Orthodontic brackets are components bonded to teeth that transfer force from archwires to move teeth into proper alignment and function. There are various bracket designs that differ in material, size, shape, and prescription. Andrews developed pre-adjusted edgewise brackets incorporating average tooth angulation, inclination, and rotation values to reduce need for archwire bending. Modern bracket types include self-ligating, ceramic, and lingual systems that offer improved aesthetics, reduced friction, and patient comfort. Proper bracket selection and placement are important for achieving an optimal orthodontic outcome.
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.for more details please visit
www.indiandentalacademy.com
Description :
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Description :
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Intrusion arches /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
00919248678078
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
Andrew’s straight wire appliance /certified fixed orthodontic courses by Indi...Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Edge wise appliance /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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.
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.for more details please visit
www.indiandentalacademy.com
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Indian dental academy
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
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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
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
00919248678078
Comparison of The Roth prescription,Alexander prescription & MBT prescription...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
Fixed appliances and its components 3 /certified fixed orthodontic courses b...Indian dental academy
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
00919248678078
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.for more details please visit
www.indiandentalacademy.com
Intrusion arches /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
00919248678078
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
Andrew’s straight wire appliance /certified fixed orthodontic courses by Indi...Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Edge wise appliance /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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.
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.for more details please visit
www.indiandentalacademy.com
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Indian dental academy
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
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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
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
00919248678078
Comparison of The Roth prescription,Alexander prescription & MBT prescription...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
Fixed appliances and its components 3 /certified fixed orthodontic courses b...Indian dental academy
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
00919248678078
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Prepared by Hisham Pasha N K
ORTHODONTIC TREATMENT ,E-ARCH, EDGEWISE, METALIC BRACKETS, BEGG APPLIANCE(1920), STEPS IN BONDING , etc
A seminar conducted by Dr.Sayyida.N.K @ Government Dental College, Calicut
Description :
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.for more details please visit
www.indiandentalacademy.com
Description :
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Exploring Materials for Orthodontic Mini-Implants: A Comprehensive Overview.pdfsafabasiouny1
A temporary anchorage device (TAD) is a device that is temporarily fixed to bone for the purpose of enhancing orthodontic anchorage either by supporting the teeth of the reactive unit ( indirect anchorage ) or by obviating the need for the reactive unit altogether(direct anchorage), and which is subsequently removed after use.
They can be located transosteally, subperiosteally or endosteally; and they can be fixed to bone either mechanically (cortically stabilized) or biochemecially (osseointegrated). It should also be pointed out that dental implants placed for the ultimate purpose of supporting a prosthesis, regardless of the fact that they may be used for orthodontic anchorage, are not considered temporary anchorage devices since they are not removed and discarded after orthodontic treatment. By using dental implants and temporary anchorage devices for orthodontic purposes we are able to obtain zero anchorage loss.
Currently, several terms are used to refer to skeletal anchorage devices, the most inclusive being temporary anchorage devices. Other names include implants, mini-implants, miniscrews, micro-screws, screws, mini-plates, and plates.
Implants and mini-implants usually necessitate osseointegration for stability, whereas screws, miniscrews and micro-screws are generally loaded immediately after placement and receive their stability from mechanical retention in the bone
Plates are attached to bone through a surgical procedure necessitating the elevation of a flap. A portion is left emerging in the oral cavity to serve as appoint of application of the force system
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.for more details please visit
www.indiandentalacademy.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. Introduction
For all patients, the lower third of the face, and
particularly the teeth are vital for social
communication and acceptance. Orthodontic
treatment aims to position teeth to achieve
optimum aesthetics and function. Over the years
clinicians have considered how bracket design can
achieve this treatment objective
3. At the beginning of the 1970s Andrews defined six keys or characteristics of
a normal occlusion:
the molar relationship;
crown angulation;
crown inclination;
No rotations;
No spaces;
flat curve of spee
4. Andrews described a pre-adjusted orthodontic bracket designed to control tooth
movement in three dimensions, which required fewer bends introduced into the
archwire to manipulate tooth position.
The buccolingual crown thickness, crown angulation and crown inclination of
individual teeth from 120 study models were measured, taken from patients
who had never received orthodontic treatment. These values were averaged and
their values incorporated into a bracket system designed to create the six keys to
occlusion.
