Evaluation of orthodontic brackets/cosmetic dentistry courses

EVOLUTION OFEVOLUTION OF
ORTHODONTICORTHODONTIC
BRACKETSBRACKETS
-- PART VPART V
www.indiandentalacademy.comwww.indiandentalacademy.com

All contemporary fixed appliance areAll contemporary fixed appliance are
based on the Angles design from the 20based on the Angles design from the 20thth
centaurycentaury
““Father Of OrthodontistFather Of Orthodontist””

Pierre Fauchard’s OrthodonticPierre Fauchard’s Orthodontic
appliance-1728appliance-1728

Dwinelles Jackscrew-1849Dwinelles Jackscrew-1849

Angle’s JackscrewAngle’s Jackscrew

Angles Retraction screwAngles Retraction screw

According To Angle-According To Angle-
A standard appliance must have fiveA standard appliance must have five
important properties-important properties-
1.1. SimpleSimple
2.2. StableStable
3.3. EfficiencyEfficiency
4.4. DelicateDelicate
5.5. InconspicuousInconspicuous

Historical perspectiveHistorical perspective
In 1907 - E-archIn 1907 - E-arch
Four basic designs-Four basic designs-
1.1. Basic E arch.Basic E arch.
2.2. Ribbed E arch.Ribbed E arch.
3.3. E arch without threaded ends.E arch without threaded ends.
4.4. E arch with hooks.E arch with hooks.

The E Arch applianceThe E Arch appliance
Basic E archBasic E arch Ribbed E ArchRibbed E Arch

E Arch Without Treaded EndsE Arch Without Treaded Ends

E Arch With HooksE Arch With Hooks

DrawbackDrawback
Dentition was enlarged in all dimensionsDentition was enlarged in all dimensions
by tippingby tipping
Once the retention appliance wasOnce the retention appliance was
discarded various degree of malocclusiondiscarded various degree of malocclusion
resultedresulted

Pin and tube-1910Pin and tube-1910
Bands were put on all theBands were put on all the
teeth with a vertical tube intoteeth with a vertical tube into
which soldered pin from thewhich soldered pin from the
archwire was placed .archwire was placed .
Advantage-good axialAdvantage-good axial
controlcontrol
Disadvantage -limited m-dDisadvantage -limited m-d
controlcontrol
-difficult-difficult

The Ribbon Arch-1915The Ribbon Arch-1915
Brackets wereBrackets were
introduced withintroduced with
appliance.appliance.
Tube of the pin wasTube of the pin was
modified to providemodified to provide
vertically positionedvertically positioned
rectangular slot.rectangular slot.
A ribbon arch of 10x20A ribbon arch of 10x20
gold wire was placed ingold wire was placed in
this slot .this slot .

BRACKET-BRACKET-was introduced by
DR E H ANGLE 1916
THUROW-as an orthodontic attachment
secured to a tooth for the purpose of
engaging an arch wire .
As an attachment that serves to deliver
the necessary tooth moving forces .

Edgewise ApplianceEdgewise Appliance
Angle oriented the slotAngle oriented the slot
from vertical tofrom vertical to
horizontal and insertedhorizontal and inserted
rectangular wire into it.rectangular wire into it.
This provided theThis provided the
solution to the problemssolution to the problems
caused by the previouscaused by the previous
applianceappliance

Begg ApplianceBegg Appliance
This was developed by Dr P.R.Begg 1956This was developed by Dr P.R.Begg 1956
It utilizes the ribbon arch type bracketsIt utilizes the ribbon arch type brackets
and was manufactured to accept 016’and was manufactured to accept 016’
round wireround wire
Wire was held in position with the lockWire was held in position with the lock
pinspins

Bracket design –Bracket design –
-modified ribbon arch-modified ribbon arch
bracketbracket
- .020 x .045 slot.020 x .045 slot

Lock pins –Lock pins –
Safety lock pinsSafety lock pins
Double safety pinDouble safety pin
Hook pinHook pin

Evolution of the edgewise bracketsEvolution of the edgewise brackets
Original angle bracket wasOriginal angle bracket was
made up of a soft gold with .made up of a soft gold with .
22 x .28 slot.22 x .28 slot.
It was .050 wide and wasIt was .050 wide and was
soldered to gold bandsoldered to gold band
material .material .
Angle soldered gold eyeletsAngle soldered gold eyelets
in appropriate positions onin appropriate positions on
the band.the band.

To overcome this problem –To overcome this problem –
two edgewise brackets were used ontwo edgewise brackets were used on
the same tooththe same tooth
This provide a good rotational control.This provide a good rotational control.
Disadvantage-perfect alignment.Disadvantage-perfect alignment.

Twin BracketTwin Bracket
Joining together of two edgewise bracketsJoining together of two edgewise brackets
““SIAMESE TWIN BRACKET”SIAMESE TWIN BRACKET”
The space between two brackets wasThe space between two brackets was
approx 0.050approx 0.050
Initially for upper central incisors andInitially for upper central incisors and
molars.molars.
Terminology was changed to -“TWINTerminology was changed to -“TWIN
BRACKET”.BRACKET”.

Twin BracketTwin Bracket
They are available in four sizes-They are available in four sizes-
1.1. Extra wideExtra wide
2.2. StandardStandard
3.3. IntermediateIntermediate
4.4. JuniorJunior
Solid bracket-posterior bracketSolid bracket-posterior bracket
0.100’” wide in dimension.0.100’” wide in dimension.

Twin BracketsTwin Brackets

Curved Base Twin BracketCurved Base Twin Bracket
Curving of the base of the twin bracket toCurving of the base of the twin bracket to
conform to the curvature of the canine andconform to the curvature of the canine and
the premolar teeth.the premolar teeth.
Besides the advantage of twin bracketBesides the advantage of twin bracket
offering rotational and greater axial controloffering rotational and greater axial control
it also incorporated what is termed asit also incorporated what is termed as
““ POSITIVE CONTROL”POSITIVE CONTROL”

Curved Base Twin BracketCurved Base Twin Bracket

Rotational control of twin bracketRotational control of twin bracket
The actual mechanism is by deflection ofThe actual mechanism is by deflection of
the archwire.the archwire.
The more resilient the archwire the moreThe more resilient the archwire the more
readily it can be tied into the twin bracket.readily it can be tied into the twin bracket.
However 100% control cannot be obtainedHowever 100% control cannot be obtained
Final 10% desired rotation has toFinal 10% desired rotation has to
accomplished by additional means.accomplished by additional means.www.indiandentalacademy.comwww.indiandentalacademy.com

Lewis bracketLewis bracket
This was the next development forThis was the next development for
bringing about efficient tooth rotation.bringing about efficient tooth rotation.
He soldered auxiliary rotation arm thatHe soldered auxiliary rotation arm that
abutted against the bracket itself and thusabutted against the bracket itself and thus
offered a lever arm to deflect archwire andoffered a lever arm to deflect archwire and
rotate the teeth.rotate the teeth.
Present day lewis bracket is a one piecePresent day lewis bracket is a one piece
bracket with rotational wings which isbracket with rotational wings which is
equivalent to original edgewise bracketequivalent to original edgewise bracket
with single width feature.with single width feature.

Regular Lewis
Bracket

Advantage –Advantage –
1.1. 100% desired tooth100% desired tooth
rotation .rotation .
2.2. OvercorrectionOvercorrection
3.3. Error in bracket placement .Error in bracket placement .
Curved Lewis bracketCurved Lewis bracket
advantage-advantage-
1.1. Increase contact with band .Increase contact with band .
2.2. Reduces trapping of theReduces trapping of the
food.food. www.indiandentalacademy.comwww.indiandentalacademy.com

Vertical slot lewis bracketVertical slot lewis bracket
further refinement wasfurther refinement was
done by incorporating a 020done by incorporating a 020
x020 vertical slotx020 vertical slot
Advantage-Advantage-
uprighting spring to correctuprighting spring to correct
axial inclination.axial inclination.

Steiner bracketSteiner bracket
This bracket incorporated flexible rotationThis bracket incorporated flexible rotation
arms and therefore did not rely entirely onarms and therefore did not rely entirely on
the resiliency of archwire for tooth rotation.the resiliency of archwire for tooth rotation.
It uses a single width edgewise bracketIt uses a single width edgewise bracket
and has the inherent advantage andand has the inherent advantage and
disadvantage of the same .disadvantage of the same .

