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

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  • Evolution of orthodontic Brackets /certified fixed orthodontic courses by Indian dental academy

    1. 1. EVOLUTION OF ORTHODONTIC BRACKETSINDIAN DENTAL ACADEMY www.indiandentalacademy.com www.indiandentalacademy.com www.indiandentalacad emy.com 1
    2. 2. All contemporary fixed appliance arebased on the Angles design from the 20 th centaury “Father Of Orthodontist ” www.indiandentalacademy.com www.indiandentalacad emy.com 2
    3. 3. Pierre Fauchard’s Orthodonticappliance-1728 www.indiandentalacademy.com www.indiandentalacad emy.com 3
    4. 4. Dwinelles Jackscrew-1849 www.indiandentalacademy.com www.indiandentalacad emy.com 4
    5. 5. Angle’s Jackscrew www.indiandentalacademy.com www.indiandentalacad emy.com 5
    6. 6. Angles Retraction screw www.indiandentalacademy.com www.indiandentalacad emy.com 6
    7. 7. According To Angle- A standard appliance must have five important properties-1. Simple2. Stable3. Efficiency4. Delicate5. Inconspicuous www.indiandentalacademy.com www.indiandentalacad emy.com 7
    8. 8. Historical perspective In 1907 - E-arch Four basic designs-1. Basic E arch.2. Ribbed E arch.3. E arch without threaded ends.4. E arch www.indiandentalacademy.com with hooks. www.indiandentalacad emy.com 8
    9. 9. The E Arch appliance Basic E arch Ribbed E Arch www.indiandentalacademy.com www.indiandentalacad emy.com 9
    10. 10. E Arch Without Treaded Ends www.indiandentalacademy.com www.indiandentalacad emy.com 10
    11. 11. E Arch With Hooks www.indiandentalacademy.com www.indiandentalacad emy.com 11
    12. 12. Drawback Dentition was enlarged in all dimensions by tipping Once the retention appliance was discarded various degree of malocclusion resulted www.indiandentalacademy.com www.indiandentalacad emy.com 12
    13. 13. Pin and tube-1910Bands were put on all theteeth with a vertical tube intowhich soldered pin from thearchwire was placed .Advantage-good axialcontrolDisadvantage -limited m-dcontrol www.indiandentalacademy.com-difficult www.indiandentalacad emy.com 13
    14. 14. The Ribbon Arch-1915 Brackets were introduced with appliance. Tube of the pin was modified to provide vertically positioned rectangular slot. A ribbon arch of 10x20 gold wire was placed in this slot . www.indiandentalacademy.com www.indiandentalacad emy.com 14
    15. 15. BRACKET-was introduced byBRACKET- DR E H ANGLE 1916THUROW-as an orthodontic attachmentsecured to a tooth for the purpose ofengaging an arch wire .As an attachment that serves to deliverthe necessary tooth moving forces . www.indiandentalacademy.com www.indiandentalacad emy.com 15
    16. 16. Edgewise ApplianceAngle oriented the slotfrom vertical tohorizontal and insertedrectangular wire into it.This provided thesolution to the problemscaused by the previousappliance www.indiandentalacademy.com www.indiandentalacad emy.com 16
    17. 17. Begg Appliance This was developed by Dr P.R.Begg 1956 It utilizes the ribbon arch type brackets and was manufactured to accept 016’ round wire Wire was held in position with the lock pins www.indiandentalacademy.com www.indiandentalacad emy.com 17
    18. 18. Begg Appliance Bracket design – -modified ribbon arch bracket- .020 x .045 slot www.indiandentalacademy.com www.indiandentalacad emy.com 18
    19. 19. Begg Appliance Lock pins – Safety lock pins Double safety pin Hook pin www.indiandentalacademy.com www.indiandentalacad emy.com 19
    20. 20. Evolution of the edgewisebracketsOriginal angle bracket wasmade up of a soft gold with .22 x .28 slot.It was .050 wide and wassoldered to gold bandmaterial .Angle soldered gold eyeletsin appropriate positions on www.indiandentalacademy.comthe band. www.indiandentalacad emy.com 20
    21. 21. To overcome this problem – two edgewise brackets were used on the same toothThis provide a good rotational control.Disadvantage-perfect alignment. www.indiandentalacademy.com www.indiandentalacad emy.com 21
    22. 22. Twin Bracket Joining together of two edgewise brackets “SIAMESE TWIN BRACKET” The space between two brackets was approx 0.050 Initially for upper central incisors and molars. Terminology was changed to -“TWIN BRACKET”. www.indiandentalacademy.com www.indiandentalacad emy.com 22
    23. 23. Twin Bracket They are available in four sizes-1. Extra wide2. Standard3. Intermediate4. Junior Solid bracket-posterior bracket www.indiandentalacademy.com 0.100’” wide in dimension. www.indiandentalacad emy.com 23
    24. 24. Twin Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 24
    25. 25. Curved Base Twin Bracket Curving of the base of the twin bracket to conform to the curvature of the canine and the premolar teeth. Besides the advantage of twin bracket offering rotational and greater axial control it also incorporated what is termed as “ www.indiandentalacademy.com POSITIVE CONTROL” www.indiandentalacad emy.com 25
    26. 26. Curved Base Twin Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 26
    27. 27. Rotational control of twin bracketThe actual mechanism is by deflection of thearchwire.The more resilient the archwire the more readilyit can be tied into the twin bracket.However 100% control cannot be obtained www.indiandentalacademy.comFinal 10% desired rotation has to accomplished www.indiandentalacadby additional means. emy.com 27
    28. 28. Lewis bracketThis was the next development forbringing about efficient tooth rotation.He soldered auxiliary rotation arm thatabutted against the bracket itself and thusoffered a lever arm to deflect archwire androtate the teeth.Present day lewis bracket is a one piecebracket with rotational wings which isequivalentwww.indiandentalacademy.com to original edgewise bracketwith single www.indiandentalacad width feature. emy.com 28
    29. 29. Regular Lewis Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 29
    30. 30. Lewis bracket Advantage –1. 100% desired tooth rotation .2. Overcorrection3. Error in bracket placement . Curved Lewis bracket advantage-1. Increase contact with band . www.indiandentalacademy.com2. Reduces trapping of the www.indiandentalacad food. emy.com 30
    31. 31. Lewis bracketVertical slot lewis bracketfurther refinement wasdone by incorporating a 020x020 vertical slotAdvantage-uprighting spring to correct www.indiandentalacademy.comaxial inclination. www.indiandentalacad emy.com 31
    32. 32. Steiner bracket This bracket incorporated flexible rotation arms and therefore did not rely entirely on the resiliency of archwire for tooth rotation. It uses a single width edgewise bracket and has the inherent advantage and disadvantage of the same . www.indiandentalacademy.com www.indiandentalacad emy.com 32
    33. 33. The Straight Wire Appliance Andrews classified brackets into three types-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 www.indiandentalacademy.com brackets designed with some in built featureswww.indiandentalacad ,but always require some wire bending. emy.com 33
    34. 34. The Straight Wire Appliance3. Fully programmed appliance- a set of brackets designed to guide teeth directly to their goal positions with unbent wires. Standard brackets. Transition brackets. www.indiandentalacademy.com www.indiandentalacad emy.com 34
    35. 35. Terminologies www.indiandentalacademy.com www.indiandentalacad emy.com 35
    36. 36. Non Programmed EdgewiseBracket Feature www.indiandentalacademy.com www.indiandentalacad emy.com 36
    37. 37. The Straight Wire Appliance Design shortcomings –1. Bracket base perpendicular to bracket stem.2. Bracket bases are not contoured.3. Slots are not angulated4. Bracket stem are of equal faciolingual thickness.5. Maxillary molar offset is not built in.6. Bracket sitting techniques are unsatisfactory. www.indiandentalacademy.com www.indiandentalacad emy.com 37
    38. 38. The Straight Wire Appliance1. Bracket base perpendicular to bracket stem. -this feature causes problems of slot inclination and occlusogingival position www.indiandentalacademy.com www.indiandentalacad emy.com 38
    39. 39. The Straight Wire Appliance2. Bracket bases are not contoured.- Occlosogingivally the base of a non- programmed brackets is flat . www.indiandentalacademy.com www.indiandentalacad emy.com 39
    40. 40. The Straight Wire Appliance www.indiandentalacademy.com www.indiandentalacad emy.com 40
    41. 41. Slots are not angulated Mesio distal www.indiandentalacademy.com www.indiandentalacad emy.com 41
    42. 42. The Straight Wire Appliance3. Slots are not angulated- www.indiandentalacademy.com www.indiandentalacad emy.com 42
