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Materials used in Orthodontics
Dr. Nabil Al-Zubair
THE BEGINNINGS
Teeth were regarded by
the ANCIENTS as:
(Very Precious) to the
extent that:
‘‘. . . special Penalties
[were exacted] for
knocking out the teeth of
an individual, either
freeman or slave.’’
‫القدماء‬
‫العقوبات‬
Greece were:
burying their dead with appliances that were used to
maintain space and prevent collapse of the dentition
during life
As early as 400 BC, Hippocrates :
referenced in his writings
the correction of tooth irregularities
‫دفن‬‫موتاهم‬
In a Roman tomb in Egypt, finds:
a number of teeth bound with a gold wire
at the time of Christ,
Aurelius Cornelius Celsus first records:
the treatment of teeth by finger pressure
‫في‬‫رومانية‬ ‫مقبرة‬
- inherent malocclusions and the
use of corrective forces are
recognized,
- the first orthodontic material is documented—a gold ligature wire
- the virtue of maintaining space
is appreciated, and
Thus,
-‫نجح‬‫تقويم‬ ‫وفى‬ ‫الفكين‬ ‫تشوهات‬ ‫عالج‬ ‫في‬ ‫الزهراوى‬
‫ابتكرها‬ ‫جراحية‬ ‫آالت‬ ‫باستخدام‬ ‫األسنان‬‫خصيصا‬
-‫الزهراوى‬‫الذهبية‬ ‫األسنان‬ ‫جسور‬ ‫استخدم‬ ‫من‬ ‫أول‬
‫والفضية‬‫ضغط‬ ‫وأدوات‬‫األسنان‬
-‫كما‬ ‫لقلعها‬ ‫الكالليب‬ ‫وأستعمل‬ ‫األسنان‬ ‫بطب‬ ‫أهتم‬‫أستعمل‬
‫منها‬ ‫الزائد‬ ‫لنشر‬ ‫المبارد‬
‫القاسم‬ ‫أبو‬‫الزهراوي‬403‫هـ‬/1013‫م‬
In 1887, Edward Angle used:
- Nickelsilver alloys in his
orthodontic accessories.
- Subsequently he replaced them
with copper, nickel and silver-
free zinc alloys.
- Eventually, gold alloys became
his favorite choice
CLASSIFICATION OF ORTHODONTIC MATERIALS
I Classification according to the structure of orthodontic materials
II Classification according to usage
I Classification according to the STRUCTURE of orthodontic materials
Wire alloys
Orthodontic band
Orthodontic brackets
Ceramic brackets
Filler particles in cements
Polycarbonates for brackets
Adhesive resins for bonding
Polyurethane elastomers for tooth
movement
Ceramic materials Polymeric materialsMetallic materials
II Classification according to usage_1
- Gold alloys
- Stainless steel
- Co-Cr-Ni (elgiloy)
- B-titanium
- Nickel –titanium
- Stainless steel
- Titanium
- Plastics
- Polycarbonates
and ceramics
Wire Brackets
Conventional ligatures fluoride
releasing elastomerics
Elastomeric ligature and chains
Ii- Non-metallic with Optiflex
i- Metallic wires
i- Metallic wires
OPTIFLEX ARCHWIRE
 Optiflex is a non metallic
orthodontic arch wire
 It was designed by DR. TALASS
 In the year 1992
and manufactured by Ormco.
Ii- Non-metallic with Optiflex
 It has got unique mechanical
properties with a highly aesthetic
appearance
 Made of clear optical fiber
OPTIFLEX ARCHWIRE
 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 ARCHWIRE
1) It the most aesthetic orthodontic
archwire
2) It is completely stain resistant,
and will not stain or loose its
clear look even after several
weeks in mouth
3) Its effective in moving teeth
using light continuous force
OPTIFLEX ARCHWIRE
4) it is Very flexible ,
5) has an extremely wide range of
actions,
6) when indicated it can be tied with
electrometric ligatures to severely
malaligned teeth without fear of
fracturing the arch wire.
7) Due to superior properties
optiflex can be used with any
bracket system
II Classification according to usage_2
- Chemically cured /
- Light cured
- Thermo-cured
Orthodontic adhesive
composite resin
- Zinc phosphate
- Zinc
polycarbocxylate
- Glass ionomers
- Alginate impression martial
- Brass
- Lock pins
- Mini-implant
MiscellaneousCements
Ideal requirements of these cements are
• Adequate working and setting time
• High strength
• Resistance to dissolution
• Clinically acceptable bond strength
• Anti carcinogenic property
Zinc phosphate cement
Zinc polycarboxylate cement
Glass ionomer
The cements that are widely used for cementation orthodontics bands are:
Cements used in Orthodontics
Orthodontic application of cements are limited to luting of bands and appliances
- Alginate is the most extensively used impression material today
- Irreversible hydrocolloids: used for recording minimum detail; e.g. study models
ALGINATE
1. Easy to manipulate
2. Relatively inexpensive
3. Comfortable for the patient
4. They are hydrophilic
5. Have pleasant taste
6. Long shelf-life
1. tear easily
2. Models should be poured
immediately
3. They have limited detail
reproduction
4. Can retard gypsum setting
DISADVANTAGESADVANTAGES
ALGINATE
Removable vs. Fixed
Two Types of Orthodontic Appliances:
• Bands
• Brackets
• Wires
• Accessory appliances
Fixed appliances
• 24K plating gold bracket
Brackets
• Metal bracket
• Clear Bracket
Brackets
Brackets
Plastic brackets
• Staining and discoloration
• Poor dimensional stability
• Larger friction
Ceramic brackets
Brackets
– Durable, resist staining
– Can be custom-molded
– Dimensionally stable
Advantages over plastic brackets
‫متين‬
Ceramic brackets
Brackets
– Bulkier than metal bracket
– Fractures of brackets
– Friction is bigger than that in metal bracket
– Wear on teeth contacting a bracket
– Enamel damage on debonding
Disadvantages over metal brackets
• Metal-reinforced ceramic bracket
Brackets
Self ligating bracket
Brackets
The negative space between the buccal surface of the maxillary first premolar
and the inner point at which the lips join when the patient smiles.
