademy.com
  4. 4. 1. Brackets 2. Wires 3. Rings or Chains 4. Auxiliaries TOGETHER IN A HARMONY BETWEEN “ function and esthetics ” www.indiandentalacademy.com
  5. 5. HISTORICAL PRESPECTIVE FIXED APPLIANCES INTRODUCED IN 1800’s BANDING OF ANTERIOR &POSTERIOR TEETH BONDING OF ANTERIOR ATTACHMENTS www.indiandentalacademy.com
  6. 6. REDUCTION OF BRACKET SIZES CERAMIC /COMPOSITE BRACKETS COMPOSITE ARCHWIRES LINGUAL ORTHODONTICS INVISALIGN SYSTEM www.indiandentalacademy.com
  7. 7. ANTERIOR BAND1NG : www.indiandentalacademy.com
  8. 8. TWIN BRACKETS MINI-TWIN BRACKETS www.indiandentalacademy.com
  9. 9. DESIGN VARIATIONS www.indiandentalacademy.com
  10. 10. TOOTH COLOURED BRACKETS 1. PLASTIC BRACKETS introduced by NEUMAN (1969) Acrylic, nylon, epoxies, polysulphones, polycarbonates USED IN a. Minimal torque situations b.Treatment of short duration STEEL SLOTED PLASTIC BRACKETS ----BEST SUITED www.indiandentalacademy.com
  11. 11. ADVANTAGES 1.Nontoxic 2.Easy fabrication 3.Good abrasion resistance 4.Good impact strength 5.No bad odour /distaste DISADVANTAGES 1.Lack of strength 2.Wire - slot wear 3. Water absorption & degradation 3.Discoloration and staining 4.Poor dimensional stability www.indiandentalacademy.com
  12. 12. 2.CERAMIC BRACKETS Introduced by MICHEAL SWARTZ (1987)  FULL CERAMIC BRACKETS  CERAMIC BRACKETS WITH METAL INSERTS www.indiandentalacademy.com
  13. 13. Full ceramic brackets With metal inserts www.indiandentalacademy.com
  14. 14.  MONOCRYSTALLINE /POLYCRYSTALLINE ALUMINA ( 2100`C )  ZIRCONIA (1000`C ) ------Made of 3D inorganic molecules Extremely high hardness and compressive strength. Both are highly biocompatible www.indiandentalacademy.com
  15. 15. BONDING OF CERAMIC BRACKETS TO ENAMEL: 1. Mechanical retention via indentation / undercuts in base. 2. Chemical bonding with silane coupling agents. www.indiandentalacademy.com
  16. 16. DISADVANTAGES 1. BRACKET FAILURE * Fracture of brackets * Friction within bracket slots * Tooth wear on bracket contact 2. BULK OF THE BRACKETS 3. SURFACE ROUGHNESS 4. INHIBITION OF POLYMERISATION 5. DEBONDING DIFFICULTIES * ENAMEL DAMAGE * Pulpal damage www.indiandentalacademy.com
  17. 17. CASE SELECTION CRITERIA Ceramic brackets are contraindicated in 1.Deep bite cases 2.Bruxism patients 3.Large restorations 4.Need for significant torque 5.Children www.indiandentalacademy.com
  18. 18. 3.COMPOSITE BRACKETS A Composite is a multiphase material brought about by combining materials that differ in composition /form to obtain specific characteristics and properties. The constituents retain their identities and properties. Can be simplified as ‘dispersion of fillers(particles /fibres /whiskers ) in a binder or matrix (metals /ceramics /resins)’. Reinforcement of polymer with ceramic metals –most common combination in ORTHODONTICS www.indiandentalacademy.com
  19. 19. COMPOSITION Manufactured by ‘INJECTION MOLDING TECHNIQUE’. COMPOSITE PRECURSOR -Plasma treated high strength Polyethylene fibers REINFORCED WITH 1.Glass 2.Mineral filler 3.Metal 4.Ceramic liner 5.Metal liner www.indiandentalacademy.com
  20. 20. ADVANTAGES 1.SUPERIOR IMPACT RESISTANCE 2.INCREASED COMPRESSIVE STRENGTH 3.FATIGUE RESISTANCE 4.RESISTANCE TO DISCOLORATION DISADVANTAGES 1.CREVICE CORROSION 2.DISINFECTION PROBLEMS 3.DIFFICULTY TO DETECT CRACKS 4.EXPENSIVE & CANNOT BE RECYCLED www.indiandentalacademy.com
  21. 21. ARCH WIRES-COSMETIC ADVANCES 1. Arch wires with plastic tubing coating 2. Marsenol 3. Lee-white 4. Composite archwires 5. Optiflex archwires 6. Fibre reinforced composite www.indiandentalacademy.com
  22. 22. ARCH WIRES WITH PLASTIC TUBING COATING : Earliest to be introduced Stainless steel arch wires were coated with plastics DISADVANTAGES 1. Easy peeling off of the coating 2. Loss of friction control www.indiandentalacademy.com
  23. 23. MARSENOL: E.T.E COATED NICKEL TITANIUM It exhibits all the characteristics of NiTi . The coating is adherent and is flexible,fracture resistant, delivers force over long periods. LEE WHITE: STAINLESS STEEL NiTi bonded to EPOXY COATING Coating is completely opaque, does not peel ,chip , stain or discolor www.indiandentalacademy.com
