Recent trends in pea

RECENT TRENDS IN
PRE-ADJUSTED EDGEWISE
APPLIANCES (PEA)
Presented by
Dr. Jitendra Raghuwanshi
PG-2nd year
SEMINAR NO -07 DATE 01/06/16

2
 Introduction of PEA
 Shortcoming of Edgewise appliances
 Development of PEA
 Changes or recent bracket
prescriptions
• Andrews prescription
• Roth prescription
• MBT prescription
 Recent philosophy or systems in PEA
• MBT system
• Butterfly system
• Damon system
CONTENTS

3
 Recent arch wires used in PEA
 Self ligating brackets
 Recent mechanics used in PEA
 Conclusion
CONTENTS

4
Angle (1927) suggested angulating the bracket to
free the archwire from second order bends.
Holdaway (1952) overangulated the brackets
adjacent to the extraction site for second order
correction.
Development of pre-adjusted edgewise
appliances

5
Jarabak (1957) incorporated slot inclination in the brackets and
recommended bracket angulation.
Stifter (1958) introduced bracket with three dimensional control.
Brackets had male and female parts.
The female part was attached to the tooth.The male part was
altered according to the various combinations of inclination,
angulation and crown prominence.
appliances

What are the design
shortcomings of non
programmed appliance?
5-Jun-166

• PERPENDICULAR BASES
• The base of the nonprogrammed bracket is
perpendicular to the faciolingual axis of its
stem.
5-Jun-167
Designs shortcomings in edgewise
appliance

Bases not contoured occlusogingivally
5-Jun-168
appliance

Slots are not angulated
90°
5-Jun-169
appliance

• Maxillary molar offset not built –in.
The mesiobuccal cusp of each optimally positioned
maxillary molar is more facially prominent than the
distobuccal cusp.
10˚
5-Jun-1610
appliance

11
Lawrence Andrews was credited with the scientific development
of the concept and mechanotherapy of the preadjusted
appliance.(1971)
The Preadjusted, Preangulated appliance was based on the
concept that,
 The bracket bases would accurately fit each tooth at a
predetermined point,
 The bracket slots would passively accept a straight wire.
appliances

12
This original straight wire appliance was a Hybrid Twin
Edgewise appliance with built in tip, torque and in –out values,
to achieve the six keys of normal occlusion.
Later many straight wire techniques were introduced which
were modifications of Andrew`s concept of Straight wire
technique
appliances

13
Changing or recent trends in PEA
BRACKET PRESCRIPTION
Tip, Torque, Rotation,

In Andrew’s Original System:1971
Concerning the 1st order information: There is no
antirotation system on any tooth, except a 10° distal
offset on upper molars.
Changes in bracket prescription
Rotation,

Concerning the 2nd order information: Teeth of the
buccal segments all present a positive angulation,
meaning that they all have a mesial crown tip, mostly
for the 1st and 2nd upper molars.
ANDREWS = Tip

Concerning the 3rd order information:
On the upper arch:
- The upper incisor has only a 7° torque
- The upper canine has a negative torque of –7, equal to
the torque of the biscuspids.
- The torque if slightly greater on molars.
On the Lower arch:
- The torque on the buccal segments
is progressive from the canines
to the 2nd molars.
ANDREWS = Torque

In 1974, Ronold Roth:
Based on anticipation of relapse during and after
treatment came up with his fully programmed
universal appliance.
Thus he systematically included the information for
over correction in all three planes of space.
ROTH = Tip, Torque, Rotation,

Concerning the 1st order information: All teeth in the buccal
segment have anti rotation system.
 Upper molars reinforce distal offset from 10° to 14° and
lower molars 4° anti-rotation
ROTH = Rotation,

Concerning the 2nd order information : Canine
angulation increased to 11°to 13° Maxillary buccal
segment lose their mesial tip and are in more anchorage
situation.
ROTH = Tip

Concerning 3rd order information:
• The torque on the upper incisors is increased by 5°
• Torque on the upper canines decreased by 5°
• Torque is markedly greater on molars. (-14° instead
of -9°)
ROTH = Torque

Concerning 3rd order information:
On the lower arch :
- Torque on the buccal segments stays identical to
Andrew’s except for a decrease from 35° to 30° on the
second molar which decreases the “rolling effect”
(lingual tip) sometimes noticed with Andrews’ torque.
ROTH = Torque

-Combination of Andrew’s and Roth with few changes
- Anti rotation system was removed, all the mesial tip has been
removed.
-Upper incisors have markedly increased torque of 17 ° and 10 °
and upper canine -7 ° torque.
-The torque on the lower incisors increase to -6 °
McLAUGHLIN AND BENNETT (1975-1997)

Richard P cLaughlin
John C ennett
Hugo J Trevisi 5-Jun-1624

MBT
TM
brackets
Ovoid archwire
selection
Light forces and
sliding mechanics
Bracket positioned with
the help of gauges
MBT
TM
brackets Ovoid / tapered /square
archwire selection
Updated Light forces
and sliding mechanics
Bracket positioned with
the help of gauges
5-Jun-1625