Buccal Corridor Width ‫عرض‬‫الشدقى‬ ‫الممر‬
• Lingual brackets
Invisible orthodontics?
• Invisalign
• Lingual bracketsInvisible orthodontics?
Step 1:
Visit your
orthodontist
or dentist
Step 2:
Invisalign®
makes your
aligners
Step 3:
You receive
your aligners
in a few
weeks.
Step 4:
You wear
your aligners.
Step 5:
You've
finished
treatment!
Invisalign
Invisalign
 Mild-moderate crowding with IPR or
expansion
 Posterior dental expansion
 Close mild-moderate spacing
Clear aligner therapy (CAT) applicability
CAT performs well:
 Absolute intrusion (1 or 2 teeth only)
 Lower incisor extraction for severe crowding
 Tip molar distally
0.1-0.5 mm in thickness
•Dental expansion for blocked-out teeth
•Extrusion of incisors*
•High canines
•Severe rotations (particularly of round teeth)
•Leveling by relative intrusion
•Molar uprighting (any teeth with large
undercuts)
•Translation of molars*
•Closure of premolar extraction spaces*
CAT does not perform well:
Clear aligner therapy (CAT) applicability
• patients treated with Invisalign RELAPSED more than
those treated with conventional fixed appliances.
Invisalign vs. braces
• Type:
– NiTi wire (Nickel-Titanium wire)
– TMA wires (Titanium-
Molybdenum-Alloy)
– Stainless steel wire
Wires
• Shape
– Round wire
– Rectangular wire
Properties of arch wires
– related to force levels,
rigidity, formability, etc.
• Maintains force over a range of tooth movement
General Characteristics of Orthodontic Forces
• Optimal: light, continuous
– Ideal Material
• Maintains elasticity
1.Cantilever Beam:-
is one whose:
- one end is fixed and the
- other end carries a point or
concentrated load.
2. Simply Supported Beam:-
is one which:
- carries two reaction forces at
its two ends &
- a point load at its mid-point.
Types of Beams
Physical Properties of Orthodontic Wires
‫عند‬،، ‫إنفعال‬ ‫عنه‬ ‫ينتج‬ ‫إجهاد‬ ‫تحت‬ ‫تقع‬ ‫المرنة‬ ‫المواد‬ ‫على‬ ‫معينة‬ ‫بقوى‬ ‫التأثير‬
‫هذا‬‫الشكل‬ ‫فى‬ ‫تغير‬ ‫إلى‬ ‫اإلنفعال‬ ‫هذا‬ ‫يؤدي‬ ‫قد‬ ‫وكذلك‬ ‫بالنقصان‬ ‫أو‬ ‫وحجمها‬ ‫طولها‬ ‫فى‬ ‫بالزيادة‬ ‫إما‬ ‫يكون‬ ‫اإلنفعال‬.
‫اإلنفعال‬ ‫تعريف‬:
‫هو‬‫المؤثرة‬ ‫للقوة‬ ‫المادة‬ ‫إستجابة‬
‫أو‬ ‫الطول‬ ‫فى‬ ً‫ا‬‫تغير‬ ‫يكون‬ ‫فقد‬ ‫عليها‬
‫الشكل‬ ‫أو‬ ‫الحجم‬.
‫اإلنفعال‬ ‫أن‬ ‫القول‬ ‫يمكن‬ ‫آخر‬ ‫بمعنى‬
‫إلى‬ ‫بالنسبة‬ ‫الطول‬ ‫فى‬ ‫التغير‬ ‫هو‬
‫الحجم‬ ‫فى‬ ‫التغير‬ ‫أو‬ ‫األصلى‬ ‫الطول‬
‫األصلى‬ ‫للحجم‬ ‫بالنسبة‬.
