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Concepts of bracketConcepts of bracket
positioning techniquespositioning techniques
www.indiandentalacademy.comwww.indiand...
Andrew’s Bracket siting proceduresAndrew’s Bracket siting procedures
Andrews emphasized that the accurate placement of the...
FACCFACC
For all teeth except molars, it is located at the
mid-developmental ridge that runs vertically and is the most
pr...
Hence he reasoned that it should be possible for anyone with
average skill to draw with a pencil the FACC of crowns of all...
Vari simplex disciplineVari simplex discipline
It is one of the pre adjusted edge wise system. It was introduced
in 1978 b...
Bracket height :-
each bracket is placed at a predetermined position on each tooth
relative to the other teeth.
Bicuspid b...
Roth’s prescriptionRoth’s prescription
In 1968, R . H ROTH was introduced to Dr. L.F.
ANDREWS.
He started designing his ow...
Bracket placementBracket placement
standardstandard
MaxillaryMaxillary
1/11/1
2/22/2
3/33/3
4/44/4
5/55/5
6/66/6
4.54.5
4....
MBT PHILOSOPHYMBT PHILOSOPHY
The MBT philosophy of orthodontic treatment has been
developed over a twenty yr period of tim...
The use of a bracket placement chart was developed in 1994,
as well as Dougherty gauges, dramatically reduces bracket
plac...
Use of Bracket Placement Chart:-
1. Measure the clinical crown heights of as many fully erupted
teeth as possible from the...
4. Position each bracket initially by visualizing the vertical long
axis of the clinical crown (or the buccal groove of th...
Combination anchorage techniqueCombination anchorage technique
- four stage light wire appliance- four stage light wire ap...
BRACKET AND TUBE PLACEMENT
similar to that of straight wire appliances like edge wise slot parallel and at
the same level...
BRACKET AND TUBE PLACEMENT
www.indiandentalacademy.comwww.indiandentalacademy.com
Level anchorage systemLevel anchorage system
ROOT began using the angulated appliances of Holdaway in
1954 and since that ...
BRACKET PLACEMENT
www.indiandentalacademy.comwww.indiandentalacademy.com
Bioefficient bracket systemBioefficient bracket system
It is a modification of preadjusted systemIt is a modification of p...
www.indiandentalacademy.comwww.indiandentalacademy.com
The Next Generation :StraightThe Next Generation :Straight
Wire ApplianceWire Appliance
 This concept was introduced by C...
 There are atleast five reasons –There are atleast five reasons –
1.1. Inaccurate bracket placementsInaccurate bracket pl...
4.4. Need for overcorrectionNeed for overcorrection
5.5. Mechanical deficiencies of the edgewise appliance –forceMechanica...
The Next Generation :StraightThe Next Generation :Straight
Wire ApplianceWire Appliance
THE SLOT MACHINETHE SLOT MACHINE
w...
www.indiandentalacademy.comwww.indiandentalacademy.com
Advanced Preadjusted ApplianceAdvanced Preadjusted Appliance
FabricationFabrication
 TorqueTorque –with the use of an inc...
 HeightHeight – more precise height– more precise height measurements aremeasurements are
possiblepossible
All this requi...