5. ORTHODONTIC BRACKET
Orthodontic brackets are
passive components of
fixed orthodontic appliance
,bonded to enamel which
provide the means to
transfer the force applied
by the activated archwire
to the tooth
7. Andrews defines five basic appliance types:
Non –programmed
appliances
• Are a sets of brackets that are the same for all tooth types and which rely totally
on wire bending to obtain optimal tooth position .
Partially programmed
appliance
• Are a sets of brackets designed with some built-in features but which always
require some wire bending .
Fully programmed
appliances
• Are a sets of brackets designed to guide teeth directly to their goal positions with unbent archwire
.
• The generic term is
Pre-adjusted
edgewise
appliances
8. Cont :
Semi-custom appliances
• The term semi-custom appliances is used to describe the
variations from standard Straight-Wire technique, such as
inverting brackets or mixing of brackets from different
prescriptions in order to produce specific tooth movements
to an individual patient's needs .
• These include the BEDDTIOT appliance and the use of
mixed prescription Straight-Wire appliances where the mix
of prescription has tried in part to customize the appliance to
the patient.
9. Custom appliances are a set of brackets designed to match
precisely the unique morphology and guidance needs of a
specific patient .
Custom appliances can be divided into two classes:
A. appliances which have custom prescription but a
standard base and pad E.g.: Insignia
B. Appliances with custom prescriptions, base and pad
E.g.: Incognito
11. Advantages of SWA :
Ease of arch wire placement.
patient comfort due to absence of the wire bending
use of sliding mechanics
precision and finishing
flexibility of biomechanics
multiple bracket design
12. 6- Bracket identification
Bracket identification can be divided into identifying which tooth the
bracket is designed for (arch, quadrant, tooth type)
prescription the bracket has (angulation, inclination and counter-rotation).
• maxillary: cast or indented dot on distogingival tie wing painted dot
on distogingival tie wing.
• mandibular: cast or indented dash on distogingival tie wing painted
dot on distogingival tie wing .
13. Disadvantages of SWA
1. Friction
2. Perceived anchorage demands
3. Technical, biological and mechanical variability still requires
adjustments in the appliance to accommodate this.
Greekmore, 1993 described some reasons why current pre-adjusted
orthodontic appliances do not achieve ideal tooth positions with the use
of "straight" wires:
A. The most frequent reason is inaccurate bracket placement.
B. Variations in the malocclusion require variations in the positions of
maxillary and mandibular incisors.
C. Variations in tooth structure, such as irregular facial surfaces,
crown-root angulations.
14. Some terminology in SWA
1. Bracket base: the most lingual portion of the bracket
stem
2. Slot Base: the lingual wall of the slot.
3. Slot point the centerline of the slot. It is equidistant from
the gingival and occlusal slot walls and is centered
mesiodistally.
4. Slot axis: the line connect slot and base point
5. Bracket Stem: the portion of a bracket between the
bracket base and the slot base.
6. Base Point: it is a point on the bracket base at the
extension of the slot axis.
15. Edgewise brackets have rectangular slots, which are deeper in the
horizontal as opposed to vertical plane.
Slot and archwire dimensions have traditionally been described
with the original dimensions being 0.022 inches vertically and 0.028
inches horizontally to accommodate gold archwires, which were
quite soft.
Once stiffer stainless steel archwires were introduced, slot size
was reduced to 0.018 inches vertically and 0.028 inches horizontally.
However, with greater uptake of preadjusted edgewise systems,
there has been a move back to the original slot dimension.
Slot height and depth
16. Advantage of 022 over 018 slot
It gives lighter forces in the early stages of treatment
Better control of tipping during sliding
Better control of rotation during sliding
Better control of arch width
Multiple wire size selection
18. Types of bracket designs:
Single wing Mini bracket Siamese
Self ligation brackets Tip-edge
19. Single wing brackets :
1- Alexander signature brackets
Wick Alexander uses single wing brackets on canines and bicuspids in the Alexander discipline.
2- Attract brackets :
are a single wing bracket in which the mesiodistal width has been reduced but an attempt made
to maintain rotational control by extending the bracket channel beyond the tie wings.
