Orthodontic brackets part 1

Orthodontic
brackets-part 1
www.indiandentalacademy.com

Evolution of brackets
(appliance)
“All you can do is push ,pull ,or turn a
tooth. “ Edward H Angle to Frederick Noyes
Bracket- an attachment that serves to
deliver the necessary tooth moving forces
Bracket may be defined as an
orthodontic attachment secured to a tooth
for the purpose of engaging an arch
wire .-Thurow

Edward Hartley Angle

Angle system
A standard appliance must haveA standard appliance must have
five important properties-five important properties-
1.1.SimpleSimple
2.2.StableStable
3.3.EfficiencyEfficiency
4.4.DelicateDelicate
5.5.InconspicuousInconspicuous
Patient Orthodontist
Manufacturer/supplier

E Arch -1907
Basic E arch

Ribbed E -arch

E arch without
threaded ends

E arch with hooks

Pin and tube-1910

The Ribbon Arch-1915

Edgewise Appliance
 0.022*0.028
 0.050 Inch wide
 Gold bracket
 Gold band
 Ligature tie

Three dimensional
control of tooth
 First order
bends
 Second order
bends
 Third order
bends
 In & out
 Tip
 torque

Begg Appliance
 It utilizes the ribbon arch type
brackets and was
manufactured to accept 016’
round wire
 Wire was held in position with
the lock pins .020 x .045 slot
Dr P.R.Begg 1956

Lock pins
 Safety lock pins
 Hook lock pins
 High hat pins

Evolution of the edgewise
brackets
 Soldering gold eyelets- Angle
 Use of two brackets on a single tooth
 “Siamese twin brackets

Twin brackets

Tweed-Merrifield
appliance
 Double wide brackets
on 6 anteriors
 Intermediate Single
width brackets on
Premolar bands
 Twin brackets on
molars
 0.022 tubes on
second molars

Twin brackets
 ADVANTAGES
 Rotational control : mainly by deflection of arch
wire
 Positive control
 DISADVANTAGES
 10% play of arch wire
 Decreased amount of arch wire ,Inter bracket
span & resiliency
 Closing loop arch wires
 Second order bendswww.indiandentalacademy.com

Lewis bracket
 He soldered
auxiliary rotation
arm that abutted
against the bracket
itself and thus
offered a lever arm
to deflect arch wire
and rotate the teeth

Advantages of Lewis
bracket
 Does not interfere with resiliency
,closing loops &second order bends
 100% correction & over corrections

Curved Lewis bracket
 advantages
1. Increase contact
with band .
2. Reduces trapping
of the food.

Vertical slot Lewis
bracket
Here further refinement was done by
incorporating a 020 x020 vertical slot
Use of up righting spring to correct axial
inclination possible.

Creekmore Uni Twin
Bracket
 Rationale –Twin bracket
offered better rotational
control which the
single bracket could not
match until the
rotational wings were
added
 Disadv-Badly rotated
tooth

 Steiner bracket
 This bracket incorporated flexible
rotation arms and therefore did not
rely entirely on the resiliency of arch
wire for tooth rotation.
 It uses a single width edgewise
bracket and has the inherent
advantage and disadvantage of the
same

Broussard bracket
 Was designed by
“Grayford broussard”
 Modified edgewise
bracket in which there
is addition of 0.0185 x
0.046 slot –to accept
0.018 auxiliary wire
 special torque
brackets.- 0,7˚,17˚,22˚

Burstone’s canine & 2nd
premolar brackets
This consists of a
basic .022 x .028
edgewise slot &
additional .017 x .
025 vertical
auxiliary tube for
insertion of
retraction
assemblies.

Changing concepts
1955-1970
 1955 Acid etch by Buonocore
 1965 Direct bonding by Newman
 1970 bisGMA widely used for bonding
 Complex wire bending skills needed
for refined tooth movement in std E W
 Begg technique used by uninformed
,unskilled & poorly trained operators
 1972 six keys to normal occlusion
Lawrence F.Andrewswww.indiandentalacademy.com

Deltoid brackets
 Single type –
poor rotational
control
 Twin brackets-
reduced wire
 Winged
brackets –poor
oral hygiene
Anthony B Viazis

 Rotational control
 Sliding mechanics
 Reduced friction
 Orientation
 Torque control
Deltoid brackets

DUAL ENVIROMENT
BRACKET
 Design was based on computer
modeling
 Large outer slot - 0.040”-0.030”
allows maximum arch wire
flexibility in the initial phases of the
treatment
 Smaller inner slot - 0.018” 0.016”
accepts small rectangular wires for
maximum control in the later stages
of the treatment
.
Schudy 1990Schudy 1990

Features of Edgewise
Bracket

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.www.indiandentalacademy.com

Design shortcomings of
Non programmed bracket
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 sitting techniques are unsatisfactory.

 Inclinations
 Occlusogingi
val levels
Perpendicular base & stem

Non contoured bases
Occlusogingival
Mesiodistal www.indiandentalacademy.com

Slots are not angulated

Bracket stem are of equal
faciolingual thickness.