    43. 43. The Straight Wire Appliance www.indiandentalacademy.com www.indiandentalacad emy.com 43
    44. 44. The Straight Wire Appliance4. Bracket stem are of equal faciolingual thickness.- www.indiandentalacademy.com www.indiandentalacad emy.com 44
    45. 45. The Straight Wire Appliance5. Maxillary molar offset is not built in. www.indiandentalacademy.com www.indiandentalacad emy.com 45
    46. 46. The Straight Wire Appliance6. Bracket sitting techniques are unsatisfactory. Various authors have their own way of positioning the brackets.-Tweed recommends sitting brackets in specified number of millimeters from the incisal edge. www.indiandentalacademy.com-Holdaway advocates that the bracket sitting www.indiandentalacad should altered according to the malocclusion emy.com 46
    47. 47. The Straight Wire Appliance According to Jarabak bracket sites for inclination should be determined by the shape of the crown. Saltzman recommends except for the maxillary lateral incisor ,brackets should be located inwww.indiandentalacademy.com the middle third of the crown. www.indiandentalacad emy.com 47
    48. 48. The Straight Wire Appliance1. According to Andrews suitable bracket site has three criteria- No interference with either gingiva or with opposing tooth. Angulation and inclination of the crown . Middle of each bracket site must share the same plane of surface when the teeth in the arch are optimally positioned. www.indiandentalacademy.com www.indiandentalacad emy.com 48
    49. 49. The Straight Wire Appliance Fully programmed appliance- - Slot-siting feature - Convenience feature www.indiandentalacademy.com - Auxiliary feature www.indiandentalacad emy.com 49
    50. 50. The Straight Wire Appliance Slot siting feature-Feature 1- mid transverse planes of the slot stem and crown must be the same.Feature 2-base of the bracket for each tooth type must have same inclination as the facial plane of the crown. www.indiandentalacademy.com www.indiandentalacad emy.com 50
    51. 51. www.indiandentalacademy.comwww.indiandentalacad emy.com 51
    52. 52. The Straight Wire ApplianceFeature 4- mid sagittal plane of the slot stem and crown must be same.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.comFeature 6 - base should match the m-d www.indiandentalacad contour of the tooth. emy.com 52
    53. 53. www.indiandentalacademy.comwww.indiandentalacad emy.com 53
    54. 54. The Straight Wire Appliance Feature 7 - the vertical component should be parallel to one another. Feature 8 – all slots point must have same distance between them and the crown embrasure line. www.indiandentalacademy.com www.indiandentalacad emy.com 54
    55. 55. www.indiandentalacademy.comwww.indiandentalacad emy.com 55
    56. 56. The Straight Wire Appliance Convenience feature-.1. The gingival tie wings of the post Brackets extend farther laterally .2. Base are inclined .3. Facial surface of the incisor and canine brackets are designed to parallel their bases.4. In mandibular brackets the tie wings are designedwww.indiandentalacademy.com with least amount occlusofacial prominence www.indiandentalacad5. Bracket identification. emy.com 56
    57. 57. Convenience feature- www.indiandentalacademy.com www.indiandentalacad emy.com 57
    58. 58. www.indiandentalacademy.comwww.indiandentalacad emy.com 58
    59. 59. The Straight Wire Appliance Auxiliary feature –- Power arms- Hooks- Face bow tubes- Utility tubes- Rotational wings www.indiandentalacademy.com www.indiandentalacad emy.com 59
    60. 60. The Straight Wire Appliance Fully programmed translation brackets- Are used when bodily movement of the teeth is required . If they are not available ,teeth will not be within 2˚ or 0.5 mm of where they should be at the conclusion of the treatment . They have all the qualities of the standard brackets plus few other feature . www.indiandentalacademy.com www.indiandentalacad emy.com 60
    61. 61. The Straight Wire ApplianceCounterbuccolingual tip- a slot sittingfeature for maxillary molar thatcounteracts buccolingual tip duringtranslation and then overcorrect.Countermesiodistal tip –a slot sitingfeature that counteracts mesial or distaltipping during translation and thenovercorrects.Counterrotation – a slot siting feature that www.indiandentalacademy.comcounteracts rotation during translation and www.indiandentalacadthen overcorrects , emy.com 61
    62. 62. The Straight Wire Appliance Translation problems – Translation- “uniform movement of the body in a straight line”. However bracket is placed in wrong place in two ways-1. It is occlusal .2. It is located laterally . www.indiandentalacademy.com www.indiandentalacad emy.com 62
    63. 63. The Straight Wire Appliance Translation problems www.indiandentalacademy.com www.indiandentalacad emy.com 63
    64. 64. The Straight Wire Appliance Lever Effects Of An Optimal www.indiandentalacademy.com www.indiandentalacad emy.com 64
    65. 65. The Straight Wire Appliance Translation solutions- lever www.indiandentalacademy.com www.indiandentalacad emy.com 65
    66. 66. The Straight Wire Appliance Lever common to all edgewise brackets www.indiandentalacademy.com www.indiandentalacad emy.com 66
    67. 67. The Straight Wire ApplianceCounterrotationSlot rotation plus mesiodistal slot length plusarchwire flex plus mesial or distal force equalscounterrotation and rotation overcorrection. www.indiandentalacademy.com www.indiandentalacad emy.com 67
    68. 68. The Straight Wire Appliance Countermesiodistal tip Slot angulation plus mesiodistal slot length plus power arm length plus activated archwire and www.indiandentalacademy.com www.indiandentalacad emy.com 68
    69. 69. The Straight Wire Appliance Partly programmed brackets- By definition p p. brackets are the one which lack atleast one slot sitting feature because of which it would fail to fully direct each slot to its tooth slot site.1. Slot inclination .2. Slot angulation.3. Slot prominence.4. Horizontal base contour. www.indiandentalacademy.com www.indiandentalacad emy.com 69
    70. 70. The Straight Wire Appliance •Counter mesio distal tip www.indiandentalacademy.com www.indiandentalacad emy.com 70
    71. 71. The Straight Wire ApplianceCounterbuccolingual tip www.indiandentalacademy.com www.indiandentalacad emy.com 71
    72. 72. The Straight Wire Appliance Translation bracket categories –1. Minimum translation brackets –requiring a translation of 2 mm or less2. Medium translation brackets – requiring a translation of more than 2mm but less than 4 mm3. Maximum translation brackets -requiring a translation of more than 4 mm. www.indiandentalacademy.com www.indiandentalacad emy.com 72
    73. 73. The Universal BracketDeveloped by Dr.Spencer R Atkinson --1928Appliance has undergone periodicrefinements without losing its essentialfeatures. www.indiandentalacademy.com Modified to improve its leverage and www.indiandentalacadrotational potential . emy.com 73
    74. 74. Design- -vertical hallow shaft with two lateral welding tabs -central shaft has two slot openings1. Horizontal – opening labially at gingival third2. Vertical –opens incisally near the base and extends gingival one third of the bracket height www.indiandentalacademy.com -. www.indiandentalacad emy.com 74
    75. 75. Original Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 75
    76. 76. Five Archwire CombinationsAvailable www.indiandentalacademy.com www.indiandentalacad emy.com 76
    77. 77. The incisal slot can hold-.008-.016 roundor .008 x.020 up to .015 x .028 wire . - corrections of rotations ,leveling or torque.Gingival slot can only hold round wireranging from .008 - .016 -mesiodistal axial inclinations ,act as aguide when teeth are moved bodily inmesial or distal direction. www.indiandentalacademy.com www.indiandentalacad emy.com 77
    78. 78. The 3-D Universal Bracket(1974) -Jorge Fastlicht www.indiandentalacademy.com www.indiandentalacad emy.com 78
    79. 79. Comparison of PreviousUniversal Bracket with 3-DUniversal www.indiandentalacademy.com www.indiandentalacad emy.com 79
    80. 80. Six basic movements www.indiandentalacademy.com www.indiandentalacad emy.com 80
    81. 81. Six basic movements www.indiandentalacademy.com www.indiandentalacad emy.com 81
    82. 82. Conventional light Wire bracket and3 - D Universal Bracket Easy ligation Use of two wires simultaneously . As the bracket is wide very light wires are used in initial stages. Improve rotation potential. More space inside the www.indiandentalacademy.com vertical shaft. www.indiandentalacad emy.com 82