RANGE OF BRACKETS
TORQUE IN BASE
IN-OUT SPECIFICATION
TIP SPECIFICATION
TORQUE SPECIFICATION
VERSATILE BRACKET SYSTEM
5-Jun-1626

Range Of Brackets
• Unitek™ Full-Sized Twin Bracket
• This provides the greatest degree of control; it holds a key
advantage when treating patients with larger teeth, difficult
malocclusions and in cases which are prone to breakage.
STANDARD SIZE
METAL BRACKET
MID-SIZE METAL
BRACKET
ESTHETIC BRACKETS
5-Jun-1627

• Victory Series™ Bracket
• This mid-size bracket delivers a superb
combination of comfort, control and
aesthetics.
• It is ideal in cases with smaller teeth and
minimal to moderate degrees of difficulty.
Range Of Brackets
STANDARD SIZE
METAL BRACKET
MID-SIZE METAL
BRACKET
ESTHETIC BRACKETS
5-Jun-1628

• Clarity™ Bracket
• For those patient who desire the greatest degree of
,
• Clarity ceramic brackets blend nicely against the tooth
surface for a more refined look.
• The metal slot allows for better sliding mechanics.
Range Of Brackets
STANDARD SIZE
METAL BRACKET
MID-SIZE METAL
BRACKET
ESTHETIC BRACKETS
5-Jun-1629

• The original rectangular shape of the standard metal
SWA has been supersheded by the rhomboidal form.
• Reduces the bulk of each bracket.
• Allows reference lines in both the horizontal and the
vertical planes, thereby assisting in accuracy of bracket
placement.
5-Jun-1630
McLAUGHLIN AND BENNETT
RHOMBOIDAL SHAPE

5-Jun-1632
TORQUE IN BASE

Upper anterior tip Lower Anterior tip
canine Lateral
incisor
Central
incisor
Canine Lateral
incisor
Central
incisor
Andrews
Norms
8.4 8.0 3.6 2.5 0.4 0.5
Original SWA 11 9 5 5 2 2
MBT TM 8 8 4 3 0 0
5-Jun-1633
TIP- SPECIFICATION

Upper premolar tip Lower premolar tip
2nd premolar 1st premolar 2nd premolar 1st premolar
Andrews
norms
2.8 2.7 1.5 1.3
Original SWA 2 2 2 2
MBT
TM
0 0 2 2
SWA tip
MBT tip
5-Jun-1634

Upper molar tip Lower molar tip
2nd molar 1st molar 2nd molar 1st molar
Andrews
norms
0.4 5.7 2.9 2.0
Original SWA 5 5 2 2
MBT
TM
0 0 0 0
5-Jun-1635

Torque is not efficiently expressed.
The area of torque expression is small and depends on twist
effect of a relatively small wire.
5-Jun-1637

Upper incisor torque Lower incisor torque
Lateral incisor Central incisor Lateral incisor Central incisor
Original
SWA 3 7 -1 -1
MBT
TM
10 17 -6 -6
• Greater palatal root torque in upper incisors
• Greater labial root torque in the lower incisors
5-Jun-1639

U: Central incisor U: Lateral incisor
The most common torque need for the upper incisors
during orthodontic treatment is increased palatal root
torque. This torque tends to be lost during the stages of
overjet reduction and space closure.
5-Jun-1640

The most common torque need for the lower incisors
is labial root torque to bring them into a more upright
position.
This is because they tend to be inclined labially due to
elimination of crowding, leveling of the curve of Spee,
and the use of Class II mechanics elastics.
5-Jun-1641

Upper canine
torque
Lower canine
torque
Original SWA
-7 -11
MBT
TM
-7 -6
Upper canine torque appeared to be satisfactory
-11
0
torque in lower canine (SWA) tends to leave
roots in more prominent.
5-Jun-1642

Upper premolar
torque
Lower premolar
torque
2nd premolar 1st premolar 2nd premolar 1st premolar
Original SWA -7 -7 -22 -17
MBT
TM
-7 -7 -17 -12
• Upper premolar value proved to be satisfactory.
• Lower premolars : lingual crown torque decreased
in MBT
TM
5-Jun-1643

Upper molar
torque
Lower molar
torque
2nd molar 1st molar 2nd molar 1st
molar
Original SWA -9 --9 -35 -30
MBT
TM
-14 -14 -10 -20
• Increasing the buccal root torque in the upper molars
reduces the possibility of palatal cusp interferences.
SWA torque MBT torque
5-Jun-1644

The Butterfly System
• Introduced by Dr. Bowman S.J ,
JCO 2004.
5-Jun-1645

The Butterfly System
JCO 2004.
5-Jun-1646
“In 1996, the American Board of Orthodontics
reported on the common mistakes found in case
reports failing Phase III examination. As some type
of preadjusted appliance was often used, some
shortcomings of existing straightwire concepts may
warrant improvements.”

