Selfligating brackets /certified fixed orthodontic courses by Indian dental academy

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


SELF LIGATING BRACKETS
• Introduction
• Types of Self Ligating Brackets
• Advantages of Self Ligating Brackets
• Conclusion


INTRODUCTION
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Self ligating Brackets are a Ligatureless
bracket system that has a mechanical
device built into the bracket to close off
the slot.
The concept of Self ligating brackets has
been in existence since 1935 . Russell lock
edgewise attachment was the first self
ligating bracket and was described by Dr
Jacob Stolzenberg in 1935.
Newer designs of these brackets continue
to appear even today.

Properties of an ideal ligation system
The concept that brackets are ligated via tie-wings is so
prevalent that it is worthwhile considering a list of ideal
properties of any ligation system.
Ligation should :
 be secure and robust;
 ensure full bracket engagement of the archwire;
 exhibit low friction between bracket and archwire;
 be quick and easy to use;
 permit high friction when desired;
 permit easy attachment of elastic chain;
 assist good oral hygiene;
 be comfortable for the patient.

DRAW BACKS OF CONVENTIONAL LIGATION
 Failure to provide and to maintain full archwire engagement.
 High friction.
 For elastomerics, the force (and therefore tooth control) decays
and they are sometimes lost.
 Potential impediment to oral hygiene.
 Wire ligation is very slow.
Wire ties are secure, robust, enable full, partial or distant ligation,
and have lower friction than elastomerics. Their largest drawback is
the time required for ligation. Elastomerics are quick, but less good
in every other respect. Neither method is ideal or nearly as good as a
molar tube assembly, which is universally adopted as the ‘ligation’ of
choice on posterior teeth. www.indiandentalacademy.com

Advantages of Self Ligating Brackets
These advantages apply in principle to all selfligating brackets, although the different makes vary in
their ability to deliver these advantages consistently in
practice:
 More certain full archwire engagement;
 Low friction between bracket and archwire;
 Less chairside assistance;
 Faster archwire removal and ligation.


Self ligating brackets
ACTIVE CLIPS

PASSIVE SLIDES


ACTIVE CLIP BRACKETS
Speed – Orec – 1980
Time - Adenta - 1994
EvolutionLT – Adenta – 2002
Inovation – GAC – 2000
Inovation – R – GAC –2002


PASSIVE SLIDES BRACKETS
Edgelock – Ormco – 1972
Mobil lock – Forestadent – 1974
Activa – A company – 1986
Damon SL – A company - 1996
Twin lock – Ormco – 1998
Damon 2 - A company – 2000
Damon 3 – A company -200
Smart clip – 3M unitek

Russell Lock Edgewise
Attachment
First Self Ligating Bracket
described by Dr. Jacob Stolzenberg
Year 1935.It is an edgewise appliance.
• Russell bracket had a flat head
screw seated snugly in a circular,
threaded opening in the face of the
bracket

• Horizontal screw could be loosened or
tightened with a small watch repair screw
driver to obtain the desired tooth
movement
• Loosening allows bodily translation of
round wire,whereas tightening facilitates
root torquing with rectangular wire.
• The flat lingual surface of this nut created a
fourth wall to the arch wire slot and its
variable position controlled arch wire activity

EDGE LOCK BRACKET
First Passive Self Ligating
Bracket described by Dr. Wild man
in the Year 1972.

•

Edgelock bracket had a round body
with a rigid labial sliding cap.
A special opening tool was used to
move the slide occlusally for archwire
insertion.
When the cap was closed over the
archwire with finger pressure, the bracket
slot was converted to a tube with in which
the arch wire had total freedom of
movement.

Mobil Lock Bracket
• It is a Passive edgewise Self
Ligating Bracket described by Dr.
Franz Sander in the Year 1974.
• Mobil lock bracket had a rigid
Semicircular labial disk
• A Special opening Tool was
required to open and close the
semicircular labial disk.
• The passive outer wall
transformed the bracket slot in to a
tube that loosely contained the arch
wire.

Evolution of self-ligating
bracket designs
depicting path of travel
for outer (fourth) wall,

view of a maxillary, left canine
SPEED appliance.