40% smaller than a conventional twin – and single-wing design.
The brackets are radiussed to make them more comfortable.
more suitable for treating certain types of patients where trauma from the appliance must be
kept to a minimum .
The brackets are poor at controlling rotations on severely malposed teeth .
21. Self-Ligating Brackets
Self-ligating brackets have an in-built metal face, which can be
opened and closed.
Commonly used SL system:
1-Damon SL brackets .
2-Damon 2 3-Damon MX
25. Synergy brackets
Synergy’s manufactured in the metal injection molding
process (MIM) –and the rounded arch slot walls reduce
binding and friction, giving a gentler, more continuous force.
Treatment time is faster.
Synergy’s rounded arch slot floor reduces friction since the
arch wire contacts the floor at only two points.
26. Cont.
Includes 6 wings 3 on each side of bracket slot .
The lateral wings may be included in ligation for correction
of rotation of teeth but only center wings may be ligated
during sliding mechanics to reduce force of ligation
27. Advantages
Reduced Friction
Multiple Ligating Options
Reduced Treatment Time •
Rounded Arch Walls
Rounded Arch Floor
Rounded arch walls allow tangental contact of the arch
wire and flared arch slot openings, thus avoiding binding
as the arch wire enters or exits the arch slot. This feature
also makes it easier to insert the arch wire into the arch slot.
29. Stainless steel brackets
A)composition :
-austenitic ss is given an AISI number (American Iron and steel Institute)
-most brackets are AISI 304 milled
-low numbers have little additional alloy metal and are soft .
-AISI 316 is too hard to be milled .
-AISI 304 composition :Fe 71% ,Ni 8%,Cr18% ,C less than 0.2 %
1- Metal brackets:
30. Types of construction
2-milled (hard)
1- cast (soft) - may distort
on debonding or in deep bite
cases close down reducing
slot size
3-metal injection moulded (MIM)
31. Bracket base
Bracket bases are designed in one of three ways to provide
adequate retention:
a mesh :It consists of irregular microscopic stainless steel particles
fused together and to the bracket base to create network of pores
for a strong adhesive grips which in turn increases the bond
strength .
particles adhered to the bracket base (spheres, rods or similar)
grooves or undercuts placed in the surface of the base
32. (1) Mesh type :
Fine or coarse , fine mesh give highest bond .
(A) Types of mesh :
34. Advantages of metal brackets :
• They can be sterilized
• They can recycled
• they exhibit least friction at wire-bracket interface
• they are not expensive .
• they resist deformation and fracture
Disadvantages:
• Non esthetic .
• Tend to get corrode and cause staining of the teeth
35. Used in allergic pt. to nickel.
in wet conditions, titanium displays a slight adhesive effect.
Titanium is covered with a thin passive surface layer of titanium dioxide called rutile.
The typical composition of
titanium brackets and rutile is as shown in Table
1. Less nickel sensitivity and less release of nickel
2. Harder than stainless steel. “this suggests that cobalt chromium brackets may have less friction
than stainless steel brackets.”
Titanium brackets :
CrCo brackets :
37. Initially constructed from acrylic ,later
polycarbonate and polyurethane metal reinforced
slots .
Problems include staining ,lack of strength
(debonding-/fractures )
Poor abrasion resistance and permanent
deformation reducing torque .
Reinforced with ceramic / fiberglass to improve
performance but problems remain with torque .
Plastic brackets
38. Ceramic brackets :
Ceramics are non –metallic materials which are first shaped and then hardened by
heat .
THE ONLY CURRENT ADVANTAGE OF CERAMIC OVER METAL BRACKETS
IS....AESTHETICS
39. Types of ceramic brackets
Polycrystalline
alumina
• Opaque
• E.g :
transcend
Monocrystalline
alumina
• Very hard and
translucent
• E.g :saffire
Polycrystalline
Zirconia
Metal
Reinforced
Polycrystalline
40. 1. Polycrystalline
Aluminium silicate particles are mixed with a binder and injected into a mould.
The mould is then heated to 1800 degrees C.
Machined with diamond tools, ultrasound or lasers to prepare bracket slot.
Advantages
It can be moulded, therefore can be produced in large quantities and at a low cost.
