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1. The Edgewise
appliance-evolution &
technique

2. Contents :-
Evolution / Historical perspective
1) Bandelette appliance
2) Angle’s E–arch
3) Pin &Tube appliance
4)Ribbon arch appliance
5) Edgewise appliance
Attachments
Modification of edgewise brackets
Evolution of buccal tube

3. Bracket placement &angulation
Evolution of the technique
-Primary edgewise
-Secondary edgewise
-Tertiary edgewise
Ideal arch form
Three orders of tooth movement
Tweed’s philosophy of treatment
Anchorage preparation
Aims & goals of treatment
Diagnostic facial triangle
Growth trends
General plan of treatment
Merrifield’s modification

4. Evolution of appliance
First attempt at tooth movement in1728 by a French
physician Pierre Fauchard
Bandalette appliance-crude alignment of teeth by
expansion of the dental arches
Disadvantage : lacked stability
no effective means of firmly fixing it in position

5. 1841-Schange introduced screw force
1849-Dwinelle developed jack screw
1871-Magil introduced dental cements to attach
bands on teeth
1866-Kingsley advocated the use of extraoral
forces
No attempt was made to correct malocclusion by
placing teeth in a stable soft tissue environment
Angle believed that teeth when moved into their correct
occlusal relationship,stability would be assumed

6. The E arch
appliance(1880)
First typical orthodontic fixed
appliance
Rigid framework –Molar bands with
heavy labial arch wire soldered
to them,
Teeth tied to it by means of brass
ligature wire
Crown movement & simple
anchorage
Teeth were expanded into normal
occlusion

7. 4 different designs:
 Basic E-arch
 Ribbed E-arch
 E-arch without threaded ends that fit into molar
sheaths ,used with an attached ball for high pull head
gear in the incisor area
 E-arch with hooks for intermaxillary elastics
Also had a maxillo mandibular growth
guidance
Disadvantages :1) correction of axial inclination could
not be accomplished
2)long term retention was required

9. The Pin &Tube
appliance(1912)
Ideal arch of E-arch was not
there
Arches were altered as tooth
movement carried out
progressing towards ideal
archform
Bands with tubes soldered on it
Pins soldered on the archwire &
made to fit into tube perfectly
Change position of pin ,solder it
again on archwire to a
different position & fit into the
tube again
Disadvantage:difficult to solder
& unsolder pins
time consuming

10. Ribbon arch appliance
(1915)
To overcome disadvantage of
pin & tube
Brackets with vertical slot
introduced
Archwire initially confirmed to
malocclusion ,held in place
by brass pins
Rectangular wire with longer
dimension vertical
Overcame 2 major problems:
1) archwire placement
2) M-D movement of
teeth
Teeth were free to move along
the archwire like strings of
beads

11. Teeth could tip M-D ,even with lockpins
Angle devised cleats to be soldered to archwire to
contact the sides of the bracket
Held the teeth upright ,but necessitates soldering new
cleats at different locations
Disadvantage:-relatively poor root control
-mesial & distal tipping bends could not
be incorporated
- enmass movement of teeth in an antero-
posterior direction was not easy

12. The Edgewise
appliance(1925)
Solution to all problems –latest &
best in orthodontic mechanism
Changed the form of bracket
located the slot in the center
& placed it in a horizontal
plane instead of a vertical
Bracket wide mesio-distally
Rectangular slot for rectangular
archwire
.022x.028 slot size ,Same size wire
Archwire inserted in narrowest
dimension -EDGEWISE
Initially called open face or tie
brackets
Archwire held with brass ligature &
S-S ligature later

13. Accessories used in edgewise

14. Types of headgear used:-
High pull :- intrusion of maxillary incisors
increase the lingual root torque
used with cl.II elastics
Intermediate pull headgear :- distalise maxillary
dentition when bite is not deep
hold the maxilla during anchorage
preparation
Low pull headgear :- open bite case
support mandibular dental arch in
older patients
The Kloehn cervical gear:- growth trend is type A or C
restricting the maxillary growth so that
mandible can catch up

15. Angle "malocclusion must be treated s.t.the
denture is a self-sustaining ,self maintaining
unit and all parts of denture exerting or
sustaining forces must be perfectly balanced”
1) fully normal proximal contact relations of
teeth
2) normal cusp & inclined plane relation
3) normal upright axial position & relation of
teeth
this is essential if the teeth are to balance
with the muscles & sustain the forces of
occlusion

16. Angle introduced the bracket 2 yrs.before his
death
Proposed nonextraction treatment for all
malocclusion
Expansion of the dentition –method of teeth
alignment
Muscular balance was upset,teeth were moved
to an unstable positions-------high frequency
of relapse
Little attention to establishment of anchorage

17. Graduated from an Angle
course given by George
Hahn in 1928
Tweed diagnosed & treated
cases under Angle’s
guidance
He held to Angle’s firm
conviction that one must
never extract - for 3 yrs.
High frequency of relapse –
discouraging
Important observation-
1) facial balance &post
treatment success related to
upright mandibular incisors
2) to get lower incisors
upright ,one must prepare
anchorage & extract teeth

18. His technique can be summarised as an anchorage
technique
While most operators were concentrating on how best
to move teeth ,he focused himself on how not to
move teeth
To a great extent “cart has been placed before the
horse”,Dr Tweed placed the horse where he
belongs ,in front of the cart
Angle gave orthodontics the edgewise bracket ,but
Tweed gave the speciality the appliance

