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Evolution of orthodontic brackets /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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Evolution of orthodontic brackets /certified fixed orthodontic courses by Indian dental academy

  1. 1. EVOLUTION OF ORTHODONTIC BRACKETS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com 1
  2. 2. Contents                Brief summary Idea for introducing horizontal slot Single width bracket Twin bracket Tripple bracket Jarabak bracket Lewis bracket Lang bracket Steiner bracket Broussard bracket Bioefficient bracket Dual env bracket Unitwin bracket Transition from 022 to 018 slot Andrews straight wire app. www.indiandentalacademy.com 2
  3. 3. E.H ANGLE  E arch appliance  Pin and tube appliance  Ribbon arch appliance  Open face or tie bracket www.indiandentalacademy.com 3
  4. 4. Evolution of edgewise appliance  1907 – angle discontinued the use of jack screws E Arch www.indiandentalacademy.com 4
  5. 5. Evolution of edgewise appliance Basic E arch www.indiandentalacademy.com 5
  6. 6. Evolution of edgewise appliance Ribbed E arch www.indiandentalacademy.com 6
  7. 7. Evolution of edgewise appliance E arch without threaded ends www.indiandentalacademy.com 7
  8. 8. Evolution of edgewise appliance E arch with hooks www.indiandentalacademy.com 8
  9. 9. Evolution of edgewise appliance Pin and tube-1910 www.indiandentalacademy.com 9
  10. 10. Evolution of edgewise appliance www.indiandentalacademy.com 10
  11. 11. Evolution of edgewise appliance The Ribbon Arch-1915 Brackets www.indiandentalacademy.com 11
  12. 12. Evolution of edgewise appliance Open face bracket www.indiandentalacademy.com 12
  13. 13. Evolution of edgewise appliance www.indiandentalacademy.com 13
  14. 14. Single width bracket 050’’ or 1.25 mm www.indiandentalacademy.com 14
  15. 15. Siamese twin bracket Swain Interbracket span 050’’ www.indiandentalacademy.com 15
  16. 16. www.indiandentalacademy.com 16
  17. 17. Curved base twin bracket Mechanism of action  deflection www.indiandentalacademy.com 17
  18. 18. Posterior brackets  Twice the width of single width bracket 010’’or 2.5mm www.indiandentalacademy.com 18
  19. 19. Tripple bracket Better rotational and tipping adjustments Control over rotation  selective tying www.indiandentalacademy.com 19
  20. 20. Long edgewise bracket   Horizontal and vertical slotted bracket Jarabak Horizontal slot  .017’’ wide .038’’ deep Vertical slot  .017’’ wide .045’’ deep www.indiandentalacademy.com 20
  21. 21. Long edgewise bracket     Available in 3 lengths .160’’ .120’’ distal .140’’ mesial Vertical slot on the base On distal end  www.indiandentalacademy.com .016×.016 21
  22. 22. Long edgewise bracket Horizontal slot offcentred by .046’’ from the incisal edge www.indiandentalacademy.com 22
  23. 23. Long edgewise bracket www.indiandentalacademy.com 23
  24. 24. Lewis bracket Soldered auxiliary rotation arms Single width feature- retained www.indiandentalacademy.com 24
  25. 25. Lewis bracket  Types: www.indiandentalacademy.com 25
  26. 26. Curved base lewis bracket Increase contact with band . Reduces trapping of the food. www.indiandentalacademy.com 26
  27. 27. Vertical slot Lewis bracket 020 x020 vertical slot www.indiandentalacademy.com 27
  28. 28. Steiner bracket  Flexible rotation arms - did not rely entirely on the resiliency of archwire for tooth rotation.  Single width edgewise bracket www.indiandentalacademy.com 28
  29. 29. Lang brackets Howard Lang Single width bracket Flat rotational control wing www.indiandentalacademy.com 29
  30. 30. Lang brackets Wedge shape in profile Allows ease in lagation Prevents food lodgments www.indiandentalacademy.com 30
  31. 31. Lang brackets Flattening of archwire curvature Incomplete seating of the wire. Curvature maintained www.indiandentalacademy.com 31
  32. 32. Broussard bracket Grayford broussard Modified edgewise bracket in which there is addition of 0.0185 x 0.046 slot –to accept doubled 0.018 auxiliary wire www.indiandentalacademy.com 32
  33. 33. Unitwin bracket (1989)      Thomas Creekmore Centered slot concept Single bracket Without tie wings Slot placed in the center of a .045’’twin bracket www.indiandentalacademy.com 33
  34. 34. Unitwin bracket (1989)    Utilizes the feature of both single and twin bracket Maximum inter bracket span  single width Rotational control  twin tie wings www.indiandentalacademy.com 34