Disadvantages
Structural imperfections
High friction.
Opaque.
Low fracture toughness.
41. 2. Monocrystalline
1. Machined from synthetic sapphire .
2. Aluminium oxide particles are melted (heated to over 2100 degrees C)
3. Then cooled slowly and then milled
Advantages
1. Less imperfections and impurities,.
2. Clear
3. Lower friction
Disadvantages
1. Expensive
2. Low toughness
42. • Metal reinforced polycrystalline
The most successful ceramic bracket is the Clarity bracket which goes some way
towards addressing some of the problems by incorporating a metal slot to reduce friction
and a weakness in the base to allow easier debonding.
E.g: Clarity
Zirconia:
Opaque
Poor aesthetics .
Similar frictional properties to alumina brackets.
43. Problems with ceramic brackets :
1. Bracket ligation
2. Friction
3. Enamel wear
4. Bond strength and debonding
5. Cost :basically ceramic brackets are EXPENSIVE
44. Ligation
Problems:
i. Metal ligatures are obvious under clear brackets.
ii. Ligatures lockers can fracture the brackets.
Solutions:
Use Teflon coated ligatures or 'white' elastomeric modules..
Self-ligating ceramic brackets (Damon clear)
46. Solutions
Use ceramic brackets with metal lined slots.
Use closing loops rather than sliding mechanics.
Use metal premolar bracket.
Consider the following :
Rectangular AWs > Round
NiTi and TMA > Stainless steel
47. Enamel wear
Ceramic is 7 times harder than enamel.
Solutions
Must not bond teeth where there is an occlusal interference.
Advance the upper incisors before bonding the lowers as in
class II D2 cases.
Rubber ligatures over tie wing slot can preventing contact of
the opposing dentition with the ceramic bracket, are a further
method of reducing the risk of enamel damage (Russell, 2005)
48. Bond strength
. bond strength greatest between bracket and composite, therefore enamel fracture more
likely
Solutions
I. Avoid the use of ceramic bracket in the following scenarios
1. Heavily restored teeth,
2. Thin labial enamel
3. Small teeth,
4. Cracked enamel
I. Addition of certain features to reduce bond strength
Moderate mechanical retention features, grooves etc
Use meal mesh in base (but poor aesthetics)
Reduce silane coupling
Select weaker bonding resin
modify etch (60 seconds - weaker bond than 15 seconds)
49. Enamel fracture and debonding
1. 1- Risk of bracket fracturing and being inhaled, swallowed or flying ceramic fragment missile.
Solutions
Protect eyes by using safety glasses .
Remove excess of the bonding from around the bracket before debonding
Keep a finger over the bracket to prevent it becoming a projectile;
Apply the debonding pliers on the mesial and distal of the bracket;
Main force is squeezing and very gently twist.
Specialised debonding techniques like:
Special debonding pliers
Electro-thermal to soften adhesive prior to debonding
Laser debonding
3M unitek incorporate a stress concentrator at the base of the bracket to make their removal easy.
50. Bracket prescriptions
For all prescriptions, the prominence values (in-out first order
bend) are the same and so the only variables within a prescription
are:
A. Angulation
B. Inclination
C. Offset (counter-rotation)
51. Prominence
Prominence or in/out or first order correction: it is an adjustment built into
the bracket base to compensate for the differing buccolingual thickness of
teeth
Reduces or eliminates the need for first order wire bends .
52. Crown Angulation (tipping) :
Angulation or tip is built into brackets to ensure that teeth are
placed at a specified mesiodistal angulation.
Tip is built into brackets in the Straight-Wire Appliance by
cutting the slot at an angle to the vertical axis of the bracket.
53. Crown inclination (Torque)
Refers to the built –in inclination of the bracket slot to control labiolingual crown (torque) .
. It may be placed in a preadjusted bracket by putting the torque in the face or in its base
of the bracket.
54. Offset (counter-rotation)
Offset (also known as counter-rotation in translation series brackets) is
built into upper buccal tube assemblies, premolar, canine, incisor brackets
and lower molar tubes in translation series prescriptions to counteract the
tendency of teeth to tip into the extraction space during space closure.
This rotational correction tends to rotate teeth mesially anterior to
the extraction site and distally distal to it.