The Straight Wire ApplianceThe Straight Wire Appliance
Andrews classified brackets into three types-Andrews classified brackets into three types-
1.1. Non programmed appliance-Non programmed appliance-a set of bracketsa set of brackets
designed the same for all tooth types ,relyingdesigned the same for all tooth types ,relying
totally on wire bending.totally on wire bending.
2.2. Partly programmed appliance-Partly programmed appliance- a set ofa set of
brackets designed with some in builtbrackets designed with some in built
features ,but always require some wirefeatures ,but always require some wire
bending.bending.

3.3. Fully programmed appliance-Fully programmed appliance- a set ofa set of
brackets designed to guide teeth directlybrackets designed to guide teeth directly
to their goal positions with unbent wires.to their goal positions with unbent wires.
Standard brackets.Standard brackets.
Transition brackets.Transition brackets.

TerminologiesTerminologies

Non Programmed EdgewiseNon Programmed Edgewise
Bracket FeatureBracket Feature

Design shortcomings –Design shortcomings –
1.1. Bracket base perpendicular to bracket stem.Bracket base perpendicular to bracket stem.
2.2. Bracket bases are not contoured.Bracket bases are not contoured.
3.3. Slots are not angulatedSlots are not angulated
4.4. Bracket stem are of equal faciolingualBracket stem are of equal faciolingual
thickness.thickness.
5.5. Maxillary molar offset is not built in.Maxillary molar offset is not built in.
6.6. Bracket sitting techniques are unsatisfactory.Bracket sitting techniques are unsatisfactory.

1.1. Bracket base perpendicular to bracket stem.Bracket base perpendicular to bracket stem.
-this feature causes problems of slot inclination-this feature causes problems of slot inclination
and occlusogingival positionand occlusogingival position

2.2. Bracket bases areBracket bases are
not contoured.not contoured.
- OcclosogingivallyOcclosogingivally
the base of a non-the base of a non-
programmedprogrammed
brackets is flat .brackets is flat .

Slots are not angulatedSlots are not angulated
Mesio distalMesio distal

3.3. Slots are not angulated-Slots are not angulated-

4.4. Bracket stem are ofBracket stem are of
equal faciolingualequal faciolingual
thickness.thickness.
--

5.5. Maxillary molarMaxillary molar
offset is not built in.offset is not built in.

6.6. Bracket sitting techniques are unsatisfactory.Bracket sitting techniques are unsatisfactory.
Various authors have their own way ofVarious authors have their own way of
positioning the brackets.positioning the brackets.
--TweedTweed recommends sitting brackets inrecommends sitting brackets in
specified number of millimeters from the incisalspecified number of millimeters from the incisal
edge.edge.
--HoldawayHoldaway advocates that the bracket sittingadvocates that the bracket sitting
should altered according to the malocclusionshould altered according to the malocclusion

According toAccording to JarabakJarabak bracket sites forbracket sites for
inclination should be determined by theinclination should be determined by the
shape of the crown.shape of the crown.
SaltzmanSaltzman recommends except for therecommends except for the
maxillary lateral incisor ,brackets shouldmaxillary lateral incisor ,brackets should
be located in the middle third of the crown.be located in the middle third of the crown.

1.1. According to Andrews suitable bracketAccording to Andrews suitable bracket
site has three criteria-site has three criteria-
 No interference with either gingiva orNo interference with either gingiva or
with opposing tooth.with opposing tooth.
 Angulation and inclination of the crown .Angulation and inclination of the crown .
 Middle of each bracket site must shareMiddle of each bracket site must share
the same plane of surface when thethe same plane of surface when the
teeth in the arch are optimally positioned.teeth in the arch are optimally positioned.

Fully programmed appliance-Fully programmed appliance-
- Slot-siting feature- Slot-siting feature
- Convenience feature- Convenience feature
- Auxiliary feature- Auxiliary feature

Slot siting feature-Slot siting feature-
Feature 1- mid transverse planes of the slotFeature 1- mid transverse planes of the slot
stem and crown must be thestem and crown must be the
same.same.
Feature 2-base of the bracket for each toothFeature 2-base of the bracket for each tooth
type must have same inclinationtype must have same inclination
as the facial plane of theas the facial plane of the
crown.crown.

Feature 4- mid sagittal plane of the slotFeature 4- mid sagittal plane of the slot
stem and crown must be same.stem and crown must be same.
Feature 5 -the plane of the bracket base atFeature 5 -the plane of the bracket base at
its base point must be identical toits base point must be identical to
the facial plane of the crown at thethe facial plane of the crown at the
FA point.FA point.
Feature 6 - base should match the m-dFeature 6 - base should match the m-d
contour of the tooth.contour of the tooth.

Feature 7 - the vertical component shouldFeature 7 - the vertical component should
be parallel to one another.be parallel to one another.
Feature 8 – all slots point must have sameFeature 8 – all slots point must have same
distance between them anddistance between them and
the crown embrasure line.the crown embrasure line.

Convenience feature-Convenience feature-..
1.1. The gingival tie wings of the postThe gingival tie wings of the post
Brackets extend farther laterally .Brackets extend farther laterally .
2.2. Base are inclined .Base are inclined .
3.3. Facial surface of the incisor and canineFacial surface of the incisor and canine
brackets are designed to parallel theirbrackets are designed to parallel their
bases.bases.
4.4. In mandibular brackets the tie wings areIn mandibular brackets the tie wings are
designed with least amount occlusofacialdesigned with least amount occlusofacial
prominenceprominence
5.5. Bracket identification.Bracket identification.www.indiandentalacademy.comwww.indiandentalacademy.com

Convenience feature-Convenience feature-

Auxiliary feature –Auxiliary feature –
- Power armsPower arms
- HooksHooks
- Face bow tubesFace bow tubes
- Utility tubesUtility tubes
- Rotational wingsRotational wings

Fully programmed translation brackets-Fully programmed translation brackets-
Are used when bodily movement of theAre used when bodily movement of the
teeth is required .teeth is required .
If they are not available ,teeth will not beIf they are not available ,teeth will not be
within 2within 2˚ or 0.5 mm of where they should˚ or 0.5 mm of where they should
be at the conclusion of the treatment .be at the conclusion of the treatment .
They have all the qualitiesThey have all the qualities of the standardof the standard
brackets plus few other feature .brackets plus few other feature .

Counterbuccolingual tip-Counterbuccolingual tip- a slot sittinga slot sitting
feature for maxillary molar thatfeature for maxillary molar that
counteracts buccolingual tip duringcounteracts buccolingual tip during
translation and then overcorrect.translation and then overcorrect.
Countermesiodistal tipCountermesiodistal tip –a slot siting–a slot siting
feature that counteracts mesial or distalfeature that counteracts mesial or distal
tipping during translation and thentipping during translation and then
overcorrects.overcorrects.
CounterrotationCounterrotation – a slot siting feature that– a slot siting feature that
counteracts rotation during translation andcounteracts rotation during translation and
then overcorrects ,then overcorrects ,

Translation problemsTranslation problems ––
TranslatioTranslation- “uniform movement of then- “uniform movement of the
body in a straight line”.body in a straight line”.
However bracket is placed in wrongHowever bracket is placed in wrong
place in two ways-place in two ways-
1.1. It is occlusal .It is occlusal .
2.2. It is located laterally .It is located laterally .

Translation problemsTranslation problems

Lever Effects Of AnLever Effects Of An
OptimalOptimal

Translation solutions-Translation solutions-
leverlever

Lever common to allLever common to all
edgewise bracketsedgewise brackets

CounterrotationCounterrotation
Slot rotation plus mesiodistal slot length plusSlot rotation plus mesiodistal slot length plus
archwire flex plus mesial or distal force equalsarchwire flex plus mesial or distal force equals
counterrotation and rotation overcorrection.counterrotation and rotation overcorrection.

Countermesiodistal tipCountermesiodistal tip
Slot angulation plus mesiodistal slot lengthSlot angulation plus mesiodistal slot length
plus power arm length plus activatedplus power arm length plus activated
archwire andarchwire and

Partly programmed brackets-Partly programmed brackets-
By definition p p. brackets are the oneBy definition p p. brackets are the one
which lack atleast one slot sitting featurewhich lack atleast one slot sitting feature
because of which it would fail to fullybecause of which it would fail to fully
direct each slot to its tooth slot site.direct each slot to its tooth slot site.
1. Slot inclination .1. Slot inclination .
2. Slot angulation.2. Slot angulation.
3. Slot prominence.3. Slot prominence.
4. Horizontal base contour.4. Horizontal base contour.

