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TIP EDGE
CONCEPTS & APPLICATIONS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
...
INTRODUCTION
 Improved bracket designs, materials &

techniques
 Evolution & hybridization of Past & Present
technology
...
 TipEdge – Convergent Technology with

Divergent Philosophy
 Overcomes disadvantages & retains advantages
of
Begg & Edge...
History
 1915 – Ribbon Arch Appliance by E.H.Angle

Enmasse movt. not possible
2nd order bends couldn’t be incorporated
P...
 1928 – Edgewise Appliance by E.H.Angle

No provision for pos’r space closure
Restricts a-p correction of dental arches
...
 1933 – Begg Appliance by P.R.Begg

Return to ribbon arch brackets
Uncontrolled tipping
3 dimensional control inadequate
...
 1958 – Edgewise bracket slots angulated by Reed

Holdaway
 1950’s– Torque incorporated in edgewise brackets by
Ivan Lee...
 Overview of the 2 major bracket systems has

helped to define the
Ideal Bracket Requirements Labially facing a/wire slo...
 1986 – A bracket system was developed that

combined the previously mentioned
characteristics
 TipEdge Appliance & Diff...
 Diagonally opposed corners were removed from

PEA slot
 Vertical slot was added
 Bracket used with Differential Force ...
Advantage of Tip Edge over Edgewise.
 Archwire slots open & close.
Ease of archwire changes.
Prevents undesirable couples...
 Facilitates space opening & closing.
 Enables correction of interarch malrelationships

by making use of intermax. anch...
 Easy bite opening as 0.016 wires with anchor

bends are used.
Torquing & uprighting by aux. forces.
stability & molar co...
Adv. Of Tip Edge over Begg.
 Horizontally facing slots facilitate archwire

engagement esp. on rotated teeth.
 Elastomer...
 Limited crown tipping & root uprighting.
20 - 25° of tip edge vs 60° of Begg brackets.
 Programmed differential mechani...
Appliances:
Tip Edge brackets.
Molar tubes.
Archwires.
Elastics.
Elastomerics.

Elastomeric ties,



E-chains,



Tip –...
Auxiliaries.


Rotating springs.



Sidewinder or conv. uprighting spring.



Torque bars.



TRT.



Power pins.


...
Tip Edge brackets.
Modified preadjusted edgewise slot.
ie., diagonally opposed corners removed.
0.022 x 0.028.
Ltd. distal...
 Adv. Of vertical slot.
wire bending.
Aux. placed/ removed without
removing archwire.
Do not interfere with main
mechanic...
Tip & Torque values similar to PEA brackets.
In Cl III non – surgical cases, torque ed.


U/ CI - + 22°.



U/LI - + 17°...
Identifying features.
O on uppers.
on lowers.
/ on PM’s.
Available in single, twin versions.
Deep groves in U/CI bracket...
Molar tube.
3 types.
Round molar tube
with torquing flap.
.036 x.250
After bite opening,
retraction & major
torquing, flap...
 Combination round &

rectangular tube.
Gingival round tube – 0.036
x 0.250
During bite opening lessens
distortion.
Occlu...
 Combination rectangular & flat oval tube

with converting flaps.
When 2nd molars are anchor teeth.
Provide max. molar co...
 Archwires
Initial a/wire
.016 round,high tensile, non-relaxing AJW wire
Necessary for adequate molar control & incisor
i...
 Intermediate a/wire

With the conclusion of Stage 1, wire ceases to
source of tooth moving forces
Assumes role of retain...
 Final a/wire

Rectangular wire - .0215’’x .028’’
Used for finishing
Expresses torque in molars
After uprighting & when r...
 Auxiliaries

Power Pins
Ideal for engagement of elastics/elastomerics
Eliminates need for bracket with integral hooks
Op...
 Bilevel Pins

Capture auxiliary behind tie-wings
Eg. Open coil spring threaded over .016 Sswire
Torquing auxiliary

www....
 Rotating Springs

Same as those used in Begg technique
Easy means rotating teeth without removing
a/wire
Fabricated in ....
 Uprighting Springs

Permits individual tooth uprighting without a/wire
modifications
2 types – Standard
Sidewinder
Both ...
 Sidewinder US

Coil rests on labial surface of bracket
More Aesthetic & Hygienic
Inserted from gingival or incisal
Brack...
 Torquing Auxiliaries – Conventional torq. aux.