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Concepts of orthodontic bracket positioning techniques / fixed orthodontics courses

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Concepts of orthodontic bracket positioning techniques / fixed orthodontics courses

  1. 1. Concepts of bracketConcepts of bracket positioning techniquespositioning techniques www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. Andrew’s Bracket siting proceduresAndrew’s Bracket siting procedures Andrews emphasized that the accurate placement of the brackets was an integral part of the straight wire appliance. He suggested a bracket siting procedure, which was aimed at targeting the slot within 2 degrees and 0.5 mm of the precise placement over the slot site. (This is the area on a tooth that would accept the bracket such that the bracket slot would receive a ‘straight’ arch wire passively when the tooth gets optimally positioned). www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. FACCFACC For all teeth except molars, it is located at the mid-developmental ridge that runs vertically and is the most prominent portion in the central area of the labial or buccal Surface. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. Hence he reasoned that it should be possible for anyone with average skill to draw with a pencil the FACC of crowns of all the teeth, mark their midpoints and align the midpoint of the base of each bracket with the FA point in such a way that the sides of the brackets are parallel with the FACC. He demonstrated that most of the people are able to mark the midpoint of a line about 10mm in length (a figure close to the length of FACC of a maxillary central incisor) to the accuracy of within 0.5 mm. Further, they can also judge the parallelism of two or more lines within the accuracy of 2 degrees www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. Vari simplex disciplineVari simplex discipline It is one of the pre adjusted edge wise system. It was introduced in 1978 by Dr. R. G . Wick Alexander. The name vari – simplex discipline was chosen after very much thought “VARI” means the variety of bracket types used ( twin, lewis an lang) Simplex refers to the KISS principle. Discipline instead of appliance. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. Bracket height :- each bracket is placed at a predetermined position on each tooth relative to the other teeth. Bicuspid bracket height is the key because its clinical crown height is so variable. Its normal bracket slot height is 4.5mm Maxillary arch:- Centrals – x Laterals – x – 0.5 Cuspids – x+0.5 Bicuspids – x First molars – x-0.5 Second molars – x-1 Mandibular arch Centrals – x-0.5 Laterals – x-0.5 Cuspids – x+ 0.5 Bicuspids – x First molars – x- 0.5 www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. Roth’s prescriptionRoth’s prescription In 1968, R . H ROTH was introduced to Dr. L.F. ANDREWS. He started designing his own prescription as a clinical trial and error evaluation that lasted severed years. Cases were evaluated by the use of Intra oral photographs and Mounted models for tooth positions During treatment and at the end of appliance therapy ( the straight wire appliance – 17 yrs later – Ronald H Roth Jco vol 1987sep(632-42) www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. Bracket placementBracket placement standardstandard MaxillaryMaxillary 1/11/1 2/22/2 3/33/3 4/44/4 5/55/5 6/66/6 4.54.5 4.54.5 4.754.75 4.54.5 4.54.5 3.753.75 21/1221/12 3/33/3 4/44/4 5/55/5 6/66/6 4.04.0 4.254.25 4.04.0 3.753.75 3.53.5www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. MBT PHILOSOPHYMBT PHILOSOPHY The MBT philosophy of orthodontic treatment has been developed over a twenty yr period of time and has involved the combined efforts of its three principle clinicians, Dr. Mc Laughlin, Dr. Bennett, Dr. Trevisi Their philosophy places emphasis on 1. Treatment mechanics 2. The preadjusted appliance 3. Bracket placement technique 4. Arch form and arch wire sequencing. (Systemized orthodontic treatment mechanics McLaughin Bennet . Trevisi) www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. The use of a bracket placement chart was developed in 1994, as well as Dougherty gauges, dramatically reduces bracket placement errors in the vertical dimension. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. Use of Bracket Placement Chart:- 1. Measure the clinical crown heights of as many fully erupted teeth as possible from the patient's study casts, using dividers and a millimeter ruler. 2. Divide each measurement in half and round to the nearest .5mm to obtain the distance from the incisal or occlusal edge to the center of the clinical crown. 3. Select the row in the Bracket Placement Chart that contains the greatest number of equal values. Measurements for teeth that are disproportionately large or small will differ from those in the selected row, but will thereby be automatically adjusted. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. 4. Position each bracket initially by visualizing the vertical long axis of the clinical crown (or the buccal groove of the molar) as a vertical reference and the estimated center of the clinical crown as a horizontal reference. 