Evolution of orthodontic brackets /certified fixed orthodontic courses by Indian dental academy

EVOLUTION OF ORTHODONTIC
BRACKETS

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

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Contents
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Brief summary
Idea for introducing horizontal slot
Single width bracket
Twin bracket
Tripple bracket
Jarabak bracket
Lewis bracket
Lang bracket
Steiner bracket
Broussard bracket
Bioefficient bracket
Dual env bracket
Unitwin bracket
Transition from 022 to 018 slot
Andrews straight wire app.

2

E.H ANGLE


E arch appliance



Pin and tube appliance



Ribbon arch appliance



Open face or tie bracket


3

Evolution of edgewise appliance


1907 – angle discontinued the use of jack screws

E Arch


4


Basic E arch

5


Ribbed E arch

6


E arch without threaded ends

7


E arch with hooks


8

Pin and tube-1910


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10

The Ribbon Arch-1915

Brackets


11


Open face bracket

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13


050’’ or 1.25 mm

14

Siamese twin bracket

Swain
Interbracket span 050’’


15


16

Curved base twin bracket

Mechanism of action  deflection

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Posterior brackets


Twice the width of
single width bracket
010’’or 2.5mm


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Tripple bracket

Better rotational and tipping adjustments
Control over rotation  selective tying

19

Long edgewise bracket




Horizontal and vertical
slotted bracket
Jarabak

Horizontal slot  .017’’ wide
.038’’ deep
Vertical slot  .017’’ wide
.045’’ deep

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
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Available in 3 lengths
.160’’
.120’’
distal
.140’’

mesial
Vertical slot on the base
On distal end  www.indiandentalacademy.com
.016×.016

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Horizontal slot offcentred
by .046’’ from the incisal edge


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Lewis bracket

Soldered auxiliary rotation arms
Single width feature- retained

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Lewis bracket


Types:


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Curved base lewis bracket

Increase contact with band .
Reduces trapping of the food.


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Vertical slot Lewis bracket

020 x020 vertical slot

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Steiner bracket


Flexible rotation arms - did not rely entirely on the
resiliency of archwire for tooth rotation.



Single width edgewise bracket


28

Lang brackets

Howard Lang
Flat rotational control wing


29

Lang brackets

Wedge shape in profile
Allows ease in lagation
Prevents food lodgments


30

Lang brackets
Flattening of archwire curvature
Incomplete seating of the wire.

Curvature maintained


31

Broussard bracket

Grayford broussard
Modified edgewise bracket
in which there is addition of
0.0185 x 0.046 slot –to
accept doubled 0.018
auxiliary wire

32

Unitwin bracket (1989)
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Thomas Creekmore
Centered slot concept
Single bracket
Without tie wings
Slot placed in the center
of a .045’’twin bracket


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Unitwin bracket (1989)




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Utilizes the feature of
both single and twin
bracket
Maximum inter bracket
span  single width
Rotational control 
twin tie wings


34

The Dual Enviroment Bracket



George F. Schudy(1990)
Design based on computer remodeling
Large outer slot –.040’’for
twin brackets and.030’’for
single brackets.
Smaller inner slot-.018/.016’’


35



Outer slot allows the
use of full size .
016×.022 initial arch
wire



Same wire seated in
inner slot


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

Clinical advantage

1.

Faster leveling of the arches with fewer wire
changes

2.

Easier torquing of the teeth


37

Bioefficient brackets (1995)


Anthony D.Viazis 
deltoid bracket
Wide horizontal member but has a single width slot.
Multifunctional bracket for
bioefficient therapy


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

Maximum potential of any archwire is achieved when
the largest possible wire is used.

1. Conformity to the crown anatomy and gingival outline.


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2. Ease in positioning due to the bracket design.


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Improper placement  easily recognized

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3. Minimum friction - Slot is elevated from the
horizontal member. Area of contact bw the wire
and the bracket is reduced

Better esthetics


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4. Tip control -horizontal

member has a twin
bracket like effect.