Torque bar
Torque bar
Commonly employed
.022’’x.018’’ curved Niti sectio...
 Outrigger Appliance

Encourages elastic wear
Threaded over a/wire without IMH
Features 2 elastic hooks that
Extend labia...
 Elastics & Elastomerics

Intermax. & intramax. elastics, power chains,
elastomeric ties, etc.
Tipedge rings
Designed for...
Technique
 Divided into 3 Stages
 Redn of Stage 1 objectives

Increase in Stage 2 objectives
No change in Stage 3 object...
 Objectives

Alignement of ant’r teeth
Open/Close ant’r bite
Correction of over/underjets
Overcorrction of rotated teeth
...
 Bite opening mechanics

Most important goal of Stage 1
Allows for full expression of mand. growth
in correction of Class...
 If bite is open or edge to edge

Max a/wire is made straight
Mand a/wire is given mild anchor bends
 Proper use of Clas...
 Correction of Over/Under jets

Use of Class II/III elastics
If bite is edge to edge & space is available
Over/Under jet ...
 Alignement of ant’r teeth

Extn trt
Mild crowding cases
Tying e-ligature from canine to a/wire
Moderate to severe crowdi...
 Correction of rotations

By rotation springs
Achieved in 6 weeks
Over corrected rotations held by
Over rotation brackets...
 Stage 2
 Shortest of three stages
 Objectives

Pos’r space closure
Correct/maintain dental midlines
Correct pos’r cros...
 Mechanics & A/wire
 .022 round wire for max control
 Mild bite opening sweeps in U&L/wires
 Mild to moderate anchorag...
 Automatic canine rotational control

Canine rotation doesn’t occur during retraction
Cause pressure is applied at their ...
 Stage 3

Longest stage of DSAT
9-12 months in extn trt
6 months in non-extn trt
Objectives
Achieve final axial inclinati...
 Mesiodistal uprighting & labiolingual torquing-

Forces generated by aux
Uprighting is self limiting
i.e. further uprigh...
 A/wires

.020’’/.022’’ round wire
.0215’’x.028’’ rectangular wire
Round wire approach
Stage 2 wire used
Simplifies trt
I...
 Mild bite opening sweeps placed
 Max a/wire passive
 Mand a/wire expanded 1-2 mm
 Molar offsets placed to eliminate

...
 Rectangular wire approach

More vertical & horizontal control
If engaged prior to uprighting
effective molar torquing oc...
CONCLUSION
 Conventional edgewise slots provide multi-

directional tooth control throughout trt, when
actually such cont...
 Solution to all these problems is a tip edge

archwire slot, because orthodontist now have
an edgewise type bracket that...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Tip edge /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.

Indian dental academy provides dental crown &

Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit

www.indiandentalacademy.com ,or call
0091-9248678078

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Tip edge /certified fixed orthodontic courses by Indian dental academy