•Counter mesio distal tip

Counterbuccolingual tipCounterbuccolingual tip

Translation bracket categories –Translation bracket categories –
1.1. Minimum translation bracketsMinimum translation brackets –requiring–requiring
a translation of 2 mm or lessa translation of 2 mm or less
2.2. Medium translation bracketsMedium translation brackets – requiring– requiring
a translation of more than 2mm but lessa translation of more than 2mm but less
than 4 mmthan 4 mm
3.3. Maximum translation bracketsMaximum translation brackets -requiring-requiring
a translation of more than 4 mm.a translation of more than 4 mm.

The Universal BracketThe Universal Bracket
Developed by Dr.Spencer R AtkinsonDeveloped by Dr.Spencer R Atkinson
----
19281928
Appliance has undergone periodicAppliance has undergone periodic
refinements without losing its essentialrefinements without losing its essential
features.features.
Modified to improve its leverage andModified to improve its leverage and
rotational potential .rotational potential .www.indiandentalacademy.comwww.indiandentalacademy.com

Design-Design-
-vertical hallow shaft with two lateral-vertical hallow shaft with two lateral
welding tabswelding tabs
-central shaft has two slot openings-central shaft has two slot openings
1.1. HorizontalHorizontal – opening labially at gingival– opening labially at gingival
thirdthird
2.2. VerticalVertical –opens incisally near the base–opens incisally near the base
and extends gingival one third of theand extends gingival one third of the
bracket heightbracket height
-.-.

Original BracketOriginal Bracket

Five Archwire CombinationsFive Archwire Combinations
AvailableAvailable

The incisal slot can hold-.008-.016 roundThe incisal slot can hold-.008-.016 round
or .008 x.020 up to .015 x .028 wire .or .008 x.020 up to .015 x .028 wire .
- corrections of rotations ,leveling or- corrections of rotations ,leveling or
torque.torque.
Gingival slot can only hold round wireGingival slot can only hold round wire
ranging from .008 - .016ranging from .008 - .016
-mesiodistal axial inclinations ,act as a-mesiodistal axial inclinations ,act as a
guide when teeth are moved bodily inguide when teeth are moved bodily in
mesial or distal direction.mesial or distal direction.

The 3-D Universal Bracket(1974)The 3-D Universal Bracket(1974)
-Jorge Fastlicht

Comparison of Previous UniversalComparison of Previous Universal
Bracket with 3-D UniversalBracket with 3-D Universal

Six basic movementsSix basic movements

Conventional light Wire bracket andConventional light Wire bracket and
3 - D Universal Bracket3 - D Universal Bracket
Easy ligationEasy ligation
Use of two wiresUse of two wires
simultaneously .simultaneously .
As the bracket is wideAs the bracket is wide
very light wires arevery light wires are
used in initial stages.used in initial stages.
Improve rotationImprove rotation
potential.potential.
More space inside theMore space inside the
vertical shaft.vertical shaft.

The 3-D Universal BracketThe 3-D Universal Bracket
Advantage-Advantage-
1.1. Efficiency in leveling and aligningEfficiency in leveling and aligning
2.2. Permits bodily movement in m-dPermits bodily movement in m-d
directiondirection
3.3. Retracts canine without tippingRetracts canine without tipping
4.4. Torque automatically in most casesTorque automatically in most cases
5.5. Individual torque is also easily achievedIndividual torque is also easily achieved

Broussard BracketBroussard Bracket
Was designed by “Grayford broussard”Was designed by “Grayford broussard”
Modified edgewise bracket in which thereModified edgewise bracket in which there
is addition of 0.0185 x 0.046 slot –tois addition of 0.0185 x 0.046 slot –to
accept 0.018 auxiliary wireaccept 0.018 auxiliary wire
Brackets are patented by the R.M.Brackets are patented by the R.M.
company .company .
Utilizes the two force technique.Utilizes the two force technique.

Features –Features –
-quick wing-quick wing
-vertical slot-vertical slot
-round corners, smooth surface-round corners, smooth surface
- horizontal slot- horizontal slot
-special torque brackets.- 0,7-special torque brackets.- 0,7˚,˚,1717˚,22˚˚,22˚
-insert pin-insert pin

Transition from .022 to .018 slotTransition from .022 to .018 slot
The use of rectangular wires inThe use of rectangular wires in
rectangular brackets was introduced byrectangular brackets was introduced by
Edward Angle.Edward Angle.
The original appliance was designed forThe original appliance was designed for
use with gold arch wires and had a 22 xuse with gold arch wires and had a 22 x
28 slot .28 slot .
In angels concept of treatment ,slidingIn angels concept of treatment ,sliding
teeth along the arch wires to close spacesteeth along the arch wires to close spaces
was unnecessarywas unnecessary

At that time the appliance was designed toAt that time the appliance was designed to
produce appropriate force and aproduce appropriate force and a
reasonable range in torsion when goldreasonable range in torsion when gold
arch wires were usedarch wires were used
Problem originated when steel wiresProblem originated when steel wires
replaced ?replaced ?
There was a need to redesign theThere was a need to redesign the
edgewiseedgewise

Solution to this problem was obtained bySolution to this problem was obtained by
.022.022
.018.018

Using undersized wire in edgewiseUsing undersized wire in edgewise
bracket is way by which friction can bebracket is way by which friction can be
reduced.reduced.
Sliding teeth along the arch wire requiresSliding teeth along the arch wire requires
atleast 2 mil of clearance .atleast 2 mil of clearance .

Concept Of Fully PreadjustedConcept Of Fully Preadjusted
ApplianceAppliance
Reed Holdaway- made the first attempt toReed Holdaway- made the first attempt to
alter bracket slots in 1958.alter bracket slots in 1958.
Second attempt in this direction was madeSecond attempt in this direction was made
by Ivan Leeby Ivan Lee
Joseph R Jarabak was first to combineJoseph R Jarabak was first to combine
two features in 1961 –Jarabak light wiretwo features in 1961 –Jarabak light wire
bracket manufactured by Rocky Mountainbracket manufactured by Rocky Mountain
OrthodonticsOrthodontics

Roths PrescriptionRoths Prescription
In 1976 –Ronald Roth published a reportIn 1976 –Ronald Roth published a report
entitled “Five year clinical evaluation ofentitled “Five year clinical evaluation of
the Andrews Straight Wire Appliance”.the Andrews Straight Wire Appliance”.
In 1979 roth introduced a bracket set upIn 1979 roth introduced a bracket set up
with his own modifications keeping inwith his own modifications keeping in
mind –mind –
1.1. Biologic consideration .Biologic consideration .
2.2. Mechanical consideration.Mechanical consideration.

Roths PrescriptionRoths Prescription
Roths rationale –Roths rationale –
1.1. With the appliance in place ,it is virtuallyWith the appliance in place ,it is virtually
impossible ,because of the bracketimpossible ,because of the bracket
interference ,to position the teeth preciselyinterference ,to position the teeth precisely
into occlusion shown by non orthodonticinto occlusion shown by non orthodontic
normal samplenormal sample
2.2. After appliance removal ,no matter howAfter appliance removal ,no matter how
well treated the patient may be ,the teethwell treated the patient may be ,the teeth
will shift slightly from the position theywill shift slightly from the position they
occupied at the time appliance wasoccupied at the time appliance was
removed.removed. www.indiandentalacademy.comwww.indiandentalacademy.com

Bioefficient BracketBioefficient Bracket
It is a modification of preadjusted systemIt is a modification of preadjusted system
introduced by Viazis.introduced by Viazis.
The bracket prescriptions were designedThe bracket prescriptions were designed
to overcorrect malocclusion and to make itto overcorrect malocclusion and to make it
possible to work with the largest possiblepossible to work with the largest possible
wires from the start of the treatment .wires from the start of the treatment .

Rationale behind the bracket design is-Rationale behind the bracket design is-
- maximum potential of any archwire is- maximum potential of any archwire is
achieved when the largest possible wire isachieved when the largest possible wire is
used.used.
The archwire between a narrow singleThe archwire between a narrow single
bracket will have less stiffness andbracket will have less stiffness and
greater flexibility .greater flexibility .