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5. Better rotational control


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Transition from .022  .018 slot

022’’ or 0.55 mm wide
028’’ deep
Gold archwires
Late 1920s stainless steel
Difference in the properties


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Transition from .022  .018 slot
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Reduce the size of the wire
Reduce the slot width to .018’’
Smaller archwires were used 018×025’’
Force delivered was acceptable
Introduction of TMA and NiTi
Limitation of original 022 slot have been overcome


46

Andrews straight wire appliance





BRACKETS stand in between tooth and the
orthodontist
1960 – concept of fully programmed appliance
Advantage of FPA
ELIMINATES WIRE BENDING


47

Andrews


Driving force for FPA

1.

Analysis of orthodontically treated final occlusion
Analysis of naturally occurring optimal occlusion
Six keys to normal occlusion

2.
3.


48

Andrews

Andrews plane

49

Andrews

FACC
FA point
Angulation


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Andrews

Inclination


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Interarch relationship


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Crown angulation


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Crown inclination


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Crown inclination of posteriors


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Absence of rotations

Curve of spee

Tight contacts


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Andrews classification
1.

Non programmed appliance-a set of brackets
designed the same for all tooth types ,relying totally
on wire bending.

2.

Partly programmed appliance- a set of brackets
designed with some in built features ,but always
require some wire bending

3.

Fully programmed appliance- a set of brackets
designed to guide teeth directly to their goal
positions with unbent wires.

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Features of Edgewise Bracket


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Non programmed bracket


Angle’s edgewise app

FA point on FACC

All crowns will have equal facial prominences
Extensive Wire bending

59



Design shortcomings

1. Bracket base perpendicular to bracket stem.
2. Bracket bases are not contoured.
3. Slots are not angulated
4. Bracket stem are of equal faciolingual thickness.
5. Maxillary molar offset is not built in.
6. Bracket siting techniques are unsatisfactory.


60

1.

Bracket base perpendicular to bracket stem.


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63



Bracket bases are not contoured occlusogingivally.


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Greater than 2°
Greater than 0.5 mm


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66



67


Mesio-distal base contour

68



Slots not angulated


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70



Bracket stem are of equal faciolingual thickness


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Maxillary molar offset is not built in.

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Bracket siting techniques are unsatisfactory.


Wire bending
Primary wire bends (1st, 2nd,
3rd order )
Secondary wire bends
tertiary wire bends

73

Wire bending

angulation


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Wire bending

Occlusogingival slot positioning

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Wire bending

Inclination

76

Wire bending

Prominence differences

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Wire bending

Prominence differences

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Wire bending

Total 76 bends

Fully programmed appliance

79



Simplest version of FPA
Standard brackets

One bracket for each tooth except for incisors and
Maxillary molars
Partly programmed app  3 slot siting features

80



Slot siting feature
Feature 1Mid transverse planes of the
slot, stem and crown must be
the same.


81



Slot siting feature

Feature 2- Base of the bracket for each tooth type must
have same inclination as the facial plane of the crown.

82



Slot siting feature

Feature 3- Each bracket inclined base must
be contoured occluso gingivally

83

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Slot siting feature

Feature 4- Mid sagittal plane of the slot,
stem and crown must be same.

84



Slot siting feature

Feature 5 -The plane of the bracket base at its
base point must be identical to the facial
plane of the crown at the FA point

85



Slot siting feature

Feature 6 - Mesio distal curvature of base should match
tooth.

the m-d contour of the

86



Slot siting feature

Feature 7 - The vertical components should be parallel
to one another
The horizontal components
should be equidistant from the
gingiva and the cusp tips.


87

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Slot siting feature


88

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Slot siting feature

Feature 8 – All slots point
must have same distance
between them and the crown
embrasure line.


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Convenience feature-

1. The gingival tie wings of the posterior
Brackets extend farther laterally .

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2. Bases are inclined .

