This document discusses fixed orthodontic appliances. It notes that fixed appliances are attached directly to teeth and can precisely control multiple tooth movements, including rotations, intrusions and extrusions. While fixed appliances provide better control than removable appliances, they require more strict oral hygiene and are more difficult for the patient. Fixed appliances are indicated when complex tooth movement is needed and require a motivated patient and operator training. Factors like patient compliance, oral health, malocclusion severity and operator skill must be considered.

1. Dr Pramathesh Khisa
&
Dr K M Abdullah Al Harun
Lecturer
Dental Unit, SOMC, Bangladesh

2.  Appliances are fixed to the teeth
 Control of tooth movements
 Fixed appliances can produce any type of tooth
movement.
 By applying certain controlled forces to the tooth
crown via the fixed appliance
 apical and
 bodily movements, as well as
 rotations,
 intrusion and
 extrusion of teeth are also possible.

3. Precise tooth control is possible
Multiple tooth movements are possible
Less dependent on patient’s cooperation

4.  Oral hygiène maintenance becomes more
difficult.
 Poor Esthetics
 Special training for operator is a must to
achieve acceptable results.
 Fixed orthodontic appliances are costly as
compared to removable appliances.

5.  Increased chair side time
 Anchorage control is more difficult as
compared to removable appliances
 Long-term monitoring is essential to achieve
stable results

6.  Fixed orthodontic appliances are indicated
whenever multiple tooth movement is
required, e.g.
 intrusion,
 derotation,
 controlled space closure at extraction sites,
 bodily movement,
 extrusion or
 torque control, etc.

7.  Poorly motivated patient: The patient should understand that
his/her cooperation will be required throughout treatment. The
patient’s responsibility is not limited to maintaining good oral
hygiene but will also involve wearing elastics and/or headgear
and keeping appointments at regular intervals, etc.
 Poor dental health : A patient, who does not maintain oral
hygiene routinely, cannot be expected to maintain the stringent
oral hygiene procedures required with fixed appliances in place.
Careful consideration should be given to the patient’s periodontal
status as well. Patients with poor oral hygiene are more likely to
suffer from periodontal diseases.

8.  Malocclusions beyond the scope of fixed orthodontic
appliances: Malocclusions that are skeletal in nature or otherwise
beyond the scope of orthodontics should not be attempted. If the
patient refuses surgical intervention as part of an orthodontic
treatment plan, he should be properly counseled regarding its
necessity rather than proposing compromises and not achieving
stable results.
 Appropriate training of operator: Only orthodontists are
qualified to impart treatment using the fixed orthodontic
appliances. Care should be taken by students of dentistry, to only
attempt something, which is within the preview of their
curriculum and should not try behaving as orthodontists without
undertaking proper training from a recognized institution.

9.  Active components
 These include components which are capable
of generating tooth moving forces. These
include:
 a. Separators
 b. Archwires
 c. Elastics
 d. Elastomerics
 e. Springs

10.  Bands
 Brackets
 Buccal tubes
 Lingual attachments
 Lingual buttons
 Lock pins
 Ligature wires

12. Components of fixed
appliances
Active
components
Seperators
Metal Elastic
Arch
wires
Elastics Springs
Passive
components
Brackets Bands
Accessorie
s
Lockpin
s
Ligiatue
r wire
Lingual
Attachment
s
Molar
tube

13.  Brass wire
 Ring
 Dumbbell
 Kesling’s

16. • SS
• Ni-Ti
• Optiflex
• Beta titanium
• Cobalt chromium nickel

17.  Intercanine width narrowest
 Indication
 Narrow arch
 Gingival arch
 Single arch treatment

18.  Broard arch
 Buccal uprighting
and expansio of
posterior
 Maintain expansion

19.  Most preferred
 Good stability
 Minimum relapse

20. Rectangular Round

21.  Round
 Rectangular

26.  Long
 Medium
 Continuous/closed

41.  Alignment and leveling
 Overbite reduction
 Overjet reduction and space closure
 Final tooth positioning

42. Separator Holding Plier

43. Molar Band Pusher

44. Molar Band Seater

48. Mathieu needle holder

56. Thank You