- Reduced profile
- Miniature twin wing
- Rounded tie wings
- Comfortable, esthetic
& hygienic
- Vertical slot 5-Jun-1647
BUTTER FLY SYSTEM
BRACKET FEATURES

MAXILLARY ANDREWS BUTTERFLY OFFSET
Central incisors 5 5
Lateral incisors 9 9
Canines 11 9
First premolars 2 0
Second premolars 2 3
First molars 5 -6
Second molars 5 -
5-Jun-16 48
BUTTER FLY SYSTEM
MAXILLARY TIP

MANDIBULAR ANDREWS BUTTERFLY OFFSET
Canines 5 6 3 distal
First premolars 2 0
First molars 2 -6
Second molars 2 -
5-Jun-16 49
BUTTER FLY SYSTEM
MANDIBULAR TIP

0-degree+3-degree
-3-degree
NON-EXTRACTION
1ST PM-EXTRACTION
2ND PM-EXTRACTION
BUTTER FLY SYSTEM

- 60 distal tip on molars helps compensate for the difference on
marginal ridge heights ( as in Ricketts & Alexander
prescriptions)
5-Jun-1651
BUTTER FLY SYSTEM
ANGULATED FIRST MOLAR TUBE

-reduces distal crown tipping & root
convergence, also improving the stability –
5-Jun-1652
BUTTER FLY SYSTEM
PROGRESSIVE MANDIBULAR ANTERIOR TIP
TENT POSTING

MAXILLARY ANDREWS BUTTERFLY
Central incisors +7 +14
Lateral incisors +3 + 8
Canines -7 0
First premolars -7 -7
Second premolars -7 -8
First molars -9 -14
Second molars -9 -14
5-Jun-16 53
BUTTER FLY SYSTEM
MAXILLARY TORQUE

MANDIBULAR
Central incisors -1 -5 & -10
Lateral incisors -1 -5 & -10
Canines -11 -3
First molars -30 -10
5-Jun-16 54
BUTTER FLY SYSTEM
MANDIBULAR TORQUE

- 50 lingual crown torque resists incisor flaring
inherent in leveling mechanics (Al-Qabandi AJO-
DO 1999)
- Optional -100 torque can be used to counteract
labial flaring from classII elastics / fixed functional
appliances
5-Jun-1655
BUTTER FLY SYSTEM
PREVENTIVE MANDIBULAR ANTERIOR
TORQUE

• Sondhi indicated that more upper incisor torque is
required for class II div 2 cases .
• But author suggest 14 degree of torque is sufficient
for such cases, treated with maxillary molar
distalization , and fixed functional appliances.
5-Jun-1656
BUTTER FLY SYSTEM
CONSERVATIVE ANTERIOR TORQUE

-140 in the upper & -
100 in the lower
molars improves
buccolingual
occlusion.
5-Jun-1657
BUTTER FLY SYSTEM
PROGRESSIVE POSTERIOR TORQUE

Versatile-Vertical slot
• T-Pins
• Vertical or sling tie
• U-turn rotating springs
• Compliance spring
• Power arm
• Begg uprighting spring
5-Jun-1658
BUTTER FLY SYSTEM
BRACKET DESIGN

The maximum retention bonding pads on Butterfly
System brackets have photoetched pockets beneath the
mesh to enhance bond strength.
5-Jun-1659
BR
AC
KE
T
PR
ES
CRI
PTI
ON
S
BUTTER FLY SYSTEM
BONDING PAD ENHANCEMENT

• The Butterfly system was developed in an attempt to
overcome the case completion errors documented by
the American Board of Orthodontics.
• The intent was to take the best from the past while
avoiding common problems, thus producing more
efficient treatment to the patients.
5-Jun-1660
BUTTER FLY SYSTEM

Sondhi
Signature treatment system
5-Jun-1661

• Use of 3D graphic analysis allows the clinician to test the efficacy of
any prescription before applying it on to the patient.
• Through this any prescription can be analysed in a more objective
manner.
5-Jun-1662
SONDHI SYSTEM
TESTING A PRESCRIPTION

• The Mini Uni-Twin is 30% smaller in
occlusal/gingival height than Uni-Twin bracket, yet
maintains width in the mesial/distal dimension.
• Mini Uni-Twin brackets provide approximately 50%
more interbracket distance than ordinary twin
brackets.
5-Jun-1663
SONDHI SYSTEM
MINI-UNI-TWIN BRACKET.

MAXILLARY ANDREWS SONDHI
Canines 11 10
First premolars 2 0
First molars 5 0
Second molars 5 0
MANDIBULAR
Canines 5 6
First premolars 2 0
First molars 2 0
Second molars 2 6
5-Jun-1664
SONDHI SYSTEM
TIP IN BRACKET.