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3. Facial surface of the incisor and canine brackets
are designed to parallel their bases - lip comfort.

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4. In mandibular incisor brackets, the tie wings are
designed with least amount occlusofacial
prominence
5.Bracket identification.

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Auxiliary feature –
- Power arms
- Hooks
- Face bow tubes
- Utility tubes
- Rotational wings


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Incisor bracket

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3 brackets with different base inclinations

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Post treatment interjaw relationship can be predicted



Unpublished study (1968) on hundred cephs


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Incisor bracket


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Incisor bracket

Cl II

Cl I

Cl III

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Incisor bracket

Cl II

Cl I

Cl III

98

Angulation for central and lateral incisorsTooth

Central

Lateral

Maxillary

5

9

Mandibular

2

2


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Posterior bracket


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Tooth

II molar

I Molar

II PM

I PM

Canine

Maxillary

5/-9
(10o
offset)

5/-9
(10o
offset)

2/-7

2/-7

11/-7

Mandibul
ar

2/-35

2/-30

2/-22

2/-17

5/-11


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Inclination and angulation for 6-7 to finish in class
II
Tip reduced and offset removed

Tooth

II Molar

I Molar

Maxillary

0/-9

0/-9

Mandibular

-

-


102

Fully programmed Translation brackets






Bodily movement of the teeth is required
What is translation???
Translation problems
Need for over correction


103



They have all the qualities of the standard brackets
plus few other feature .
Power arm
Counter mesiodistal tip
Counter rotation
Counter buccolingual tip


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Minimum translation bracket – requiring a translation of
2 mm or less
Medium translation brackets – requiring a
translation of more than 2mm but less than 4 mm
Maximum translation brackets -requiring a
translation of more than 4 mm.


105

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Translation solutions-


106

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Concept regarding Levers


107

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Lever common to all edgewise brackets


108

Counter rotation

The slot is rotated in the direction of translation
Slot rotation plus mesiodistal slot length plus
archwire flex equals counterrotation and
rotation overcorrection.

109

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Countermesiodistal tip


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Slot angulation plus mesiodistal slot length plus power
arm length plus activated archwire equals
Countermesiodistal tip and angulation overcorrection.

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Counterbuccolingual tip

Base inclination + faciolingual slot length + arch
wire deflection = Counterbuccolingual tip

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Why different prescriptions???
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1.
2.
3.
4.
5.
6.


Valid reasons
Natural variations
Different growth patterns
Different malocclusions (Cl II div II)
Need for overcorrection (Roth)
Arch wire play (Bioprogressive therapy)
Ethnic differences
Commercial reasons

113

Why different prescriptions???
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Andrews
Roth
MBT

022 slot

Bioprogressive – 018 slot
Alexander ( vari- simplex) – 016 slot

114

Vari-simplex discipline-Alexander
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1.
2.
3.

Vari – variety of bracket used
Simplex – KISS principle
fewer archwire changes
Treatment philosophy – Tweeds fundamentals
Anchorage preparation
Positioning Mb incisors over basal bone
Orthopedic alteration using head gear


115

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Key objective
Non extraction therapy as far as possible
Interproximal enamel reduction
Control of Mb incisor position with –ve torque


116

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Bracket selection
Twin brackets
Lang brackets
Lewis brackets


117


Wedge shape in profile
Allows ease in lagation
Prevents food lodgments

Lang brackets

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Why not use lewis bracket on canine ???
Arch wire placement
Curvature maintained
Mx cuspid attrition

119

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Bracket positioning

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Key for placement –
bicuspid height --X


120

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Angulation
Measured from long axis of
crown

Major change
Tip of mand molars
2 ° to - 6°

121



Reason for -6°tip
Gain in the arch length
Promotes leveling
0° angulation in Mb 2nd molar–
Need not to be uprighted excessively


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Thank you
Leader in continuing dental education


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Evolution of orthodontic brackets /certified fixed orthodontic courses by Indian dental academy

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