  1. 1. TIP EDGE CONCEPTS & APPLICATIONS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. INTRODUCTION  Improved bracket designs, materials & techniques  Evolution & hybridization of Past & Present technology  Integration of Begg, Edgewise & PEA— TipEdge www.indiandentalacademy.com
  3. 3.  TipEdge – Convergent Technology with Divergent Philosophy  Overcomes disadvantages & retains advantages of Begg & Edgewise/PEA  Therefore, it has a cutting edge even over the most widely used system - PEA www.indiandentalacademy.com
  4. 4. History  1915 – Ribbon Arch Appliance by E.H.Angle Enmasse movt. not possible 2nd order bends couldn’t be incorporated PM couldn’t be moved bodily www.indiandentalacademy.com
  5. 5.  1928 – Edgewise Appliance by E.H.Angle No provision for pos’r space closure Restricts a-p correction of dental arches  1930’s – Strang incorporated loops in a/wire for opening & closing pos’r spaces www.indiandentalacademy.com
  6. 6.  1933 – Begg Appliance by P.R.Begg Return to ribbon arch brackets Uncontrolled tipping 3 dimensional control inadequate  1960 – Uprighting spring by P.R.Begg www.indiandentalacademy.com
  7. 7.  1958 – Edgewise bracket slots angulated by Reed Holdaway  1950’s– Torque incorporated in edgewise brackets by Ivan Lee  1961 – Jarabak Light Wire Appliance by Joseph R. Jarabak  1970’s-Fully preadjusted appliance by Lawrence F.Andrews Above & other refinements made major repositioning of teeth & jaws more difficult www.indiandentalacademy.com
  8. 8.  Overview of the 2 major bracket systems has helped to define the Ideal Bracket Requirements Labially facing a/wire slot  Ease of ligation with elastomeric rings  Permit ltd. crown tipping  Root uprighting & torquing by auxiliaries  3 Dimensional control in finishing stage www.indiandentalacademy.com
  9. 9.  1986 – A bracket system was developed that combined the previously mentioned characteristics  TipEdge Appliance & Differential Straight Arch Technique  By Peter Kesling with Andrew Hogg www.indiandentalacademy.com
  10. 10.  Diagonally opposed corners were removed from PEA slot  Vertical slot was added  Bracket used with Differential Force Light Wire concept Rate of tooth movt. Can be varied by the amt. Of force acting /unit root surface area www.indiandentalacademy.com
  11. 11. Advantage of Tip Edge over Edgewise.  Archwire slots open & close. Ease of archwire changes. Prevents undesirable couples on antr. teeth.  Diminished anchorage bends. Light forces are used – antr. teeth retracted by crown tipping. www.indiandentalacademy.com
  12. 12.  Facilitates space opening & closing.  Enables correction of interarch malrelationships by making use of intermax. anchorage.  vertical control. Permit distal tipping of 6-8 teeth with no flexing of the wire, preventing elongation of incisors. www.indiandentalacademy.com
  13. 13.  Easy bite opening as 0.016 wires with anchor bends are used. Torquing & uprighting by aux. forces. stability & molar control.  Does away with extraoral anchorage.  gingival & root morbidity. www.indiandentalacademy.com
  14. 14. Adv. Of Tip Edge over Begg.  Horizontally facing slots facilitate archwire engagement esp. on rotated teeth.  Elastomeric ties acts as a cushion. patient comfort & bond failure.  In out compensations eliminate need for molar offsets. www.indiandentalacademy.com
  15. 15.  Limited crown tipping & root uprighting. 20 - 25° of tip edge vs 60° of Begg brackets.  Programmed differential mechanics at work. Tip edge br. stops free crown tipping at a predetermined angle, antr. anchorage  mesial movt. of post teeth.  Better finishing due to greater 3 dimensional control.  Teaching & learning made easier due to similarity to edgewise br. www.indiandentalacademy.com
  16. 16. Appliances: Tip Edge brackets. Molar tubes. Archwires. Elastics. Elastomerics. Elastomeric ties,  E-chains,  Tip – Edge rings. www.indiandentalacademy.com
  17. 17. Auxiliaries.  Rotating springs.  Sidewinder or conv. uprighting spring.  Torque bars.  TRT.  Power pins.  Crimpable hooks.  Outrigger appliance. www.indiandentalacademy.com
  18. 18. Tip Edge brackets. Modified preadjusted edgewise slot. ie., diagonally opposed corners removed. 0.022 x 0.028. Ltd. distal tipping of - 20° for all teeth mesial to the extn. site. - 25° for canines. Vertical slot – 0.020 x 0.020” – for aux. www.indiandentalacademy.com
  19. 19.  Adv. Of vertical slot. wire bending. Aux. placed/ removed without removing archwire. Do not interfere with main mechanics of tip edge. Ensure long activation time of aux. www.indiandentalacademy.com