    83. 83. The 3-D Universal Bracket Advantage-1. Efficiency in leveling and aligning2. Permits bodily movement in m-d direction3. Retracts canine without tipping4. Torque automatically in most cases5. Individual torque is also easily achievedwww.indiandentalacademy.com www.indiandentalacad emy.com 83
    84. 84. Broussard Bracket Was designed by “Grayford broussard” Modified edgewise bracket in which there is addition of 0.0185 x 0.046 slot – to accept 0.018 auxiliary wire Brackets are patented by the R.M. company . Utilizes the two force technique. www.indiandentalacademy.com www.indiandentalacad emy.com 84
    85. 85. Broussard Bracket Features – -quick wing -vertical slot -round corners, smooth surface - horizontal slot -special torque brackets.- 0,7 ˚,17˚,22˚ -insert pinwww.indiandentalacademy.com www.indiandentalacad emy.com 85
    86. 86. Broussard Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 86
    87. 87. Broussard Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 87
    88. 88. Transition from .022 to .018slot The use of rectangular wires in rectangular brackets was introduced by Edward Angle. The original appliance was designed for use with gold arch wires and had a 22 x 28 slot . In angels concept of treatment ,sliding teeth along the arch wires to close spaces was unnecessary www.indiandentalacademy.com www.indiandentalacad emy.com 88
    89. 89. Transition from .022 to .018slotAt that time the appliance was designed toproduce appropriate force and areasonable range in torsion when goldarch wires were usedProblem originated when steel wiresreplaced ? www.indiandentalacademy.com There was a need to redesign the www.indiandentalacad edgewise emy.com 89
    90. 90. Transition from .022 to .018slot Solution to this problem was obtained by .022 .018 www.indiandentalacademy.com www.indiandentalacad emy.com 90
    91. 91. Transition from .022 to .018slot Using undersized wire in edgewise bracket is way by which friction can be reduced. Sliding teeth along the arch wire requires atleast 2 mil of clearance . www.indiandentalacademy.com www.indiandentalacad emy.com 91
    92. 92. Concept Of Fully PreadjustedApplianceReed Holdaway- made the first attempt toalter bracket slots in 1958.Second attempt in this direction was madeby Ivan LeeJoseph R Jarabak was first to combinetwo features in 1961 –Jarabak light wire www.indiandentalacademy.combracket manufactured by Rocky Mountain www.indiandentalacadOrthodontics emy.com 92
    93. 93. Roths Prescription In 1976 –Ronald Roth published a report entitled “Five year clinical evaluation of the Andrews Straight Wire Appliance”. In 1979 roth introduced a bracket set up with his own modifications keeping in mind –1. Biologic consideration .2. Mechanical consideration. www.indiandentalacademy.com www.indiandentalacad emy.com 93
    94. 94. Roths Prescription Roths rationale –1. With the appliance in place ,it is virtually impossible ,because of the bracket interference ,to position the teeth precisely into occlusion shown by non orthodontic normal sample2. After appliance removal ,no matter how well treated the patient may be ,the teeth will shift slightly from the position they occupied at the time appliance www.indiandentalacademy.com was removed. www.indiandentalacad emy.com 94
    95. 95. Bioefficient Bracket It is a modification of preadjusted system introduced by Viazis. The bracket prescriptions were designed to overcorrect malocclusion and to make it possible to work with the largest possible wires from the start of the treatment . www.indiandentalacademy.com www.indiandentalacad emy.com 95
    96. 96. Bioefficient Bracket Rationale behind the bracket design is- - maximum potential of any archwire is achieved when the largest possible wire is used. The archwire between a narrow single bracket will have less stiffness and greater flexibility . www.indiandentalacademy.com www.indiandentalacad emy.com 96
    97. 97. Bioefficient Bracket The bracket is designed to fulfill following requirements-1. Conformity to the crown anatomy and gingival outline www.indiandentalacademy.com www.indiandentalacad emy.com 97
    98. 98. Bioefficient Bracket2. Ease of use- Variability in the bracket positioning is usually attributable to improper mesiodistal or buccolingual placement of the slot www.indiandentalacademy.com www.indiandentalacad emy.com 98
    99. 99. Bioefficient Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 99
    100. 100. Bioefficient Bracket3. Minimum friction www.indiandentalacademy.com www.indiandentalacad emy.com 100
    101. 101. Bioefficient Bracket4. Tip control www.indiandentalacademy.com www.indiandentalacad emy.com 101
    102. 102. Bioefficient Bracket5. Rotational control-narrow ,elongated configuration of the bracket ,with the wings moved towards the mesiodistal surface of the teeth provide maximum rotational control www.indiandentalacademy.com www.indiandentalacad emy.com 102
    103. 103. Bioefficient Bracket6. Vertical slot6. High torque in the anterior brackets. www.indiandentalacademy.com www.indiandentalacad emy.com 103
    104. 104. Vari Simplex Discipline The actual appliance was born in 1978. All the brackets used in this system pretorqued , preangulated and exhibit specific bracket base thickness for in/out compensations . www.indiandentalacademy.com www.indiandentalacad emy.com 104
    105. 105. Vari Simplex Discipline Factors determining the design of the appliance-1. Size and shape of the teeth ,especially mesio distal width and curvature .2. Selection of proper bracket style to fit the size and the shape of each tooth .3. Accessibility of the tooth .4. Patientwww.indiandentalacademy.com comfort . www.indiandentalacad emy.com 105
    106. 106. Vari Simplex Discipline Factors defining the bracket system--Type of bracket-Placement positions-Angulations-Torque-In /out compensations www.indiandentalacademy.com www.indiandentalacad emy.com 106
    107. 107. Vari Simplex Discipline Brackets used in vari simplex1. Twin bracket-- Used on large flat surfaced teeth.-Mini –Diamond bracket inrhomboid design.- Advantage –a) Flat surface .b) Easy accessibility .c) Mini twin bracket . www.indiandentalacademy.comd) Patient comfort. www.indiandentalacad emy.com 107
    108. 108. Vari Simplex Discipline Twin bracket on the lateral incisor are provided with additional tie wing for easy initial wire placement. Additional permanent hooks are present on the lateral incisor www.indiandentalacademy.com www.indiandentalacad emy.com 108
    109. 109. Vari Simplex Discipline2. Lang bracket-- Was invented by Dr Howard Lang- Used round surfaced teeth at the corners of the arch . Design--single bracket a flat rotational control wing-each wing has a circular hole .- Wedge shape in profile www.indiandentalacademy.com www.indiandentalacad emy.com 109
    110. 110. www.indiandentalacademy.comwww.indiandentalacad emy.com 110
    111. 111. www.indiandentalacademy.comwww.indiandentalacad emy.com 111
    112. 112. Vari Simplex Discipline Reasons for using Lang bracket on cuspids-1. Twin bracket reduces the inter-bracket distance.2. Better rotational control.3. Full bracket engagement with a twin bracket is difficult on a round surfaced tooth.4. Prevents attrition on the maxillary cuspid. www.indiandentalacademy.com www.indiandentalacad emy.com 112
    113. 113. Vari Simplex Discipline3. Lewis bracket-- They are used for large round surfaced teeth that are not at the curve of the arch - bicuspids .- Small flat surface teeth www.indiandentalacademy.com - mandibular incisors. www.indiandentalacad emy.com 113
    114. 114. Vari Simplex Discipline Design –- Consists of fixed wing single bracket with built in labial curvature of the rotational wings .- This provides a three point contact .- Bracket is wedge shape in profile view www.indiandentalacademy.com www.indiandentalacad emy.com 114
    115. 115. Vari Simplex Discipline Advantages of using fixed Lewis wing over flexible Steiner wing-1. Additional force .2. Save adjustment time.3. Edges of the Lewis bracket are less sharp . www.indiandentalacademy.com4. Breakages are less . www.indiandentalacad emy.com 115
    116. 116. Vari Simplex Discipline Salient features-1. -3˚ torque on maxillary cuspid2. No torque in the second molar tube.3. -5˚ lingual crown torque in the mandibular incisors www.indiandentalacademy.com www.indiandentalacad emy.com 116
    117. 117. Creekmore Uni Twin Bracket Rationale – -Twin bracket offered better rotational control which the single bracket could not match until the rotational wings were added -Still when a tooth is rotated badly and misaligned at the start of the treatment ,rotational wings of the single bracket will interfere with full engagement of the archwire . www.indiandentalacademy.com www.indiandentalacad emy.com 117
