Fixed appliances are devices attached to teeth that cannot be removed by the patient and are used to precisely move teeth. They are indicated when multiple tooth movements are needed. Components include active items like separators, archwires, and elastics, and passive items like brackets, bands, and molar tubes. Separators create space for banding. Archwires apply force in various planes. Bands are used for teeth requiring heavy forces or multiple attachments. Brackets connect teeth to archwires. Molar tubes house archwires and connect to headgear. Early appliances included E-Arches, pin-and-tube, and ribbon arches. Edgewise appliances provided better control but required complex bends. Contemporary appliances

3. DEFINITION
Fixed Appliances are devices or
equipments that are attached to the
teeth , cannot be removed by the
patient and are capable of causing
tooth movement.

4. INDICATIONS
Fixed Appliances are indicated when precise
tooth movements are required
 Correction of mild to moderate skeletal discrepancies
 Intrusion/ Extrusion of teeh

Correction of rotation
 Overbite reduction by intrusion of incisors
 Multiple tooth movements required in one arch
 Active closure of spaces: extraction spaces/hypodontia

6. Components of fixed appliances
Active components
Seperators
metal
Arch wires
elastic
Passive components
Elastics
Springs
Brackets
Bands
Lockpins
Accessories
Molar tube
Ligiature
wire
modules

9. SEPARTORS
 Seperators are used to create space
for banding teeth
 Tight proximal contacts does not
allow proper banding of teeth
PRINCIPLE:
 It is a device to wedge the teeth in
place B/w the teeth
TYPES Metal seperators
Elastic seperators

10. ARCHWIRES
• Ideal Properties

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




Springback
Stiffness
Formability
Resilience
Biocompatibilty
Joinability
Frictional characteristics

11. Materials
•
•
•
•
•
Stainless steel/ Cobalt chromium
Precious metal
Nickel-Titanium
Beta-Titanium
Composite Plastics

12. BANDS
Bands are thin strips of stainless steel which are adapted to
the contours of the tooth to which attachments are welded
or soldered
TYPES :
1. Preformed
1. Molar Bands
2. Custom made
2.Premolars
3.Incisors

14. BRACKETS
The force required for orthodontic tooth movement is
transmitted from the active components through the
bracket.

15. MOLAR TUBE
Accessory Archwire
Slot
Main
Archwire Slot
Headgear
tube

17. BANDS FOR
ATTACHMENTS.
BONDED
ATTACHMENTS.

18. Indications for Banding
• Teeth that will receive heavy intermittent
forces against the attachments.
• Teeth that will require both labial and
lingual attachments.
• Teeth with short clinical crowns.
• Teeth with extensive restorations.

19. STEPS IN BANDING
1.SEPERATION
2.FITTING BANDS
3. CEMENTATION

20. BONDED ATTACHMENTS
• Mechanical locking of an adhesive to irregularities in the
enamel surface of the tooth and to mechanical locks
formed in base of the 0rthodontic attachment.
COMPONENTS OF THE SYSTEM :
1. Tooth surface and its preperation.
2. The design of the attachment base.
3. Bonding material itself

21. Armamentarium

22. Direct Bonding
1. Cleaning
2.Acid etching
3.A small amount of bonding agent is
squeezed into the mesh on the back of the
bracket , and it is pressed to place on the
tooth surface.

23. 4.Excess bonded material is removed from
around the bracket
5.For light cured materials, a cordless light
is used to activate the adhesive bonding
process
6.The bracket is bonded in place.

24. Indirect Bonding
1.Brackets are placed precisely on a cast
of the teeth and held in place with a
fitted resin
2.After the brackets are cured in the ideal
position, a transfer tray is formed and
placed on the working cast.
3 The trays are removed from the working
cast after soaking in warm water and
trimmed.

25. 4. The teeth are isolated , etched,
and a chemically cured two
paste resin is painted on the
etched enamel and brackets.
5. After the resin has completely
set , the trays are carefully
removed , leaving the brackets
bonded to the teeth.

26. ACCURACY IN PLACEMENT!

27. Debanding/Debonding

28. RULES!!!!!!
 Bonded attachements are almost always preferred for anterior
teeth and premolars .
 Bands usually are preferred for first molars , especially if both buccal
and lingual attachments are needed.
 Second molars are bonded if exposure of crown allows it , banded if
not.
 There is an increasing trend towards bonded attachments on all the
teeth ,however, especially in older patients who have longer clinical
crown and tighter contacts .