  20. 20. Tip & Torque values similar to PEA brackets. In Cl III non – surgical cases, torque ed.  U/ CI - + 22°.  U/LI - + 17° Similar tip & torque values for 1st & 2nd PM for each arch. Torque of L/ PM - -20°. Brackets can be switched from L to R for clockwise or counterclockwise movt. www.indiandentalacademy.com
  21. 21. Identifying features. O on uppers. on lowers. / on PM’s. Available in single, twin versions. Deep groves in U/CI brackets – torque bar. Lateral extensions – provide rotational control & accept archwire easily. www.indiandentalacademy.com
  22. 22. Molar tube. 3 types. Round molar tube with torquing flap. .036 x.250 After bite opening, retraction & major torquing, flap is folded for finishing with edgewise archwire. www.indiandentalacademy.com
  23. 23.  Combination round & rectangular tube. Gingival round tube – 0.036 x 0.250 During bite opening lessens distortion. Occlusal rect. tube – 0.022x 0.028” , 5.5mm. Same used on PM brackets. Permits levelling before or after space closure. www.indiandentalacademy.com
  24. 24.  Combination rectangular & flat oval tube with converting flaps. When 2nd molars are anchor teeth. Provide max. molar control as they erupt. Converting flaps create 0.036 round tubes. Rect. tube same dimensions. www.indiandentalacademy.com
  25. 25.  Archwires Initial a/wire .016 round,high tensile, non-relaxing AJW wire Necessary for adequate molar control & incisor intrusion Moderate to Severe crowding cases Loops bent into .016 wire Sectional .016 or .018 coaxial wire Sectional .014 or .016 Niti www.indiandentalacademy.com
  26. 26.  Intermediate a/wire With the conclusion of Stage 1, wire ceases to source of tooth moving forces Assumes role of retainers Heavier .020’’ or .022” wire used during Space closure and Root uprighting & torquing stages www.indiandentalacademy.com
  27. 27.  Final a/wire Rectangular wire - .0215’’x .028’’ Used for finishing Expresses torque in molars After uprighting & when retained with tipedge rings, Full expression of tip & torque in all other teeth www.indiandentalacademy.com
  28. 28.  Auxiliaries Power Pins Ideal for engagement of elastics/elastomerics Eliminates need for bracket with integral hooks Optional – inserted or removed from vertical slot at any time with a/wire & ligature in place Low profile head with 15 degree inclination Labially when inserted gingivally Lingually when inserted incisally Can be used on both sides of the arch www.indiandentalacademy.com
  29. 29.  Bilevel Pins Capture auxiliary behind tie-wings Eg. Open coil spring threaded over .016 Sswire Torquing auxiliary www.indiandentalacademy.com
  30. 30.  Rotating Springs Same as those used in Begg technique Easy means rotating teeth without removing a/wire Fabricated in .014 SS Preformed ones available in Clockwise & Counterclockwise versions www.indiandentalacademy.com
  31. 31.  Uprighting Springs Permits individual tooth uprighting without a/wire modifications 2 types – Standard Sidewinder Both fabricated in .014’’ & available in CW & CCW Standard US – Activation coil rests on tip of bracket www.indiandentalacademy.com
  32. 32.  Sidewinder US Coil rests on labial surface of bracket More Aesthetic & Hygienic Inserted from gingival or incisal Bracket must be ligated with O ring On finishing with rectangular wire , Changes role from uprighting to torquing www.indiandentalacademy.com
  33. 33.  Torquing Auxiliaries – Conventional torq. aux. Torque bar Torque bar Commonly employed .022’’x.018’’ curved Niti sectional wire with 30 degree torque Virtually invisible – Placed lingual to a/wire in deep grooves of incisor brackets Can’t be used in ceramic brackets Both aux. used with round wire www.indiandentalacademy.com
  34. 34.  Outrigger Appliance Encourages elastic wear Threaded over a/wire without IMH Features 2 elastic hooks that Extend labially - elastics not worn Swing incisally - elastics are worn Serves as uncomfortable but not painful reminder www.indiandentalacademy.com
  35. 35.  Elastics & Elastomerics Intermax. & intramax. elastics, power chains, elastomeric ties, etc. Tipedge rings Designed for use with tipedge brackets Lingually facing lugs wedge between a/wire & bracket converting Tipedge  PEA With rectangular wires, 3 dimensional control possible Strap across ring enhances wedging force Creates flexible edgewise bracket Locking haemostats are used for placing it www.indiandentalacademy.com
  36. 36. Technique  Divided into 3 Stages  Redn of Stage 1 objectives Increase in Stage 2 objectives No change in Stage 3 objectives  Stage 1 Only stage in which tooth moving forces are generated by a/wires All obj. to be addressed simultaneously www.indiandentalacademy.com