    118. 118. Creekmore Uni Twin Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 118
    119. 119. Burstone Cuspid Bracket Bracket design- -consists of a basic . 022 x .028 edgewise slot -additional .017 x . 025 vertical or horizontal auxiliary . www.indiandentalacademy.com www.indiandentalacad emy.com 119
    120. 120. THE DUAL ENVIROMENTBRACKETIntroduced by –Schudy 1990Design was based on computer modelingUses the advantage of having smallerwires and greater intrabracket space. www.indiandentalacademy.com www.indiandentalacad emy.com 120
    121. 121. BRACKET DESIGN Large outer slot - 0.040” -0.030” Smaller inner slot - 0.018” -0.016” www.indiandentalacademy.com www.indiandentalacad emy.com 121
    122. 122. THE DUAL ENVIROMENTBRACKET www.indiandentalacademy.com www.indiandentalacad emy.com 122
    123. 123. The larger outer slot allows maximum archwire flexibility in the initial phases of thetreatment .The smaller inner slot accepts smallrectangular wires for maximum control inthe later stages of the treatment . www.indiandentalacademy.com www.indiandentalacad emy.com 123
    124. 124. According to the author-1. Faster leveling of the arches with fewer arch wires changes. -larger posterior intrabracket space permit teeth to move easily2. Easier torquing of the teeth with less discomfort.3. Fewer permanent set in arch wires due to mastication. www.indiandentalacademy.com www.indiandentalacad emy.com 124
    125. 125. Torque In Base Vs Face www.indiandentalacademy.com www.indiandentalacad emy.com 125
    126. 126. Begg /Chun-Hoon“Original”Combinaton Brackets Interchangeability of techniques,for transfer cases or for retentive labial rectangular archwire after 3rd stage of lightwire treatment. Ample room provided for edgewise ligature wire. Available in regular and www.indiandentalacademy.com curved bases. www.indiandentalacad emy.com 126
    127. 127. Begg /Chun-Hoon “FullFlanged”Combinaton Brackets Modified version which offered gingivally extended welding flanges to provide more welding area Also allow archwire to rest completely within the bracket. www.indiandentalacademy.com www.indiandentalacad emy.com 127
    128. 128. Kamedanized BeggThis was introduced by Dr Akira Kameda.He modified the Begg technique to complywith the demands of time and progress oftechnology .This was based on 25 yrs of clinicalexperience .The basic idea was to solve unfinishedand/or unstable parts of pure Begg www.indiandentalacademy.comtechnique. www.indiandentalacad emy.com 128
    129. 129. Kamedanized BeggBasic design of the appliance was samewith few modifications .He introduced what was called as KBbuccal tube and torquing brackets .These according to the author werenecessary for carrying out the KB www.indiandentalacademy.comtechnique. www.indiandentalacad emy.com 129
    130. 130. Kamedanized Begg In 1983 , he introduced torquing and reverse torquing brackets . Built in torque adjustments is obtained by raising the incisal or gingival edge of the bracket base away from the tooth surface. www.indiandentalacademy.com www.indiandentalacad emy.com 130
    131. 131. Kamedanized Begg Advantage of using round buccal tube with a round wire .But it had its own pitfalls-1. Free tooth movement is possible ,but anchor molars tend to roll in.2. Correcting lingually inclined molars is difficult.3. Directing the forces of anchorage bends and bitewww.indiandentalacademy.com opening bends is difficult. www.indiandentalacad emy.com 131
    132. 132. Kamedanized Begg To overcome this problem he introduced -Ribbon Arch Buccal Tubes -1986 www.indiandentalacademy.com www.indiandentalacad emy.com 132
    133. 133. Kamedanized Begg In 1992 JIOS – mentioned that efforts are going on to develop a new type of KB bracket with a built in T-Pin. www.indiandentalacademy.com www.indiandentalacad emy.com 133
    134. 134. Kamedanized Begg Also labio lingual thickness of these KB Brackets are same as non torque brackets, regardless of the of 10 ˚ or 20˚built in torque. www.indiandentalacademy.com www.indiandentalacad emy.com 134
    135. 135. Refined Begg Appliance A – brackets used are TP-256-00,with a depth of .020 and height of .045 www.indiandentalacademy.com www.indiandentalacad emy.com 135
    136. 136. Refined Begg Appliance Molar tubes – Round molar tubes . 036 and 6 mm length. Oval tubes .072 x . 024 and 5mm length. www.indiandentalacademy.com www.indiandentalacad emy.com 136
    137. 137. Refined Begg Appliance Combination tube (TP Lab) They consist of a round gingival tube of .036 and 6.2 mm length. Rectangular .025 x . 018 -5.5mm long www.indiandentalacademy.com www.indiandentalacad emy.com 137
    138. 138. Refined Begg Appliance Built in adjustments1. Anti rotational brackets . www.indiandentalacademy.com www.indiandentalacad emy.com 138
    139. 139. Refined Begg Appliance2. Built in torque www.indiandentalacademy.com www.indiandentalacad emy.com 139
    140. 140. Refined Begg Appliance Other attachments –1. Hooks www.indiandentalacademy.com www.indiandentalacad emy.com 140
    141. 141. Refined Begg Appliance2. Lingual buttons ,cleats and eyelets www.indiandentalacademy.com www.indiandentalacad emy.com 141
    142. 142. Refined Begg Appliance3. Additional round tubes www.indiandentalacademy.com www.indiandentalacad emy.com 142
    143. 143. Refined Begg Appliance Pins used in Refined Begg www.indiandentalacademy.com www.indiandentalacad emy.com 143
    144. 144. Combination brackets www.indiandentalacademy.com www.indiandentalacad emy.com 144
    145. 145. Modular Self LockingAppliance Introduced by –FOGEL AND MAGILL -1976 Key objective to treat greater number ,better ,faster easier ,at a lower cost and by using an appliance which can achieve www.indiandentalacademy.com the optimal biologic response. www.indiandentalacad emy.com 145
    146. 146. Modular Self LockingAppliance It is a light wire system using a single pivotal bracket or twin self locking low frictional attachments . www.indiandentalacademy.com www.indiandentalacad emy.com 146
    147. 147. Modular Self LockingAppliance Insert bracket – Archwire chamber Beaks Insert slot Slot apex Seat www.indiandentalacademy.com stem www.indiandentalacad emy.com 147
    148. 148. Modular Self LockingAppliance www.indiandentalacademy.com www.indiandentalacad emy.com 148
    149. 149. Modular Self LockingAppliance Placement of the insert bracket- www.indiandentalacademy.com www.indiandentalacad emy.com 149
    150. 150. Modular Self LockingAppliance Receptacle –available in three sizes- Small (.150”)- Medium (.180”)- Wide (.200”)- Three vertical slots are present which accommodate insert brackets and the auxiliaries www.indiandentalacademy.com www.indiandentalacad emy.com 150
    151. 151. Modular Self LockingAppliance www.indiandentalacademy.com www.indiandentalacad emy.com 151
    152. 152. Modular Self LockingAppliance Archwire play www.indiandentalacademy.com www.indiandentalacad emy.com 152
    153. 153. Modular Self LockingAppliance Insertion of wire into the insert bracket www.indiandentalacademy.com www.indiandentalacad emy.com 153
    154. 154. Modular Self LockingAppliance Removal of archwire www.indiandentalacademy.com www.indiandentalacad emy.com 154
    155. 155. Modernized Begg –CombinationTechniqueWilliam Thompson AJO –JUNE 1981The rationale was to develop a treatmentmechanics that uses the advantages ofboth BEGG and STRAIGHT WIRE at thesame timewww.indiandentalacademy.com minimizing thedisadvantageous. www.indiandentalacad emy.com 155
    156. 156. Modernized BeggThe appliance was aimed at achievinglight ,rapid tipping forces to correct grosschanges in the tooth position at one stagein the treatment. While more rigid andprecise appliance to be used in the laterstage of the treatment to producemaximum tooth detailing and occlusal www.indiandentalacademy.comintercuspation. www.indiandentalacad emy.com 156
    157. 157. Modernized Begg Begg force Physiologic force system system-unipoint contact - muscle action-anchor bend - tooth morphology-archwire action - cuspal interlock-auxiliary - freeway & functional-tipping forces - occlusal forces-Intrusive forces - bone density www.indiandentalacademy.com www.indiandentalacad-extrusive forces - growth emy.com 157
    158. 158. Modernized Begg Favourable characteristics of Begg-1. Rapid bite opening.2. Rapid ant. Alignment.3. En mass anterior retraction.4. Good anchor control.5. Ant. Root torque is unlimited.6. Predictable molar and incisor positions. www.indiandentalacademy.com www.indiandentalacad emy.com 158