SPEED bracket
It is an Active Self ligating
Bracket described by Dr. Hanson in
the year 1975.

Components of SPEED Bracket
• Bracket body
• Spring clip
• In-out adaptor
• Mesh pad

Bracket body
• Single bracket body system
• Body design is narrow for
the Anteriors .
• Body design slightly wider
for the posteriors which
features a miniaturized
mushroom-shaped hook that
neatly projects from the distalgingival of each bracket body.
• Multislotted.

1. Pre torqued arch wire slot
• Arch wire slot is available in either
0.018 x 0.025 inch or 0.022 x 0.028
inch
to accommodate round,
rectangular,and
SPEED shaped arch
2. Auxiliary slot
wires
• It is 0.016-inch square auxiliary slot
• It runs parallel to the main arch wire slot
occlusally.
• Auxillary slot remains as a tube even when
spring clip is in open position
3. Spring retainer slot
• The spring retainer slot houses the recurved
tip of the spring clip.

Spring clip
a ) Roll-shaped, flexible spring clip
b ) Highly resilient spring clip opens and
closes in a vertical manner to permit arch
wire removal and insertion
c ) Shape of the clip eliminates any
possibility of accidental arch wire release
through the incorporation of a recurved tip.

In-out adaptor
Adaptor features both an angular and a
translational dimension,Which ensures the creation
of an exceptionally smooth arch form.

Mesh pad
Foil mesh bonding pad


Advantages of SPEED Bracket
Size
a ) It is 30% less in size of conventional PEA
brackets. This smaller size adds ease to bond on
small and partially erupted tooth
b ) Esthetics

Auxillary slot
a ) Preformed hooks for use with elastics
b ) Segmental arch wires
c ) A ligature tie or elastomeric thread may be fed
through the slot and then tied to the arch wire

Bracket Base
It consists of sintered porous metal coating which
is an irregular microscopic stainless steel particles
fused together and to the bracket base to create
network of pores for a strong adhesive grips
which in turn increases the bond strength.

Mushroom hook
Mushroom hook permits the gingival positioning
of the elastomeric power module and hence, the
chances of frictional drag between the arch wire and
the elastomeric power module become nonexistent.

Activa bracket
It is Passive Self Ligating
Bracket described by Erwin
pletcher in theYear 1986
•Activa bracket had an
inflexible, curved arm that
rotated occlusogingivally around
the cylindrical bracket body
•The arch wire is retained by a
resilient clip that rotates into a
retaining groove.

• Clips can be opened and closed with a
wide range of commonly used hand
instruments including ligature directors,
flat plastics, and Mitchell's trimmers
• Vertical slots behind the arch wire
channel.

Advantages of vertical slot
• T-shaped locking pins are used for Closure of
diastema with T pins and elastic chain
• Ligature connection of palatal canine to
buccal sectional wire
• Rotating spring used to overrotate a canine.

Disadvantages of Activa Brackets
Higher bond failure rate
Bases are slightly smaller than covventional
brackets which lead to less rigidity of the bracket
base and easier distortion of the base and
consequent bond failure under external loading
forces

Less convenient with power chain
When closing the multiple spaces, elastic
chain must either be placed behind the arch wire
or T-shaped locking pins must be placed in
several brackets.

Difficulties during bracket placement
Tie-wings are useful holding points for tweezers
and their absence dictates minor changes in
bracket placement technique especially with canine
brackets

Breakage of arch wire retaining clips
Clip breakages are mainly due to the excessive
force while trying to engage a stiffer arch wire .
If a clip breaks, it is possible to replace it with a
new clip without removing and replacing the
bracket.

Time bracket
Active Self Ligating
Bracket described by Wolf
Gang Heiser in the Year 1994
First one-piece self-ligating
system with CAD/CAM
computer technology
Time bracket had a rigid
curved arm that wraps
occlusogingivally around t he
labial aspect of bracket
body

• Spring clip can be opened by dental probe
• The spring clip can be removed by overopening it or by sliding it mesially or
distally.