19. Among his other contributions :-
a)Emphasized the four objective of orthodontic treatment with
emphasis & concern for facial esthetics
b)Developed the concept of up righting teeth over basal bone
esp.lower incisors
c)Made the extraction of teeth for treatment acceptable
d)Enhanced the clinical application of cephalometrics
e)Developed the diagnostic facial triangle to make cephalometrics
a diagnostic tool & a guide in treatment & evaluation of results
f)He developed the concepts of orderly treatment procedures
&introduced anchorage preparation as a major step in
treatment
g)He developed a fundamentally sound & consistent preorthodontic
guidance program using & popularizing serial extraction of
primary & permanent teeth

20. Over the years several modifications in the appliance
Angle advocated Non–extraction treatment
Basic concepts which are cornerstones of modern
edgewise orthodontics:-
1)Ability to obtain tooth movement in all 3 planes of
space with a single archwire
2)The philosophy of treating to an ideal arch or to
Angle’s concept of ‘Line of Occlusion’
The line with which ,in form and position according to type,the teeth
must be in harmony if in normal occlusion.
3)The use of rectangular or square edgewise arches
which if properly employed can control arch
width ,arch form ,B-L crown inclinations,axial root
inclinations & incisor crown-root torque

21. Types of head gears
High pull:- Intrusion of maxillary incisors
Increase lingual root torque
Used with cl. II elastics
Intermediate pull:-Distalize maxillary denture when bite
is not deep.
Hold the maxillary arch when using
cl.III elastics during anch.preparation
Low pull:- In open bite cases
To augment anchorage in mandibular arch in
adult patients
The Kloehn cervical gear:-restricting maxillary growth to allow
mandibular growth in growing patients

22. ATTACHMENTS
Evolution of edgewise brackets
Original bracket – soft gold , .
022 x .028 inch slot
1)Single width brackets
original bracket .050 inch
wide & soldered to the gold
band material
archwire rests on bottom of
bracket slot instead of the band
ineffective for tooth rotation
because of the narrow width
Angle devised gold eyelets to
be soldered on bands

23. 2)Twin brackets
- two brackets on one base
-“Siamese twin brackets” by Swain
- space between two brackets was
.050 inch (equal to width of one
bracket )
Main advantage :
- ability to effect tooth
rotations without using
auxiliaries
Available in different widths:-
 Extra wide
 Standard
 Intermediate
 Junior

24. 3)Curved base twin
bracket
curved bases to confirm to
the curvatures of the canines
& premolars
Advantages of twin brackets :
Offers a positive control
Disadvantages:
increased width decreases
the inter bracket span ,thus
decrease the resiliency

25. 4)Lewis bracket
Developed by Lewis in 1950.
To overcome the problem of
efficient tooth rotation.
He soldered auxillary rotation
arms that abutted against
the bracket itself thus,
offered a lever arm to deflect
the archwire & rotate the
tooth.
One piece bracket with integral
rotation wings
These wings do not interfere
with occlusogingival
deflections of archwire & do
not decrease the
interbracket span

26. 5)Curved base Lewis
bracket
Curved base confirms to
the canine ,premolar
surface
Wings lie close to the
tooth throughout their
length ,so less trapping
of food

27. 5)Vertical slot Lewis bracket
Incorporation of .020 x .020 inch vertical slot
Possible to use uprighting spring to correct axial
inclinations if needed
Advantages of Lewis brackets:
1) complete rotational
control
2)do not reduce the
interbracket span

28. Steiner bracket
Given by Cecil C Steiner in 1931
Incorporated flexible rotation arms & so did not rely on
the resiliency of the archwire for tooth rotation
Introduced tie wings for ease of ligation
Broussard bracket
Designed by Garford Broussard
for use in the Broussard
technique
Addition of a 0.0185 x 0.046
inch vertical slot to accept a
doubled 0.018 inch auxillary
wire

29. Evolution of edgewise buccal tube
Original appliance had .022x .028 inch gold or nickel
silver tubing soldered to the molar band
Length –3/16 or ¼ inch
Notched distal ends- to facilitate a tie back ligature
Hook –gingival to buccal tubes ,soldered on the bands
for placement of elastics
Inconel tube- gold buccal tubes were discarded
Stamped buccal tube with welding flanges or
Inconel tube which could be soldered to the band

31. Combination buccal tubes
Incorporates a round tube for
insertion of a face bow
Fairly close tolerances must be
maintained between
archwire & tube for effective
transmission of torque to the
tooth
Triple buccal tube
additional rectangular tube for
auxillary sectional & base
archwire

32. Bracket & tube placement
Angle“goal of correct bracket & tube placement is to
produce an ideal occlusion at the end of treatment
with flat ,straight ,ideal archwires
Tweed advocates – millimeter measurement from
bracket slot to the incisal edge
UPPER ARCH LOWER ARCH
Centrals –4.5 Anteriors-4.0
Laterals –4.0 Canines-4.5
Canines –5.0 Premolars-5.0
Premolars-4.5 Molars-4.0
Molars –3.5

33. Bracket angulation
Brackets –parallel to the long axis of the tooth
Holdaway (1952) described three uses for bracket
angulation
a) as an aid in paralleling roots adjacent to extraction
spaces
b) as a method of setting up posterior anchorage
units into tipped back or anchorage prepared
positions
c) as a means of obtaining correct axial inclinations or
artistic positioning