    159. 159. Modernized Begg Unfavourable characteristics-1. Post. Root torque is difficult.2. Three dimensional arch coordination is difficult.3. Maintaining rotations is difficult4. Maintaining upright and torque is difficult.5. www.indiandentalacademy.com Finishing intricacies is difficult. www.indiandentalacad emy.com 159
    160. 160. Modernized Begg Favourable characteristics of SWA-1. Precision in arch coordination is routine.2. Precision intercuspation is routine.3. Buccolingual root torque is routine.4. Simplified finishing wires are routine .5. Minimal wire adjustments in finishing. www.indiandentalacademy.com www.indiandentalacad emy.com 160
    161. 161. Modernized Begg Unfavourable characteristics –1. Rigid appliance due to interbracket distance.2. More friction with sliding mechanics.3. Additional supportive anchorage recommended.4. Segmental retraction of anterior teeth.5. Forward www.indiandentalacademy.com tipping of incisors in continuous wire leveling. www.indiandentalacad6. Prolonged bite emy.com mechanics. opening 161
    162. 162. Four Stage Bracket Appliance design- -combination bracket design-lower third of the bracket is a type 256 Begg bracket-upper two thirds is a .018 x .025 straight wire slotwww.indiandentalacademy.com . www.indiandentalacad emy.com 162
    163. 163. Four Stage Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 163
    164. 164. Four Stage Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 164
    165. 165. Four Stage Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 165
    166. 166. Four Stage BracketBegg procedures should be carriedcompletely through stage I and stage IIand partly through stage III .When the edgewise slots are parallel toeach other Begg portion of the treatmentis ceased .www.indiandentalacademy.com www.indiandentalacad emy.com 166
    167. 167. www.indiandentalacademy.comwww.indiandentalacad emy.com 167
    168. 168. Four Stage Bracket The author claims that the clinical use of this combination appliance has shown good results . He believes that there is a possibility of further improvement in design and technique of this appliance. www.indiandentalacademy.com www.indiandentalacad emy.com 168
    169. 169. THE BEDDTIOT APPLIANCE Begg Edgewise Diagnosis-Determined Totally Individualized Orthodontic Technique. - RICHARD HOCEVAR-1985The 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. www.indiandentalacademy.com www.indiandentalacad emy.com 169
    170. 170. BRACKET DESIGN Lingual narrow ,single width -0.050”1.3mm Edgewise Bracket 2 slots- Horizontal-.022(height)x.028(depth) Vertical- .020 x .020 Archwire slot are torque with indicator gingival groove –lingual root torque Occlusal groove-lingual crown torque www.indiandentalacademy.com www.indiandentalacad emy.com 170
    171. 171. THE BEDDTIOT APPLIANCE www.indiandentalacademy.com www.indiandentalacad emy.com 171
    172. 172. THE BEDDTIOT APPLIANCE www.indiandentalacademy.com www.indiandentalacad emy.com 172
    173. 173. Except for the torque the brackets areidentical and interchangeable .There are a total of five brackets whichdiffer only in the torque-0˚,5˚,10˚,15˚.Buccal tubes -4.5 mm - .022 x .02825˚ - lingual crown torque for lower www.indiandentalacademy.com 10˚ - for the upper molars. www.indiandentalacad emy.com 173
    174. 174. Characteristic feature- In cases of deep bite or severe anchorage cases – additional rectangular tube is is placed diagonally at an angle of 15˚,with its mesial end pointing gingivally. Advantage –1. Increase the anchorage.2. Built inwww.indiandentalacademy.com anchor bend. www.indiandentalacad emy.com 174
    175. 175. THE BEDDTIOT APPLIANCE www.indiandentalacademy.com www.indiandentalacad emy.com 175
    176. 176. Tip EdgeIntroduced by Peter Kesling based on hisexperiences with differential toothmovement and thesis written in 1968Based on the rationale that each tooth hasto tip freely either measily or distally –notin both directions .Keeping this in mind the appliance wasdesigned to provide all the benefits ofdifferentialwww.indiandentalacademy.com tooth movement plus predetermined degree of final crown tip and www.indiandentalacadtorque emy.com 176
    177. 177. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 177
    178. 178. Tip Edge Basic design consist of- -removal of diagonally opposed corners of a conventional edgewise slot -slot size is .022 x.028 -lateral extensions or wings -vertical slot .020 x.020 - deep grooves www.indiandentalacademy.com www.indiandentalacad emy.com 178
    179. 179. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 179
    180. 180. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 180
    181. 181. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 181
    182. 182. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 182
    183. 183. Tip Edge Molar tube are designed – .036 round gingival tube .022 x .028 occlusal tube They are available with –1. Extraction and non extraction kits2. Torque in base /face3. Over rotational bracket4. With in/out compensations www.indiandentalacademy.com5. Positing jigs www.indiandentalacad6. Tip edge rings. emy.com 183
    184. 184. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 184
    185. 185. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 185
    186. 186. Tip Edge www.indiandentalacademy.com www.indiandentalacad emy.com 186
    187. 187. Tip Edge Advantage over original edgewise –1. Adversely tipped teeth2. Anchorage control Advantage over ribbon arch-1. Inout compensation. www.indiandentalacademy.com2. Prevent distal crown tipping of cuspid www.indiandentalacad emy.com 187
    188. 188. Combination AnchorageTechnique Clinical experience with the combination brackets provide extensive knowledge regarding the expanded capabilities of the technique. What was originally believed to be modernized Begg was actually a true combination anchorage technique. www.indiandentalacademy.com www.indiandentalacad emy.com 188
    189. 189. Combination Anchorage Technique The original combination brackets proved to be-- Bulky .- Weak.- Aesthetically unattractive.- Problems with pinning rotations- Slot closure- www.indiandentalacademy.com Occlusal interference. www.indiandentalacad emy.com 189
    190. 190. Combination Anchorage Technique The bracket design was changed –- It had a .022 x .035 gingival or ribbon arch slot.- .018 x .025 .022 x .028 edgewise slot.- Enclosed vertical slot . www.indiandentalacademy.com www.indiandentalacad emy.com 190
    191. 191. Combination AnchorageTechnique www.indiandentalacademy.com www.indiandentalacad emy.com 191
    192. 192. Combination AnchorageTechnique www.indiandentalacademy.com www.indiandentalacad emy.com 192
    193. 193. Combination AnchorageTechnique www.indiandentalacademy.com www.indiandentalacad emy.com 193
    194. 194. Combination Anchorage Technique Brackets are available with colour coding for easy identification . - maxillary –red mandibular-blue- Varying degree of torque for the anterior brackets.- Molar attachments with convertible molar tubes. www.indiandentalacademy.com www.indiandentalacad- Redesigned pin slot . emy.com 194
    195. 195. Combination AnchorageTechnique a) Phase III retention pin b) Phase I and II retention pin c) Tandem, hook pin www.indiandentalacademy.com d) Bypass www.indiandentalacad clamp emy.com 195
    196. 196. Begg – Ribbon Arch CombinationSystem Introduced by Nikhil Vashi JIOS-Jan 1991 Appliance was designed to combine the advantages of the BEGG and the Edgewise and the Preadjusted Appliance www.indiandentalacademy.com www.indiandentalacad emy.com 196
    197. 197. Begg – Ribbon Arch CombinationSystem Design- A gingival ribbon wise slot (018 x 027). An incisal or occlusal horizontal slot (020 x 020) Two vertical slot for lock pins or ligature wire www.indiandentalacademy.com www.indiandentalacad emy.com 197
    198. 198. Begg – Ribbon Arch CombinationSystem BRACS www.indiandentalacademy.com www.indiandentalacad emy.com 198
    199. 199. Begg – Ribbon Arch CombinationSystem Molar tube is rectangular ribbon wise for ribbon arch and has a 6˚ offset . www.indiandentalacademy.com www.indiandentalacad emy.com 199
    200. 200. Begg – Ribbon Arch CombinationSystem Different movements can be obtained just by tying or pinning the archwire differently. www.indiandentalacademy.com www.indiandentalacad emy.com 200
    201. 201. Begg – Ribbon Arch CombinationSystem www.indiandentalacademy.com www.indiandentalacad emy.com 201
    202. 202. Begg – Ribbon Arch CombinationSystem Bite opening is done with around wire like 016 ss. In the next phase retraction of anteriors is done by free or controlled tipping or by bodily translation. In the last phase – initially a 016 x016 or 016 x 022 can be used and then 017 x 025 and 018 025 ss can be used for final finishing . www.indiandentalacademy.com www.indiandentalacad emy.com 202