30. E-Arch (Angles first appliance)
Pin and tube appliance
Edge wise appliance by Angle
Preadjusted edgewise appliance
by lawrence Andrews
Ribbon arch appliance by Angle
Modified Ribbon arch by
Raymond begg
Tip edge appliances by peter Kesling

32. E-Arch
Pin and
tube
Ribbon
Arch
Edgewise

33. 3.Ribbon Arch
1.E-Arch
 Only heavy interrupted forces
 Only tipping movements achieved
 Unable to precisely position any individual
tooth
2.Pin and Tube
 Overcome the drawbacks of E-Arch
 Incredible degree of craftsmanship was involved in
constructing and adjusting the pin and tube
appliance
 Impractical clinically
 Only Angle’s and one of his students ever
mastered this appliance
 Heavy base arch meant that the spring qualities
were poor
 Many small adjustments needed
 Archwire was small enough to have good spring
qualities and efficiently aligned malposed teeth
 Major weakness of the appliance was that it provided
relatively poor control of root position
 Resiliency of the ribbon archwire did not allow
generation of moments necessary to torque roots to a
new position
 Incisogingival and buccolingual tooth movements
were possible but mesiodistal tooth movements could
not be achieved
4.Edgewise




Ability to move teeth in all 3 planes of space
Good control over tooth movement
Bodily movement possible
Precise finishing possible

34. Bends
1st order
2nd order
3rd order

36. Disadvantages of Angle’s edgewise
appliance
• Heavy forces required Complex
wire bending
• Increased friction
• Extraoral forces for anchorage
required
• Difficulty in opening deep bites

37. TWEED’S MODIFICATION OF EDGEWISE
• Advocated extraction of teeth in selected cases
for better stability
• Tweed moved the teeth bodily and used the
subdivision approach for anchorage control, first
sliding the canines distally the arch wire and then
retracting the incisors

38. BEGG’S APPLIANCE
• Modified ribbon arch technique and
introduced the Begg’s light wire
differential force technique
• Concluded extraction of teeth was
necessary and set out to adapt ribbon
arch appliance so that it
could be used for better root positioning
control.

39. • Begg’s adaptation took 3 forms:
1. Replaced precious metal wire with high strength 16 mil stainless steel
2. Retained the original ribbon arch bracket but turned it upside down so that the
bracket slot pointed gingivally rather than occlusally
3. He added auxillary springs to the appliance for the control of root position
• Resulting in reduced friction as the area of contact between the narrow ribbon
arch bracket and the archwire was very small and the force of the wire was also
small
• Begg’s strategy for anchorage control was tipping/uprighting

40. LABIOLINGUAL, TWIN WIRE
• First half of the 20th century, Labiolingual appliance & Twinwire appliance
were major competing appliances for repositioning teeth
• Bands on first molars and a combination of heavy lingual and labial
archwires to which fingersprings were soldered to move individual teeth
 Labiolingual appliance

41. • Twin wire appliance used bands on incisors as well as
molars and featured twin 10mil steel archwires for
alignment of the incisor teeth.
• Delicate wires were protected with long tubes that
extended forward from the molars to the vicinity of
canines.
• None of these appliances were capable of more than
tipping

42. CONTEMPORARY EDGEWISE
• Major steps in evolution of edgewise include :
 Automatic rotational control
 Alteration in Bracket Slot
Dimensions
 Straight Wire Prescriptions

43. EDGEWISE TECHNIQUE IN WIRE
BENDING
PURPOSE
COMPENSATION
First Order/In and Out bends
To compensate for difference in
thickness of labial surfaces of individual
teeth
Compensated by built-in variation in
thickness of bracket base
Second Order/ Tip back bends
Required for mesiodistal root positioning Compensated by angulating bracket base
or bracket slot
Third Order/ Torque bends
Required to compensate for the
difference in inclination of facial surface
to the true vertical
Bracket slots are inclined to preadjusted
appliances to compensate for third order
bends

44. Bends
1st order
2nd order
3rd order

48. SELF LIGATING
BRACKETS
‘’A bracket which
utilizes a
permanently
installed , movable
component to
entrap the arch
wire.’’

49. INDIVIDUALLY CUSTOMIZED BRACKETS
 Offer the prospect of eliminating almost
all archwire wire bending.
 3D scan is taken of a dental cast
 The information is used to precisely cut
each bracket using CAD/CAM technology
, so that slot for each bracket has the
appropriate thickness, inclination and
torque needed for ideal positioning of the
tooth and archwires with an arch form
established for that patient are supplied.

50. ARCH FORM AND ARCH WIRE FABRICATION

51. WIRE BENDING ROBOTS

52. ANY QUESTIONS???