‫اإلجهاد‬‫واإلنفعال‬Stress and Strain:
‫اإلجهاد‬ ‫تعريف‬:
‫هو‬‫المؤثرة‬ ‫القوة‬
‫وحدة‬ ‫على‬ ‫عموديا‬
‫المساحة‬
σ = F/A
Stress Strain
Stress
Strain
– Defined by stress-strain response to external load
Materials & Production of Orthodontic Force
• Strain= internal distortion produced
by the load
- deflection/unit length
• Stress= internal distribution of the load
- force/unit area
• Elastic behavior
Yield strength
Ultimate tensile strength
Plastic Region
Stress
Strain
Failure point
Elastic Region
• Measure deflection = strain
- examples:
• Bending
• Twisting
• Change in length
Orthodontic Model: Beam Metal Spanning
• Force applied to a beam = stress
– Stiffness
– Range, springback
– Strength
- Resilience, formability
Beam Properties in Orthodontics
• Defined in force deflection or stress-strain diagrams
• Useful properties:
3. Ultimate tensile (yield) strength
1. Proportional limit
2. Yield strength
• Maximum load wire can sustain
Bending Properties of an Orthodontic Wire
• Point at which
permanent
deformation is
first observed
• Similar to
“elastic limit”
• Point at which 0.1%
deformation occurs
Defined by 3 points
Stress Strain
Proportional limit
Yield strength
Ultimate tensile strength
0.1%
– Young’s modulus
Stiffness of an Orthodontic Wire
Modulus of elasticity (E)
– Slope of load deflection curve
– Stiffness α E
– Springiness α 1/E
Resistance of a body to elastic
deformation caused by an
applied force
- Describes the stiffness or springiness of a wire
‫المرونة‬ ‫معامل‬
‫الجسم‬ ‫مقاومة‬‫الناجم‬ ‫للتشوه‬‫المستخدمة‬ ‫القوة‬ ‫عن‬
Low stiffness leads to:
- an ability to apply lower forces
- a more constant force to be delivered
over time and
- greater ease and accuracy in applying
a given force.
STIFFNESS or LOAD DEFLECTION RATE
more Horizontal, and vice versa
As the springiness (elasticity) of a wire increases,
The slope of the stress -strain curve becomes
Spring back is also referred to as maximum elastic deflection or working range
Decreasing the number of arch wire changes
Higher springback values provide:
The ability to apply large activations
with a resultant increase in working time of
the appliance
SPRINGBACK
thus
• Related to elastic
portion of force deflection
curve (slope)
Stiffness versus Springiness
Springiness= 1/stiffness• Reciprocal relationship
– More horizontal= greater springiness
– More vertical= stiffer
• Range
Distance wire will bend elastically
before permanent deformation
Range versus Springback
• Springback
– Found after wire deflected beyond its
yield point
– Clinically useful
• Wires often deflected past yield point
‫النطاق‬
‫المسافة‬‫شكله‬ ‫فيها‬ ‫الى‬ ‫ويعود‬ ‫السلك‬ ‫ثني‬ ‫يتم‬ ‫التي‬
‫قبل‬ ‫السابق‬‫دائم‬ ‫تشوه‬ ‫حدوث‬
• Strength = stiffness x range
Relationship of Strength, Stiffness & Range
• Resilience
– Area under stress-strain curve to proportional limit
– Represents Energy Storage Capacity
Resilience, Formability
High formability provides:
the ability to bend a wire into desired configurations
such as loops, coils .etc. without fracturing the wire
• Formability
– The amount of permanent
deformation a wire can
withstand before breaking
• Deflection properties:
– High strength
– Low stiffness (usually)
– High range
– High formability
Ideal Orthodontic Wire Material
• Strength = stiffness x range
• Other properties:
– Weldable, solderable
– Reasonable cost
• No one wire meets all criteria!
Wire Materials
– Before 1950’s:
gold alloys, corrosion
resistant
Wire Materials
– 1970’s applied to orthodontics
– Demonstrates exceptional
springiness
• Two special properties: Shape
Memory, Superelasticity
– Improved strength,
springiness
– Corrosion resistant:
chromium
• Typical: 18% chromium,
8% nickel
Nickel-titanium
(NiTi) alloys
Precious metal alloys Stainless steel,
cobalt-chromium (elgiloy®) alloys
Stainless steel alloy:
• In the past:
• the arch wire & springs were
constructed from GOLD or
platinized gold,
• But because these materials are
very expensive; therefore the
stainless steel alloy is used as an
alternative alloy in orthodontic
appliance.
• Alloys: are mixtures of two or more metallic elements.
First and foremost alloys used in orthodontics in forms of wires, bands and brackets
History – The advent of stainless steel
- Stainless steel was introduced into
orthodontic practice in 1929,
when Renfert, a North American
company, began selling wires made
from these alloys, which were
produced by a German company
named Krupp
Stainless Steel Alloys
Properties of Stainless Steel
 Passivation
 Sensitization
 Stabilization
• Composition: Stainless steel alloy
Fe 71%
Ni 8%
Cr 18%
C <0.2%
Resist Tarnish and corrosion
The loss of chromium from the alloy that occurs with heat
Stabilized against the formation of chromium carbide
Stainless Steel Wires
Rectangular
Round
gauges from 0.15mm – 1 mm
Properties of Stainless Steel
Passivation
known as a passavating film
They Resist Tarnish and corrosion because of:
- The presence of chromium:
If the oxide layer is disturbed by
mechanical or chemical actions
the wire can corrode
Chromium + Oxygen = chromic oxide
forms on the surface of the wire
and prevents corrosion
A thin, transparent layer
(-) The nicks and rough places left
on a wire after it is bent with
pliers may produce localized
electric couples that allow
corrosion
- Acetic and lactic acids do not attack the passavating
film
- can be used in the cleaning of Hawley retainers
containing stainless steel wires
(-) If bits of carbon steel are
incorporated into the surface of a
stainless steel wire that comes
into contact with carbon steel
pliers, cutters, or burs, starts the
process of corrosion
(-) Chlorine cleansers attack 18 - 8
steels and cause corrosion
The loss of chromium from the alloy that
occurs with heat is known as sensitization
Sensitization
Cr + C Chromium carbide
400 - 900 ° C
Reduction in corrosion resistance
Chromium carbide most rapidly
forms at 650 ° C and begins to
decompose above that temperature
Loss of passivating effect
Weakening of the metal
Stabilization
Stainless steel can be
stabilized against the
formation of chromium
carbide by adding an element
such as titanium that
precipitates as carbide in
preference to chromium.