Maxillary molar offset
is not built in

Bracket sitting techniques
are unsatisfactory.
Tweed recommends sitting brackets in
specified number of millimeters from the
incisal edge.
Holdaway advocates that the bracket sitting
should altered according to the
malocclusion
According to Jarabak bracket sites for
inclination should be determined by the shape
of the crown.
Saltzman recommends except for the maxillary
lateral incisor ,brackets should be located inwww.indiandentalacademy.com

Wire bending
 Primary Wire bending
 1st
,2nd
& 3rd
order bends
 Secondary Wire bending
 Slot irregularities
 Side effects
 Human errors
 Tertiary Wire bending
 Loops ,&stops

Partly programmed
appliance
 Bracket angulation -Reed Holdaway
1958
 Bracket slot angulation

Torqued brackets
•Ivan Lee suggested torquing
of slots
•Torque in base
•Torque in face

 Raised base upper lateral brackets
 Angulated molar brackets/tubes
 Jarabak combined 2 features

Fully programmed
appliance
 The Straight Wire Appliance
- Slot-siting feature
-
- Convenience feature
- Auxiliary feature

Feature 1- mid transverse planes of the slot
stem and crown must be the same

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

 Feature 3-each bracket inclined base
must be contoured o-g

 Feature 4- mid sagittal plane of the
slot stem and crown must
be same

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.

 Feature 6 - base should match the m-d
contour of the tooth.

 Feature 7 - the vertical component should
be parallel to one another.

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

Convenience features
1. The gingival tie wings of the post
Brackets extend farther laterally .

 Base are inclined

Facial surface of the incisor and
canine brackets are designed to
parallel their bases.

In mandibular brackets the tie wings
are designed with least amount
occlusofacial prominence
Bracket identification

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

 The Straight Wire Appliance
Slot-siting feature
Convenience feature
Auxiliary feature

Translation problems
Counter buccolingual tipCounter buccolingual tip
Counter mesiodistal tipCounter mesiodistal tip
Counter rotationCounter rotation

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

Vari Simplex Discipline
Factors defining the
bracket system-
-Type of bracket
-Placement positions
-Angulations
-Torque
-In /out compensations
Alexander-1978

Lang bracket-cuspids
 It was invented
by Dr Howard
Lang
 single bracket
with a flat
rotational control
wing
-each wing has a
circular hole .
- Wedge shape in
profile

 Lewis brackets-Bicuspids & lower incisors
 Twin brackets with convertible sheath-1st
molars
 Bracket positioning –X
 Tip –0 all posteriors(-6 lower 1st
molar)
 Torque-negative with lower incisors (-5)
 -3˚ torque on maxillary cuspid
 No torque in the second molar tube
 In out –thick for upper laterals & lower incisors
Vari Simplex Discipline

Roth Prescription
 “Five year clinical evaluation of the
Andrews Straight Wire Appliance 1976
 Inventory
– Tip canine upper 11-13,lower 5-7
 Anchorage loss
– Tip posteriors upper 0 ,lower-1
 Over correction
– Torque increased with upper incisors by 5

MBT
 McLaughlin &Bennett 1975-1993
– Bracket positioning
– ,lacebacks, & bendbacks for anchorage
control
– leveling with light arch wires ,
– sliding mechanics with 0.019/0.025 steel
wires
– Ovoid arch wire

MBT Versatile+
 Additional tip in upper anteriors caused
– Anchorage strain ( 8-11-13 canine)
– Bite deepening
– Upper canine root apex close to premolars
 Overall increase in upper anterior torque
 Three torque options for canines 7,0,-7
 Square ,ovoid &tapered arch form

Slot size 0.022 / 0.018?
 0.022 Angle used gold wires
 SS wire being rigid applies excessive force
 lower wire in larger slot torque lost
 0.018 slot ideal when sliding is not needed
 Alexander-0.18 for ease of placement &
patient comfort
 MBT 0.022 slot
– Reduces treatment forces(opening stages)
– Working wire is.019/.025 works well with sliding
mechanics
– .018slot working wire .017 has greater
deflection & shows bindingwww.indiandentalacademy.com

Begg today
 Conventional Begg
 Modified Begg
 Refined Begg

Kamedanized Begg
 introduced by Dr Akira
Kameda
 He introduced
torquing and reverse
torquing brackets In
1983
 Ribbon arch buccal
tube in 1986.
 efforts are going on to
develop a new type of
KB bracket with a built
in T-Pin.www.indiandentalacademy.com

Refined Begg
Anti rotationalAnti rotational
brackets .brackets .
Pins used in Refined Begg

References
 Orthodontics- current principles &
technique-Graber &Swain
 Orthodontics- current principles &
technique-Graber & Vanarsdall
 Straight wire –The concept &appliance –
Andrews
 The Alexander discipline –contemporary
concepts &philosophies -Wick Alexander
 Atlas of Orthodontics- principles & clinical
applications –Viazis

References
 Begg orthodontic theory &technique-
Begg & Kesling
 Refined Begg for modern times
-Dr V P Jayade
 Systemized orthodontic treatment
-McLaughlin ,Bennett & Trevisi
 New vistas in orthodontics –Kesling
 K B technique its theory & practice-
JIOS1992Dr Akira Kameda

Orthodontic brackets part 1

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Orthodontic brackets part 1