MAXILLARY ANDREWS SONDHI
Central incisors +7 +22
Lateral incisors +3 +14
Canines -7 +3
First molars -9 -14
MANDIBULAR
Central incisors -1 -1
Lateral incisors -1 -1
Canines -11 -7
First molars -30 -25
5-Jun-1665
SONDHI SYSTEM
TORQUE IN BRACKET.

Recent trends in
Orthodontic arch wires

• Aesthetics has become an important and integral part
of the orthodontic treatment.
• With the invention of revolutionary aesthetic brackets,
the need for the aesthetic wires became very strong.
ADVANCEMENT IN ARCH WIRE
AESTHETIC WIRES

AESTHETIC WIRES
The first esthetic transparent nonmetallic orthodontic
wire contained
• a silica core,
• a silicone resin middle layer,
• a stain-resistant nylon outer layer
marketed as Optiflex by Ormco.(1992)

• Teflon coating imparts to the wire a hue which is
similar to that of natural teeth.
• The coating is applied by an atomic process that
forms a layer of about 20-25 μm thickness on the
wire.
• This layer then undergoes a heating process and
acquires a surface with excellent sliding properties
and substrate adhesion
TEFLON COATED S.S. WIRES

• It is noted that Teflon coating protects the underlying
wire from the corrosion process.
• However, since this coating is subject to flaws that
may occur during clinical use, corrosion of the
underlying wire is likely to take place after its
prolonged use in the oral cavity.
TEFLON COATED S.S. WIRES

Developed by TP Orthodontics.
Timolium archwires combine the flexibility, continuous
force and springback of nickel titanium with the high
stiffness and bendability of stainless steel wire.
TIMOLIUM WIRES

When compared to Nickel Titanium or Beta Titanium
wire, Timolium outperforms in the following:
• More resistant to breakage,
• smoother for reduced friction,
• brightly polished and aesthetically pleasing,
• Nickel free for sensitive patients,
• Easier to bend and shape, can be welded.
TIMOLIUM WIRES

• Bioforce archwires’ are one arch wires introduced
by GAC
• BioForce is aesthetic and is part of the first and only
family of biologically correct archwires.
ADVANCEMENT IN ARCH WIRES
BIOFORCE WIRES

• The concept was first described by Dr. Miura of Japan.
• His idea was that if one starts with a “cold alloy” and
then heat treats it under controlled conditions, the
stiffness of the resulting arch wire will be related to the
length of its heat treatment.
BIOFORCE WIRES

• The NiTi BioForce wires apply low, gentle forces to
the anteriors and increasingly stronger forces
across the posteriors until plateauing at the
molars.
BioForce arch wires have the unique property of
delivering remarkably accurate and biologically
correct forces, to optimally move the teeth of
different parts of the dental arch.
BIOFORCE WIRES

• Optiflex is a non metallic orthodontic arch wire
designed by Dr. Talass and manufactured by
Ormco.
• It has got unique mechanical properties with a
highly aesthetic appearance made of clear optical
fiber.
OPTIFLEX WIRES

It comprises of 3 layers.
A. A silicon dioxide core that provides the force for
moving tooth.
B. A silicon resin middle layer that protects the core
form moisture and adds strength.
C. A strain resistant nylon outer layer that prevents
damage to the wire and further increases strength.
OPTIFLEX WIRES

 It the most aesthetic orthodontic archwire.
 It is completely stain resistant, and will not stain or loose its
clear look even after several weeks in mouth.
 It is effective in moving teeth using light continuous force
 Optiflex is very flexible , it has an extremely wide range of
actions,
 Due to superior properties optiflex can be used with any
bracket system
OPTIFLEX WIRES
Advantages

• Marsenol is a tooth coloured nickel titanium wire .
• It is an elastomeric poly tetra fluroethyl emulsion(PTFE) coated
nickel titanium.
• It exhibits all the same working characteristics of an uncoated
super elastic Nickel titanium wire. The coating adheres, to wire
and remains flexible.
• The wire delivers constant force on long periods of activation
and is fracture resistant.
MARSENOL (Glenroe technology)

• Manufactured by LEE pharmaceutical.
• It is resistant stainless steel or Nickel titanium
archwire bonded to a tooth colored epoxy coating.
• Suitable for use with ceramic and plastic brackets.
• The epoxy coating is completely opaque does not chip,
peel, scratch or discolor.
LEE WHITE WIRES

• Organic polymer retainer wire made from 1.6mm diameter round
polytheline terephthalate.
• This material can be bent with a plier, but will return to its original
shape if it is not heat–treated for a few seconds at temperature less
than 230°C(melting point).
ORGANIC POLYMER WIRE
Patients who have worn aesthetic ceramic or plastic brackets
during orthodontic treatment are likely to want aesthetic
retainers after treatment, so these wires are used for aesthetic
maxillary retainers.