Very few of the stainless steel
wires used by orthodontists
are stabilized.
40% Co
20% Cr
15% Ni
15.8% Fe
7% Mo
2% Mn
0.15% C
0.04% Be
Composition
COBALT – CHROMIUM – NICKLE (or) ELGILOY
Cobalt – chromium – nickel orthodontic wire (elgiloy) was developed
during 1950’s by elgiloy corporation
- Elgiloy is available in four
different temper (levels of
resistance) & color coded :
- Blue (soft)
- Yellow (ductible)
- Green (semi-resilient)
- Red (resilient)
Properties
- Elgiloy has excellent Resistance to Tarnish and corrosion
similar to stainless steel because of passivating effect
- It can be subjected to soldering and
welding procedure
However, because of their
- high values of modulus of elasticity,
wires manufactured from these alloys have
- the highest force delivery, along with lower elastic ranges and springback.
The stainless and Elgiloy blue wires are:
- the least expensive, and have excellent formability and good
joining characteristics
• Introduced 1980’s
– Demonstrate superelasticity
• Large reversible strains
– Over wide range of deflection,
force nearly constant
– Very desirable characteristic
Austenitic NiTi (A-NiTi)
• Good choice:
– Initial stages of Tx
– Leveling and aligning (good stiffness, range)
• Poor choice:
– Finishing (poor formability)
Uses of Ni-Ti Arch wires
Wire alloy Composition Modulus of
Elasticity
Yield Strength
(MPa)
Springback
Austenitic
Stainless Steel
7-12% Cr
8-12% Ni
0.15% C
Balance Fe
160-180 1100-1500 0.006-0.0094 (AR)
0.0065- 0.0099 (HT)
Cobalt -
Chromium -
Nickel,
40% Co, 20% Cr, 15%
Ni, 15.8% Fe, 7%
Mo, 2% Mn, 0.15%
C, 0.04% Be
160-190 830-1000 0.0045-0.0065 (AR)
0.0054- 0.0074 (HT)
Beta - Titanium 77.8% Ti, 11.3% Mo,
6.6% Zr, 4.3% Sn
62-69 690-970 0.0094-0.011
Nickel - Titanium 55% Ni, 45% Ti 34 210-410 0.0058-0.016
Physical Properties of Orthodontic Wires
• Wire properties
– Significantly affected by wire
(beam) cross section and length
Elastic Properties:
Effects of Size and Shape
• Magnitude of change varies
with wire material
• Strength
– Changes to third power
• Ratio between larger to
smaller beam
• E.g., double diameter:
deliver 8x strength
• Springiness
– Changes to fourth
power
• Ratio between smaller
to larger beam
• E.g., double diameter:
wire 1/16 as springy
Effects of Diameter: Cantilever
Strength d 2d = 8 (2d/d)³
Springiness d 2d = 1/16 (d/2d)⁴
Rang d 2d 1/2 (d/2d)
• Strength = stiffness x range
• Strength = 1/(1/16)x 0.5
Springiness= 1/stiffness
1/16= 1/stiffness
Stiffness = 1/(1/16)
• Strength = 16 x 0.5 = 8
Distance wire will bend elastically before
permanent deformation
Effects of Diameter: Cantilever
• Range
– E.g., double diameter:
half the range
Effects of Diameter: Cantilever
• Strength
– Decreases
proportionately
– E.g., double length: half
the strength
• Springiness
– Increase by cube of
ratio
– E.g., double length: 8x
the springiness
Effects of Length: Cantilever
Strength 1/2 1/4 1 2
Springiness 1 8 1 1/4
Rang 1 4 1 1/2
• Range
– Increases by square of ratio
– E.g., double length: 4x the range
– Light wire:
• Low strength, low force, high range
• Example: removable appliance
– Finger spring
– High strength needed to avoid deformation
– Force can be reduced by increasing wire length
• Add helix
Spring Design
• Requires appropriate balance:
– Heavy wire:
• High strength, high force, low range
The most important allergies in relation to orthodontics
treatment are those associated with exposure to:
- Latex
- Nickel containing alloys
- Acrylic
- Impression materials
Hypersensitivity reaction: either
- Type I (immediate)- present as localized urticaria
or anaphylaxis
- Type IV (delayed) – results in localized allergic
contact dermatitis (those related to nickle)
Allergy to Orthodontic Materials
- Staff should be aware of emergency protocol
for dealing with anaphylactic reaction
Management of latex allergy
- The use of elastomeric ties could be avoided
with the use of self-ligating brackets
- The use of latex products
should be avoided
Management of latex allergy
- Inter-maxillary elastics replaced with
latex-free elastics
- Space closure should be undertaken with nickel-titanium coils
Nickel Allergy
- Typically, Type IV hypersensitivity
reactions present on the skin as contact
dermatitis;
- however, intra-oral manifestation are
less common
- there appears to be a higher threshold
nickel concentration intra-orally to
induce a reaction
- Nickel-titanium archwires, stainless steel products
- (archwires, brackets, headgears) – all containing
nickel
- Affecting over 10% of females
Management of Nickel Allergy
- Brackets- Ceramic, gold,
titanium or polycarbonate
- Use of fiber-reinforced
composite wires
- Use of clear plastic aligners
Use of nickel free products:
Dr. NabiL Al-Zubair
Congratulations Graduation