5. Use a bracket placement gauge to adjust the bracket heights to the exact values from the chart. A light-cured adhesive is recommended for direct bonding because of its unlimited positioning time www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. Combination anchorage techniqueCombination anchorage technique - four stage light wire appliance- four stage light wire appliance - 1988- 1988 (( combination anchorage technique – Thompson vol 1988 Ajo-do may 363-79combination anchorage technique – Thompson vol 1988 Ajo-do may 363-79)) CAT in its early structure was principally a four stage Begg light wire system, the fourth stage being the straight wire finally. The concept was to use a light wire appliance system to establish the early organization of the malocclusion and to finish the treatment with more rigid and precise straight wire appliances. What was originally believed to be modernized Begg wasWhat was originally believed to be modernized Begg was actually a true combination anchorage technique.actually a true combination anchorage technique.www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. BRACKET AND TUBE PLACEMENT similar to that of straight wire appliances like edge wise slot parallel and at the same level as the interproximal contact point of the teeth in normal occlusion. Molar tube can be banded or bonded. Remaining brackets are bonded on the anterior and premolars keeping the molar tube as guide line. Molar tube placement rectangular tube 3.5 mm from the molar cusp tip. Other teeth are at the same level except canine and lateral incisor If maxillary molars are interfering in static of functional occlusion, -position have to be altered. Canines edge wise slot should be 4mm Maxillary lateral incisors 3 mm from the incisal edge. Non extraction case – mandibular I premolar – 4mm www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. BRACKET AND TUBE PLACEMENT www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. Level anchorage systemLevel anchorage system ROOT began using the angulated appliances of Holdaway in 1954 and since that time, he included the anchorage needed to reduce ANB angle, correct class II molar relationships, close extraction space, and level curve of Spee. In 1975 Root began using a completely preadjusted appliance, varying the amount of angulation in the buccal segment by severity of the malocclusion www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. BRACKET PLACEMENT www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. Bioefficient bracket systemBioefficient bracket system It is a modification of preadjusted systemIt is a modification of preadjusted system introduced byintroduced by Viazis.Viazis. The bracket prescriptions were designed toThe bracket prescriptions were designed to overcorrect malocclusion and to make it possibleovercorrect malocclusion and to make it possible to work with the largest possible wires from theto work with the largest possible wires from the start of the treatment .start of the treatment . (Atlas of advanced orthodontics: a guide to clinical efficiency - Anthony D. Viazis) www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. The Next Generation :StraightThe Next Generation :Straight Wire ApplianceWire Appliance  This concept was introduced by Creekmore andThis concept was introduced by Creekmore and Randy in 1993 AJORandy in 1993 AJO  Frequently anticipated results are not achievedFrequently anticipated results are not achieved by using a preadjusted appliance and straightby using a preadjusted appliance and straight wire .wire . www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21.  There are atleast five reasons –There are atleast five reasons – 1.1. Inaccurate bracket placementsInaccurate bracket placements –a mean of .34–a mean of .34 mm error in vertical plane and 5.54mm error in vertical plane and 5.54˚ for˚ for angular placement is observedangular placement is observed - Balut et.al- Balut et.al 2.2. Variations in tooth structureVariations in tooth structure 3.3. Variations in ant –post and vertical jaw relationsVariations in ant –post and vertical jaw relations require variations in the position of the max andrequire variations in the position of the max and mand incisors.mand incisors. www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. 4.4. Need for overcorrectionNeed for overcorrection 5.5. Mechanical deficiencies of the edgewise appliance –forceMechanical deficiencies of the edgewise appliance –force application away from CRes.application away from CRes. -play between arch wire and slot.-play between arch wire and slot. -force diminution.-force diminution. www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. The Next Generation :StraightThe Next Generation :Straight Wire ApplianceWire Appliance THE SLOT MACHINETHE SLOT MACHINE www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. Advanced Preadjusted ApplianceAdvanced Preadjusted Appliance FabricationFabrication  TorqueTorque –with the use of an incisor Torque–with the use of an incisor Torque Template (Creekmore Enterprises ).Template (Creekmore Enterprises ).  TipTip -can be adjusted taking in consideration the-can be adjusted taking in consideration the anchorage requirement .anchorage requirement .  Rotations-Rotations- rotations can be accurately measuredrotations can be accurately measured by using rotational guidesby using rotational guides www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26.  HeightHeight – more precise height– more precise height measurements aremeasurements are possiblepossible All this requires proper planning of individual toothAll this requires proper planning of individual tooth movement so as to determine exact amount of torque ,tipmovement so as to determine exact amount of torque ,tip rotation and height parameter for eachrotation and height parameter for each toothtooth www.indiandentalacademy.comwww.indiandentalacademy.com

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