Esthetic orthodontics /certified fixed orthodontic courses by Indian dental academy
INDIAN DENTAL ACADEMY
Leader in continuing dental education
Orthodontic patients – their demand
development of appliances
acceptable aesthetic for the patient
adequate technical performance for the clinician
Early attempts to coat metal brackets with
a tooth colored coating were unsuccessful
due to failure of the coating to adhere and
There was a firm trend towards the development
of smaller stainless steel brackets.
Although these generally provide the technical
performance required by the orthodontist, they
offer little aesthetic advantage over conventionally
An attempt to improve esthetics while
maintaining bracket strength has resulted
recently in the development of a ceramic
Single-crystal alumina – most translucent
Poly-crystal alumina – less than singlecrystal
Zirconia – inferior esthetics
Greater opacity, yellowish tint
Two or more polymers
These have properties intermediate
between those of the constituents
Materials should be so chosen that the
property of one constituent improves
the deficient property of others
Epoxy Coated Wires
Epoxy coated tooth-colored arch wires with
a NiTi (superelastic) or stainless steel core.
Superior wear resistance and color stability
Retains superelastic qualities
More natural looking than white coatings
Optiflex is a new orthodontic arch wire designed
to combine unique mechanical properties with a
highly esthetic appearance.
Made of clear optical fiber, it comprises three
A silicon dioxide core that provides the force for moving
A silicon resin middle layer that protects the core from
moisture and adds strength.
A stain-resistant nylon outer layer that prevents damage
to the wire and further increases its strength.
Essix retainers are clear, thin cuspid-to-cuspid
appliances appliances that snap into place and are
retained, without clasps, by the many natural
undercuts gingival to the anterior contact points.
They are fabricated from .030" Essix plastic sheet,
which is reduced to .015" during thermoforming.
Additionally, tooth movement is possible in
all planes of space.
Two types of space that must be evident
for tooth movement with Essix appliances
space within the appliance and
space within the dentition
Was the brainchild of Zia Chishti and Kelsey Wirth,
graduate students in Stanford University's MBA program.
Kelsey Wirth had traditional braces in high school, which she
reportedly hated whereas Zia Chishti had finished adult
treatment with traditional braces, and now wore a clear
He noticed that if he did not wear his retainer for a few days,
his teeth shifted slightly -- but the plastic retainer soon
moved his teeth back the desired position.
Together they started Align Technologies in April 1997 and
with the help of a handful of forward thinking orthodontists,
they applied 3-D computer imaging graphics and created the
Step 1 - Diagnosis and Treatment Plan
Step 2 - Polyvinylsiloxane Impressions and
Step 3 - The Digitization Process
Step 4 - ClinCheck
Step 5 -Manufacture of Appliances
mild spacing (1 - 3 mm),
moderate spacing (4 - 6 mm),
mild crowding (1- 3 mm),
moderate crowding (4 - 6 mm),
narrow arches that are dental in origin (4 6 mm),
as well as patients who have relapsed
following conventional orthodontic
Long-fiber composites can be used as
adjuncts for active tooth movement
The FRC rope or strip is cut to length, and
the protective transparent foil is gently
The tooth is prepared for bonding with the
conventional polishing and etching.
The FRC is placed in position and
contoured to the tooth, then light-cured to
form an effective connecting bar.
Clinical Use of FRC
During the early 1970’s, Dr.Craven Kurz, an orthodontist,
then Assistant Professor of occlusion and gnathology at the
UCLA School of dentistry found his private orthodontic
practice to be increasingly dominated by adult patients.
A particular patient who was an employee of playboy, bunny
club, presented to his practice requesting treatment.
Because of her public position, she refused metal or plastic
labial appliances on esthetic grounds.
From her demand for an appliance that did not show, the
concept of a lingually bonded appliance was born.
List of difficulties encountered during the
development of the lingual appliance:
Tissue Irritation and speech difficulties
Base pad Adaptation
Appliance placement and bonding
Ormco manufactured the
first Kurz lingual appliance.
Flat maxillary occlusal bite
plane from canine to
Lower incisor & PM
brackets were low profile &
No hooks on any brackets.
Hooks were added to
all canine brackets
Hooks were added to
all anterior & PM
The first molar had
bracket with internal
The second molar had
terminal sheath without
Low profile anterior inclined plane in central
& lateral incisor. Hooks were optional based
on treatment needs & hygiene concerns
torque in the maxillary
Canine had an
inclined plane with
Hooks were optional.
Maxillary inclined plane is square in shape.
Hooks available in all brackets & are
elongated.TPA attachment is optional.
Hinge cap available for molar brackets.
Maxillary anterior inclined plane is heart shaped
with short hooks. Premolar brackets were
widened mesiodistally for better angulation &
rotational control. Molar brackets with hinge cap
or terminal sheath
Intrusion of anterior teeth
Maxillary arch expansion
Combining mandibular repositioning
therapy with orthodontic movements
Distalization of maxillary molars