Disadvantages of Time Brackets
• Bracket base has microetched mechanical undercuts
• With one piece bracket system,the distance between
slot and base is increased which inturn reduced the
inout values.This is more marked in lower incisor
with reduction of prominence by 1/3

TwinLock bracket

Is a Passive self ligating Bracket
described by Jim Wildman in the Year
1998
Twin lock Bracket had flat,
rectangular slide, housed between the
tie wings of an edgewise twin bracket.
Passive slide is moved occlusally into
the slot open position with a universal
scaler
Passive slide is moved gingivally
with finger pressure to entrap the
archwire in a passive configuration.

Damon SL I bracket
Is a Passive self ligating bracket described
by Dwight Damon in the Year 1996.
Damon I had a Flat rectangular slide
outside the face of bracket, which
straddled along the tie wings
The slide clicked into a positive open or
shut position and opened in a downwards
direction in both jaws to give a full view of
the slot.
A tiny U – shaped wire spring lays under
the slide to provide positive open and shut
position

Disadvantage of DamonSL I Bracket
• Inadvertent opening of the slide
• Loss of Slide
Can be due to Breakage of slide caused by
work hardening of slide corners and also due to
the overall length of the slide and the play in the
slide/bracket contact. This permitted over-opening
of the slide, which could pass beyond the stop
provided by the underlying U-shaped wire.

Damon 2 bracket
Is a Passive self ligating
bracket introduced by Dr.
Dwight Damon in the Year
2000.
The imperfections in
Damon brackets led to the
development of Damon2
brackets.

These brackets retain the same vertical slide
action and U-shaped spring to control opening
and closing, but place the slide within the shelter
of the tiewings.
Combined with the metal injection
moulding manufacture, which permits closer
tolerances, these developments have almost
completely eliminated inadvertent slide opening
or slide breakage.
Slides can be opened and closed with
conventional light wire plier.
Slide can be opened inferiorly in both arches
in order to give an unobstructed view of the
slot.

DAMON -3
1. A combination of clear material and
stainless steel provides the aesthetics your
patients will love.
2. Remarkably easy-to-use slide
mechanism makes wire changes easier.
3. Ultra-smooth contours and rounded
edges provide maximum comfort.
4. Slot with four solid walls facilitates fast
low-friction tooth movement with maximum
control.
5. High-retention mechanical bonding base
assures strong, reliable bonding.

GAC IN – OVATION BRACKET

Is a First twin bracket with active clip
Micheal C Alpern in the Year 2002


• These are very similar to the SPEED bracket in
conception and design, but are of a twin
configuration Bracket manufactured with metal
injection moulding
• V – Tool(Tweezer ) is used for opening the clip
• Active clip which is made from cobalt chromium
alloy is highly resistant to fracture
Slot Blocker :
• Prevents archwire from escaping from the bracket
• Torque Expression

Horizontal slot
• This slot runs through the occlusal
wings
Super mesh base
• This houses a wide mesh over a tighter
mesh
Disadvantages
• Gingival end of the spring clip is
difficult to open especially in the
lower arch.

In-Ovation-R
In-Ovation-R remains passive with
small leveling wires, while it actively seats your finishing
wires.
In-Ovation-R's hook is smooth
and rounded for enhanced function,
aesthetics, and patient comfort. full rotational control
with the clip's full span and slot blocker is possible.
Easy to Open and Easy to Close.
Functionality


Oyster Self Ligating Bracket
First Translucent Self Ligating
Bracket Year : 2003
• Strong,Fiberglass reinforced
composite polymer
• Cap can be removed and place
back again
• Mushroom hook for elastic
attachment
Disadvantage

• Poor Dimensional Stability
• Staining nature


PHILIPPE SELF LIGATING
LINGUAL BRACKET
Philippe Self ligating Brackets were
introduced in the year 2002
• These brackets can be bonded
directly to the lingual surface of
the tooth
• Bracket wings are opened with
Haideman spatula
• Brackets are closed with a
Weingart utility plier .

Advantages
• Post-treatment retention
• Limited intrusion
• Closure of minor spaces.
• Correction of mild crowding
• Alternative to conventional lingual brackets
in cases that do not require 3rd - order tooth
movements

Disadvantages
• These brackets do not have slots

SMART CLIP SELF LIGATING BRACKETS

Has Twin bracket design that lets you keep your
preferred treatment techniques.