The bracket isThe bracket is
designed to fulfilldesigned to fulfill
followingfollowing
requirements-requirements-
1.1. Conformity to theConformity to the
crown anatomycrown anatomy
and gingivaland gingival
outlineoutline

2.2. Ease of use-Ease of use-
Variability in theVariability in the
bracket positioning isbracket positioning is
usually attributable tousually attributable to
improper mesiodistalimproper mesiodistal
or buccolingualor buccolingual
placement of the slotplacement of the slot

3.3. Minimum frictionMinimum friction

4.4. Tip controlTip control

5.5. Rotational control-narrow ,elongatedRotational control-narrow ,elongated
configuration of the bracket ,with the wingsconfiguration of the bracket ,with the wings
moved towards the mesiodistal surface ofmoved towards the mesiodistal surface of
the teeth provide maximum rotationalthe teeth provide maximum rotational
controlcontrol

6.6. Vertical slotVertical slot
6.6. High torque in the anterior brackets.High torque in the anterior brackets.

Vari Simplex DisciplineVari Simplex Discipline
The actual appliance was born in 1978.The actual appliance was born in 1978.
All the brackets used in this systemAll the brackets used in this system
pretorqued , preangulated and exhibitpretorqued , preangulated and exhibit
specific bracket base thickness for in/outspecific bracket base thickness for in/out
compensations .compensations .

Factors determining the design of theFactors determining the design of the
appliance-appliance-
1.1. Size and shape of the teeth ,especiallySize and shape of the teeth ,especially
mesio distal width and curvature .mesio distal width and curvature .
2.2. Selection of proper bracket style to fit theSelection of proper bracket style to fit the
size and the shape of each tooth .size and the shape of each tooth .
3.3. Accessibility of the tooth .Accessibility of the tooth .
4.4. Patient comfort .Patient comfort .

Factors defining the bracket system-Factors defining the bracket system-
-Type of bracket-Type of bracket
-Placement positions-Placement positions
-Angulations-Angulations
-Torque-Torque
-In /out compensations-In /out compensations

Brackets used in vari simplexBrackets used in vari simplex
1.1. Twin bracket-Twin bracket-
- Used on large flat surfaced teeth.- Used on large flat surfaced teeth.
-Mini –Diamond bracket in-Mini –Diamond bracket in
rhomboid design.rhomboid design.
- Advantage –Advantage –
a)a) Flat surface .Flat surface .
b)b) Easy accessibility .Easy accessibility .
c)c) Mini twin bracket .Mini twin bracket .
d)d) Patient comfort.Patient comfort.

Twin bracket on the lateral incisor areTwin bracket on the lateral incisor are
provided with additional tie wing for easyprovided with additional tie wing for easy
initial wire placement.initial wire placement.
Additional permanent hooks are presentAdditional permanent hooks are present
on the lateral incisoron the lateral incisor

2.2. Lang bracket-Lang bracket-
- Was invented by Dr Howard LangWas invented by Dr Howard Lang
- Used round surfaced teeth at the cornersUsed round surfaced teeth at the corners
of the arch .of the arch .
Design-Design-
-single bracket a flat rotational control wing-single bracket a flat rotational control wing
-each wing has a circular hole .-each wing has a circular hole .
- Wedge shape in profile- Wedge shape in profile

Reasons for using Lang bracket onReasons for using Lang bracket on
cuspids-cuspids-
1.1. Twin bracket reduces the inter-bracketTwin bracket reduces the inter-bracket
distance.distance.
2.2. Better rotational control.Better rotational control.
3.3. Full bracket engagement with a twinFull bracket engagement with a twin
bracket is difficult on a round surfacedbracket is difficult on a round surfaced
tooth.tooth.
4.4. Prevents attrition on the maxillary cuspid.Prevents attrition on the maxillary cuspid.

3.3. Lewis bracket-Lewis bracket-
- They are used for large roundThey are used for large round
surfaced teeth that are not atsurfaced teeth that are not at
the curve of the arch - bicuspids .the curve of the arch - bicuspids .
- Small flat surface teethSmall flat surface teeth
- mandibular incisors.- mandibular incisors.

Design –Design –
- Consists of fixed wing single bracket withConsists of fixed wing single bracket with
built in labial curvature of the rotationalbuilt in labial curvature of the rotational
wings .wings .
- This provides a three point contact .This provides a three point contact .
- Bracket is wedge shape in profile viewBracket is wedge shape in profile view

Advantages of using fixed Lewis wing overAdvantages of using fixed Lewis wing over
flexible Steiner wing-flexible Steiner wing-
1.1. Additional force .Additional force .
2.2. Save adjustment time.Save adjustment time.
3.3. Edges of the Lewis bracket are lessEdges of the Lewis bracket are less
sharp .sharp .
4.4. Breakages are less .Breakages are less .

Salient features-Salient features-
1.1. -3-3˚ torque on maxillary cuspid˚ torque on maxillary cuspid
2.2. No torque in the second molar tube.No torque in the second molar tube.
3.3. -5˚ lingual crown torque in the-5˚ lingual crown torque in the
mandibular incisorsmandibular incisors

Creekmore Uni Twin BracketCreekmore Uni Twin Bracket
Rationale –Rationale –
-Twin bracket offered better rotational control-Twin bracket offered better rotational control
which the single bracket could not matchwhich the single bracket could not match
until the rotational wings were addeduntil the rotational wings were added
-Still when a tooth is rotated badly and-Still when a tooth is rotated badly and
misaligned at the start of the treatmentmisaligned at the start of the treatment
,rotational wings of the single bracket will,rotational wings of the single bracket will
interfere with full engagement of the archwire .interfere with full engagement of the archwire .

Creekmore Uni Twin BracketCreekmore Uni Twin Bracket

Burstone Cuspid BracketBurstone Cuspid Bracket
Bracket design-Bracket design-
-consists of a basic .-consists of a basic .
022 x .028 edgewise022 x .028 edgewise
slotslot
-additional .017 x .025-additional .017 x .025
vertical or horizontalvertical or horizontal
auxiliary .auxiliary .

THE DUAL ENVIROMENTTHE DUAL ENVIROMENT
BRACKETBRACKET
Introduced by –Schudy 1990Introduced by –Schudy 1990
Design was based on computer modelingDesign was based on computer modeling
Uses the advantage of having smallerUses the advantage of having smaller
wires and greater intrabracket space.wires and greater intrabracket space.

BRACKET DESIGNBRACKET DESIGN
Large outer slot - 0.040”Large outer slot - 0.040”
-0.030”-0.030”
Smaller inner slot - 0.018”Smaller inner slot - 0.018”
-0.016”-0.016”

THE DUAL ENVIROMENTTHE DUAL ENVIROMENT
BRACKETBRACKET

The larger outer slot allows maximum archThe larger outer slot allows maximum arch
wire flexibility in the initial phases of thewire flexibility in the initial phases of the
treatment .treatment .
The smaller inner slot accepts smallThe smaller inner slot accepts small
rectangular wires for maximum control inrectangular wires for maximum control in
the later stages of the treatment .the later stages of the treatment .

According to the author-According to the author-
1.1. Faster leveling of the arches with fewerFaster leveling of the arches with fewer
arch wires changes.arch wires changes.
-larger posterior intrabracket space-larger posterior intrabracket space
permit teeth to move easilypermit teeth to move easily
2.2. Easier torquing of the teeth with lessEasier torquing of the teeth with less
discomfort.discomfort.
3.3. Fewer permanent set in arch wires dueFewer permanent set in arch wires due
to mastication.to mastication.

Torque In Base Vs FaceTorque In Base Vs Face

Begg /Chun-HoonBegg /Chun-Hoon
“Original”Combinaton Brackets“Original”Combinaton Brackets
Interchangeability ofInterchangeability of
techniques,for transfertechniques,for transfer
cases or for retentivecases or for retentive
labial rectangular archwirelabial rectangular archwire
after 3after 3rdrd
stage of lightwirestage of lightwire
treatment.treatment.
Ample room provided forAmple room provided for
edgewise ligature wire.edgewise ligature wire.
Available in regular andAvailable in regular and
curved bases.curved bases.

Begg /Chun-Hoon “FullBegg /Chun-Hoon “Full
Flanged”Combinaton BracketsFlanged”Combinaton Brackets
Modified version which offered gingivallyModified version which offered gingivally
extended welding flanges to provide moreextended welding flanges to provide more
welding areawelding area
Also allow archwire to rest completelyAlso allow archwire to rest completely
within the bracket.within the bracket.

Kamedanized BeggKamedanized Begg
This was introduced by Dr Akira Kameda.This was introduced by Dr Akira Kameda.
He modified the Begg technique to complyHe modified the Begg technique to comply
with the demands of time and progress ofwith the demands of time and progress of
technology .technology .
This was based on 25 yrs of clinicalThis was based on 25 yrs of clinical
experience .experience .
The basic idea was to solve unfinishedThe basic idea was to solve unfinished
and/or unstable parts of pure Beggand/or unstable parts of pure Begg
technique.technique.