• Excellent combination of high elastic
recovery, high tensile strength and
low weight.
• Excellent formability
• Allow for tailoring of flexural and torsional properties.
• Excellent aesthetics because of their translucency.
FIBRE REINFORCED COMPOSITE WIRES

• Ability to directly bond attachments to these wires,
• Eliminating the need for soldering and electrical
resistance welding
• Such wires can also be directly bonded to teeth,
obviating the need for brackets (i.e. When anchorage
from a large number of teeth is required)
FIBRE REINFORCED COMPOSITE WIRES

85
• Orthodontic brackets have been modified in several
ways to decrease frictional resistance and
improve the efficiency of sliding mechanics.
• These changes initially focused on bracket
width, interbracket distance and ligation
technique.
LIGATION IN PEA

• Self ligating brackets: are ligature less bracket
systems that have a mechanical device built into
the bracket to close off the edgewise slot
(cacciafesta et al., 2003)
• Self ligating brackets: is defined as a bracket,
which utilizes a permanently installed, moveable
component to entrap the archwire.
86
SELF LIGATING BRACKETS

• The self ligating bracket was introduced to create
a “friction free” enviroment with the belief that it
will allow for better sliding mechanics; as the teeth
move more rapidly, treatment time is decreased.
87

• The basic premise of the self ligating bracket is that
the closing or opening mechanism of the bracket turns
the bracket slot into the tube that passively or actively
contains the wire.
• In the absence of ligature wire or elastomeric ties
88
Reduced
friction
Faster tooth
movement

ACTIVE SELF LIGATING BRACKETS
Active self ligating brackets have a spring clip to
entrap the archwire.
This spring clip constrain the arch wire in the slot and
has the ability to restore and subsequently release
energy through elastic deflection thus imparting a light
continuous force on the tooth resulting in a precise and
controlled tooth movement eg. Speed brackets.

PASSIVE SELF LIGATING BRACKETS
Passive self ligating brackets have a slide that can be
closed which does not encroach on the slot lumen, thus
exerting no active force on the archwire.
Tooth control is determined solely by the fit between
bracket slot and archwire.
Eg: Damon brackets.

 The Russell attachment, was developed by Dr. Jacob
Stolzenberg in early 1930,s
 A flat-head screw seated snugly in a circular threaded
opening in the face of the bracket
 The horizontal screw could be loosened or tightened
91
FIRST- SELF LIGATING BRACKETS

It is an Active Self ligating
Bracket described by Dr.
Hanson in the year 1973.
Components of SPEED Bracket
• Bracket body
• Spring clip
• In-out adaptor
• Mesh pad
•Mushroom hook 92
SPEED BRACKETS

• Designed by Dr. Wolfgang Heiser, the Time
bracket is similar in appearance to the SPEED
bracket but its design and mode of action are
significantly different.
• The Time bracket features a rigid, curved arm
that wraps occlusogingivally around the
labial aspect of the bracket body
93
Time brackets- 1995

• A special instrument is used to pivot the arm
gingivally into the slot-open position or occlusally
into the slot-closed position.
• The stiffness of the bracket arm prevents any
substantial interaction with the archwire, thereby
rendering Time a passive bracket.
94
Time brackets- 1995

• Dr. Dwight Damon . Introduced Damon SL 1 and
Damon SL 2 in 1997 and 1999.
• The Damon SL I and the Damon SL II are both
edgewise twin brackets;
95
Damon brackets

• The difference between these two generations is that
the first featured a labial cover that straddled the tie
wings, while the second incorporates a flat,
rectangular slide between the tie wings
96
Damon brackets

97
Damon brackets
• In both versions, the slide moves incisally on the
maxillary brackets and gingivally on the
mandibular brackets.
• Special opening and closing pliers are required to
move the slide.
• Both the Damon SL I and the Damon SL II form
rectangular edgewise tubes by means of a solid
outer wall.

• The Damon philosophy is based on the principle of
using just enough force to initiate tooth movement .
• The underlying principle behind the threshold force is
that it must be low enough to prevent occluding the
blood vessels in PDL to allow the cells and
necessary biochemical messengers to be
transported to the site where bone resorption and
apposition will occur and thus permit tooth movement
98
DAMON PHILOSOPHY

• Very low levels of static and dynamic friction
• Rigid ligation due to the positive closure of the slot by
the gate or slide .
• Control of tooth position because there is an edgewise
slot of adequate width and depth .
Extended intervals between treatment visits
99
DAMON PHILOSOPHY
Key features

It is a self-ligating bracket system consisting of a twin
bracket for rotational control and has an “active” clip
for seating an arch wire
100
In-ovation brackets

The bracket design not only combines all the important
features of an effective self- ligating system, it goes even
further to provide the highest level of versatility, function
and comfort
101
In-ovation brackets

First Translucent Self
Ligating Bracket
Strong,Fiberglass reinforced
composite polymer
Cap can be removed and place
back again
102
FIRST- SELF LIGATING BRACKETS
Oyster brackets-2004

Mushroom hook for elastic
attachment
Disadvantage
• Poor Dimensional Stability
• Staining nature
103
Oyster brackets