  35. 35. The Dual Enviroment Bracket   George F. Schudy(1990) Design based on computer remodeling Large outer slot –.040’’for twin brackets and.030’’for single brackets. Smaller inner slot-.018/.016’’ www.indiandentalacademy.com 35
  36. 36. The Dual Enviroment Bracket  Outer slot allows the use of full size . 016×.022 initial arch wire  Same wire seated in inner slot www.indiandentalacademy.com 36
  37. 37. The Dual Enviroment Bracket  Clinical advantage 1. Faster leveling of the arches with fewer wire changes 2. Easier torquing of the teeth www.indiandentalacademy.com 37
  38. 38. Bioefficient brackets (1995)  Anthony D.Viazis  deltoid bracket Wide horizontal member but has a single width slot. Multifunctional bracket for bioefficient therapy www.indiandentalacademy.com 38
  39. 39. Bioefficient brackets (1995)  Maximum potential of any archwire is achieved when the largest possible wire is used. 1. Conformity to the crown anatomy and gingival outline. www.indiandentalacademy.com 39
  40. 40. Bioefficient brackets (1995) 2. Ease in positioning due to the bracket design. www.indiandentalacademy.com 40
  41. 41. Bioefficient brackets (1995) Improper placement  easily recognized www.indiandentalacademy.com 41
  42. 42. Bioefficient brackets (1995) 3. Minimum friction - Slot is elevated from the horizontal member. Area of contact bw the wire and the bracket is reduced Better esthetics www.indiandentalacademy.com 42
  43. 43. Bioefficient brackets (1995) 4. Tip control -horizontal member has a twin bracket like effect. www.indiandentalacademy.com 43
  44. 44. Bioefficient brackets (1995) 5. Better rotational control www.indiandentalacademy.com 44
  45. 45. Transition from .022  .018 slot 022’’ or 0.55 mm wide 028’’ deep Gold archwires Late 1920s stainless steel Difference in the properties www.indiandentalacademy.com 45
  46. 46. Transition from .022  .018 slot       Reduce the size of the wire Reduce the slot width to .018’’ Smaller archwires were used 018×025’’ Force delivered was acceptable Introduction of TMA and NiTi Limitation of original 022 slot have been overcome www.indiandentalacademy.com 46
  47. 47. Andrews straight wire appliance    BRACKETS stand in between tooth and the orthodontist 1960 – concept of fully programmed appliance Advantage of FPA ELIMINATES WIRE BENDING www.indiandentalacademy.com 47
  48. 48. Andrews  Driving force for FPA 1. Analysis of orthodontically treated final occlusion Analysis of naturally occurring optimal occlusion Six keys to normal occlusion 2. 3. www.indiandentalacademy.com 48
  49. 49. Andrews Andrews plane www.indiandentalacademy.com 49
  50. 50. Andrews FACC FA point Angulation www.indiandentalacademy.com 50
  51. 51. Andrews Inclination www.indiandentalacademy.com 51
  52. 52. Interarch relationship www.indiandentalacademy.com 52
  53. 53. Crown angulation www.indiandentalacademy.com 53
  54. 54. Crown inclination www.indiandentalacademy.com 54
  55. 55. Crown inclination of posteriors www.indiandentalacademy.com 55
  56. 56. Absence of rotations Curve of spee Tight contacts www.indiandentalacademy.com 56
  57. 57. Andrews classification 1. Non programmed appliance-a set of brackets designed the same for all tooth types ,relying totally on wire bending. 2. Partly programmed appliance- a set of brackets designed with some in built features ,but always require some wire bending 3. Fully programmed appliance- a set of brackets designed to guide teeth directly to their goal positions with unbent wires. www.indiandentalacademy.com 57
  58. 58. Features of Edgewise Bracket www.indiandentalacademy.com 58
  59. 59. Non programmed bracket  Angle’s edgewise app FA point on FACC All crowns will have equal facial prominences Extensive Wire bending www.indiandentalacademy.com 59
  60. 60. Non programmed bracket  Design shortcomings 1. Bracket base perpendicular to bracket stem. 2. Bracket bases are not contoured. 3. Slots are not angulated 4. Bracket stem are of equal faciolingual thickness. 5. Maxillary molar offset is not built in. 6. Bracket siting techniques are unsatisfactory. www.indiandentalacademy.com 60
  61. 61. Non programmed bracket 1. Bracket base perpendicular to bracket stem. www.indiandentalacademy.com 61
  62. 62. Non programmed bracket www.indiandentalacademy.com 62
  63. 63. Non programmed bracket www.indiandentalacademy.com 63
  64. 64. Non programmed bracket  Bracket bases are not contoured occlusogingivally. www.indiandentalacademy.com 64
  65. 65. Non programmed bracket Greater than 2° Greater than 0.5 mm www.indiandentalacademy.com 65