Basic design of the appliance was sameBasic design of the appliance was same
with few modifications .with few modifications .
He introduced what was called as KBHe introduced what was called as KB
buccal tube and torquing brackets .buccal tube and torquing brackets .
These according to the author wereThese according to the author were
necessary for carrying out the KBnecessary for carrying out the KB

In 1983 , heIn 1983 , he
introduced torquingintroduced torquing
and reverse torquingand reverse torquing
brackets .brackets .
Built in torqueBuilt in torque
adjustments isadjustments is
obtained by raisingobtained by raising
the incisal or gingivalthe incisal or gingival
edge of the bracketedge of the bracket
base away from thebase away from the
tooth surface.tooth surface.

Advantage of using round buccal tubeAdvantage of using round buccal tube
with a round wire .But it had its ownwith a round wire .But it had its own
pitfalls-pitfalls-
1.1. Free tooth movement is possible ,butFree tooth movement is possible ,but
anchor molars tend to roll in.anchor molars tend to roll in.
2.2. Correcting lingually inclined molars isCorrecting lingually inclined molars is
difficult.difficult.
3.3. Directing the forces of anchorage bendsDirecting the forces of anchorage bends
and bite opening bends is difficult.and bite opening bends is difficult.

To overcome thisTo overcome this
problem heproblem he
introduced -introduced -RibbonRibbon
Arch Buccal TubesArch Buccal Tubes
-1986-1986

In 1992 JIOS –In 1992 JIOS –
mentioned thatmentioned that
efforts are goingefforts are going
on to develop aon to develop a
new type of KBnew type of KB
bracket with a builtbracket with a built
in T-Pin.in T-Pin.

Also labio lingualAlso labio lingual
thickness of these KBthickness of these KB
Brackets are same asBrackets are same as
non torque brackets,non torque brackets,
regardless of the ofregardless of the of
1010 ˚˚ or 20or 20˚built in˚built in
torque.torque.

Refined Begg ApplianceRefined Begg Appliance
A – brackets used areA – brackets used are
TP-256-00,with aTP-256-00,with a
depth of .020 anddepth of .020 and
height of .045height of .045

Molar tubesMolar tubes ––
Round molar tubes .Round molar tubes .
036 and 6 mm length.036 and 6 mm length.
Oval tubes .072 x .Oval tubes .072 x .
024 and 5mm length.024 and 5mm length.

Combination tubeCombination tube
(TP Lab)(TP Lab)
They consist of aThey consist of a
round gingival tuberound gingival tube
of .036 and 6.2 mmof .036 and 6.2 mm
length.length.
Rectangular .025 x .Rectangular .025 x .
018 -5.5mm long018 -5.5mm long

Built in adjustmentsBuilt in adjustments
1.1. Anti rotationalAnti rotational
brackets .brackets .

2.2. Built in torqueBuilt in torque

Other attachments –Other attachments –
1.1. HooksHooks

2.2. Lingual buttonsLingual buttons
,cleats and eyelets,cleats and eyelets

3.3. Additional roundAdditional round
tubestubes

Pins used in Refined Begg

Combination bracketsCombination brackets

Modular Self Locking ApplianceModular Self Locking Appliance
Introduced by –FOGEL AND MAGILLIntroduced by –FOGEL AND MAGILL
-1976-1976
Key objective to treat greater numberKey objective to treat greater number
,better ,faster easier ,at a lower cost and,better ,faster easier ,at a lower cost and
by using an appliance which can achieveby using an appliance which can achieve
the optimal biologic response.the optimal biologic response.

It is a light wireIt is a light wire
system using a singlesystem using a single
pivotal bracket or twinpivotal bracket or twin
self locking lowself locking low
frictional attachmentsfrictional attachments
..

Insert bracketInsert bracket ––
Archwire chamberArchwire chamber
BeaksBeaks
Insert slotInsert slot
Slot apexSlot apex
SeatSeat
stemstem

Placement of thePlacement of the
insert bracket-insert bracket-

ReceptacleReceptacle –available in three sizes–available in three sizes
- Small (.150”)Small (.150”)
- Medium (.180”)Medium (.180”)
- Wide (.200”)Wide (.200”)
- Three vertical slots are present whichThree vertical slots are present which
accommodate insert brackets and theaccommodate insert brackets and the
auxiliariesauxiliaries

Archwire play

Insertion of wire intoInsertion of wire into
the insert bracketthe insert bracket

Removal of archwireRemoval of archwire

Modernized BeggModernized Begg –Combination–Combination
TechniqueTechnique
William Thompson AJO –JUNE 1981William Thompson AJO –JUNE 1981
The rationale was to develop a treatmentThe rationale was to develop a treatment
mechanics that uses the advantages ofmechanics that uses the advantages of
both BEGG and STRAIGHT WIRE at theboth BEGG and STRAIGHT WIRE at the
same time minimizing thesame time minimizing the
disadvantageous.disadvantageous.

Modernized BeggModernized Begg
The appliance was aimed at achievingThe appliance was aimed at achieving
light ,rapid tipping forces to correct grosslight ,rapid tipping forces to correct gross
changes in the tooth position at one stagechanges in the tooth position at one stage
in the treatment. While more rigid andin the treatment. While more rigid and
precise appliance to be used in the laterprecise appliance to be used in the later
stage of the treatment to producestage of the treatment to produce
maximum tooth detailing and occlusalmaximum tooth detailing and occlusal
intercuspation.intercuspation.

Begg forceBegg force Physiologic forcePhysiologic force
systemsystem systemsystem
-unipoint contact - muscle action-unipoint contact - muscle action
-anchor bend - tooth morphology-anchor bend - tooth morphology
-archwire action - cuspal interlock-archwire action - cuspal interlock
-auxiliary - freeway & functional-auxiliary - freeway & functional
-tipping forces - occlusal forces-tipping forces - occlusal forces
-Intrusive forces - bone density-Intrusive forces - bone density

Favourable characteristics of Begg-Favourable characteristics of Begg-
1.1. Rapid bite opening.Rapid bite opening.
2.2. Rapid ant. Alignment.Rapid ant. Alignment.
3.3. En mass anterior retraction.En mass anterior retraction.
4.4. Good anchor control.Good anchor control.
5.5. Ant. Root torque is unlimited.Ant. Root torque is unlimited.
6.6. Predictable molar and incisor positions.Predictable molar and incisor positions.

Unfavourable characteristics-Unfavourable characteristics-
1.1. Post. Root torque is difficult.Post. Root torque is difficult.
2.2. Three dimensional arch coordination isThree dimensional arch coordination is
difficult.difficult.
3.3. Maintaining rotations is difficultMaintaining rotations is difficult
4.4. Maintaining upright and torque is difficult.Maintaining upright and torque is difficult.
5.5. Finishing intricacies is difficult.Finishing intricacies is difficult.

Favourable characteristics of SWA-Favourable characteristics of SWA-
1.1. Precision in arch coordination is routine.Precision in arch coordination is routine.
2.2. Precision intercuspation is routine.Precision intercuspation is routine.
3.3. Buccolingual root torque is routine.Buccolingual root torque is routine.
4.4. Simplified finishing wires are routine .Simplified finishing wires are routine .
5.5. Minimal wire adjustments in finishing.Minimal wire adjustments in finishing.

Unfavourable characteristicsUnfavourable characteristics ––
1.1. Rigid appliance due to interbracketRigid appliance due to interbracket
distance.distance.
2.2. More friction with sliding mechanics.More friction with sliding mechanics.
3.3. Additional supportive anchorageAdditional supportive anchorage
recommended.recommended.
4.4. Segmental retraction of anterior teeth.Segmental retraction of anterior teeth.
5.5. Forward tipping of incisors in continuousForward tipping of incisors in continuous
wire leveling.wire leveling.
6.6. Prolonged bite opening mechanics.Prolonged bite opening mechanics.www.indiandentalacademy.comwww.indiandentalacademy.com

Four Stage BracketFour Stage Bracket
Appliance design-Appliance design-
-combination bracket design-combination bracket design
-lower third of the bracket is a type 256-lower third of the bracket is a type 256
Begg bracketBegg bracket
-upper two thirds is a .018 x .025 straight-upper two thirds is a .018 x .025 straight
wire slot .wire slot .