• Smart clip is mid sized twin bracket
• It consists of 2 Nitinol clips that open and close
through elastic deformation when material exerts
force on the clip.
104
Smart clip

105
Smartclip system shares the same philosophy as MBT
appliance system i.e.:
Maximum versatility
Mid sized twin bracket
Bracket prescription
Use of light forces
It consists of 2 Nitinol clips that open and close
through elastic deformation when material
exerts force on the clip.
Smart clip

• Smart clip system is classified as a passive bracket
system because the archwire works freely within the
bracket slot , without any pressure from the clip onto
the orthodontic archwire.
106
Smart clip

107
Smart clip

• Mesh bonding base
• The bracket body
• A pair of clips
108
Smart clip- PARTS

109
RECENT MECHANICS USED IN PEA

110
Light wire auxiliaries with pre-adjusted
edgewise appliance to control individual
incisor torque
APOS Trends in Orthodontics January 2015, Vol 5, Issue 1
Sharanya Sabrish, Sadashiva Shetty , Prakash AT

111
Light wire auxiliaries with pre-adjusted edgewise appliance
to control individual incisor torque
Torque control of individual incisors using pre-
adjusted edgewise (PAE) appliance is a common
clinical challenge.
To overcome the inherent disadvantages of the PAE
appliance in efficiency of torque delivery.
The use of light wire auxiliaries for early control of the
roots of the instanding tooth in the alignment stage.

112
For the alignment of 42 which was lingually
displaced, and to bring it into the arch by bodily
displacement rather than labial tipping, a LIght
wire auxiliary (Mollenhauer aligning auxiliary)
was used in conjunction with PAE appliance

113
After getting the space for alignment of 42, the MAA was made
using 0.009” Supreme Australian wire as per the technique by
Mollenhauer and engaged on the lower arch before engaging the
main arch wire by tying it to individual brackets

114
The inter-box wire segment on either side of 42 was made longer than
the other interbox segments so that it could be deflected lingually to
engage 42.
The base arch wire during engagement of MAA was 0.016 × 0.022 SS
so that there would be no detrimental effects on the arch form.
Once engaged the MAA did not need monthly reactivations. After 3
months another MAA was constructed and used for another 3 months.

115
When the MAA is pulled open and tied to the lower incisor bracket
a couple is generated,
• Incisal part of the box applying a lingual force on the tooth
• Gingival part of the box applying a labial force on the tooth.
This couple causes labial root torque with respect to 42
BIO-MECHANICS

116
ADVANTAGES OF MAA
 Biomechanically more efficient for torque delivery than
conventional PAE techniques.
 No need to step down the wire since it generates the labial
force itself.
 In upper arch, use of MAA in cases of instanding incisors
eliminates the need to reverse the bracket to get a labial root
torque.
 Eliminates the need to make individual torque bends in the
archwires, use of torque bars etc.

117
Incisor Retraction
with a Compressed Open-Coil Spring
Volume xlviii number 10 © 2014 JCO,
Alexei Petrov, Aram Davidyan,

118
Incisor Retraction with a Compressed Open-Coil Spring
Measure a round .016" or .018" nickel titanium
archwire to extend just beyond self-ligating tubes
bonded to the terminal molars of the upper arch.
Thread two 6-7mm segments of nickel titanium open-
coil spring onto the wire. After heat treating the wire
ends and bending end stops, place small beads of light-
cured composite over the bends.

119
Compress the coil springs, and ligate the archwire with
the coils immediately distal to the molar tubes.
The compressed coils will push the archwire posteriorly,
thus retracting the incisors usually with only one
archwire activation.

120
The patient shown here, presenting with spaced and
protrusive incisors, was treated in 12 weeks with this
simple technique.

121
YIN YANG WIRE FOR CANT CORRECTION
ERIC LIOU

122
YIN YAN WIRE FOR CANT CORRECTION
ERIC LIOU
Taiji line ( yin and yang lines) as the name suggests, is
named by the traditional Chinese Tai Chi, which is mainly
representational graphic in the middle of the arc.
Dr. Eric j liou proposed this approach in the current context
of Orthodontics to correct or resolved the occlusal plane
skew (occlusal canting).

123
Material of yin-yang wire
1) 0.016 x 0.022 SSW
2) 0.017 x 0.025 B-Ti wire (beta-Ti)

124
FABRICATION
1. A pair of wire
2. Bending a 110 degree V-bend in the midline
3. Bend a upward hook distal to canine
110 degree V-bend
in the midline
and
Helix

125
Bending an upward hook
distal to canine.
RANGE OF ACTION:
FIRST PREMOLAR to FIRST PREMOLAR

126
Mechanism = Always oppsite of thinking
Extrusion ~~ Intrusion
(seemingly extrusion,
in fact, intrusion)
Intrusion ~~ Extrusion
(seemingly intrusion,
in fact, extrusion)