  37. 37.  Objectives Alignement of ant’r teeth Open/Close ant’r bite Correction of over/underjets Overcorrction of rotated teeth Correction of molar relation & pos’r crossbite started; need not be completed before going to Stage 2 www.indiandentalacademy.com
  38. 38.  Bite opening mechanics Most important goal of Stage 1 Allows for full expression of mand. growth in correction of Class II MO .016’’ high tensile wire with bite opening bends PM not bracketed & engaged in Stage 1 Space preserved for pm in non-extn trt Plastic tubing from canine to molar Molar stops www.indiandentalacademy.com
  39. 39.  If bite is open or edge to edge Max a/wire is made straight Mand a/wire is given mild anchor bends  Proper use of Class II elastics in conjunction with high tensile wire will open the severest deep bite  Elastics to be worn 24hrs/day www.indiandentalacademy.com
  40. 40.  Correction of Over/Under jets Use of Class II/III elastics If bite is edge to edge & space is available Over/Under jet corrected by Class I elastics with in the faulty arch Eliminates molar extrusion www.indiandentalacademy.com
  41. 41.  Alignement of ant’r teeth Extn trt Mild crowding cases Tying e-ligature from canine to a/wire Moderate to severe crowding cases Coaxial or Niti aligning aux Nonextn trt Crowding is corrected by looped a/wire www.indiandentalacademy.com
  42. 42.  Correction of rotations By rotation springs Achieved in 6 weeks Over corrected rotations held by Over rotation brackets in incisors Offset bonding in pm & canines www.indiandentalacademy.com
  43. 43.  Stage 2  Shortest of three stages  Objectives Pos’r space closure Correct/maintain dental midlines Correct pos’r crossbites Achieve Class I molar relation Over rotate severely rotated pm’s Level anchor molars if tipped distally Maintain all Stage 1 corrections www.indiandentalacademy.com
  44. 44.  Mechanics & A/wire  .022 round wire for max control  Mild bite opening sweeps in U&L/wires  Mild to moderate anchorage situations A/wire engaged in rectangular tube  Max anchorage situations A/wire inserted in large diameter round tube www.indiandentalacademy.com
  45. 45.  Automatic canine rotational control Canine rotation doesn’t occur during retraction Cause pressure is applied at their contact pts. with LI  Braking Mechanics Employed when abundant space is available to prevent over retraction Side winder springs Heavy horizontal forces Smaller rooted ant’r teeth become a large anchor unit & pos’r teeth move mesially www.indiandentalacademy.com
  46. 46.  Stage 3 Longest stage of DSAT 9-12 months in extn trt 6 months in non-extn trt Objectives Achieve final axial inclination Maintain all corrections www.indiandentalacademy.com
  47. 47.  Mesiodistal uprighting & labiolingual torquing- Forces generated by aux Uprighting is self limiting i.e. further uprighting stops as each tooth reaches its desired m-d inclination Torquing is self limiting only in conjunction with rectangular wires www.indiandentalacademy.com
  48. 48.  A/wires .020’’/.022’’ round wire .0215’’x.028’’ rectangular wire Round wire approach Stage 2 wire used Simplifies trt Indications Severe a-p skeletal discrepancies When there is no need for molar torquing & labiolingual repositioning of canines & LI www.indiandentalacademy.com
  49. 49.  Mild bite opening sweeps placed  Max a/wire passive  Mand a/wire expanded 1-2 mm  Molar offsets placed to eliminate Horizontal play Facilitates rectangular wire engagement  A/wire ends are cinched www.indiandentalacademy.com
  50. 50.  Rectangular wire approach More vertical & horizontal control If engaged prior to uprighting effective molar torquing occurs cause inter bracket span is 100% Indicated when full expression of torque is needed  Combination approach www.indiandentalacademy.com
  51. 51. CONCLUSION  Conventional edgewise slots provide multi- directional tooth control throughout trt, when actually such control is required only during finishing  PEA slots compound this problem.  Majority of edgewwise orthodontist have come to accept these problems as facts of orthodontic life, yet these are only facts of the slot itself. www.indiandentalacademy.com
  52. 52.  Solution to all these problems is a tip edge archwire slot, because orthodontist now have an edgewise type bracket that provides all the advantages to be gained by free crown tipping as well as the final luxury of achieving predetermined tip & torque angles for all teeth.  There fore tooth are treated more kindly than with any other bracket wire combination. www.indiandentalacademy.com
  53. 53. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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