Begg procedures should be carriedBegg procedures should be carried
completely through stage I and stage IIcompletely through stage I and stage II
and partly through stage III .and partly through stage III .
When the edgewise slots are parallel toWhen the edgewise slots are parallel to
each other Begg portion of the treatmenteach other Begg portion of the treatment
is ceased .is ceased .

The author claims that the clinical use ofThe author claims that the clinical use of
this combination appliance has shownthis combination appliance has shown
good results .good results .
He believes that there is a possibility ofHe believes that there is a possibility of
further improvement in design andfurther improvement in design and
technique of this appliance.technique of this appliance.

THE BEDDTIOT APPLIANCETHE BEDDTIOT APPLIANCE
Begg Edgewise Diagnosis-DeterminedBegg Edgewise Diagnosis-Determined
Totally Individualized OrthodonticTotally Individualized Orthodontic
Technique.Technique.
-- RICHARD HOCEVAR-1985RICHARD HOCEVAR-1985
TheThe appliance offered the capacity to employ the
principles and features of the Begg and edgewise
mechanism in specific situation in which they are most
advantageous.

BRACKET DESIGNBRACKET DESIGN
Lingual narrow ,single widthLingual narrow ,single width
-0.050”1.3mm Edgewise Bracket-0.050”1.3mm Edgewise Bracket
2 slots-2 slots-
Horizontal-.022(height)x.028(depth)Horizontal-.022(height)x.028(depth)
Vertical- .020 x .020Vertical- .020 x .020
Archwire slot are torque with indicatorArchwire slot are torque with indicator
gingival groove –lingual root torquegingival groove –lingual root torque
Occlusal groove-lingual crown torqueOcclusal groove-lingual crown torque

THE BEDDTIOT APPLIANCETHE BEDDTIOT APPLIANCE

Except for the torque the brackets areExcept for the torque the brackets are
identical and interchangeable .identical and interchangeable .
There are a total of five brackets whichThere are a total of five brackets which
differ only in the torque-0˚,5˚,10˚,15˚.differ only in the torque-0˚,5˚,10˚,15˚.
Buccal tubes -4.5 mmBuccal tubes -4.5 mm
- .022 x .028- .022 x .028
25˚ - lingual crown torque for lower25˚ - lingual crown torque for lower
10˚ - for the upper molars.10˚ - for the upper molars.

Characteristic feature-Characteristic feature-
In cases of deep bite or severeIn cases of deep bite or severe
anchorage cases –anchorage cases –
additional rectangular tube is is placedadditional rectangular tube is is placed
diagonally at an angle of 15˚,with itsdiagonally at an angle of 15˚,with its
mesial end pointing gingivally.mesial end pointing gingivally.
Advantage –Advantage –
1.1. Increase the anchorage.Increase the anchorage.
2.2. Built in anchor bend.Built in anchor bend.

Tip EdgeTip Edge
Introduced by Peter Kesling based on hisIntroduced by Peter Kesling based on his
experiences with differential toothexperiences with differential tooth
movement and thesis written in 1968movement and thesis written in 1968
Based on the rationale that each tooth hasBased on the rationale that each tooth has
to tip freely either measily or distally –notto tip freely either measily or distally –not
in both directions .in both directions .
Keeping this in mind the appliance wasKeeping this in mind the appliance was
designed to provide all the benefits ofdesigned to provide all the benefits of
differential tooth movement plus predifferential tooth movement plus pre
determined degree of final crown tip anddetermined degree of final crown tip and
torquetorque www.indiandentalacademy.comwww.indiandentalacademy.com

Tip EdgeTip Edge

Tip EdgeTip Edge
Basic design consist of-Basic design consist of-
-removal of diagonally opposed corners of-removal of diagonally opposed corners of
a conventional edgewise slota conventional edgewise slot
-slot size is .022 x.028-slot size is .022 x.028
-lateral extensions or wings-lateral extensions or wings
-vertical slot .020 x.020-vertical slot .020 x.020
- deep grooves- deep grooves

Tip EdgeTip Edge
Molar tube are designed –Molar tube are designed –
.036 round gingival tube.036 round gingival tube
.022 x .028 occlusal tube.022 x .028 occlusal tube
They are available with –They are available with –
1.1. Extraction and non extraction kitsExtraction and non extraction kits
2.2. Torque in base /faceTorque in base /face
3.3. Over rotational bracketOver rotational bracket
4.4. With in/out compensationsWith in/out compensations
5.5. Positing jigsPositing jigs
6.6. Tip edge rings.Tip edge rings.www.indiandentalacademy.comwww.indiandentalacademy.com

Tip EdgeTip Edge
Advantage over original edgewise –Advantage over original edgewise –
1.1. Adversely tipped teethAdversely tipped teeth
2.2. Anchorage controlAnchorage control
Advantage over ribbon arch-Advantage over ribbon arch-
1.1. Inout compensation.Inout compensation.
2.2. Prevent distal crown tipping of cuspidPrevent distal crown tipping of cuspid

Combination AnchorageCombination Anchorage
TechniqueTechnique
Clinical experience with the combinationClinical experience with the combination
brackets provide extensive knowledgebrackets provide extensive knowledge
regarding the expanded capabilities of theregarding the expanded capabilities of the
What was originally believed to beWhat was originally believed to be
modernized Begg was actually a truemodernized Begg was actually a true
combination anchorage technique.combination anchorage technique.

TechniqueTechnique
The original combination brackets provedThe original combination brackets proved
to be-to be-
- Bulky .Bulky .
- Weak.Weak.
- Aesthetically unattractive.Aesthetically unattractive.
- Problems with pinning rotationsProblems with pinning rotations
- Slot closureSlot closure
- Occlusal interference.Occlusal interference.

TechniqueTechnique
The bracket design was changedThe bracket design was changed ––
- It had a .022 x .035 gingival or ribbon- It had a .022 x .035 gingival or ribbon
arch slot.arch slot.
- .018 x .025 .022 x .028 edgewise slot.- .018 x .025 .022 x .028 edgewise slot.
- Enclosed vertical slot .- Enclosed vertical slot .

TechniqueTechnique

TechniqueTechnique
Brackets are available with colour codingBrackets are available with colour coding
for easy identification .for easy identification .
- maxillary –red- maxillary –red
mandibular-bluemandibular-blue
- Varying degree of torque for the anterior- Varying degree of torque for the anterior
brackets.brackets.
- Molar attachments with convertible molarMolar attachments with convertible molar
tubes.tubes.
- Redesigned pin slot .Redesigned pin slot .

Combination Anchorage TechniqueCombination Anchorage Technique
a)a) Phase III retentionPhase III retention
pinpin
b)b) Phase I and IIPhase I and II
retention pinretention pin
c)c) Tandem, hook pinTandem, hook pin
d)d) Bypass clampBypass clamp

Begg – Ribbon Arch CombinationBegg – Ribbon Arch Combination
SystemSystem
Introduced by Nikhil Vashi JIOS-Jan 1991Introduced by Nikhil Vashi JIOS-Jan 1991
Appliance was designed to combine theAppliance was designed to combine the
advantages of the BEGG and theadvantages of the BEGG and the
Edgewise and the Preadjusted ApplianceEdgewise and the Preadjusted Appliance

SystemSystem
Design-Design-
A gingival ribbon wise slot (018 x 027).A gingival ribbon wise slot (018 x 027).
An incisal or occlusal horizontal slot (020 xAn incisal or occlusal horizontal slot (020 x
020)020)
Two vertical slot for lock pins or ligatureTwo vertical slot for lock pins or ligature
wirewire

SystemSystem
BRACSBRACS

SystemSystem
Molar tube is rectangular ribbon wise for ribbonMolar tube is rectangular ribbon wise for ribbon
arch and has a 6arch and has a 6˚ offset .˚ offset .

SystemSystem
Different movements can be obtained just byDifferent movements can be obtained just by
tying or pinning the archwire differently.tying or pinning the archwire differently.

SystemSystem

SystemSystem
Bite opening is done with around wire likeBite opening is done with around wire like
016 ss.016 ss.
In the next phase retraction of anteriors isIn the next phase retraction of anteriors is
done by free or controlled tipping or bydone by free or controlled tipping or by
bodily translation.bodily translation.
In the last phase – initially a 016 x016 orIn the last phase – initially a 016 x016 or
016 x 022 can be used and then 017 x016 x 022 can be used and then 017 x
025 and 018 025 ss can be used for final025 and 018 025 ss can be used for final
finishing .finishing .

