Fixed orthodontic appliance /certified fixed orthodontic courses by Indian dental academy

FIXED ORTHODONTIC
APPLIANCES

www.indiandentalacademy.com

INDIAN DENTAL ACADEMY
Leader in continuing dental education


Removable vs. Fixed Appliances
REMOVABLE
Tipping only
No control over root
movement
Pt’s co-operation
Hygienic

FIXED
Bodily translation
Control of root
movement
Less dependent on pt’s
co-op
Less hygienic


DEVELOPMENT OF FIXED
ORTHODONTIC APPLIANCES


Development of Fixed appliances
Early fixed appliances
Late 1800s
Edward Angle


EARLY FIXED APPLIANCES


Standard Edgewise appliance
Early 1900s


Pre-adjusted edgewise appliance
1970s
Refined manufacturing process with “builtin” adjustments specific for each tooth
Advances in material sciences made
attachment much smaller

BANDED APPLIANCES


Bonding to Enamel


Bonding Surface - Bracket Base


BONDED APPLIANCES


Lingual Appliance


CERAMIC APPLIANCES


Self Ligating Appliance


PASSIVE FIXED APPLIANCES


Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Buccal Tubes
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances

Posterior attachments
MOLAR TUBES


Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances

Anterior Attachments
Brackets


ARCH WIRES
Maxillary and mandibular
Arch form described as “parabolic shaped”
Size and cross-section of wires vary
Material varies eg. Nickel Titanium alloy
(NiTi), Titanium Molybdenum Alloy
(TMA), Stainless Steel


Elastics


EXTRA ORAL FORCES - HEAD GEAR


Coil Spring

Closed or open coil springs

Pre-Adjusted Edgewise
Appliance or The Straight Wire
Appliance
Larry Andrews - studied normal occlusion
and individual tooth positions
Developed prescriptions for individual
tooth position
Elements of “ideal” tooth position are built
into the appliance
Minimizing active “wire manipulation” The Straight Wire Concept

First order / in-out - Horizontal plane
Second order / tip - Mesio-distal angulation
Third order / torque - Labio-lingual
angulation
3 - Dimensional control of tooth position


First order or In-out


First order / in-out - Horizontal plane
Second order / tip - Mesio-distal angulation
Third order / torque - Labio-lingual
angulation


Second order or Tip

4


Third order or Torque

4

To “Torque” is the least efficient
tooth movement using orthodontic
appliances

Significance of accurate bracket/band
positioning
Precise tooth positioning
Optimal effect of “pre-adjustment”
Occlusion
Esthetics
Stability


POSITIONING BRACKETS GENERAL INSTRUCTIONS
Rhomboidal shape
Disto-lingual wing mark
Central scribe line (long axis)


Maxillary Central Incisors

4

4

• Distance from the slot to the
incisal edge = 4mm
• From the occlusal, the bracket
is centered mesio-distally.
• As a guide, approximate the
incisal edge of the incisor with
the base of the bracket
perpendicular to the clinical
crown long axis.


Maxillary Lateral Incisor
Distance from the slot to the incisal edge
•
= 3.5mm
3.5

3.5


Maxillary Cuspids
• Distance from cusp tip to bracket slot =
4.5 mm
• The severe angulation and prominent
o
anatomy of cuspids (10 ) can make
placement difficult
•
4.5 mm From the occlusal view, the bracket is
centered mesio-distally on the prominent
buccal developmental ridge. This also
corresponds to the clinical crown long
axis. This will usually be mesial to the
center of the contacts
4.5


Maxillary Bicuspids
• Distance from cusp tip to bracket slot =
4 mm
From the occlusal view, the bracket is
centered mesio-distally on the prominent
buccal developmental ridge. This also
corresponds to the clinical crown long
axis.


Mandibular Incisors


Mandibular Cuspid


Mandibular Bicuspids


Maxillary first molar bands


Mandibular first molar bands


Palmer notation used in Orthodontics
Right

Left

Upper
Tooth #

7
2

6
3

2 3 4 5
10 11 12 13

6
14

7
15

Tooth #

31 30 29 28 27 26 25 24 23 22 21 20

19

18

Lower

7

6

7

6

5
4

5

4
5

4

3
6

3

2
7

2

1
8

1

1
9

1

2

3

4

5

Upper

Lower

The bracket height chart is written in Palmer Notation. This notation numbers the teeth starting
st
nd
with the central incisors as 1. The laterals are then 2. The canines are 3. The 1 and 2
st
nd
premolars are 4 and 5 respectively, the 1 molars are 6 and the 2 molars are 7.


Bracket Heights from Cusp tip or Incisal Edge
nd

st

nd

st

st

nd

st

nd

Right

2
M

1
M

2
B

1
B

Cu

LI

CI

CI

LI

Cu

1
B

2
B

1
M

2
M

Left

Upper

7

6

5

4

3

2

1

1

2

3

4

5

6

7

Upper

Bracket
height

4.5
4

4

4

4

3.5
Occ
plane

4

3.5

4

4

4

3.5

3.5

→

Bracket
height

In mm

4.5

3.5

3.5 In mm
4

4

4

4

4

4

4

4.5
Lower

7

6

5

4

3

4

4

4

4

5

6

4.5
2

1

1

2

3


7

Lower

Thank you
Leader in continuing dental education


Fixed orthodontic appliance /certified fixed orthodontic courses by Indian dental academy

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