    203. 203. Begg – Ribbon Arch CombinationSystem BRACS has following advantages-1. Rapid differential movements of teeth with better control and less friction.2. Helps in proper finishing of the case.3. Need for patient co-operation is minimal.4. Eliminates the need for heavy elastics .5. Eliminates complicated and unstable stage III mechanics.6. www.indiandentalacademy.com Reduced the treatment duration. www.indiandentalacad emy.com 203
    204. 204. “J” bracket- Begg CombinationBracket Introduced by Dr Jayade –JIOS 1991 Requisites of a good combination –1. It must be capable of delivering all the advantages of the Begg appliance and at the same time eliminate all its disadvantages .2. It must permit the incorporation of SW concept of finishing without its disadvantages. www.indiandentalacademy.com3. Should have more than one slot . www.indiandentalacad4. Should be economical . emy.com 204
    205. 205. “J” bracket- Begg CombinationBracket Advantages of multiple slot brackets over single bracket-1. Diametrically opposite treatment requirements.2. Possibility of applying forces to the teeth at different areas .3. Switching slots help in altering or reinforcing anchorage.4. Use of segmental /tandem wires. www.indiandentalacademy.com www.indiandentalacad emy.com 205
    206. 206. “J” bracket- Begg CombinationBracket Rationale of orientation of slots in the new design-- All bracket slots are cuboidal. www.indiandentalacademy.com www.indiandentalacad emy.com 206
    207. 207. “J” bracket- Begg CombinationBracket Movements which remain unaffected by this orientation of the slot –1. Intrusion or extrusion .2. Labio lingual crown tipping using round wire www.indiandentalacademy.com3. Labio lingual root movement www.indiandentalacad emy.com 207
    208. 208. “J” bracket- Begg CombinationBracket Movements which are affected by changing the slot orientation –1. Mesiodistal crown tipping (slot height).2. www.indiandentalacademy.com Rotational control (slot depth) www.indiandentalacad emy.com 208
    209. 209. “J” bracket- Begg CombinationBracket Disadvantage of the twin slot arrangement- Drastically reduce mesio-distal tipping. Decrease in the inter bracket wire span. www.indiandentalacademy.com www.indiandentalacad emy.com 209
    210. 210. “J” bracket- Begg CombinationBracket Net effect of changed orientation of the slot-1. Permits optimum mesio distal crown tipping .2. Affords good rotational control.3. Allows to fully utilize torquing abilities of rectangular wire.4. Partly overcomes disadvantages of twin bracket configuration. www.indiandentalacademy.com www.indiandentalacad emy.com 210
    211. 211. “J” bracket- Begg CombinationBracket “J” bracket configuration –1. The single slot(.024 ht x .1 mm wide). This permits easy tipping to adequate extent in initial stages faces horizontally.2. The twin slots(.032ht x .018 depth, placed 3mm apart) www.indiandentalacademy.com www.indiandentalacad emy.com 211
    212. 212. “J” bracket- Begg CombinationBracket www.indiandentalacademy.com www.indiandentalacad emy.com 212
    213. 213. “J” bracket- Begg CombinationBracket Advantages-- Better rotational control.- Possibility of using uprighting springs and auxiliaries along with round .018 round base wire .- Possibility of using full torquing potential of rectangular wire upto 018 x 025 www.indiandentalacademy.com www.indiandentalacad emy.com 213
    214. 214. “J” bracket- Begg CombinationBracket3. Using both slots together when necessary ,advantage of the combination bracket can be derived . www.indiandentalacademy.com www.indiandentalacad emy.com 214
    215. 215. “J” bracket- Begg CombinationBracket Molar attachment –When only first molar are available for anchorage molar band carry gingival rectangular tube in ribbonwise orientation and a round tube occlusally .When both 1st and 2nd molar have to be utilized 2nd molar will have such a combination tube and 1st molar twin www.indiandentalacademy.com rectangular attachment gingivally ,and an www.indiandentalacad occlusal round tube. emy.com 215
    216. 216. Brackets Used In LingualOrthodontics www.indiandentalacademy.com www.indiandentalacad emy.com 216
    217. 217. Bracket Design For LingualOrthodontics Lingual light Wire Technique-Stephen F Paige –Aug 1982 JCO. With the advent of bonding of attachments directly on the teeth ,it became possible to bond brackets directly on the lingual surface . Fujita who confirmed that orthodontic treatment with brackets placed on the lingual was possible . www.indiandentalacademy.com www.indiandentalacad emy.com 217
    218. 218. Bracket Design For LingualOrthodontics Bracket design criteria –1. Decreased interbracket distance –narrow mesiodistally.2. Because of decreased bracket width ,mesiodistal root control becomes more difficult –vertical slot for arch www.indiandentalacademy.com auxiliaries . www.indiandentalacad emy.com 218
    219. 219. Bracket Design For LingualOrthodontics3. Topography of the lingual surface vary to a great deal-until future advances make precision direct bonded placement ,”straight wire” approach to bracket design appears impractical. www.indiandentalacademy.com www.indiandentalacad emy.com 219
    220. 220. Bracket Design For LingualOrthodontics4. Ease of insertion, ligation and removal of archwire – incisal or occlusal placement of arch wire . www.indiandentalacademy.com Begg bracket fulfils all these criteria www.indiandentalacad emy.com 220
    221. 221. Bracket Design For LingualOrthodontics Unipoint combination bracket (Unitek). www.indiandentalacademy.com www.indiandentalacad emy.com 221
    222. 222. Bracket Design For LingualOrthodontics Molar tubes- Conventional oval tubes with mesiogingival hook (Unitek 0456-516). www.indiandentalacademy.com www.indiandentalacad emy.com 222
    223. 223. Bracket Design For LingualOrthodontics Methods of ligation- www.indiandentalacademy.com www.indiandentalacad emy.com 223
    224. 224. Bracket Design For LingualOrthodontics Lingual Begg light wire technique – Peter K-J Yen Nov 1986 JCO. They developed a technique that used regular Begg light wire and labial bracketswww.indiandentalacademy.com www.indiandentalacad emy.com 224
    225. 225. Bracket Design For LingualOrthodontics Regular 256 Begg brackets were used Lower labial incisors were used for both upper and lower incisors Upper lateral incisor labial brackets were adapted to cuspids Curved upper cuspid labial brackets were used for bicuspids. www.indiandentalacademy.com www.indiandentalacad emy.com 225
    226. 226. Bracket Design For LingualOrthodontics To provide proper interbracket distance in stage I vertical slots of the bracket were incisally . For stage II and III new set of brackets were bonded with vertical slots www.indiandentalacademy.com directed gingivally www.indiandentalacad emy.com 226
    227. 227. Bracket Design For LingualOrthodontics In Aug 1989 AJO-Thomas Creekmore An acceptable lingual orthodontic appliance system must include the following key elements-  It should align teeth from the lingual side as efficient as from the labial side.  A mean of positioning the bracket precisely www.indiandentalacademy.com to create a “near” SWA on the lingual side. www.indiandentalacad emy.com 227
    228. 228. Bracket Design For Lingual Orthodontics  A consistent and accurate indirect bonding  A selection of preformed archwires with canine and premolars offsets.  Specially designed pliersThe appliance that satisfy all the above requisites is the www.indiandentalacademy.com “conceal system” developed by the Unitek corp. www.indiandentalacad emy.com 228
    229. 229. Characteristic feature-The foundation of the design is theopening of the wire slot to the occlusalaspect rather then to the lingual aspect. www.indiandentalacademy.com www.indiandentalacad emy.com 229
    230. 230. Bracket Design For LingualOrthodontics First 1 mm of the molar tube opens to the occlusal aspect. www.indiandentalacademy.com www.indiandentalacad emy.com 230
    231. 231. Bracket Design For LingualOrthodontics The occlusal approach had potential problem - ligation - design for adequate tip www.indiandentalacademy.com www.indiandentalacad emy.com 231
    232. 232. Bracket Design For LingualOrthodontics Conceal brackets are designed around Unitwin Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 232
    233. 233. Bracket Design For LingualOrthodontics Bracket has three different slot widths for three different functions of tip (a-b) , torque (e-f), rotation (c-f or e-d). www.indiandentalacademy.com www.indiandentalacad emy.com 233