SystemSystem
BRACS has following advantages-BRACS has following advantages-
1.1. Rapid differential movements of teeth withRapid differential movements of teeth with
better control and less friction.better control and less friction.
2.2. Helps in proper finishing of the case.Helps in proper finishing of the case.
3.3. Need for patient co-operation is minimal.Need for patient co-operation is minimal.
4.4. Eliminates the need for heavy elastics .Eliminates the need for heavy elastics .
5.5. Eliminates complicated and unstable stage IIIEliminates complicated and unstable stage III
mechanics.mechanics.
6.6. Reduced the treatment duration.Reduced the treatment duration.

““J” bracket- Begg CombinationJ” bracket- Begg Combination
BracketBracket
Introduced by Dr Jayade –JIOS 1991Introduced by Dr Jayade –JIOS 1991
Requisites of a good combination –Requisites of a good combination –
1.1. It must be capable of delivering all theIt must be capable of delivering all the
advantages of the Begg appliance and at theadvantages of the Begg appliance and at the
same time eliminate all its disadvantages .same time eliminate all its disadvantages .
2.2. It must permit the incorporation of SW conceptIt must permit the incorporation of SW concept
of finishing without its disadvantages.of finishing without its disadvantages.
3.3. Should have more than one slot .Should have more than one slot .
4.4. Should be economical .Should be economical .

BracketBracket
Advantages of multiple slot brackets overAdvantages of multiple slot brackets over
single bracket-single bracket-
1.1. Diametrically opposite treatmentDiametrically opposite treatment
requirements.requirements.
2.2. Possibility of applying forces to the teethPossibility of applying forces to the teeth
at different areas .at different areas .
3.3. Switching slots help in altering orSwitching slots help in altering or
reinforcing anchorage.reinforcing anchorage.
4.4. Use of segmental /tandem wires.Use of segmental /tandem wires.

BracketBracket
Rationale ofRationale of
orientation of slots inorientation of slots in
the new design-the new design-
- All bracket slots areAll bracket slots are
cuboidal.cuboidal.

BracketBracket
Movements which remain unaffected byMovements which remain unaffected by
this orientation of the slot –this orientation of the slot –
1.1. Intrusion or extrusion .Intrusion or extrusion .
2.2. Labio lingual crown tipping using roundLabio lingual crown tipping using round
wirewire
3.3. Labio lingual root movementLabio lingual root movement

BracketBracket
Movements which are affected byMovements which are affected by
changing the slot orientation –changing the slot orientation –
1.1. Mesiodistal crown tipping (slot height).Mesiodistal crown tipping (slot height).
2.2. Rotational control (slot depth)Rotational control (slot depth)

BracketBracket
Disadvantage of the twin slotDisadvantage of the twin slot
arrangement-arrangement-
 Drastically reduce mesio-distal tipping.Drastically reduce mesio-distal tipping.
 Decrease in the inter bracket wire span.Decrease in the inter bracket wire span.

BracketBracket
Net effect of changed orientation of theNet effect of changed orientation of the
slot-slot-
1.1. Permits optimum mesio distal crownPermits optimum mesio distal crown
tipping .tipping .
2.2. Affords good rotational control.Affords good rotational control.
3.3. Allows to fully utilize torquing abilities ofAllows to fully utilize torquing abilities of
rectangular wire.rectangular wire.
4.4. Partly overcomes disadvantages of twinPartly overcomes disadvantages of twin
bracket configuration.bracket configuration.

BracketBracket
““J” bracket configuration –J” bracket configuration –
1.1. The single slot(.024 ht x .1 mm wide).The single slot(.024 ht x .1 mm wide).
This permits easy tipping to adequateThis permits easy tipping to adequate
extent in initial stages faces horizontally.extent in initial stages faces horizontally.
2.2. The twin slots(.032ht x .018 depth,The twin slots(.032ht x .018 depth,
placed 3mm apart)placed 3mm apart)

BracketBracket

BracketBracket
Advantages-Advantages-
- Better rotational control.- Better rotational control.
- Possibility of using uprighting springs- Possibility of using uprighting springs
and auxiliaries along with round .018and auxiliaries along with round .018
round base wire .round base wire .
- Possibility of using full torquing potential- Possibility of using full torquing potential
of rectangular wire upto 018 x 025of rectangular wire upto 018 x 025

BracketBracket
3.3. Using both slots together whenUsing both slots together when
necessary ,advantage of the combinationnecessary ,advantage of the combination
bracket can be derived .bracket can be derived .

BracketBracket
Molar attachment –Molar attachment –
When only first molar are available forWhen only first molar are available for
anchorage molar band carry gingivalanchorage molar band carry gingival
rectangular tube in ribbonwise orientationrectangular tube in ribbonwise orientation
and a round tube occlusally .and a round tube occlusally .
When both 1When both 1stst
and 2and 2ndnd
molar have to bemolar have to be
utilized 2utilized 2ndnd
molar will have such amolar will have such a
combination tube and 1combination tube and 1stst
molar twinmolar twin
rectangular attachment gingivally ,and anrectangular attachment gingivally ,and an
occlusal round tube.occlusal round tube.www.indiandentalacademy.comwww.indiandentalacademy.com

Brackets Used In LingualBrackets Used In Lingual

Bracket Design For LingualBracket Design For Lingual
Lingual light Wire Technique-Stephen FLingual light Wire Technique-Stephen F
Paige –Aug 1982 JCO.Paige –Aug 1982 JCO.
With the advent of bonding of attachmentsWith the advent of bonding of attachments
directly on the teeth ,it became possible todirectly on the teeth ,it became possible to
bond brackets directly on the lingualbond brackets directly on the lingual
surface .surface .
Fujita who confirmed that orthodonticFujita who confirmed that orthodontic
treatment with brackets placed on thetreatment with brackets placed on the
lingual was possible .lingual was possible .

Bracket design criteriaBracket design criteria
––
1.1. Decreased interbracketDecreased interbracket
distance –narrowdistance –narrow
mesiodistally.mesiodistally.
2.2. Because of decreasedBecause of decreased
bracket widthbracket width
,mesiodistal root control,mesiodistal root control
becomes more difficultbecomes more difficult
–vertical slot for arch–vertical slot for arch
auxiliaries .auxiliaries .

3.3. Topography of theTopography of the
lingual surface varylingual surface vary
to a great deal-untilto a great deal-until
future advancesfuture advances
make precisionmake precision
direct bondeddirect bonded
placement ,”straightplacement ,”straight
wire” approach towire” approach to
bracket designbracket design
appears impractical.appears impractical.

4.4. Ease of insertion, ligation and removal ofEase of insertion, ligation and removal of
archwire – incisal or occlusal placementarchwire – incisal or occlusal placement
of arch wire .of arch wire .
Begg bracket fulfils all these criteriaBegg bracket fulfils all these criteria

Unipoint combination bracket (Unitek).Unipoint combination bracket (Unitek).

Molar tubesMolar tubes
- Conventional oval tubes with mesiogingival- Conventional oval tubes with mesiogingival
hook (Unitek 0456-516).hook (Unitek 0456-516).

Methods of ligation-Methods of ligation-

Lingual Begg light wire technique –PeterLingual Begg light wire technique –Peter
K-J Yen Nov 1986 JCO.K-J Yen Nov 1986 JCO.
They developed a technique that usedThey developed a technique that used
regular Begg light wire and labial bracketsregular Begg light wire and labial brackets

Regular 256 Begg brackets were usedRegular 256 Begg brackets were used
Lower labial incisors were used for bothLower labial incisors were used for both
upper and lower incisorsupper and lower incisors
Upper lateral incisor labial brackets wereUpper lateral incisor labial brackets were
adapted to cuspidsadapted to cuspids
Curved upper cuspid labial brackets wereCurved upper cuspid labial brackets were
used for bicuspids.used for bicuspids.

To provide properTo provide proper
interbracket distanceinterbracket distance
in stage I vertical slotsin stage I vertical slots
of the bracket wereof the bracket were
incisally .incisally .
For stage II and IIIFor stage II and III
new set of bracketsnew set of brackets
were bonded withwere bonded with
vertical slots directedvertical slots directed
gingivallygingivally

In Aug 1989 AJO-Thomas CreekmoreIn Aug 1989 AJO-Thomas Creekmore
An acceptable lingual orthodontic applianceAn acceptable lingual orthodontic appliance
system must include the following keysystem must include the following key
elements-elements-

It should align teeth from the lingual side asIt should align teeth from the lingual side as
efficient as from the labial side.efficient as from the labial side.