  66. 66. Non programmed bracket www.indiandentalacademy.com 66
  67. 67. Non programmed bracket www.indiandentalacademy.com 67
  68. 68. Non programmed bracket Mesio-distal base contour www.indiandentalacademy.com 68
  69. 69. Non programmed bracket  Slots not angulated www.indiandentalacademy.com 69
  70. 70. Non programmed bracket www.indiandentalacademy.com 70
  71. 71. Non programmed bracket  Bracket stem are of equal faciolingual thickness www.indiandentalacademy.com 71
  72. 72. Non programmed bracket Maxillary molar offset is not built in. www.indiandentalacademy.com 72
  73. 73. Non programmed bracket Bracket siting techniques are unsatisfactory.  Wire bending Primary wire bends (1st, 2nd, 3rd order ) Secondary wire bends tertiary wire bends www.indiandentalacademy.com 73
  74. 74. Wire bending angulation www.indiandentalacademy.com 74
  75. 75. Wire bending Occlusogingival slot positioning www.indiandentalacademy.com 75
  76. 76. Wire bending Inclination www.indiandentalacademy.com 76
  77. 77. Wire bending Prominence differences www.indiandentalacademy.com 77
  78. 78. Wire bending Prominence differences www.indiandentalacademy.com 78
  79. 79. Wire bending Total 76 bends Fully programmed appliance www.indiandentalacademy.com 79
  80. 80. Fully programmed appliance  Simplest version of FPA Standard brackets One bracket for each tooth except for incisors and Maxillary molars Partly programmed app  3 slot siting features www.indiandentalacademy.com 80
  81. 81. Fully programmed appliance  Slot siting feature Feature 1Mid transverse planes of the slot, stem and crown must be the same. www.indiandentalacademy.com 81
  82. 82. Fully programmed appliance  Slot siting feature Feature 2- Base of the bracket for each tooth type must have same inclination as the facial plane of the crown. www.indiandentalacademy.com 82
  83. 83. Fully programmed appliance  Slot siting feature Feature 3- Each bracket inclined base must be contoured occluso gingivally www.indiandentalacademy.com 83
  84. 84. Fully programmed appliance  Slot siting feature Feature 4- Mid sagittal plane of the slot, stem and crown must be same. www.indiandentalacademy.com 84
  85. 85. Fully programmed appliance  Slot siting feature Feature 5 -The plane of the bracket base at its base point must be identical to the facial plane of the crown at the FA point www.indiandentalacademy.com 85
  86. 86. Fully programmed appliance  Slot siting feature Feature 6 - Mesio distal curvature of base should match tooth. the m-d contour of the www.indiandentalacademy.com 86
  87. 87. Fully programmed appliance  Slot siting feature Feature 7 - The vertical components should be parallel to one another The horizontal components should be equidistant from the gingiva and the cusp tips. www.indiandentalacademy.com 87
  88. 88. Fully programmed appliance  Slot siting feature www.indiandentalacademy.com 88
  89. 89. Fully programmed appliance  Slot siting feature Feature 8 – All slots point must have same distance between them and the crown embrasure line. www.indiandentalacademy.com 89
  90. 90. Fully programmed appliance Convenience feature- 1. The gingival tie wings of the posterior Brackets extend farther laterally . www.indiandentalacademy.com 90
  91. 91. Fully programmed appliance Convenience feature- 2. Bases are inclined . www.indiandentalacademy.com 91
  92. 92. Fully programmed appliance Convenience feature- 3. Facial surface of the incisor and canine brackets are designed to parallel their bases - lip comfort. www.indiandentalacademy.com 92
  93. 93. Fully programmed appliance Convenience feature- 4. In mandibular incisor brackets, the tie wings are designed with least amount occlusofacial prominence 5.Bracket identification. www.indiandentalacademy.com 93
  94. 94. Fully programmed appliance Auxiliary feature – - Power arms - Hooks - Face bow tubes - Utility tubes - Rotational wings www.indiandentalacademy.com 94
  95. 95. Fully programmed appliance  Incisor bracket  3 brackets with different base inclinations  Post treatment interjaw relationship can be predicted  Unpublished study (1968) on hundred cephs www.indiandentalacademy.com 95
  96. 96. Fully programmed appliance Incisor bracket www.indiandentalacademy.com 96
  97. 97. Fully programmed appliance Incisor bracket Cl II Cl I Cl III www.indiandentalacademy.com 97
  98. 98. Fully programmed appliance Incisor bracket Cl II Cl I Cl III www.indiandentalacademy.com 98
  99. 99. Angulation for central and lateral incisorsTooth Central Lateral Maxillary 5 9 Mandibular 2 2 www.indiandentalacademy.com 99