    234. 234. Bracket Design For LingualOrthodontics www.indiandentalacademy.com www.indiandentalacad emy.com 234
    235. 235. Bracket Design For LingualOrthodontics Difficult challenge of small working space – anterior brackets have Y configuration with a single tie wing projecting gingivally and twin tie wing projecting occlusally www.indiandentalacademy.com www.indiandentalacad emy.com 235
    236. 236. Self ligating Brackets The first self ligating bracket was developed by DR .Jacob Stolzenberg in early 1930’s. Design – - bracket had a flat head screw seated snugly in a circular ,threaded opening in the face of the bracket.- The horizontal screw could be loosened or tightened www.indiandentalacademy.com www.indiandentalacad emy.com 236
    237. 237. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 237
    238. 238. Self ligating Brackets In 1971 Dr Jim Wildman developed the Edgelok bracket . Design –- Bracket had a round body with a rigid labial sliding cap- This design made the bracket “passive” in its interplay with the arch-wire.- This was the first “passive” self ligating www.indiandentalacademy.com bracket ,and first to enjoy any sort of www.indiandentalacad commercial success.emy.com 238
    239. 239. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 239
    240. 240. Self ligating Brackets About 2 years later Dr. Franz Sander introduced the Mobil-lock bracket Design-- Semi circular locking mechanism- A special tool was used to rotate the lock intowww.indiandentalacademy.com its closed or open position www.indiandentalacad emy.com 240
    241. 241. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 241
    242. 242. Self ligating Brackets “Speed” bracket introduced by Dr Herbert Hanson in 1976 and became available in the market in 1980. Stands for- Spring loaded Precision Edgewise Energy Delivery www.indiandentalacademy.com www.indiandentalacad emy.com 242
    243. 243. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 243
    244. 244. Self ligating Brackets Design –1. The bracket body – prior to welding -four slots -shallow triangular groove - welding flange - no gingival tie wing www.indiandentalacademy.com www.indiandentalacad emy.com 244
    245. 245. Self ligating Brackets .018 x .025 horizontal slot .017 x.017 horizontal slot . Vertical spring slot. Instrument access slot. - Shallow transverse groove www.indiandentalacademy.com www.indiandentalacad emy.com 245
    246. 246. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 246
    247. 247. Self ligating Brackets Spring clip- Highly resilient spring clip made up of . 005 x .060 or .005 x.072 ss strip . Curved occlusal portion has an angle of wrap of 217˚ 30 minutes when free from external stresses . Prior to insertion spring arms converge at an angle of 37˚ 30 minutes. www.indiandentalacademy.com www.indiandentalacad emy.com 247
    248. 248. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 248
    249. 249. Self ligating Brackets The bonding base- When viewed from the labial mesial and distal edges of each of the welding pad are parallel to each other Gingival edge is curved gingivally in form of a semi-ellipse. www.indiandentalacademy.com www.indiandentalacad emy.com 249
    250. 250. Self ligating Brackets Bracket –spring assembly - when the spring is in the slot close position ,its arms are held apart so as to reduce their angle of convergence by atleast 2˚ -This causes elastic deformation www.indiandentalacademy.com www.indiandentalacad emy.com 250
    251. 251. Self ligating Brackets Rotational control about three axes –1. The occlusogingival axis (rotations)2. The labiolingual axis tipping) www.indiandentalacademy.com3. The mesiodistal axis (torquing) www.indiandentalacad emy.com 251
    252. 252. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 252
    253. 253. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 253
    254. 254. Self ligating BracketsHelps the operator in saving as much as 5minutes per arch change .It permits a high degree of precision inthree dimensional control of tooth .Well suited for sliding mechanics .Capacity to store relatively large amount www.indiandentalacademy.comof energy for release at desirably slow www.indiandentalacadrate. emy.com 254
    255. 255. Self ligating Brackets Later in 1986 Dr Erwin Pletcher introduced Activa bracket Like the straight wire appliance it is a fully programmed appliance with specific tooth positions built into a special bracket for each tooth. www.indiandentalacademy.com www.indiandentalacad emy.com 255
    256. 256. Self ligating Brackets It has a horizontal slot of .022” x.022” Vertical slot of .020 x.020” Bracket has a inflexible ,curved arm that rotates occluso-gingivally around the cylindrical bracket body. All brackets are colour coded . The latches close to the gingival . www.indiandentalacademy.com www.indiandentalacad emy.com 256
    257. 257. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 257
    258. 258. Self ligating Brackets Advantages-1. Vertical slot can be used to engage hooks, rotational and uprighting spring.2. The bracket are smaller than the twin or mini bracket.3. Friction is significantly reduced.4. There is 100% compatibility with other straight wire bracket.5. Time factor. www.indiandentalacademy.com6. Teeth move faster and with less force. www.indiandentalacad emy.com 258
    259. 259. Self ligating Brackets In 1995 Dr Wolfgang Heiser introduced the -Time- bracket. Design-- Rigid ,curved that wraps occlusogingivally around the labial aspect of the bracket body- A special instrument is used to pivot the arm gingivally into the slot open position or occlusallywww.indiandentalacademy.com into the slot closed position. www.indiandentalacad emy.com 259
    260. 260. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 260
    261. 261. Self ligating Brackets Next to follow was The Twin Lock bracket which was introduced in1998 It had a flat ,rectangular slide ,housed between the tie wing of an edgewise twin bracket. Slot is moved with a universal scalar www.indiandentalacademy.com www.indiandentalacad emy.com 261
    262. 262. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 262
    263. 263. Self ligating Brackets Between 1996 and 1999 Dr Dwight Damon introduced the Damon SL I and Damon SL II brackets. The basic difference is that the first had a labial cover that straddled the tie wing ,while the second incorporates a flat , rectangular slide between the tie wings . www.indiandentalacademy.com www.indiandentalacad emy.com 263
    264. 264. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 264
    265. 265. Self ligating Brackets www.indiandentalacademy.com www.indiandentalacad emy.com 265
    266. 266. In-Ovation BracketIt is self ligating bracket system consisting of atwin bracket for rotational control and has anactive clip for seating arch wire .Manufactures claim that the bracket design notonly combines all the important features of aneffective self ligating system ,it goes even furtherto provide the highest level of versatility ,functionand comfort. www.indiandentalacademy.com www.indiandentalacad emy.com 266
    267. 267. In-Ovation Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 267
    268. 268. In-Ovation BracketLow profileFour full tie wingsSlot blockerHorizontal V SlotCompound contoured baseTorque in base www.indiandentalacademy.com www.indiandentalacad emy.com 268
    269. 269. In-Ovation Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 269
    270. 270. In-Ovation BracketReduced resistanceReduced chairtimeEnhanced hygieneEnhanced interbracketdistance www.indiandentalacademy.com www.indiandentalacad emy.com 270
    271. 271. In-Ovation Bracket New instruments which are designed to make in-ovation brackets more efficient1. Beaver Tail2. V tool3. Positioner www.indiandentalacademy.com www.indiandentalacad emy.com 271
    272. 272. In-Ovation Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 272
    273. 273. In-Ovation Bracket Super mesh www.indiandentalacademy.com www.indiandentalacad emy.com 273
    274. 274. In-Ovation Bracket Bite Ramps www.indiandentalacademy.com www.indiandentalacad emy.com 274
    275. 275. Friction Free BracketWas introduced by Kazuto et.al in early1990”s J Jap Orhtod.Basic idea of the design was to reducefriction between the bracket slot and thearchwire.So that tooth movement could be www.indiandentalacademy.comaccomplished with lighter forces . www.indiandentalacad emy.com 275
    276. 276. Friction Free Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 276
