Tip /certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

TIP EDGE CONCEPT
DIFFERENTIAL STRAIGHT ARCH TECHNIQUE


Introduction
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modified edgewise slot
dynamic in action
new concept of tooth movement
review some of the orthodontic
appliances and especially archwire
slots that have preceded it


Review of E. H, Angle's
Appliance Design
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individual tooth control to achieve differing
treatment objectives
emphasized the importance of permitting teeth
to tip freely


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quest for an appliance system that
would provide total, three-dimensional
tooth control
pin and tube appliance (1910)
ribbon arch (1915)
edgewise appliance (1925)


Changes In treatment goals
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relapse often followed expansion
necessary to remove teeth
P. R. Begg: reverted to ribbon arch
brackets
Tweed: increased both elastic and
archwire forces and used extraoral
anchorage
similar treatment goals yet
using appliances invented by Angle for
nonextraction, expansion treatment

Changes in Brackets
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wider, siamese brackets
preadjusted bracket slots
more difficult to accomplish the major
repositioning of both the teeth and
jaws
simple, functional design
detrimental to maintain teeth in their
final torque and tip inclinations while
attempting major repositioning

Fighting The Limitations Of The
Edgewise Archwire Slot (A
Sixty Year Review)
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Uprighting is accomplished. . , through
exertion of even, gentle, continuous
tipping force in distal direction on
their crowns." E-H., Angle-1929:
Second order bends
"Second order" brackets


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"The edgewise bracket is . . .
extremely violent in its action.“: A.V.
Sved-1938
Changed edgewise slot sides to pivot
points.


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"As soon as this mechanism
(edgewise) was brought into use. . . no
longer were the molars the only
anchor teeth-in fact, each and every
tooth is now an anchorage
auxiliary”:R.W. Strang-1941
Round archwires
Return to occipital anchorage

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". . . Cuspid tip-back bends are necessary.
Their purpose is to break down the… toe
hold. . . present in the cuspid regions. They
convert stationary anchorage into simple
anchorage,.." C.H. Tweed-1941
Anchorage preparation
Second order bends.
No brackets on selected teeth
Headgear

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"II you want to retract cuspids easily . .
. stay out of the slot: H.D. Kesling1943
Kept archwire out of slot while
retracting with a coil spring.


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"Beware of wide channel brackets."
P.R. Begg-1960'
Changed to ribbon arch brackets


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"As one attempts to move a tooth by
bends or twists in a continuous
archwire reactive forces are placed on
the adjacent teeth which may produce
undesirable side effects”:C.J.
Burstone-1962
Segmented arches
Transpalatal bars
Headgear.

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“. . . early in treatment the (canine) slot
angulation . . . can undesirably extrude
incisors. To avoid this side effect, the
archwire should not engage incisor
slots until the canine angulation is
correct." L.F. Andrews-1975
Sectional arches.
Elastics to "loose" canines
Power arms
Headgear

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"The greatest deterrent to retraction
and/or space closure for the past 60
years has been the edgewise archwire
slot.“:P.C. Kesling-1987
Created the Tip Edge bracket.


Development of The TipEdge Bracket
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necessary for each tooth to tip freely either
mesially or distally but not in both the
directions
each tooth tips distally--except those distal
to extraction sites which tip mesially
anterior teeth are free to tip in all directions
as they are depressed
The face of the edgewise bracket (the slot)
has been changed to permit free crown
tipping followed by controlled root uprighting

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slot size: .022 “ x .028"
Lateral extensions (wings)
vertical slot is .020" x .020" square
with both the gingival and incisal ends
chamfered


Advantages compared To
Original Edgewise Brackets
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initial, straight archwires into ordinary
edgewise slots in brackets of these
teeth cam interfere with retraction, bite
opening, patient comfort or cause
bond failures
Diminished anchorage demands and
increased vertical control


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anchor molars are not subjected to
forces great enough to initiate their
movement until spaces are closed
three-dimensional control is not
continual, but optional and utilized only
when required


Advantages Of Tip-Edge
Brackets over Ribbon Arch
Type Brackets
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in/out compensation built eliminates
the need for molar (or other) offsets
Horizontally facing archwire slots
facilitate initial archwire engagement


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slots can stop free distal crown tipping
of canines at a predetermined angle
programmed differential mechanics at
work


Design and Size of Archwire
Slots in Tip-Edge Brackets
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"propeller" archwire slot is to permit
crown tipping in one direction followed
by controlled root uprighting in the
other


No need for overangulations
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designed to permit initial crown tipping
followed by root uprighting with the
teeth under complete control
light forces (2 ounces) used do not
cause undesired rotations during
space closure
Patient comfort is ensured
full vertical and angular control during
final uprighting and torquing

Tip-Edge Bracket Archwire Slot
Angulations (Slot Size - .022")
MAXILLARY

Initial, Mesiodistal
Crown Tip

Final
Crown Tip

Final
Root Torque

Central Incisor

20° Distal

5°

12°

Lateral Incisor

20° Distal

9°

8°

Canine

25° Distal

11"

-4°

First Premolar

20° Distal Or Mesial

0°

-7°

Second
Premolar


0°

-7°


MANDIBULAR

Initial, Mesiodistal
Crown Tip

Final
Crown Tip

Final
Root
Torque

Central Incisor

20° Distal

2°

-1°

Lateral incisor

20° Distal

5°

-1°

Canine

25° Distal

5°

-11°

First Premolar


0"

-20°

Second Premolar


0°

-20°


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Slot design is the same for each tooth
in all types and classes of
malocclusions
The only choice to be made is the
direction of free crown tipping of
premolars
major Class II or III apical base
discrepancies

THE DIFFERENTIAL
STRAIGHT-ARCH
TECHNIQUE


Differential Tooth Movement
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anatomically correct positions in the
jaws under the influence of very light
forces
light intraoral forces do not place
undue strain on the anchor molars
maximum control of the vertical
dimension
based on a technique and method of
tooth move-ment developed by Dr.
P.R. Begg

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attritional occlusion :occlusion is not
static, but ever changing
movement of teeth is not segmented
into groups, with one group waiting for
another
overcorrection of the teeth to allow for
the natural tendency for relapse
appliances themselves do not have
adequate time to function as retainers

Thank you
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Tip /certified fixed orthodontic courses by Indian dental academy

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