  100. 100. Fully programmed appliance  Posterior bracket www.indiandentalacademy.com 100
  101. 101. Tooth II molar I Molar II PM I PM Canine Maxillary 5/-9 (10o offset) 5/-9 (10o offset) 2/-7 2/-7 11/-7 Mandibul ar 2/-35 2/-30 2/-22 2/-17 5/-11 www.indiandentalacademy.com 101
  102. 102. Inclination and angulation for 6-7 to finish in class II Tip reduced and offset removed Tooth II Molar I Molar Maxillary 0/-9 0/-9 Mandibular - - www.indiandentalacademy.com 102
  103. 103. Fully programmed Translation brackets     Bodily movement of the teeth is required What is translation??? Translation problems Need for over correction www.indiandentalacademy.com 103
  104. 104. Fully programmed Translation brackets  They have all the qualities of the standard brackets plus few other feature . Power arm Counter mesiodistal tip Counter rotation Counter buccolingual tip www.indiandentalacademy.com 104
  105. 105. Fully programmed Translation brackets Minimum translation bracket – requiring a translation of 2 mm or less Medium translation brackets – requiring a translation of more than 2mm but less than 4 mm Maximum translation brackets -requiring a translation of more than 4 mm. www.indiandentalacademy.com 105
  106. 106. Fully programmed Translation brackets  Translation solutions- www.indiandentalacademy.com 106
  107. 107. Fully programmed Translation brackets  Concept regarding Levers www.indiandentalacademy.com 107
  108. 108. Fully programmed Translation brackets  Lever common to all edgewise brackets www.indiandentalacademy.com 108
  109. 109. Fully programmed Translation brackets Counter rotation The slot is rotated in the direction of translation Slot rotation plus mesiodistal slot length plus archwire flex equals counterrotation and rotation overcorrection. www.indiandentalacademy.com 109
  110. 110. Fully programmed Translation brackets  Countermesiodistal tip www.indiandentalacademy.com 110
  111. 111. Fully programmed Translation brackets Slot angulation plus mesiodistal slot length plus power arm length plus activated archwire equals Countermesiodistal tip and angulation overcorrection. www.indiandentalacademy.com 111
  112. 112. Fully programmed Translation brackets Counterbuccolingual tip Base inclination + faciolingual slot length + arch wire deflection = Counterbuccolingual tip www.indiandentalacademy.com 112
  113. 113. Why different prescriptions???  1. 2. 3. 4. 5. 6.  Valid reasons Natural variations Different growth patterns Different malocclusions (Cl II div II) Need for overcorrection (Roth) Arch wire play (Bioprogressive therapy) Ethnic differences Commercial reasons www.indiandentalacademy.com 113
  114. 114. Why different prescriptions???    Andrews Roth MBT 022 slot Bioprogressive – 018 slot Alexander ( vari- simplex) – 016 slot www.indiandentalacademy.com 114
  115. 115. Vari-simplex discipline-Alexander    1. 2. 3. Vari – variety of bracket used Simplex – KISS principle fewer archwire changes Treatment philosophy – Tweeds fundamentals Anchorage preparation Positioning Mb incisors over basal bone Orthopedic alteration using head gear www.indiandentalacademy.com 115
  116. 116. Vari-simplex discipline-Alexander  Key objective Non extraction therapy as far as possible Interproximal enamel reduction Control of Mb incisor position with –ve torque www.indiandentalacademy.com 116
  117. 117. Vari-simplex discipline-Alexander  Bracket selection Twin brackets Lang brackets Lewis brackets www.indiandentalacademy.com 117
  118. 118. Vari-simplex discipline-Alexander Wedge shape in profile Allows ease in lagation Prevents food lodgments Lang brackets www.indiandentalacademy.com 118
  119. 119. Vari-simplex discipline-Alexander Why not use lewis bracket on canine ??? Arch wire placement Curvature maintained Mx cuspid attrition www.indiandentalacademy.com 119
  120. 120. Vari-simplex discipline-Alexander  Bracket positioning  Key for placement – bicuspid height --X www.indiandentalacademy.com 120
  121. 121. Vari-simplex discipline-Alexander  Angulation Measured from long axis of crown Major change Tip of mand molars 2 ° to - 6° www.indiandentalacademy.com 121
  122. 122. Vari-simplex discipline-Alexander  Reason for -6°tip Gain in the arch length Promotes leveling 0° angulation in Mb 2nd molar– Need not to be uprighted excessively www.indiandentalacademy.com 122
  123. 123. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com 123

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