    277. 277. Friction Free Bracket Frictional force =acting tangentially at the contact surface is the product of a vertical load and coefficient of friction www.indiandentalacademy.com www.indiandentalacad emy.com 277
    278. 278. The Next Generation :StraightWire Appliance This concept was introduced by Creekmore and Randy in 1993 AJO Frequently anticipated results are not achieved by using a preadjusted appliance and straight wire . www.indiandentalacademy.com www.indiandentalacad emy.com 278
    279. 279. The Next Generation :Straight Wire Appliance There are atleast five reasons –1. Inaccurate bracket placements –a mean of .34 mm error in vertical plane and 5.54˚ for angular placement is observed - Balut et.al2. Variations in tooth structure3. Variations www.indiandentalacademy.com in ant –post and vertical jaw www.indiandentalacad relations require variations in the position emy.com of the max and mand incisors. 279
    280. 280. The Next Generation :StraightWire Appliance4. Need for overcorrection5. Mechanical deficiencies of the edgewise appliance –force application away from CRes. -play between arch wire and slot. -force diminution. www.indiandentalacademy.com www.indiandentalacad emy.com 280
    281. 281. The Next Generation :StraightWire Appliance THE SLOT MACHINE www.indiandentalacademy.com www.indiandentalacad emy.com 281
    282. 282. The Next Generation :StraightWire Appliance www.indiandentalacademy.com www.indiandentalacad emy.com 282
    283. 283. The Next Generation :StraightWire Appliance Advanced Preadjusted Appliance Fabrication Torque –with the use of an incisor Torque Template (Creekmore Enterprises ). Tip -can be adjusted taking in consideration the anchorage requirement . Rotations- rotations can be accurately measured by using rotational guides www.indiandentalacademy.com www.indiandentalacad emy.com 283
    284. 284. The Next Generation :StraightWire ApplianceHeight – more precise height measurements are possible All this requires proper planning of individual tooth movement so as to determine exact amount of torque ,tip , rotation www.indiandentalacademy.com and height parameter for each tooth www.indiandentalacad emy.com 284
    285. 285. The Elan and Orthos System This was introduced by Craig Andreiko These are two appliance system that represent the first modern CAD/CAM technology for appliance design in orthodontic field. www.indiandentalacademy.com www.indiandentalacad emy.com 285
    286. 286. The Elan and Orthos SystemElan is first system to integrate treatmentplan and appliance for a specific patient.Elan system begins with digitizing theskeletal and dental entity of the patient .The system then proceeds to design anocclusion based on the practitionerstreatment plan and on algorithmsdeveloped to mate the three dimensionalpositioningwww.indiandentalacademy.com of the dentition to the skeletalframework.www.indiandentalacad emy.com 286
    287. 287. The Elan and Orthos System Base on all these the system designs and fabricate brackets ,wires and bracket positioning devices that are essentially reversed engineered from the desired final results for that individual patient . Begin with the end in mind www.indiandentalacademy.com www.indiandentalacad emy.com 287
    288. 288. The Elan and Orthos System Mandibular brackets are place as occlusally as possible for hygiene and assuring clearance from the buccal cusp Maxillary bracket are placed fairly central due to absence of interference . Currently the system is available only in the twin www.indiandentalacademy.com bracket configuration with both 018 and www.indiandentalacad 022 . emy.com 288
    289. 289. The Elan and Orthos System Advantages –1. Highly individualized treatment .2. More efficient.3. Fewer appointments .4. Allows the operator to spend more time on designing treatment plans and less time bending wires . www.indiandentalacademy.com www.indiandentalacad emy.com 289
    290. 290. The Elan and Orthos System Orthos system is a new average prescription and appliance design based on computer analysis of more than 100 cases derived from the Elan technology. It consist of a coordinated system of www.indiandentalacademy.com brackets www.indiandentalacad ,buccal tubes and wires . emy.com 290
    291. 291. The Elan and Orthos System Prescriptions incorporated in the appliance design are meant for a particular race . Asian version of orthos will soon be available . Although there are many differences most significant are in the mandibular posterior teeth andwww.indiandentalacademy.com maxillary anterior teeth. www.indiandentalacad emy.com 291
    292. 292. Evolution of Brackets Based OnMaterials www.indiandentalacademy.com www.indiandentalacad emy.com 292
    293. 293. Angles Era Initially all the attachments were made in noble metals and their alloys - - gold (75%) -platinum -iridium -silver www.indiandentalacademy.com www.indiandentalacad emy.com 293
    294. 294. Angles Era Advantage –1. Esthetically pleasing2. Corrosion resistant. Disadvantages –1. Lack of flexibility www.indiandentalacademy.com2. Tensile strength. www.indiandentalacad emy.com 294
    295. 295. Angles Era In 1887 Angle tried replacing the noble metals with German silver Angle later varied its composition –so that it could be used – Jack Screw -Traction Screw www.indiandentalacademy.comStainless steel replaced all these materialswww.indiandentalacad emy.com 295
    296. 296. Metal Brackets Advantages of the metal brackets -1. Excellent strength.2. Friction .3. Smooth surface finish. Disadvantages of the metal brackets –1. Corrosion2. Biocompatibility www.indiandentalacademy.com3. Esthetics www.indiandentalacad emy.com 296
    297. 297. Plastic brackets With the introduction of new materials like polycarbonates and polysulfones it was possible to manufacture esthetic brackets Advantage –1. Esthetically acceptable www.indiandentalacademy.com when compared to steel. www.indiandentalacad emy.com 297
    298. 298. Plastic brackets Disadvantages-1. Staining and discoloration.2. Poor dimensional stability (lack the strength to resist distortion and breakage).3. Undue friction between the bracket slot and the wire made sliding mechanics difficult. www.indiandentalacademy.com www.indiandentalacad4. Need for compatible bonding resin. emy.com 298
    299. 299. Plastic bracketsTo some of the disadvantages plastic bracketswith metal inserts were introduced www.indiandentalacademy.com www.indiandentalacad emy.com 299
    300. 300. Ceramic brackets These were introduced in early 1980’s. Earlier brackets were opaque and bulky By the end of the decade – high purity alumina was introduced which made these brackets clear as compared to earlier ones. www.indiandentalacademy.com www.indiandentalacad emy.com 300
    301. 301. Ceramic brackets www.indiandentalacademy.com www.indiandentalacad emy.com 301
    302. 302. Ceramic brackets Advantages of ceramic bracket over plastic-1. Stain resistant,2. Durable3. Good dimension stability.4. Custom molded for individual teeth.5. Allowed incorporation of the SWA featurewww.indiandentalacademy.com www.indiandentalacad emy.com 302
    303. 303. Ceramic brackets Earlier ceramic brackets were made of alumina-1. Brittle –fracture was common . www.indiandentalacademy.com Rounded www.indiandentalacad was given and smooth design emy.com 303
    304. 304. Ceramic brackets Later Zirconia brackets were introduced -- Surface hardening treatment was done- Lower Youngs modulus- Higher overall strength Disadvantage – increase coefficient of friction. www.indiandentalacademy.com www.indiandentalacad emy.com 304
    305. 305. Ceramic bracketsPolycrystalline alumina-American ,Dentarum Signature,Rocky MtnPCA with metal slot- Unitek ,ClarityMonocystalline alumina-A Co,Starfire www.indiandentalacademy.comPolycrystalline Zirconia- Yamura,Toray www.indiandentalacad emy.com 305
    306. 306. Ceramic brackets www.indiandentalacademy.com www.indiandentalacad Ceramic Bracket With Metal Insert emy.com 306
    307. 307. Ceramic brackets Disadvantage-1. Fracture .2. Hardness .3. Bulkier .4. High friction .5. Enamel damage at the time of removal. www.indiandentalacademy.com www.indiandentalacad emy.com 307
    308. 308. Composite Bracket Two or more polymers These have properties medium between those of the constituents so maerials should be so chosen that the property of one constituent improves the deficient property of others www.indiandentalacademy.com www.indiandentalacad emy.com 308
    309. 309. Composite Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 309
    310. 310. Composite Bracket www.indiandentalacademy.com www.indiandentalacad emy.com 310

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