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Materials used in Orthodontics _ Dr. Nabil Al-Zubair

  • 1. Materials used in Orthodontics Dr. Nabil Al-Zubair
  • 2. THE BEGINNINGS Teeth were regarded by the ANCIENTS as: (Very Precious) to the extent that: ‘‘. . . special Penalties [were exacted] for knocking out the teeth of an individual, either freeman or slave.’’ ‫القدماء‬ ‫العقوبات‬
  • 3. Greece were: burying their dead with appliances that were used to maintain space and prevent collapse of the dentition during life As early as 400 BC, Hippocrates : referenced in his writings the correction of tooth irregularities ‫دفن‬‫موتاهم‬
  • 4. In a Roman tomb in Egypt, finds: a number of teeth bound with a gold wire at the time of Christ, Aurelius Cornelius Celsus first records: the treatment of teeth by finger pressure ‫في‬‫رومانية‬ ‫مقبرة‬
  • 5. - inherent malocclusions and the use of corrective forces are recognized, - the first orthodontic material is documented—a gold ligature wire - the virtue of maintaining space is appreciated, and Thus,
  • 6. -‫نجح‬‫تقويم‬ ‫وفى‬ ‫الفكين‬ ‫تشوهات‬ ‫عالج‬ ‫في‬ ‫الزهراوى‬ ‫ابتكرها‬ ‫جراحية‬ ‫آالت‬ ‫باستخدام‬ ‫األسنان‬‫خصيصا‬ -‫الزهراوى‬‫الذهبية‬ ‫األسنان‬ ‫جسور‬ ‫استخدم‬ ‫من‬ ‫أول‬ ‫والفضية‬‫ضغط‬ ‫وأدوات‬‫األسنان‬ -‫كما‬ ‫لقلعها‬ ‫الكالليب‬ ‫وأستعمل‬ ‫األسنان‬ ‫بطب‬ ‫أهتم‬‫أستعمل‬ ‫منها‬ ‫الزائد‬ ‫لنشر‬ ‫المبارد‬ ‫القاسم‬ ‫أبو‬‫الزهراوي‬403‫هـ‬/1013‫م‬
  • 7. In 1887, Edward Angle used: - Nickelsilver alloys in his orthodontic accessories. - Subsequently he replaced them with copper, nickel and silver- free zinc alloys. - Eventually, gold alloys became his favorite choice
  • 8. CLASSIFICATION OF ORTHODONTIC MATERIALS I Classification according to the structure of orthodontic materials II Classification according to usage
  • 9. I Classification according to the STRUCTURE of orthodontic materials Wire alloys Orthodontic band Orthodontic brackets Ceramic brackets Filler particles in cements Polycarbonates for brackets Adhesive resins for bonding Polyurethane elastomers for tooth movement Ceramic materials Polymeric materialsMetallic materials
  • 10. II Classification according to usage_1 - Gold alloys - Stainless steel - Co-Cr-Ni (elgiloy) - B-titanium - Nickel –titanium - Stainless steel - Titanium - Plastics - Polycarbonates and ceramics Wire Brackets Conventional ligatures fluoride releasing elastomerics Elastomeric ligature and chains Ii- Non-metallic with Optiflex i- Metallic wires
  • 12. OPTIFLEX ARCHWIRE  Optiflex is a non metallic orthodontic arch wire  It was designed by DR. TALASS  In the year 1992 and manufactured by Ormco. Ii- Non-metallic with Optiflex  It has got unique mechanical properties with a highly aesthetic appearance  Made of clear optical fiber
  • 13. OPTIFLEX ARCHWIRE  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
  • 14. OPTIFLEX ARCHWIRE 1) It the most aesthetic orthodontic archwire 2) It is completely stain resistant, and will not stain or loose its clear look even after several weeks in mouth 3) Its effective in moving teeth using light continuous force
  • 15. OPTIFLEX ARCHWIRE 4) it is Very flexible , 5) has an extremely wide range of actions, 6) when indicated it can be tied with electrometric ligatures to severely malaligned teeth without fear of fracturing the arch wire. 7) Due to superior properties optiflex can be used with any bracket system
  • 16. II Classification according to usage_2 - Chemically cured / - Light cured - Thermo-cured Orthodontic adhesive composite resin - Zinc phosphate - Zinc polycarbocxylate - Glass ionomers - Alginate impression martial - Brass - Lock pins - Mini-implant MiscellaneousCements
  • 17. Ideal requirements of these cements are • Adequate working and setting time • High strength • Resistance to dissolution • Clinically acceptable bond strength • Anti carcinogenic property Zinc phosphate cement Zinc polycarboxylate cement Glass ionomer The cements that are widely used for cementation orthodontics bands are: Cements used in Orthodontics Orthodontic application of cements are limited to luting of bands and appliances
  • 18. - Alginate is the most extensively used impression material today - Irreversible hydrocolloids: used for recording minimum detail; e.g. study models ALGINATE
  • 19. 1. Easy to manipulate 2. Relatively inexpensive 3. Comfortable for the patient 4. They are hydrophilic 5. Have pleasant taste 6. Long shelf-life 1. tear easily 2. Models should be poured immediately 3. They have limited detail reproduction 4. Can retard gypsum setting DISADVANTAGESADVANTAGES ALGINATE
  • 20. Removable vs. Fixed Two Types of Orthodontic Appliances:
  • 21. • Bands • Brackets • Wires • Accessory appliances Fixed appliances
  • 22.