A mean of positioning the bracket preciselyA mean of positioning the bracket precisely
to create a “near” SWA on the lingual side.to create a “near” SWA on the lingual side.


A consistent and accurate indirect bondingA consistent and accurate indirect bonding

A selection of preformed archwires with canineA selection of preformed archwires with canine
and premolars offsets.and premolars offsets.

Specially designed pliersSpecially designed pliers
The appliance that satisfy all the above requisites is theThe appliance that satisfy all the above requisites is the
“conceal system” developed by the Unitek corp.“conceal system” developed by the Unitek corp.

Characteristic feature-Characteristic feature-
The foundation of the design is theThe foundation of the design is the
opening of the wire slot to the occlusalopening of the wire slot to the occlusal
aspect rather then to the lingual aspect.aspect rather then to the lingual aspect.

First 1 mm of the molar tube opens to theFirst 1 mm of the molar tube opens to the
occlusal aspect.occlusal aspect.

The occlusal approach had potential problemThe occlusal approach had potential problem
- ligation- ligation
- design for adequate tip- design for adequate tip

Conceal brackets are designed aroundConceal brackets are designed around
Unitwin BracketUnitwin Bracket

Bracket has three different slot widths for threeBracket has three different slot widths for three
different functions of tip (a-b) , torque (e-f),different functions of tip (a-b) , torque (e-f),
rotation (c-f or e-d).rotation (c-f or e-d).

Difficult challenge of small working space –Difficult challenge of small working space –
anterior brackets have Y configuration with aanterior brackets have Y configuration with a
single tie wing projecting gingivally and twin tiesingle tie wing projecting gingivally and twin tie
wing projecting occlusallywing projecting occlusally

Self ligating BracketsSelf ligating Brackets
The first self ligating bracket wasThe first self ligating bracket was
developed by DR .Jacob Stolzenberg indeveloped by DR .Jacob Stolzenberg in
early 1930’s.early 1930’s.
DesignDesign ––
- bracket had a flat head screw seated- bracket had a flat head screw seated
snugly in a circular ,threaded opening insnugly in a circular ,threaded opening in
the face of the bracket.the face of the bracket.
- The horizontal screw could be loosened or- The horizontal screw could be loosened or
tightenedtightened

In 1971 Dr Jim Wildman developed theIn 1971 Dr Jim Wildman developed the
Edgelok bracket .Edgelok bracket .
- Bracket had a round body with a rigidBracket had a round body with a rigid
labial sliding caplabial sliding cap
- This design made the bracket “passive” inThis design made the bracket “passive” in
its interplay with the arch-wire.its interplay with the arch-wire.
- This was the first “passive” self ligatingThis was the first “passive” self ligating
bracket ,and first to enjoy any sort ofbracket ,and first to enjoy any sort of
commercial success.commercial success.www.indiandentalacademy.comwww.indiandentalacademy.com

About 2 years later Dr. Franz SanderAbout 2 years later Dr. Franz Sander
introduced the Mobil-lock bracketintroduced the Mobil-lock bracket
Design-Design-
- Semi circular locking mechanismSemi circular locking mechanism
- A special tool was used to rotate the lockA special tool was used to rotate the lock
into its closed or open positioninto its closed or open position

““Speed” bracket introduced by Dr HerbertSpeed” bracket introduced by Dr Herbert
Hanson in 1976 and became available in theHanson in 1976 and became available in the
market in 1980.market in 1980.
Stands for-Stands for-
Spring loadedSpring loaded
PrecisionPrecision
EdgewiseEdgewise
EnergyEnergy
DeliveryDelivery

1.1. The bracket body –The bracket body –
prior to welding -four slotsprior to welding -four slots
-shallow triangular groove-shallow triangular groove
- welding flange- welding flange
- no gingival tie wing- no gingival tie wing

.018 x .025 horizontal slot.018 x .025 horizontal slot
.017 x.017 horizontal slot ..017 x.017 horizontal slot .
Vertical spring slot.Vertical spring slot.
Instrument access slot.Instrument access slot.
- Shallow transverse groove- Shallow transverse groove

Spring clip-Spring clip-
Highly resilient spring clip made up of .005Highly resilient spring clip made up of .005
x .060 or .005 x.072 ss strip .x .060 or .005 x.072 ss strip .
Curved occlusal portion has an angle ofCurved occlusal portion has an angle of
wrap of 217wrap of 217˚ 30 minutes when free from˚ 30 minutes when free from
external stresses .external stresses .
Prior to insertion spring arms converge atPrior to insertion spring arms converge at
an angle of 37˚ 30 minutes.an angle of 37˚ 30 minutes.

The bonding base-The bonding base-
When viewed from the labial mesial andWhen viewed from the labial mesial and
distal edges of each of the welding paddistal edges of each of the welding pad
are parallel to each otherare parallel to each other
Gingival edge is curved gingivally in formGingival edge is curved gingivally in form
of a semi-ellipse.of a semi-ellipse.

Bracket –spring assemblyBracket –spring assembly
- when the spring is in the slot close- when the spring is in the slot close
position ,its arms are held apart so as toposition ,its arms are held apart so as to
reduce their angle of convergence byreduce their angle of convergence by
atleast 2atleast 2˚˚
-This causes elastic deformation-This causes elastic deformation

Rotational controlRotational control about three axes –about three axes –
1.1. The occlusogingival axis (rotations)The occlusogingival axis (rotations)
2.2. The labiolingual axis tipping)The labiolingual axis tipping)
3.3. The mesiodistal axis (torquing)The mesiodistal axis (torquing)

Helps the operator in saving as much as 5Helps the operator in saving as much as 5
minutes per arch change .minutes per arch change .
It permits a high degree of precision inIt permits a high degree of precision in
three dimensional control of tooth .three dimensional control of tooth .
Well suited for sliding mechanics .Well suited for sliding mechanics .
Capacity to store relatively large amountCapacity to store relatively large amount
of energy for release at desirably slowof energy for release at desirably slowwww.indiandentalacademy.comwww.indiandentalacademy.com

Later in 1986 Dr Erwin Pletcher introducedLater in 1986 Dr Erwin Pletcher introduced
Activa bracketActiva bracket
Like the straight wire appliance it is a fullyLike the straight wire appliance it is a fully
programmed appliance with specific toothprogrammed appliance with specific tooth
positions built into a special bracket forpositions built into a special bracket for
each tooth.each tooth.

It has a horizontal slot of .022” x.022”It has a horizontal slot of .022” x.022”
Vertical slot of .020 x.020”Vertical slot of .020 x.020”
Bracket has a inflexible ,curved arm thatBracket has a inflexible ,curved arm that
rotates occluso-gingivally around therotates occluso-gingivally around the
cylindrical bracket body.cylindrical bracket body.
All brackets are colour coded .All brackets are colour coded .
The latches close to the gingival .The latches close to the gingival .

Advantages-Advantages-
1.1. Vertical slot can be used to engageVertical slot can be used to engage
hooks, rotational and uprighting spring.hooks, rotational and uprighting spring.
2.2. The bracket are smaller than the twin orThe bracket are smaller than the twin or
mini bracket.mini bracket.
3.3. Friction is significantly reduced.Friction is significantly reduced.
4.4. There is 100% compatibility with otherThere is 100% compatibility with other
straight wire bracket.straight wire bracket.
5.5. Time factor.Time factor.
6.6. Teeth move faster and with less force.Teeth move faster and with less force.

In 1995 Dr Wolfgang Heiser introducedIn 1995 Dr Wolfgang Heiser introduced
the -Time- bracket.the -Time- bracket.
Design-Design-
- Rigid ,curved that wraps occlusogingivallyRigid ,curved that wraps occlusogingivally
around the labial aspect of the bracketaround the labial aspect of the bracket
bodybody
- A special instrument is used to pivot theA special instrument is used to pivot the
arm gingivally into the slot open position orarm gingivally into the slot open position or
occlusally into the slot closed position.occlusally into the slot closed position.

Next to follow was The Twin Lock bracketNext to follow was The Twin Lock bracket
which was introduced in1998which was introduced in1998
It had a flat ,rectangular slide ,housedIt had a flat ,rectangular slide ,housed
between the tie wing of an edgewise twinbetween the tie wing of an edgewise twin
bracket.bracket.
Slot is moved with a universal scalarSlot is moved with a universal scalar

Evaluation of orthodontic brackets/cosmetic dentistry courses

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