Manufactured with MBT™ System Prescription and Engineered
from nickel-titanium, which has an intrinsic memory for shape and
force, the SmartClip™ Bracket self-ligating mechanism secures the
archwire in place, yet is specially calibrated to release the archwire
if forces exceed a predetermined level.
This helps assure that force levels recommended for
biocompatible tooth movement are not exceeded, therefore
promoting efficient tooth movement with less patient discomfort.
The integral nickel-titaniumwww.indiandentalacademy.com
clips permit easy and simple archwire

Properties of Self Ligating Brackets
1. LOW FRICTION
 In orthodontic sliding mechanics, friction is
determined by the type of archwire, the type of bracket
and the method of ligation.
 In active Self-ligating system, friction is produced as a
result of the clip pressing against the archwire. These
brackets have greater torque control without unduly
increasing the friction.
 In the passive self-ligating system, there is no actual
contact of the clip with the archwire, The full bracket
expression is achieved only when higher dimensional
wires are used.

Very low friction with self-ligating brackets has been clearly
demonstrated and quantified in work by various authors, for
both Activa and Speed brackets, and Edgelok.
 Voudouris has reported greatly reduced friction with Sigma
and Interactwin prototypes and with Damon brackets. The
friction is dramatically lower than for elastomeric rings with
conventional brackets and seems to be an inherent characteristic
of self-ligating brackets.
 Thomas et al. confirmed extremely low friction with Damon
brackets compared to both conventional pre-adjusted and also
Tip-Edge brackets.
 Kapur found dramatically lower friction with both stainless
steel and nickel-titanium wires for Damon brackets compared to
conventional brackets. With NiTi wires, the friction per bracket
was 41 g with MiniTwin and conventional ligation and 15 g
with Damon brackets; whilst with stainless steel wires, these
values were 61 and only 3.6 g, respectively

 Pizzoni et al have reported that Damon brackets showed
lower friction than Speed which in turn had less friction
than conventional brackets stating that: ‘In the case of
rectangular wires, the Damon bracket was significantly
better than any of the other brackets and should be
preferred if sliding mechanics is the technique of choice’.
 Meling et al examining the effect of friction on wire
stiffness concluded that each elastomeric placed in an ‘O’
configuration produces an average of 50 g of frictional
force.
 Ravnholt and Birte melsen in the year 1998 studied the
frictional resistance of self ligating brackets and confirmed
the low friction offered by self ligating brackets
 In 2004 kusy and henao concluded that the self-ligating
brackets performed better than the conventional brackets,
more when coupled with smaller dimension archwires

2. ACCULOCK
The precision arm accurately locks the
archwire within the dimensions of the slot in an
“all or nothing Pattern
a) Robust Ligation
b) Controlled tooth movement

3. Archflow
Archflow describes both flow mechanics of
the self ligating bracket along the archwire and the
distal drift of the archwire .

4. Autoseat
Active self ligating brackets : Automatic seating
of either a round or a rectangular archwire in the base
of the slot is responsible for the rotation and Torque
control from early of the treatment.
Passive self ligating brackets : Passive interaction
is almost strictly a one-way force interchange . The
archwire presses against the straight precision arm,
which then reacts to the archwire force Rotation
control is efficiently achieved only by using larger
rectangular archwires.

5. Arch Flexibility
a) The low friction of the resilient and flexible
stainless steel precision arms reduces inter
bracket archwire deflections , resulting in freer,
biocompatible three-dimensional tooth movements.
b) The narrowest arm and the smallest bracket body,
provide additional archwire flexibility.


6. Anchorage Conservation
a) The low friction of interactive brackets allows the
application of consistent, light forces for efficient
flow mechanics during retraction. This, in turn,
reduces posterior anchorage loss
b) Lower net force deflect archwire less and
facilitate release of binding forces between the
archwire and bracket,enhancing sliding of bracket
along the archwire.


7. Asepsis
a) The four tie-wing undercuts are left open
for the self-cleansing effects of salivary fluids.
b) The precision arm is integrated into the bracket
body, thus contributing to the prevention of enamel
discoloration and gingival inflammation.