  • 23. • 24K plating gold bracket Brackets • Metal bracket
  • 25. Brackets Plastic brackets • Staining and discoloration • Poor dimensional stability • Larger friction
  • 26.
  • 27. Ceramic brackets Brackets – Durable, resist staining – Can be custom-molded – Dimensionally stable Advantages over plastic brackets ‫متين‬
  • 28. Ceramic brackets Brackets – Bulkier than metal bracket – Fractures of brackets – Friction is bigger than that in metal bracket – Wear on teeth contacting a bracket – Enamel damage on debonding Disadvantages over metal brackets
  • 29. • Metal-reinforced ceramic bracket Brackets
  • 31. The negative space between the buccal surface of the maxillary first premolar and the inner point at which the lips join when the patient smiles. Buccal Corridor Width ‫عرض‬‫الشدقى‬ ‫الممر‬
  • 32. • Lingual brackets Invisible orthodontics? • Invisalign
  • 34. Step 1: Visit your orthodontist or dentist Step 2: Invisalign® makes your aligners Step 3: You receive your aligners in a few weeks. Step 4: You wear your aligners. Step 5: You've finished treatment! Invisalign
  • 36.  Mild-moderate crowding with IPR or expansion  Posterior dental expansion  Close mild-moderate spacing Clear aligner therapy (CAT) applicability CAT performs well:  Absolute intrusion (1 or 2 teeth only)  Lower incisor extraction for severe crowding  Tip molar distally
  • 37. 0.1-0.5 mm in thickness
  • 38. •Dental expansion for blocked-out teeth •Extrusion of incisors* •High canines •Severe rotations (particularly of round teeth) •Leveling by relative intrusion •Molar uprighting (any teeth with large undercuts) •Translation of molars* •Closure of premolar extraction spaces* CAT does not perform well: Clear aligner therapy (CAT) applicability
  • 39. • patients treated with Invisalign RELAPSED more than those treated with conventional fixed appliances. Invisalign vs. braces
  • 40. • Type: – NiTi wire (Nickel-Titanium wire) – TMA wires (Titanium- Molybdenum-Alloy) – Stainless steel wire Wires • Shape – Round wire – Rectangular wire
  • 41.
  • 42. Properties of arch wires – related to force levels, rigidity, formability, etc.
  • 43. • Maintains force over a range of tooth movement General Characteristics of Orthodontic Forces • Optimal: light, continuous – Ideal Material • Maintains elasticity
  • 44. 1.Cantilever Beam:- is one whose: - one end is fixed and the - other end carries a point or concentrated load. 2. Simply Supported Beam:- is one which: - carries two reaction forces at its two ends & - a point load at its mid-point. Types of Beams
  • 45. Physical Properties of Orthodontic Wires
  • 46. ‫عند‬،، ‫إنفعال‬ ‫عنه‬ ‫ينتج‬ ‫إجهاد‬ ‫تحت‬ ‫تقع‬ ‫المرنة‬ ‫المواد‬ ‫على‬ ‫معينة‬ ‫بقوى‬ ‫التأثير‬ ‫هذا‬‫الشكل‬ ‫فى‬ ‫تغير‬ ‫إلى‬ ‫اإلنفعال‬ ‫هذا‬ ‫يؤدي‬ ‫قد‬ ‫وكذلك‬ ‫بالنقصان‬ ‫أو‬ ‫وحجمها‬ ‫طولها‬ ‫فى‬ ‫بالزيادة‬ ‫إما‬ ‫يكون‬ ‫اإلنفعال‬. ‫اإلنفعال‬ ‫تعريف‬: ‫هو‬‫المؤثرة‬ ‫للقوة‬ ‫المادة‬ ‫إستجابة‬ ‫أو‬ ‫الطول‬ ‫فى‬ ً‫ا‬‫تغير‬ ‫يكون‬ ‫فقد‬ ‫عليها‬ ‫الشكل‬ ‫أو‬ ‫الحجم‬. ‫اإلنفعال‬ ‫أن‬ ‫القول‬ ‫يمكن‬ ‫آخر‬ ‫بمعنى‬ ‫إلى‬ ‫بالنسبة‬ ‫الطول‬ ‫فى‬ ‫التغير‬ ‫هو‬ ‫الحجم‬ ‫فى‬ ‫التغير‬ ‫أو‬ ‫األصلى‬ ‫الطول‬ ‫األصلى‬ ‫للحجم‬ ‫بالنسبة‬. ‫اإلجهاد‬‫واإلنفعال‬Stress and Strain: ‫اإلجهاد‬ ‫تعريف‬: ‫هو‬‫المؤثرة‬ ‫القوة‬ ‫وحدة‬ ‫على‬ ‫عموديا‬ ‫المساحة‬ σ = F/A Stress Strain Stress Strain
  • 47. – Defined by stress-strain response to external load Materials & Production of Orthodontic Force • Strain= internal distortion produced by the load - deflection/unit length • Stress= internal distribution of the load - force/unit area • Elastic behavior
  • 48. Yield strength Ultimate tensile strength Plastic Region Stress Strain Failure point Elastic Region
  • 49. • Measure deflection = strain - examples: • Bending • Twisting • Change in length Orthodontic Model: Beam Metal Spanning • Force applied to a beam = stress
  • 50. – Stiffness – Range, springback – Strength - Resilience, formability Beam Properties in Orthodontics • Defined in force deflection or stress-strain diagrams • Useful properties:
  • 51. 3. Ultimate tensile (yield) strength 1. Proportional limit 2. Yield strength • Maximum load wire can sustain Bending Properties of an Orthodontic Wire • Point at which permanent deformation is first observed • Similar to “elastic limit” • Point at which 0.1% deformation occurs Defined by 3 points Stress Strain Proportional limit Yield strength Ultimate tensile strength 0.1%
  • 52. – Young’s modulus Stiffness of an Orthodontic Wire Modulus of elasticity (E) – Slope of load deflection curve – Stiffness α E – Springiness α 1/E Resistance of a body to elastic deformation caused by an applied force - Describes the stiffness or springiness of a wire ‫المرونة‬ ‫معامل‬ ‫الجسم‬ ‫مقاومة‬‫الناجم‬ ‫للتشوه‬‫المستخدمة‬ ‫القوة‬ ‫عن‬