56. The most common prescriptions used seem to be:
Andrews
Roth
MBT.
57. Andrews prescription
Andrews collected 120 non orthodontic models .
He studied these models anatomically and laid down his “six keys normal
occlusion “
he made certain measurements in the non orthodontic models which helped
him in the development of SAW .
His original standard straight wire brackets were designed to treat only non
extraction cases with an ANB differential of less than 5 degree .
58. Andrews prescriptions
Andrews (1989) described different incisor bracket sets for use in
different skeletal patterns:
The Set A bracket set, designed for Class 2 skeletal patterns more less palatal
root torque in the upper incisors to facilitate the establishment of a normal
incisor relationship whereas
Set C for Class 3 skeletal patterns had the reverse.
Set S was for Class 1 malocclusions.
59. Translation (extraction) series brackets
Translation brackets were introduced by Andrews (1989) to compensate for the unwanted
tooth movements that occurred during closure of extraction spaces. These posterior bracket
sets (i.e.: molars, premolars and canines) had increased tip and anti-rotation according to
how much translation of the tooth was expected.
Minimum 0-2mm (T1)
moderate 3-4 (T2)
Maximum 5mm (T3) bracket sets are available.
T4 brackets are molar brackets without the five degrees of tip in the standard
prescription.
The existence of incisor bracket sets and translation brackets shows that Andrews did
not envisage a single appliance and prescription which would be suitable for all
malocclusions.
60.
61. Andrews has recently made minor changes to his prescription
including :
I. the adoption of his original class 3 lower incisor set with -6 degrees
of torque
II. and abandoning the tip on the upper first and second molars.
III. In addition, the torque in the lower first and second
IV. molars has been increased a little which is contrary to the trend seen
in other prescriptions
62. Roth prescriptions
THE ROTH Rx In 1979, Roth introduced a bracket setup containing
modifications of the tip, torque, rotations movement of the Andrews
standard setup brackets.
The purpose of the Roth setup was to provide over corrected tooth positions
prior to appliance removal that would allow the teeth in most instances to
settle to what was found is non orthodontic normals studied by Andrews.
One prescription for all his patients.
The objectives of Roth in his treatment are:
1. Pleasant aesthetic
2. Stability of treatment depends of good functional occlusion.
3. TMJ problem less in good occlusion
63. What made Roth to modify Andrews SW
appliance ?
Inventory problems :
To treat different cases clinicians were to buy band kits for all Andrews sets
and series .they very extensive inventory on the self .
Anchorage loss :
When mesially angulated brackets are placed on the posterior teeth, the teeth
tend to tip mesially and migrate forward that resulted is anchorage loss .
Problem in finishing
To achieve desired tooth positions with the standard SWA, it was necessary to
finish the mechanotherapy phase of treatment by placing compensating and
reverse curve in the upper and lower archwire
64. For these reasons the prescriptions are:
More torque in the upper incisors than Andrews one .
The upper canines have additional tip and less torque while lower canine
has increased tip than in the standard prescription which facilitates canine
guidance as a fundamental for functional occlusion.
The Roth prescription gives more torque in the upper molars to prevent
dropping of the palatal cusps.
Since the prescription is extraction based, there is anti-tip and anti-
rotation built into the buccal segment brackets.
66. MBT
The Bennett-McLaughlin prescription follows the Andrews prescription closely.
MBT™ treatment philosophy is:
A. Bracket design
1. Mid-size metal brackets
2. Rhomboidal shape,
3. Torque in base
4. The .022 not the .018 slot
67. Light continuous forces
Anchorage control early in treatment. This achieved by
1. Light force
2. Reduced tip
3. Laceback :-
restrict canine crowns from tipping
forward during leveling and aligning
4. Bendback :
Prevent labial movement in the anterior teeth
68. A. Aspects of versatility
For upper set of bracket
1.Options for palatally displaced upper lateral incisors (-10°).
2.Three torque options for the upper canines (-7° , 0° , and +7°).
3.Interchangeable upper premolar brackets - the same tip and torque.
4.Use of upper second molar tubes on first molars when HG not used.
5.Three torque options for lower canines (-6° , 0", and +6").
6.Bondable mini second molar tubes for partially erupted teeth
69.
70. For lower set of bracket
1. Interchangeable lower incisor brackets - the same tip and torque.
2. Use of lower second molar tubes for the upper first and second molars of the opposite side, when
finishing cases to a Class II molar relationship. Also the tube is placed at a different tip position,
with more enamel from the mesial cusp visible than from the distal cusp. This introduces the
necessary tip adjustment.
71. 3-Increased maxillary incisors labial crown torque
a. For class II D I:
It may be help in expressing the palatal root torque in undersized wire
It helps to counteract the side effect of functional appliance
It helps to counteract the side effect of class II elastic
help in the reduction of OB by proclining the ULS.
It helps to counteract the effect of retroclination during space closure
B- for class III it help to express the camouflaging effect of ULS
72. 4- Increased lingual crown torque of LLS
a. For class II D I and class II D2
It helps to counteract the side effect of class II elastic by preventing the LLS proclination
It helps to counteract the side effect of functional appliance
a. For class III it help to express the camouflaging effect of LLS
73. 6- Reduced buccal root torque of lower posterior teeth
Provide better intercuspation
Counteract the rolling effect of class II elastic or during space closure in the lower arch
It reduce the chance of gum recession
* The Rolling Effect is the tendency of the archwires to a lateral sliding.
74. 7- Reduced canine tip compared to Roth
To reduce the anchorage demand
There is a variety of canine tip prescription and uses according to the clinical scenarios as follow:
Arch form: in narrow arch use +7 to avoid dehiscence
Canine labio-palatal position: in buccaly positioned canine, better to used +7 to avoid dehiscence
Extraction: if the canine wanted to be retracted distally, use +7 to make the root in the middle of
the canceller’s bone
Expansion: use -7 in the upper
Missing lateral: use +7 in upper
75. Why MBT less anchorage demand
1. Light force
2. The wagon wheel effect: because increasing the torque will cause the mesial tip
of ULS to be reduced and this will reduce the anchorage demands
3. Reduced canine, premolar and molar tip compared to Roth
4. Upper molar 10 degree offset, counteract the unwanted rotational movement
during space closure in the upper arch and this might strengthen the anchorage.
76. Bracket
variations
Various suggestions have been made regarding bracket choice and positioning to
optimize tooth position when teeth are absent or where an attempt is made to overcome a
local problem of tooth position. The aim is to reduce the need for archwire
adjustments or auxiliaries. Careful bracket selection and positioning simplifies the
treatment of localized anomalies in the following situations:
Upper lateral incisor palatally displaced.
absent lateral incisor: space closure.
Class III malocclusions: canine angulation.
absent upper central incisors: space closure.
77. Upper lateral incisor palatally displaced
-A more elegant solution is to fitl upper ateral incisor bracket upside down
Torque ..(MBT=10)..(Roth=8)..(Andrews =3)
78. When maxillary lateral incisors are absent and space closure
is planned, which bracket is best placed on the canine?
One suggestion is to place a lateral incisor bracket on the canine
crown.( Bracket fit creates a further problem as canine crown labial
convexity is greater than that of the lateral incisor ..
solution is to place a lateral incisor bracket after recontouring of the
canine to mimic the lateral incisor.)
- An alternative is to invert the canine bracket on the canine tooth.
Torque :(MBT= -7),,(Roth= -2),,(Andrews= -7)
79. Lower canines angulation in Class III cases
-The answer is to bond contra lateral brackets
- Not only does the adaptation enable dento-alveolar compensation,
it also reduces the anchorage requirements.
80. Absent upper central incisor: space closure
As the lateral moves mesially, its root should move
further mesially than its crown; the mesial surface is
then vertical. This permits the restorative phase to build
up the distal surface with an optimal emergence profile.
This avoids the problem of retention from a
mesiogingival margin on the restoration. It has been
suggested that it is useful to bond the contra-lateral
central incisor bracket to tilt the tooth so its distal crown
aspect approaches vertical.
81. Clinical photograph with absent central incisors. Upper canine
brackets are inverted to provide additional palatal root torque.
The lateral incisor brackets are transposed to achieve improved
root paralleling prior to mesial movement and restorative
build-up