  24. 24. COMPOSITE ARCH WIRES: Made of S-2 glass fibres and acrylic resin. Manufactured by 1. Photopulstration 2. Electromagnetic radiation ADVANTAGES Translucent Strong & Springy Variable Stiffness Dimensional Stability Minimal Staining www.indiandentalacademy.com
  25. 25. ‘OPTIFLEX’ ARCH WIRES Designed by Dr. Taloss Composite of ceramic fiber-plastic-nylon. Made of 3 layers: 1. Silicon dioxide core –force production 2. Silicon resin middle layer - protection 3. Nylon outer layer –stain resistance www.indiandentalacademy.com
  26. 26. www.indiandentalacademy.com
  27. 27. ADVANTAGES  Highly esthetic  Stain resistant  Light continuous force  Greater flexibility and resiliency  Low friction  Corrosion resistance  High biocompatibility DISADVANTAGE ‘ No formability’ www.indiandentalacademy.com
  28. 28. FIBRE REINFORCED COMPOSITE Made of S GLASS FIBRES in a matrix of THERMOSET BIS-GMA Available as –1.Rope type 2.Woven strip 3.Unidirectional strip www.indiandentalacademy.com
  29. 29. USES: 1.Retainers 2.After initial aligning can replace main arch wire 3. Any attachments can be directly bonded www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. LINGUAL ORTHODONTICS “INVISIBLE BRACES” www.indiandentalacademy.com
  32. 32. CASE SELECTION CRITERIA NON EXTRACTION CASES 1.Cl.I , Deep bite , mild crowding 2Cl..I , Deep bite , generalized spacing 3.Cl.II , Deep bite 4.Cl.II div.2 , mand. retrusion 5.Diastema closure EXTRACTION CASES 1.Cl.I, low FMA , severe crowding 2.Cl.II with minimal crowding www.indiandentalacademy.com
  33. 33. ADVANTAGES 1. Totally invisible 2. Facial surfaces are not damaged 3. Lip contour not distorted DISADVANTAGES 1. Decreased accessibility 2. Small interbracket span –freq. adjustments 3. Difficulty to perform complex movements 4. Speech distortion and tongue irritation www.indiandentalacademy.com
  34. 34. CASE REPORT PRETREATMENT www.indiandentalacademy.com
  35. 35. DURING TREATMENT www.indiandentalacademy.com
  36. 36. POST TREATMENT www.indiandentalacademy.com
  37. 37. INVISALIGN The invisible way to align teeth without braces, using a series of clear removable aligners ADVANTAGES  Invisible,  Removable,  Comfortable. Invisalign also allows a person to view his own virtual treatment plan, he can see how his teeth will look when the treatment is complete. www.indiandentalacademy.com
  38. 38. The Technology Behind Invisalign Invisalign is a high-volume, customized manufacturing process by advanced computer technology | Using advanced imaging technology, Invisalign transforms the plaster models into a highly accurate 3-D digital image. www.indiandentalacademy.com
  39. 39. A computerized movie - called ClinCheck- depicting the movement of the teeth from the beginning to the final position is created . From the approved ClinCheck file, Invisalign uses laser scanning to make a customised set of aligners , sent to the clinician . www.indiandentalacademy.com
  40. 40. CASE REPORT BEFORE AFTER www.indiandentalacademy.com
  41. 41. RETAINERS QCM RETAINER ESSIX RETAINER FRC RETAINER www.indiandentalacademy.com
  42. 42. AUXILIARIES Easy to tie ligatures Elastomeric modules Rotation wedges www.indiandentalacademy.com
  43. 43. CONCLUSION “An orthodontic patient smile is no more a metallic smile” It’s in our hands to keep in pace with the recent advances in esthetic dentistry to meet the increasing esthetic concern of the patient . www.indiandentalacademy.com
  44. 44. Brackets Auxiliaries Wires www.indiandentalacademy.com
  45. 45. ACKNOWLEDGEMENT PRINCIPAL : Dr. E . Munirathnam Naidu M.D.S VICE PRINCIPAL AND HEAD OF THE DEPARTMENT: Dr. P. Jaya Kumar M.D.S. Staff Members And P.G. Students, Meenakshi Ammal Dental College, CHENNAI. www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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