8.Comfortable for the patient
Patients bonded with self ligating brackets
invariably reported that the brackets were smoother
and wings did not seem to stick into the cheeks and
lips,which reduces the risk of skin perforation and
possible infection . And also oral hygiene maintenance
is easier than with conventional brckets.

9.Less chair side time
 In 1994 Shivapuja and Berger showed that 12
minutes added time for both archwire removal and
placement in conventional method compared to self
ligating system (speed)
 In 1996,Harridine showed the self-ligating brackets
frees an additional seven minutes of the appointment for
positive reinforcement of proper oral hygiene, discussion of
progress, or simply communicating with the patient.


10.Patient Acceptance
a) Frequency of visit
The ability to ensure full and secure
engagement of modern, low modulus wires
make the interval between appointments even
up to 10 weeks.
b) Duration of visit
More time is utilized for arch wire adjustment and
change when conventional brackets are used compared
to self ligating brackets

Clinical tips in using self Ligating
Brackets


Aids in full archwire engagement with self ligating
bracket
 Opening and closing Clips / Slides
 Prevention of wire pokes
 Changing Treatment Mechanics


In cases where anchorage control is needed one can
use passive and when anchorage control is less
demanding, an active appliance can be used.
• Active brackets are preferred in cases which require
more tip and torque correction and thus aids in in a
better finishing and detailing.
• Additional torque should be added to the arch
wire in passive self-ligating bracket, or larger
dimension arch wire should be used,or expanded
archform or design of the bracket should be changed
with additional tip and torque values.
•


Conclusion
Self Ligating brackets thus offer valuable
combinations of extremely low friction, secure full
bracket engagement and reduction in duration of
archwire ligation .These development offer the
possibility of a significant reduction in average
treatment time and also in anchorage requirements,
particularly in cases requiring large tooth
movements.
While further refinements are desirable and
further studies are essential, current brackets are
able to deliver measurable benefit with good
robustness and easy to use.

REFERENCES
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Self-ligating brackets: where are we now? - by N. W. T.
Harradine -Journal of Orthodontics, Vol. 30, No. 3, 262273,
September 2003AJO-DO 1994 Mar (217-223): The
SPEED appliance: A 14-year update on this unique selfligating orthodontic mechanism-Jeffrey L. Berger.
JCO 1994 Oct (583-586): Replacement of the Spring Clip
in the SPEED Appliance - JEFFREY L. BERGER.
AJO-DO 1994 Nov (472-480): Conventional ligation
versus self-ligation - Shivapuja and Berger
Angle orthodontist 2004 ;74:202–211-Evaluation of the
Frictional Resistance of Conventional and Self-ligating
Bracket Designs Using Standardized Archwires and
Dental Typodont-Sandra P. Henao, BSa; Robert P. Kusy.

REFERENCES
EJO 1998 (283-291)-Frictional forces related to self ligating
brackets-Luca Pizzoni, Gert Ravnholt and birte melsen.


 B J O 1994; 21: 367–373 -Sims APT, Waters NE, Birnie DJ.
A comparison of the forces required to produce tooth
movement ex vivo through three types of preadjusted brackets
when subjected to determined tip or torque values..
 Berger JL. The influence of the SPEED bracket’s self-ligating
design on force levels in tooth movement: a comparative in
vitro study. AJO 1990; 97: 219–228.
 Angle orthodontist 2005;75:828-832 - Friction of conventional
and self-ligating brackets using a 10 brackets model.
 Angle orthodontist 2004;74:816-824 -Frictional forces
between lingual bracketswww.indiandentalacademy.com measured by a friction
and archwires

 Voudouris JC. Interactive edgewise mechanisms:
form and function comparison with conventional
edgewise brackets. Am J Orthod Dentofac Orthop
1997; 111: 119–140.
 Thomas S, Birnie DJ, Sherriff M. A comparative in
vitro study of the frictional characteristics of two
types of self ligating brackets and two types of
preadjusted edgewise brackets tied with elastomeric
ligatures. Eur J Orthod 1998; 20: 589–596.


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