Tip edge (2)

TIP EDGE
CONCEPTS & APPLICATIONS
www.indiandentalacademy.com

INTRODUCTION
 Improved bracket designs, materials &
techniques
 Evolution & hybridization of Past & Present
technology
 Integration of Begg, Edgewise & PEA—
TipEdge

 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

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

 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

 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

 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

 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

 1986 – A bracket system was developed that
combined the previously mentioned
characteristics
 TipEdge Appliance & Differential Straight
Arch Technique
 By Peter Kesling with Andrew Hogg

 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

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

 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.

 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.

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.

 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.

Appliances:
Tip Edge brackets.
Molar tubes.
Archwires.
Elastics.
Elastomerics.-
 Elastomeric ties,
 E-chains,
 Tip – Edge rings.

Auxiliaries.
 Rotating springs.
 Sidewinder or conv. uprighting spring.
 Torque bars.
 TRT.
 Power pins.
 Crimpable hooks.
 Outrigger appliance.

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

 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.

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.

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.

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

 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.

 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

 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

 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

 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

 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 archwww.indiandentalacademy.com

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

 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

 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

 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

 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 wirewww.indiandentalacademy.com

 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

 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

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

 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

 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

 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

 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

 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

 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

 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 correctionswww.indiandentalacademy.com

 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

 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 mesiallywww.indiandentalacademy.com

 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

 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

 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 & LIwww.indiandentalacademy.com

 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

 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

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.

 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.

Tip edge (2)

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