127

128
Torque and Intrusion Control of the
Upper Incisors with
Modified Posted Archwire
JCO march 2015 ,Volume xlix number 3
Redento Peretta, Luis Huanca Ghislanzoni

129
Torque and Intrusion Control of the Upper Incisors with
Redento Peretta ,Luis Huanca Ghislanzoni,
Controlling the vertical position and torque of the
maxillary incisors is a particular concern when
correcting an excessive overjet,with
• Class II mechanics (elastics)
• Space closure after extraction

130
Redento Peretta ,Luis Huanca Ghislanzoni,
Doubling the torque values of bracket prescriptions
can control the 3rd-order expression of the maxillary
incisors, but will have no effect on their vertical
positions.
A simple way to control both intrusion and torque of
the maxillary incisors by modified posted archwire.

131
They use .022" × .028" brackets and an .019“ × .025" stainless
steel archwire with posted hooks.
The key to this system is that, to introduce a slight curve of Spee
in the archwire mesial to the first premolars,
A 2nd-order curve in the premolar-canine section of the wire
produces a slight mesial canine crown tip that allows for incisor
intrusion.

132
To prevent uncontrolled flaring and express the torque
primarily as root movement, a stainless steel ligature
wire is twisted and tied between the upper-first-molar
hooks and the posted hooks

133
VERSATILITY of
Vertical Slot in Orthodontic Brackets
MAURO COZZANI, LAURA MAZZOTTA, S. JAY BOWMAN,
DANIEL J. RINCHUSE,
VOLUME XLIX NUMBER 9 JCO September 2015

134
VERSATILITY of
Vertical Slot in Orthodontic Brackets
• Uprighting spring
• Rotating spring
• T-pin
• Power arm
• Elastic hook
• V-tie ligation
• Overlay wire

135
Uses of the Vertical Slot in Orthodontic Brackets
Uprighting springs are typically used with V-slot single
brackets or Begg brackets to upright the roots of tipped
teeth.
In the edgewise technique, these springs provide a
reversible and versatile method of controlling
anchorage by increasing resistance to sliding.

136
The uprighting springs are inserted into the canine V-
slots and oriented to produce a mesial component of
force while Class I intra-arch sliding mechanics are
employed.
The same procedure can be used to enhance anterior
anchorage during
molar protraction
for asymmetrical space
closure.7

137
To counteract the mesial mandibular forces and
undesirable labial tipping of lower anterior teeth
produced by Class II elastics or appliances such as the
Herbst or Forsus.

138
Rotating spring
Compliance + spring

139
T-PINS
POWER ARM

140
Stainless steel ligature inserted through V-slot and
looped around archwire (“V-tie”) to direct positioning of
severely displaced teeth.
V-TIE or SLING TIE

141
PASS TECHNIQUE
Physiological Anchorage Spee-wire System
Clinical Application of the PASS Technique, JCO august 2015,
Volume xlix number
Si Chen, Gui Chen, Tianmin Xu,

142
Molar anchorage loss has been shown to occur during the
early stages of alignment with preadjusted appliances.
The most commonly used archwires for initial alignment are
nickel titanium, which cannot accommodate the tipback bends
needed to preserve molar anchorage due to its elasticity.
PASS TECHNIQUE
The Physiological Anchorage Spee-wire System
(PASS)* was designed to optimize natural anchorage
preservation while controlling friction and utilizing the
elasticity of nickel titanium wires for initial alignment.

143
PASS TECHNIQUE
The PASS appliance has two main components:
A crossed buccal tube (XBT) consisting of a −7° main tube and a
−25° tipback tube, crossing at the mesial end of the molar and a
multilevel low-friction (MLF) bracket.

144
In the PASS technique, the initial archwire is inserted into the
tipback tube, generating a protective moment for the anchor
molars from the beginning of treatment.
Engaging the wire into the anterior brackets from the gingival
direction will help maintain the anterior overbite, which is
important in most extraction cases.
PASS TECHNIQUE

145
PASS TECHNIQUE
The double-tube design also facilitates the early use of
a piggyback wire to control the upper-incisor vertical
position during alignment and to promote bite
opening in deep-bite cases

146
Intrusion of Palatally Displaced Maxillary Lateral incisors
Using
Nickel Titanium Closed-Coil Springs
Intrusion of Palatally Displaced Maxillary Lateral Incisors Using Nickel
Titanium Closed-Coil Springs, JCO-april 2015, Volume xlix number 4
Youn-sic Chun, Minji Kim, Sun Ho
Lee,grace Roh

147
Using
YOUN-SIC CHUN,LEE JCO 2015
In patients with maxillary anterior crowding, the
upper lateral incisors are often inclined palatally;
moreover, such incisors are almost always extruded
due to lack of contact with the opposing teeth.
A new spring developed at Ewha Womans University,
called the EW spring, exerts a light, continuous force of
less than 50g.

148
Using
Stainless steel wire segment bonded to upper
central incisor and canine; nickel titanium
closed-coil EW spring bonded to extruded
lateral incisor and to anchor segment.