  • 53. Low stiffness leads to: - an ability to apply lower forces - a more constant force to be delivered over time and - greater ease and accuracy in applying a given force. STIFFNESS or LOAD DEFLECTION RATE more Horizontal, and vice versa As the springiness (elasticity) of a wire increases, The slope of the stress -strain curve becomes
  • 54. Spring back is also referred to as maximum elastic deflection or working range Decreasing the number of arch wire changes Higher springback values provide: The ability to apply large activations with a resultant increase in working time of the appliance SPRINGBACK thus
  • 55. • Related to elastic portion of force deflection curve (slope) Stiffness versus Springiness Springiness= 1/stiffness• Reciprocal relationship – More horizontal= greater springiness – More vertical= stiffer
  • 56. • Range Distance wire will bend elastically before permanent deformation Range versus Springback • Springback – Found after wire deflected beyond its yield point – Clinically useful • Wires often deflected past yield point ‫النطاق‬ ‫المسافة‬‫شكله‬ ‫فيها‬ ‫الى‬ ‫ويعود‬ ‫السلك‬ ‫ثني‬ ‫يتم‬ ‫التي‬ ‫قبل‬ ‫السابق‬‫دائم‬ ‫تشوه‬ ‫حدوث‬
  • 57. • Strength = stiffness x range Relationship of Strength, Stiffness & Range
  • 58. • Resilience – Area under stress-strain curve to proportional limit – Represents Energy Storage Capacity Resilience, Formability High formability provides: the ability to bend a wire into desired configurations such as loops, coils .etc. without fracturing the wire • Formability – The amount of permanent deformation a wire can withstand before breaking
  • 59. • Deflection properties: – High strength – Low stiffness (usually) – High range – High formability Ideal Orthodontic Wire Material • Strength = stiffness x range • Other properties: – Weldable, solderable – Reasonable cost • No one wire meets all criteria!
  • 61. – Before 1950’s: gold alloys, corrosion resistant Wire Materials – 1970’s applied to orthodontics – Demonstrates exceptional springiness • Two special properties: Shape Memory, Superelasticity – Improved strength, springiness – Corrosion resistant: chromium • Typical: 18% chromium, 8% nickel Nickel-titanium (NiTi) alloys Precious metal alloys Stainless steel, cobalt-chromium (elgiloy®) alloys
  • 62.
  • 64. • In the past: • the arch wire & springs were constructed from GOLD or platinized gold, • But because these materials are very expensive; therefore the stainless steel alloy is used as an alternative alloy in orthodontic appliance. • Alloys: are mixtures of two or more metallic elements.
  • 65. First and foremost alloys used in orthodontics in forms of wires, bands and brackets History – The advent of stainless steel - Stainless steel was introduced into orthodontic practice in 1929, when Renfert, a North American company, began selling wires made from these alloys, which were produced by a German company named Krupp Stainless Steel Alloys
  • 66.
  • 67. Properties of Stainless Steel  Passivation  Sensitization  Stabilization • Composition: Stainless steel alloy Fe 71% Ni 8% Cr 18% C <0.2% Resist Tarnish and corrosion The loss of chromium from the alloy that occurs with heat Stabilized against the formation of chromium carbide Stainless Steel Wires Rectangular Round gauges from 0.15mm – 1 mm
  • 68. Properties of Stainless Steel Passivation known as a passavating film They Resist Tarnish and corrosion because of: - The presence of chromium: If the oxide layer is disturbed by mechanical or chemical actions the wire can corrode Chromium + Oxygen = chromic oxide forms on the surface of the wire and prevents corrosion A thin, transparent layer
  • 69. (-) The nicks and rough places left on a wire after it is bent with pliers may produce localized electric couples that allow corrosion - Acetic and lactic acids do not attack the passavating film - can be used in the cleaning of Hawley retainers containing stainless steel wires (-) If bits of carbon steel are incorporated into the surface of a stainless steel wire that comes into contact with carbon steel pliers, cutters, or burs, starts the process of corrosion (-) Chlorine cleansers attack 18 - 8 steels and cause corrosion
  • 70. The loss of chromium from the alloy that occurs with heat is known as sensitization Sensitization Cr + C Chromium carbide 400 - 900 ° C Reduction in corrosion resistance Chromium carbide most rapidly forms at 650 ° C and begins to decompose above that temperature Loss of passivating effect Weakening of the metal
  • 71. Stabilization Stainless steel can be stabilized against the formation of chromium carbide by adding an element such as titanium that precipitates as carbide in preference to chromium. Very few of the stainless steel wires used by orthodontists are stabilized.