149
Targeted Mechanics for Limited
Posterior Treatment with Mini-Implant
Anchorage
JCO December 2015, Volume xlix number 12
Zachary T. Librizzi, Nandakumar Janakiraman,
Afsaneh Rangiani, Ravindra Nanda,flavio A. Uribe

150
Targeted Mechanics for Limited Posterior
Treatment with Mini-Implant Anchorage
The rationale for this approach, “targeted mechanics”, is to
maintain the pretreatment buccal occlusion by bypassing these
teeth or indirectly anchoring them from mini implants while
correcting problems in the anterior region. ( eg. Open bite)
Side effects on the posterior teeth are avoided, potentially
reducing overall treatment time.

151
To correct the open bite, a tongue crib would be delivered in
conjunction with a one-couple force system from an extrusion
arch.
An extrusive force of 40g would be exerted on the incisors,
generating an intrusive force and a tip forward moment on the
upper and lower first molars

152
To counteract this side effect, the molars would be indirectly
anchored to miniimplants with the extrusive force directed
slightly labial to the center of resistance of the incisors,
This approach would require no premolar brackets or patient
compliance with elastic wear.

153
Take home message
With the introduction of new materials and
techniques used in this presentation with the sound
knowledge of bio-mechanical principles, we all
have a chance to think out of box and provide
faster treatment to our patient with more comfort.

154
CONCLUSION
• A wide array of materials and newer techniques are used in
our profession,& continuously being introduced. It is
essential to know the scientific basis for the selection &
proper use of recent techniques for successful clinical
practice.
• With the advent of CAD-CAM, and TADS, these provide a
new spark in the versatility of pre-adjusted edgewise
appliances, but although their introduction, we can’t ignore
the basic root of the biomechanical principles.

155
CONCLUSION
• Before implementing any newer technique with PEA, the
clinician should have the sound knowledge of basic
appliance system.
• The development and recent advancement in ligation
techniques and arch wire definitely provide esthetics and
comfortness to the patient but as an Orthodontist we can’t
ignore the mechanical properties of these materials
resulting the compromised treatment results and timing.

156
1. McLaughlin, Bennett, Trivesi, sysetemized orthodontic treatment
mechanics, mosby company, 2001
2. William R. Proffit -Contemporary Orthodontics, 5th edition, Mosby
Company, 2012
3. Graber Thomas M., .Vanarsdall. Jr. Robert L. – Orthodontics, Current
Principles and techniques, 2nd edition, Mosby Company, 1994.
4. Watanabe M, Nakata S, Morishita T. Organic polymer wire for aesthetic
maxillary retainers. J Clin Orthod 1996; 30: 266-71
5. Talass M E .Optiflex archwire treatment of a skeletal Class HI open bite. J
Clin Orthod 1992; 26: 245-52.
6. Krishnan V, Kumar J K . Weld characteristics of orthodontic archwire
materials. Angle Orthod 2004;74:533-38
7. Burstone C.J., Kuhlberg A.J. Fiber-reinforced composites in orthodontics.
JCO 2000; 36: 271-9
REFERENCES

157
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8. Sharanya Sabrish, Sadashiva Shetty , Prakash AT Light wire auxiliaries
with pre-adjusted edgewise appliance to control individual incisor torque,
APOS Trends in Orthodontics January 2015, Vol 5, Issue 1
9. Anjum A, Sharma P, Jain P, Singh J. Recent Advances in Orthodontic
Brackets. J Dent Sci Oral Rehab 2014;5(1):26-29.
10. S. Jay Bowman, Aldo Carano, The Butterfly System, JCO-may 2004,
Volume xxxviii number 5
11. Redento Peretta, Luis Huanca Ghislanzoni,Torque and Intrusion Control
of the Upper Incisors with a Modified Posted Archwire, JCO march 2015
,Volume xlix number 3
12. Youn-sic Chun, Minji Kim, Sun Ho Lee,grace Roh, Intrusion of Palatally
Displaced Maxillary Lateral Incisors Using Nickel Titanium Closed-Coil
Springs, JCO-april 2015, Volume xlix number 4
REFERENCES

158
14. Si Chen, Gui Chen, Tianmin Xu, Clinical Application of the PASS
Technique, JCO august 2015, Volume xlix number
15. Jeffrey L. Berger, The SPEED appliance: A 14-year update on this
unique self-ligating orthodontic mechanism, September 2003,AJO-DO
16. Alexei Petrov, Aram Davidyan, Incisor Retraction with a Compressed
Open-Coil SpringVolume xlviii number 10 © 2014 JCO,
17. Zachary T. Librizzi, Nandakumar Janakiraman, Afsaneh Rangiani,
Ravindra Nanda,flavio A. Uribe,targeted Mechanics for Limited
Posterior Treatment with Mini-Implant Anchorage, JCO December
2015, Volume xlix number 12
REFERENCES

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