  • 72. 40% Co 20% Cr 15% Ni 15.8% Fe 7% Mo 2% Mn 0.15% C 0.04% Be Composition COBALT – CHROMIUM – NICKLE (or) ELGILOY Cobalt – chromium – nickel orthodontic wire (elgiloy) was developed during 1950’s by elgiloy corporation
  • 73. - Elgiloy is available in four different temper (levels of resistance) & color coded : - Blue (soft) - Yellow (ductible) - Green (semi-resilient) - Red (resilient) Properties - Elgiloy has excellent Resistance to Tarnish and corrosion similar to stainless steel because of passivating effect - It can be subjected to soldering and welding procedure
  • 74. However, because of their - high values of modulus of elasticity, wires manufactured from these alloys have - the highest force delivery, along with lower elastic ranges and springback. The stainless and Elgiloy blue wires are: - the least expensive, and have excellent formability and good joining characteristics
  • 75. • Introduced 1980’s – Demonstrate superelasticity • Large reversible strains – Over wide range of deflection, force nearly constant – Very desirable characteristic Austenitic NiTi (A-NiTi)
  • 76. • Good choice: – Initial stages of Tx – Leveling and aligning (good stiffness, range) • Poor choice: – Finishing (poor formability) Uses of Ni-Ti Arch wires
  • 77. Wire alloy Composition Modulus of Elasticity Yield Strength (MPa) Springback Austenitic Stainless Steel 7-12% Cr 8-12% Ni 0.15% C Balance Fe 160-180 1100-1500 0.006-0.0094 (AR) 0.0065- 0.0099 (HT) Cobalt - Chromium - Nickel, 40% Co, 20% Cr, 15% Ni, 15.8% Fe, 7% Mo, 2% Mn, 0.15% C, 0.04% Be 160-190 830-1000 0.0045-0.0065 (AR) 0.0054- 0.0074 (HT) Beta - Titanium 77.8% Ti, 11.3% Mo, 6.6% Zr, 4.3% Sn 62-69 690-970 0.0094-0.011 Nickel - Titanium 55% Ni, 45% Ti 34 210-410 0.0058-0.016 Physical Properties of Orthodontic Wires
  • 78.
  • 79. • Wire properties – Significantly affected by wire (beam) cross section and length Elastic Properties: Effects of Size and Shape • Magnitude of change varies with wire material
  • 80. • Strength – Changes to third power • Ratio between larger to smaller beam • E.g., double diameter: deliver 8x strength • Springiness – Changes to fourth power • Ratio between smaller to larger beam • E.g., double diameter: wire 1/16 as springy Effects of Diameter: Cantilever Strength d 2d = 8 (2d/d)³ Springiness d 2d = 1/16 (d/2d)⁴ Rang d 2d 1/2 (d/2d)
  • 81. • Strength = stiffness x range • Strength = 1/(1/16)x 0.5 Springiness= 1/stiffness 1/16= 1/stiffness Stiffness = 1/(1/16) • Strength = 16 x 0.5 = 8 Distance wire will bend elastically before permanent deformation Effects of Diameter: Cantilever
  • 82. • Range – E.g., double diameter: half the range Effects of Diameter: Cantilever
  • 83. • Strength – Decreases proportionately – E.g., double length: half the strength • Springiness – Increase by cube of ratio – E.g., double length: 8x the springiness Effects of Length: Cantilever Strength 1/2 1/4 1 2 Springiness 1 8 1 1/4 Rang 1 4 1 1/2 • Range – Increases by square of ratio – E.g., double length: 4x the range
  • 84. – Light wire: • Low strength, low force, high range • Example: removable appliance – Finger spring – High strength needed to avoid deformation – Force can be reduced by increasing wire length • Add helix Spring Design • Requires appropriate balance: – Heavy wire: • High strength, high force, low range
  • 85. The most important allergies in relation to orthodontics treatment are those associated with exposure to: - Latex - Nickel containing alloys - Acrylic - Impression materials Hypersensitivity reaction: either - Type I (immediate)- present as localized urticaria or anaphylaxis - Type IV (delayed) – results in localized allergic contact dermatitis (those related to nickle) Allergy to Orthodontic Materials
  • 86. - Staff should be aware of emergency protocol for dealing with anaphylactic reaction Management of latex allergy - The use of elastomeric ties could be avoided with the use of self-ligating brackets - The use of latex products should be avoided
  • 87. Management of latex allergy - Inter-maxillary elastics replaced with latex-free elastics - Space closure should be undertaken with nickel-titanium coils
  • 88. Nickel Allergy - Typically, Type IV hypersensitivity reactions present on the skin as contact dermatitis; - however, intra-oral manifestation are less common - there appears to be a higher threshold nickel concentration intra-orally to induce a reaction - Nickel-titanium archwires, stainless steel products - (archwires, brackets, headgears) – all containing nickel - Affecting over 10% of females
  • 89. Management of Nickel Allergy - Brackets- Ceramic, gold, titanium or polycarbonate - Use of fiber-reinforced composite wires - Use of clear plastic aligners Use of nickel free products: