Evolution of brackets

EVOLUTION OF BRACKETS
DR.TAHER MANASAWALA
DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL
ORTHOPEDICS

Contents
 Chronology
 Evolution of the edgewise bracket
 Classification of brackets
 Manufacturing of orthodontic brackets
 Edgewise bracket
 Tweed Merrifield edgewise bracket
 C.A.T appliance
 Universal bracket system
 Tip edge and Tip edge PLUS bracket system
 Straight wire appliance
 The Butterfly system
 Roth Philosophy

 Bioprogressive therapy by Rickets
 Alexander principle
 Level anchorage system
 MBT bracket system
 Lingual bracket system
 Self ligating brackets
 Self ligating lingual brackets
 Recent advances in orthodontics
 References

Chronology
• Bandellete
• E arch
• Pin and Tube
• Ribbon arch
• Modified ribbon arch
• Universal appliance
• Edgewise
• Twin Wire appliance
• Boyd band bracket
• Ford Lock
• Russell apppliance
• Tweed Merrifield edgewise
• Pierre Fauchard
• Edward Angle
• Edward Angle
• Edward Angle
• P.R. Begg
• Spencer Atkinson
• Edward Angle
• Joseph Johnson
• Boyd
• Ford
• Russell
• Tweed and Merrifield
• 1798
• 1887
• 1910
• 1915
• 1928
• 1928
• 1928
• 1930
• 1933
• 1933
• 1935
• 1941

• Elan and Orthos
• Segmented arch
• Branson
• 1st PEA
• Edgelok bracket
• SPEED system
• New tourqued system
• 2nd PEA
• Bioprogressive therapy
• Vari-Simplex brackets
• Lingual Brackets
• Mobil-lock bracket
• Level Anchorage system
• Lang Bracket
• Craig Andreiko
• Burstone and Baldwin
• Branson
• Lawrence Andrews
• Herbert Hanson
• Thomas Creekmore
• Ronald Roth
• Robert Ricketts
• Wick Alexander
• Kinya Fujita
• Franz Sander
• Terrell Root
• Howard Lang
• 1960
• 1961
• 1966
• 1972
• 1972
• 1972
• 1973
• 1975
• 1976
• 1978
• 1979
• 1979
• 1981
• 1983

• Activa Brackets
• Tip-edge bracket
• Dual Environment bracket
• Viazis Bioeficient
• Time Brackets
• 3rd PEA
• Butterfly system
• Damon bracket
• TwinLock Bracket
• In-Ovation
• Damon 3
• Erwin Pletcher
• Peter Kesling
• George Schudy
• Anthony Viazis
• Wolfgang Heiser
• McLaughlin,Bennett &
Trevisi
• Bowman & Carano
• Dwight Damon
• A. J. Wildman
• Voudouris
• Dwight Damon
• 1986
• 1988
• 1990
• 1995
• 1995
• 1995
• 1996
• 1996
• 1998
• 2000
• 2004

 Orthodontics, as we think of it today has
its roots in France in 18th century when
French physician, Pierre Fauchard (1728)
considered as Father of Dentistry,
described an orthodontic appliance
known as ‘Bandlette’, later known as the
expansion arch.
 However the emergence of orthodontics
as a true specialty was largely the result
of the dominant, dynamic and influential
leadership of Edward Hartley Angle
(1855 to 1930), regarded as the ‘Father of
Modern Orthodontics
Milton B. Asbell A brief History of Orthodontics Am J Orthod Dentofac
Orthop ;1990,98,176-183

 Angle standardized his appliances and developed a
collection of prefabricated parts and thus introduced
the “angle system”
 Angle believed that an orthodontic appliance must
have five properties:
1. Simplicity: It must push, pull, and rotate teeth.
2. Stability: It must be fixed to the teeth.
3. Efficiency: It must be based on Newton’s third law
and anchorage.
4. Delicacy: It must be accepted by the tissues, and it
must not cause inflammation and soreness.
5. Inconspicuousness: It must be aesthetically acceptable

 In 1880 he invented his first real appliance the jack
and traction screw which marked the beginning of
his life work.
 By 1907, he had discontinued using jack screws
and was exclusively using E – arch.
Orthodontics in the past millenium Vijayalakshmi PS & Veereshi AS Journal of
Advanced Dental Research VoI : Issue I: October, 2010

 Angle’s various inventions before his edgewise
appliance are as follows:
1. Basic E arch,
2. Ribbed E Arch - for expansion
3. E Arch without threaded ends,
4. E Arch with hooks,
5. Pin and tube appliance, 1910.
Orthodontics in the past millenium Vijayalakshmi PS & Veereshi AS Journal of

E – arch appliance
 In 1887, Angle developed the prototype of first
bracket attachment
 The appliance consisted of bands only on the first
molars, with wire ligatures tied to a heavy (.060-
in) labial or lingual archwire.
 Brass ligature wire and stationary anchorage in the
molar area were used to expand all the teeth into
normal occlusion.
Orthodontics: Current principles and Technique by Thomas M.Graber and
Robert L. Vanarsdall Jr.;3rd edition

 Basic E arch was used in the mandible with baker
anchorage

Ribbed E arch
 It was used for expansion by tying brass ligatures
to the arch.

 E arch without threaded ends that fit into the molar
sheaths was used with an attached ball for high-pull
head- gear in the incisor area.

 E arch with hooks moved the entire maxillary
dentition distally and the mandibular dentition
mesially by the action of intermaxillary elastics.

Pin and Tube Appliance
 It was the first appliance with a
mechanism for root movement.
 The ideal arch of the E arch appliance
had to be sacrificed so that each tooth
could be moved with the pin and tube
attachment.
 The arches were altered as tooth
movement was carried out, always
progressing toward ideal arch form.

 Shortcomings of the appliance:
a) It was an exceedingly difficult appliance to
manipulate that only few operators could use it.
b) Patients were required to come into the office for
activation every few days.
c) Because of the round tube-round pin
relationship, the appliance lacked the ability to
correct rotations.

 Appliance was an exceedingly difficult to
manipulate as
1. The axial inclination of the pins had to be
altered
2. The square ends of the archwire had to be
fitted properly into the square tubes on the
molar bands.
3. Patients were required to come into the
office for activation every few days.

Ribbon arch appliance
 Angle in 1915 developed the ribbon
arch appliance.
 Brackets were introduced with this
new appliance.
 It was a much simpler appliance to
construct and activate.

 It was characterized by brackets with
a vertical slot
 The archwire, which initially
conformed to the malocclusion, was
held in place in the brackets by brass
pins .

Advantages:
1. It allows rotations to be readily accomplished.
2. It also offer control of buccolingual and
labiolingual movements and both inciso-gingival
and occluso-gingival movement.

 The ribbon arch appliance was not generally suitable
for
1. En-masse movement of teeth was necessary,
particularly in an anteroposterior direction in a
significant number of patient
2. Mesial and distal tipping bends could not be
incorporated into the archwire.
3. The premolar teeth could not be moved bodily.

Modified Ribbon Arch Brackets
(Begg)
 In 1928, P. R. Begg of Adelaide, south Australia, a former student
at the angle school of orthodontia
 Observed that many of the patients he had treated with expansion
using edgewise appliance experienced collapse of their occlusions
at the end of retention and/or had unacceptable soft-tissue
profiles.

 Begg soon realized it was advantageous to close
spaces by tipping the crowns toward their final
positions and reverted to ribbon arch brackets in the
early 1930s.
 He modified the ribbon arch bracket by reducing the
slot size to improve rotational control with 0.016-inch
arch wires and by facing the arch wire slot gingivally.

Advantages
1. Both tipping and bodily movement was possible
with this appliance.
2. Can be used in extraction as well as non extraction
cases.
3. Light forces were generated with this appliance that
does not damage root or tooth investing tissues.

Classification of orthodontic
brackets
1. Based on the attachment to the tooth surface :
A. Weldable
B. Bondable
1. Laminated mesh
2. Porous powder
3. Honeycomb - Microlock
4. Chemically treated

2. Based on material constituent:
A. Stainless steel
B. Polycarbonate
C. Fiber glass Reinforced
D. Ceramic
1. Alumina based
2. Zirconia based
E. Titanium brackets
F. Magnetic Brackets
G. Cobalt Chromium brackets

C. Based on the technique
I. Begg technique
II. Edgewise technique
III. Straight wire technique
IV. Brackets used in combination technique
V. Universal bracket technique
VI. Twin wire technique
VII. Tip edge technique
VIII.Brackets used in Vari Simplex complex
IX. Brackets used in lingual orthodontics

D. Based on the bracket arch wire contact :
1. Ligating brackets
2. Self ligating brackets
E. Based on manufacturing process :
1. Milled bracket
2. Casted Bracket
3. Moulded and Sintered bracket

Manufacturing of orthodontic
brackets
 From thin metal strips that is stampede to bracket shapes
 Milling – one piece attachment is milled on a lathe
 Casting – one piece brackets are casted
 Sintering – partial welding together of metal particles below their
melting point
 Metal injection molding – requires the use of the CAD system along
with computer numerical controlled tools
Brantley orthodontic materials scientific and clinical aspects ,1st edition

Edgewise appliance (1928)
 Consisted of a rectangular box with
three walls within the bracket,
0.022 inch by 0.028 inch in
dimension. Its slot opened
horizontally
 The archwire was held in position
first by a brass ligature and later by
a delicate stainless steel wire
ligature.

Modifications in the edgewise
brackets
 Original Edgewise
Two type of edgewise brackets were
introduced initially:
 Wingless brackets
 Tie brackets
 Soft gold bracket with 0.022 x 0.028
inch slot and .05 inch width was soldered
to gold band.

 Single Width Bracket
 Gold eyelets were soldered in
appropriate positions on orthodontic
bands.
 Ligature wire tied from eyelets to the
archwires rotated the teeth by means
of deflection of the archwire

 However it was necessary to continue tying the eyelets
throughout the treatment to prevent the relapse of the rotation
which was time consuming and inefficient
 The next step in development of present day edgewise brackets
began with the use of two brackets on single teeth.
 The brackets were spaced so the would effect rotation of tooth.

Twin bracket
 The next development was the joining together of two edgewise
brackets on a common base.
 These were named “ Siamese twin brackets” by Swain, the
originator of the idea.
 The space between the two brackets was approximately 0.05 inch

Curved base twin bracket
 Bending the base of brackets with
pliers for canine and premolar
caused deflection in the base .
 The base of the twin brackets were
curved to conform to the
curvatures of canine and
premolars.

Lewis Bracket
 Another approach to the problem of
efficient tooth rotation was developed
by Lewis.
 He soldered auxiliary rotational arms
that abutted against the bracket itself
and thus offered a lever arm to deflect
the archwire and rotate the teeth.

Steiners bracket
 It is single width edgewise brackets in which
flexible rotational arms incorporated.
 Flexible arms also afforded rotational effect and
thus it did not rely completely on the resiliency of
arch wire for tooth rotation.

Broussard bracket
 It was designed by Graford Broussard for use in
Broussard technique.
 Addition of 0.0185 x 0.046 inch vertical slot to
accept a doubled 0.018 inch auxiliary wire

Tweed Merrifield Edgewise
appliance
 In 1941 Charles Tweed introduced an ‘edgewise’ appliance.
 He emphasized the 4 objectives of orthodontic treatment
1. concern for facial esthetics,
2. Serial extraction,
3. Uprighting teeth over basal bone,
4. Extractions made more acceptable.
Orthodontics in the past millenium by Vijayalakshmi PS & Veereshi AS ;Journal of

 The neutral 0.022 slot edgewise appliance
consists of posterior bands and anterior
mesh pads with
1. Single, double-width 0.022 brackets
on the six anterior teeth;
2. Intermediate single width brackets
on the premolar bands;
3. Twin brackets on the first molars;
4. And heavy edgewise 0.022 tubes
with mesial hooks on the second
molars.

 The bands also have lingual hooks attached on the molars.
 Each of the brackets and tubes is placed at right angles to the
long axis of the tooth. They are precisely positioned in relation
to the incisal edges of the incisor teeth and the cusps of the
remaining teeth.
 No tips, torque, or any variations in thickness are present in the
bracket or the neutral slot.

 The concept was to use a light wire appliance system to
establish the early organization of the malocclusion and
then to finish the treatment with a more rigid and precise
straight wire appliance.

 The CAT bracket design has proved to be clinically excellent
for both light wire and straight wire treatments
 It has a 0.022 X 0.035 inch gingival or ribbon arch slot and
either a 0.018 X 0.025 inch or 0.022 x 0.028-inch straight wire
edgewise slot.
 An enclosed vertical slot also is incorporated into the bracket
for use with uprighting or rotating springs, elastic or surgical
fixation hooks, and for attachment of the tandem or double
arch wires.
Combination anchorage technique: An update of current mechanics , American
Journal of Orthod and dentofacial orthop , Volume 93, Number 5 May 1988

 Use of the two different bracket slots provides a simple and
efficient means to vary
1. anchorage (dynamic or static)
2. movement (tipping or bodily)
3. technique (light wire or straight wire)
4. resistance (one tooth or multiple teeth)
5. treatment compensation (skeletal or dental).

 With combination treatment it is possible to use light wire
mechanics at their optimum for rapid anterior alignment,
maximum retraction of incisors, and superb bite opening.
 At the desired point in treatment, the anchorage resistance can
be altered by changing slots, wire size, and friction to produce
maximum edgewise control and resistance in a specific area of
the appliance.

Universal bracket system
 From a biologic standpoint, orthodontics can be divided into two
periods “pre-and post-Oppenheim” .
 Oppenheim wrote that “gentle force continuously applied will
not only move teeth far more rapidly than great force, but that
great force causes congestion and often wholly retards the
functional activity of the cells.”
 In his later experiments, Oppenheim found, by comparing forces
employed continuously and intermittently, that the latter
influenced the results more efficaciously.
Yudelson R. The universal appliance. American journal of orthodontics.1967 Mar
1;53(3):159-81

 Schwarz found that “the most, favorable treatment is that which
works with forces not greater than the pressure of the blood
capillaries; in man, that amounts to 20-26 grams to one square
millimeter of surface.”
 Spencer Atkinson observed that various appliances and brackets
then being advanced did not truly answer the biophysiologic
theories of Oppenheim.
 Inspired by Calvin Case’s light-wire technique, Spencer R.
Atkinson invented the Universal bracket in 1967, as a means of
incorporating light forces into his technique.
1;53(3):159-81

 Working with the ribbon-arch
bracket, he first modified it by
effecting a slot running
horizontally through the bracket
at its gingival end.
 Next, he eliminated the
necessity of drilling this hole by
soldering on a tube parallel to
the ribbon-arch slot,
immediately gingival to the
bracket.
1;53(3):159-81

 Its salient features are its double
action, which is produced by an
occlusal rectangular opening or slot, a
horizontal-gingival slot, and mesial
and distal wings on a plane between
these two openings.
 The wires in the double-action
brackets are held in place by a lock
pin
1;53(3):159-81

 Brackets are placed at center of the
buccal surface of a tooth, with the
center of the bracket approximating
the center of the crown occluso-
gingivally
 The molar buccal bracket is also a
double- channel bracket, with both
channels lying horizontally and on the
same planes as the occlusal and
gingival slots.
1;53(3):159-81

 This bracket is designed to receive :
1. Single small wire in the occlusal slot
2. A small wire in both the occlusal and gingival
slots
3. Multiple wires
4. A ribbon arch in the occlusal with or without a
gingival round wire.
1;53(3):159-81

 Because of this double action, and with both wires acting in
concert with each other, the Universal bracket becomes truly a
four-dimensional appliance
 The gingival wire was designed for mesiodistal movements and
extrusion-intrusion, whereas the occlusal wire could be used for
rotations and buccolingual movement
 A fifth dimension is added when the ribbon arch is torqued for
purposes of causing a tooth to assume a position away from its
vertical position.
1;53(3):159-81

Tip edge bracket
 Tip-Edge brackets are available in single, twin or ceramic versions
to meet the preferences of all orthodontists.
 Peter Kesling modified the edgewise bracket to create Tip-Edge
bracket in 1988.
 Preadjusted in three dimensions, the Tip-Edge slot permits the use of
straight archwires in the majority of cases: both extraction and non-
extraction.

 The slot is designed so that initial
second order changes, mesio-distal
crown tipping, can be accomplished
in the presence of a straight, round
archwire and powered by light
intraoral forces-elastics or coil
springs.
 Forces for subsequent root
uprighting, tip and/or torque are
generated by auxiliaries, not by
flexing of the archwires.

Molar tubes
 To maximize the advantages inherent in differential
tooth movement, it is advantageous to utilize
relatively long and loose fitting molar tubes in the
early stages of treatment and shorter, rectangular,
tubes in the final stage.
1. Therefore, Tip-Edge tubes are of the double
configuration.
2. The longer round tube is positioned gingivally
3. The shorter, rectangular tube occlusally.

 Tip-Edge convertible
tube for the maxillary
right molar.
 Tip edge convertible
tube for the mandibular
right molar. Both tubes
have distal offsets and
torque built into their
bases

Archwires
For initial alignment
 Archwires of 0.014-inch or 0.016-inch nickel titanium can be used
(4 to 8 weeks) in Class I crowded cases. However, no elastics
should be worn with such flexible wires.
For intermediate stage
 Archwires are 0.022-inch stainless steel and may also be used
during final root uprighting or torquing.
For final finishing,
 Rectangular 0.0215-inch X 0.028-inch stainless archwires are
preferred because they automatically provide torque control of
molars.

Auxiliaries
 Power pins to accept
elastomerics or rotating
springs for rapid, physiologic
rotation.
 Power pin can be inserted
into vertical slot from either
the gingival or incisal when
desired. Eliminates need for
brackets with integral hooks

1. Mesiodistal uprighting springs
or side-winders.
 They provide localized tip
control of individual teeth
without archwire modifications.
 When finishing with rectangular
archwires, they can produce the
desired, final axial inclinations
for all teeth including torque.

Tip edge plus bracket
 Special brackets that utilized ‘deep grooves’
throughout, consisting of an auxiliary
archwire slot, cut deep to the main arch slot,
into which a super-elastic wire could
readily be ﬁtted to achieve the desired
mesio-distal uprighting.
 In the Plus bracket , an additional slot (the
deep tunnel) is cut horizontally, intersecting
the vertical tube almost at right angles
Current products and practice: Tip-Edge Plus Richard C. Parkhouse . Journal of
Orthodontics, Vol. 34, 2007, 59–68

 Tip edge and Plus bracket have
the same internal dimension
(0.020-inch round). When a light
ﬂexible wire is passed through the
tunnel (Figure 4), a second-order
uprighting force is generated by
the deﬂection of the wire,
comparable in degree to that
produced by a side winder in
conventional Tip-Edge.
Current products and practice: Tip-Edge Plus Richard C. Parkhouse . Journal of
Orthodontics, Vol. 34, 2007, 59–68

Straight wire concept
 As early as 1929 Angle had expounded the virtues
of an arch free from bends and suggested a method
to angulate brackets on bands for uprighting distal
tipping of the crowns of teeth
 Holdaway, in 1952, used angulated brackets to
eliminate the need for second-order bends.
Lawrence F. Andrews.; Straight Wire, The Concept and the Appliance ;1989

 In 1960, Jarabak and Fizzell combined the two features into an
appliance system, the Jarabak Light Wire Brackets, and were
manufactured by Rocky Mountain Orthodontics in 1961.
 They called it building treatment into the appliance
 In 1972, the total incorporation of in-out, tip-and-torque into the
bracket was advanced by Andrews in his appliance called the
Straight-wire appliance

 The concept that an edgewise appliance could be fully
programmed evolved from a series of five studies.
 The concept or idea to be developed was that
1. A more consistent and ideal result can be
obtained with it.
2. Less physical and mental drain on the operator.
3. Less over-all treatment time.
4. Less discomfort to the patient.

1st step
 In 1960, the post-treatment dental casts were
assessed in terms of static occlusion and led to
preliminary conclusion about occlusal standards:
 Incisors were not rotated.
 No crossbite or increased overjet.
 Normal molar interarch relation.

2nd step
 The second of the five steps was gathering of the
casts of naturally occurring optimal occlusion over a
4 year period.
 By 1964 the sample comprised of 120 casts

3. 3rd step
 The most important step was the discovery of six
characteristics that were consistently present in
the collection of 120 casts of naturally optimal
occlusion and they were designated "the Six Keys
to Normal Occlusion."
• KEY I: Molar Relationship
• KEY II: Crown Angulation
• KEY III: Crown Inclination
• KEY IV: Rotations
• KEY V: Tight Contacts
• KEY VI: Occlusal Plane

1. The bracket are of each tooth type
2. Vertical crown Contour
3. Crown Angulation
4. Crown Inclination
5. Maxillary molar offset
6. Horizontal crown contour
7. Facial prominence of each crown
8. Depth of Curve of spee
4th Step

Crown angulation
Maxillary teeth Mandibular teeth

Crown inclination
Maxillary teeth
Mandibular teeth

Crown prominence

Molar offset

 In the fifth project, the occlusal characteristics of the
pretreatment dental casts were compared with those in the
untreated optimal sample.
 Conclusion:
• Few post-treatment results meet the six keys standards
• Treatment priorities and results of given orthodontist share
characteristic features not always present in the results of other
orthodontists.

Edgewise appliance classification
 Non programmed – set of brackets designed for all
tooth types.
 Partly programmed – some built in features but
always require wire bending
 Fully programmed – set of brackets designed to
guide teeth directly in their positions without
unbent arches

Non programmed appliance

Fully programmed appliance
 Design features:
 Siting features – mid sagittal
mid frontal
mid transverse
 Convenience features
 Auxiliary features

Types of brackets
The brackets are divided into two main categories:
1. Standard brackets: Mainly used for non
extraction treatment.
2. Translation or extraction brackets: Used in
extraction cases . Further divided into:
minimum, medium and maximum.

 The standard brackets are to be used for non-extraction
cases.
 All teeth from canines back have 1 bracket except for the
molars which have 2 types of brackets one for treatment
ending in a class II molar relationship and one ending
treatment with class I molar relationship

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
Mandibula
r
2/-35 2/-35 2/-22 2/-17 5/-11
Standard Bracket Prescription (tip/torque)
For Class II Molar relation
TOOTH II Molar I Molar
Maxillary 0/-9 0/-9
Mandibular - -

Incisor Brackets:
 Set A: ANB angles of > 5
o
: Class II Tendency.
 Set B: ANB angles of 0
o
- 5
o
: Class I Tendency
 Set C: ANB angles of < 5
o
: Class III Tendency
-2o 2o 2o -2o
4o 4o 4o 4o
3o 7o 7o 3o
-1o -1o -1o -1o
8o 12o 12o 8o
-6o -6o -6o -6o

Translation Brackets:
 In extraction cases, teeth have to be translated into the
extraction site. Since the site of application of force is away
from the centre of resistance of the tooth, the tooth tends to tip
and rotate.
 Thus the translation series have some counter-tip and counter
rotation built into the slot. This not prevents the crown from
tipping and rotation, but also leaves the tooth in an over
corrected position.

Hence, 3 sets of translation brackets have been
developed
 Minimum extraction Brackets:
For upto 2mm of translation 2o more tip than
standard bracket, and 2o of antirotation.
 Medium extraction Brackets:
For 3-4 mm of translation 3o more tip and 4o of
antirotation.
 Maximum extraction Brackets:
For 5 mm of translation 4o more tip and 6o of
antirotation

Design shortcomings :
 Although the SWA was radically new, traditional heavy edgewise
forces continued to be used.
 No special anchorage control measures, such as second order
archwire bends, were employed.
 ’Wagon wheel effect' where tip was lost as torque was added.
 Consequently, deepening of the anterior bite, with creation of a
lateral open bite, was seen in many cases, and this became known
as the 'roller coaster' effect.

The Butterfly System
 Further enhancements could be beneficial. Creekmore and Kunik
described five reasons why current preadjusted appliances do not
achieve ideal tooth positions with the use of “straight” wires
1. Inaccurate bracket placement.
2. Variations in tooth structure.
3. Variations in anteroposterior jaw relationships affecting incisor
position.
4. Lack of overcorrection built into treatment mechanics
5. Mechanical deficiencies of the orthodontic appliance
The Butterfly System, S.jay Bowman , JCO/MAY 2004 , Vol XXXVIII No. 5

 The Butterfly System is based on a new low-profile, twin-wing
bracket
 The bracket’s reduced profile, its miniature twin wing design
and rounded tie wings, and the elimination of standard hooks
results in an appliance that is more comfortable, esthetic, and
hygienic
 The Butterfly System has several unique features designed to
improve upon existing preadjusted appliance concepts

Vertical slots
 When elastics are needed, a simple
hook pin or T-pin can be inserted
into the vertical slot of any bracket
virtually eliminating the need for
Kobayashi ties, soldered hooks,
and crimpable surgical hooks
 One of the simplest uses of the
vertical slot is for teeth that are
blocked out, lingually displaced, or
ectopically erupted

Progressive posterior torque
 Many bracket prescriptions contain
an extreme amount of mandibular
posterior lingual crown torque,
intended to obtain so-called “cortical
anchorage’’
 This tends to tip the upper posterior
teeth to the buccal and “roll in” the
lower posterior teeth to the lingual,
resulting in overly prominent
maxillary palatal cusps,
inappropriate interdigitation of the
maxillary buccal cusps, increased
occlusal interference, and an
accentuated curve of Wilson

 Other features include:
1. Reversible Second Premolar Brackets
2. Progressive Mandibular Anterior Tip
3. Angulated First Molar Attachments
4. Preventive Mandibular Anterior Torque

Work of Roth
 The Roth Set-up was introduced in the year 1967.
 The purpose of the Roth set up was to provide over corrected tooth
position prior to appliance removal which would allow the teeth in
most instances to settle what was found in non-normal studied by
Andrews
 He altered the prescription of the Andrews appliance to allow the
teeth to be placed in a slightly overcorrected position in all three
planes.
Roth RH. The straight-wire appliance 17 years later. Journal of clinical orthodontics:
JCO. 1987 Sep;21(9):632-42.

 Problems face by Roth while using SWA
1. Increased inventory
2. Anchorage loss
3. Over correction
JCO. 1987 Sep;21(9):632-42.

 Inventory -With the introduction of different series
and sets of brackets the inventory was becoming a
problem because the brackets were only available on
bands.
 Anchorage Loss - The original Andrews standard Rx
with mesially angulated was devised for treatment of
cases with less than a 5° ANB difference and non-
extraction. However, the mesial inclination in the
buccal segments creates an anchorage loss problem,
particularly in extraction cases.
JCO. 1987 Sep;21(9):632-42.

 Over correction - He suggested to finish the
cases to an "end of appliance therapy" goal in
which all tooth positions are slightly
overcorrected and from which the teeth will most
likely settle into non-orthodontic normal
positions.
JCO. 1987 Sep;21(9):632-42.

 Maxillary prescription
 Maxillary Incisors- extra torque was built (5° more than
normal).
 Canine -less negative torque in the upper canines was given to
offset the reciprocal effect of building more positive torque into
the incisors. The upper canines have 2° more distal tip, and 2°
rotation to the mesial.
JCO. 1987 Sep;21(9):632-42.

 There is a "Super Torque" set of maxillary anteriors for cases
like Class II, division 2, where an extreme amount of torque
may be needed
 Premolars - bicuspids are rotated 2° mesially to offset the
rotation that accompanies distal traction
 Molars - 14° distal rotation (twice the amount found on the
non-orthodontic normals) and 14° buccal root torque (5° more
than normal).
JCO. 1987 Sep;21(9):632-42.

Mandibular prescription
 In the mandibular arch, the incisor brackets are the same as the
non-orthodontic normals.
 Canines - 7° mesial tip and 2° distal rotation.
 The entire lower buccal segment has a 3° distal tip from normal
and a 4° distal rotation.
 These teeth settle more mesially than the uppers and
simultaneously rotate mesially, thus necessitating extra distal
rotation.
JCO. 1987 Sep;21(9):632-42.

Archwires
 The archwires are relatively flat around the incisors (both upper
and lower), curve more tightly around the cuspids and
bicuspids, and then curve gently toward the distal through the
entire buccal leg.
 The most prominent point in the front curvature of the arch is
the first bicuspid;
 The most prominent and widest point in either arch is at the
mesiobuccal cusps of the first molars.
JCO. 1987 Sep;21(9):632-42.

Arch form
 Average mandibular movement requires a fairly broad arch form
across the anterior teeth.
 If one violates mandibular movement with anterior arch form that
is too narrow, the result is improper anterior guidance, or what is
called "over-coupling" of the anterior teeth.
 In a post-orthodontic case, this usually results in either anterior
collapse or restricted lateral movement.
JCO. 1987 Sep;21(9):632-42.

Appliance Configuration
 The brackets were available welded to special bands that
were designed to get the bracket to fit on the middle of the
clinical crown.
 Later, as direct bonding became a reality, the appliance
was made available on coined bases and then on flexible
mesh pads.
JCO. 1987 Sep;21(9):632-42.

 Ultimately a brazed micromesh became an integral part of
the bracket base itself. The effect, of course, has been to
diminish the size of the appliance as much as possible for
esthetics and patient comfort.
JCO. 1987 Sep;21(9):632-42.

 Later versions of the Roth prescription included shorter T-
shaped hooks made by blocking out part of the molds when
making the plastic patterns.
 New molds were made that had short ball hooks for elastics
cast as integral parts of the brackets
JCO. 1987 Sep;21(9):632-42.

 In 1984 the "Attract" brackets were
introduced.
 These were single-width brackets that
had rounded contours and micro-molar
tubes.
 The base of the bracket slot was the
width of a twin bracket, and with the
use of the new nickel titanium wires it
was possible to rotate teeth while
maintaining minimum size for
esthetics and patient comfort.
JCO. 1987 Sep;21(9):632-42.

 The latest version of the SWA is a perfectly clear
bracket containing an agent that is chemically bonded
to the bracket base.
 These brackets are the same size as the metal twin
brackets and do not require the bulk of ceramic
brackets to provide sufficient strength.
 The bracket configurations currently available are
twin, single, Attract, Steiner, and Lang— bondable,
on bands, and in a variety of prescriptions.
JCO. 1987 Sep;21(9):632-42.

 An evolution from the edgewise technique, with
features of certain light-wire methods
incorporated

Primary edgewise
 The technique consisted of pinching, soldering, and
constructing bands to a “best fit” on each tooth.
 The band was then scratched or marked while in place, and the
brackets were soldered onto the band in a manner to account for
the correct tipping of teeth for the “ideal arch” in finishing.
Bioprogressive therapy as an answer to orthodontic needs ;Part I ;Robert Murray Ricketts,
AJO Volume 70, Number 3, September, 1976

 For making the arch wire, tooth dimensions were plotted on a
card and l/16 inch was added between the upper lateral incisors
and l/32 inch was added between all lateral incisors and
canines.
 Torque was to be placed for third- order movement, and first
order-was supplied by “step” bends.

 Band being pinched without the
bracket being attached.
 The band is fitted and the bracket
is soldered together with an eyelet
or staple.

 If space is to be made, loops are
soldered onto the main line of the
arch.
 Auxiliary hooks are attached and
soldered onto the base arch.
 If spaces are present, intermaxillary
elastics are employed
 If crowding is present in the arch stops
are placed on the arch

Secondary edgewise
 The use of round wire in the edgewise bracket.
 Round wire, while being used for extraction space closure or
contraction of the arches, rolled the anterior teeth inward.
 Uprighting was accomplished later with a rectangular wire,
usually of the 0.0215/ 0.025 inch size, but now made harder or
more rigid with gold alloy.

 Round wires in nonextraction conditions used for leveling and
rotation often resulted in a great deal of flaring of teeth, “milking”
of the arches, and loss of anchorage.
 Tiebacks were used to prevent forward drift of the arch, but still
the lower incisor tipped forward as leveling was accomplished.

Tertiary edgewise
 The next modification from secondary, or it may be thought of as
tweed edgewise.
 Double torquing bars were designed for use with more rigid steel
wires of 0.0215 /0.025 inch rectangular wire.
 Space closure was accomplished by simple open loops vertically or
horizontally bent into the arch or by push-coil tiebacks.

Development towards bio progressive
therapy

 With the development of standardized preformed
bands, Ricketts, for the new therapy, advocated a
bracket and band arrangement for alignment of band
edges to marginal ridges, for the “line of occlusion”
in fitting and cementation.

 Ricketts took two additional important factors into account for the
designs
1. The formulas were designed to prevent many common problems
produced during treatment with untorqued brackets.
2. The designs were made to assist in sufficient overtreatment of the
common malocclusions.

 Prescriptions for the fixed apparatus have been laid down for
three variations, but, all still use the basic bioprogressive
precepts:
1. Standard bioprogressive
2. Full torque
3. Triple control setup
Bioprogressive therapy as an answer to orthodontic needs ;Part I ;Robert Murray Ricketts

STANDARD TORQUE BIO-PROGRESSIVE
SET UP
 Band were designed to be placed to the marginal
ridges. Torque was built into the upper incisors
and all four canines.
 In effect, the preformed prefabricated band,
bracket, and arch wire inventory was designed
into a complete organized approach,

 Bone as well as the position for mechanical advantage of the
tooth is lost with the uprighting of the lower molar.
1. Along with the incorporated torque to the upper anterior teeth,
torque was incorporated into the lower buccal segments
2. All torque requirements had been eliminated in the wire except
for the variations needed.
FULL TORQUE CONTROL
Bioprogressive therapy as an answer to orthodontic needs ;Part I ;Robert Murray Ricketts

TRIPLE CONTROL BIOPROGRESSIVE SETUP
 It included features of over treatment of certain torque, rotation
and upper buccal segment.
 Raised brackets were designed for all canine and second
premolars, so that the non-stepped wire can be used at idealization
stage.
 Upper molar tubes were rotated in order to avoid extension of
upper molar into buccal mucosa due to flaring of tube during its
rotation.

Alexander principle
 Richard G. “Wick” Alexander designed an appliance to deliver
excellent treatment results in an easy and organized manner.
 Discipline was chosen rather than appliance to reflect the idea that
the orthodontist must be knowledgable in edgewise appliance and
must play a active role in application of appliance to the individual
patient in order that the treatment be successful.
THE 20 PRINCIPLES OF THE ALEXANDER DISCIPLINE by R. G. "Wick” Alexander

 It is also called as Vari-Simplex discipline .
 Vari – refers to variety of bracket types.
 Simplex – Kiss principle (Keep it simple sir)
1. As archwires are simple, because first, 2nd, 3rd order
effects are incorporated into the bracket.
2. Hooks are not soldered to wire. Bracket hooks are used.
3. Multiloop arch forms are rarely used

Bracket slot size and torque control
1. To obtain effective torque control, three options are available:
2. "Fill up" the bracket slot. In a O.022-inch slot, the logical
archwire is a 0.021 x 0.025-inch archwire.
3. Place certain torque in the archwire.
4. Place certain torque in the bracket slot.

 Use of single brackets instead of
twin Brackets
 Rotation wings

 Twin brackets : Used on large, flat surface of
maxillary central incisor and lateral incisor.
 Mini-Diamond twin brackets are preferred as
they are rhomboidal which aids in accurate
bracket placement and increases interbracket
span.
 Lateral incisor twin brackets have additional tie
wings for easy engagement of wire where
canines are placed high
Evolution of Orthodontic Brackets by Dr. Tamizharasi1, Dr. Senthil Kumar; JIADS VOL
-1 Issue 3 July - September,2010 |25|

 Lang Brackets
 They are used on round surfaced teeth at
the corners of the mouth i.e. on Maxillary
and Mandibular cuspids.
 It is diamond form, single bracket with
flat rotational wings containing a circular
hole. This aperture increases flexibility of
wing and can be used for ligation.
 The straight wing of lang eliminates
interferences in this curved portion of
arch.
Evolution of Orthodontic Brackets by Dr. Tamizharasi1, Dr. Senthil Kumar; JIADS VOL
-1 Issue 3 July - September,2010 |25|

Bracket prescription
 Molar Offsets
1. Maxillary First & Second
Molar-15O & 12O Distal offset
2. Mandibular First & Second
Molar-0O & 6O Distal offset

 When kept with 15 and 12 degree distal
offset, molars requires least amount of
space and provide the best occlusion
 If the final occlusion results in a Class II
or III molar relationship, the maxillary
2nd molars occlude best when they are
rotated in the opposite direction-that is,
toward the mesial. This mesial rotation
can be accomplished by positioning the
bracket and tube more to the distal,
toward the distobuccal cusp

Inclination
 Trademark of Alexanders Discipline prescription is the -5
degrees of torque in the mandibular anterior incisor
prescription.
 The torque values in the 0.018-inch slot brackets are
designed to compensate for the 5 degrees of archwire
freedom when a 0.017 x 0.025-inch stainless steel archwire
is used.

Angulation

Level anchorage system
 This system was given by Terrel L. Root in 1981.
 This system quantifies the anchorage requirements of the
orthodontic problem and thus clarify the necessary treatment
steps needed to reach the goal.
 It was designed to treat the cases efficiently to a predetermined
goal.
Root TL. The level anchorage system for correction of orthodontic malocclusions.
American journal of orthodontics. 1981 Oct 1;80(4):395-410.

Appliance proper :
 It consists of a banded or bonded edge wise appliance with built
in tip, torque and offset and an analysis and treatment planning
chart with a step by step treatment procedure.
 Hence level anchorage system could be described as utilizing a
straight wire appliance with anchorage preparation.

Pre- adjustments of Level Anchorage System for Upper arch

Pre- adjustments of Level Anchorage System for Lower
arch

Band and bracket placement to provide regular and
major anchorage
Regular Major

MBT bracket system
 McLaughlin and Bennett from 1975 to 1993 developed and refined
treatment mechanics based on sliding mechanics and continuous
light forces, mainly using standard SWA brackets
 They then worked with Trevisi from 1993- 1997 to redesign the
entire bracket system to complement their proven treatment
philosophy and to overcome the perceived inadequacies of the
original SWA.
Systemized orthodontic treatment mechanics by Richard P. McLaughlin,
John C. Bennett and Hugo J. Trevisi

McLaughlin and Bennett then worked with Trevisi to
redesign the entire bracket system
1. Bracket selection
2. Versatility of the bracket system
3. Accuracy of bracket positioning
4. Light continuous forces
5. The .022 versus the .018 slot

 Anchorage control early in treatment
 Group movement
 The use of three arch forms
 One size of rectangular steel wire
 Archwire hooks

Range of brackets
1. Standard size metal brackets -
where control is the main
requirement
2. Mid-size metal brackets - less
control, but are useful for cases
with average to small teeth.
3. Esthetic Clarity TM brackets -
where a metal appearance is not
acceptable.

Rhomboidal shape of the bracket
 The original rectangular shape of the standard
metal SWA has been superseded by the
rhomboidal form.
 reduces the bulk of each bracket.

 Brackets with torque in base
were designed so that the LA
point, the base point, and the
slot point were on the same
horizontal plane.
 To accomplish this an acute
(<90°) angle was required at
the occlusal aspect of the
bracket base, and an obtuse
(>90°) angle at the gingival
aspect of the bracket base.
Torque in base

 The in-out feature of
preadjusted brackets is 100%
fully expressed, because the
archwire lies snugly in the slot
 For example upper second
premolars have small crowns
in approximately 20% of
cases. So an alternative
bracket, which is 0.5mm
thicker than normal, is useful
for such teeth
In out specification

 The tip feature of preadjusted
brackets is almost fully expressed,
and there is less than 1° of 'slop'
when a .019 / .025 rectangular
wire is placed.
 For all molars, 0° tip is
recommended. If placed parallel
to the buccal cusps of the molars,
a 0° tip bracket will deliver 5° of
tip for the uppers and 2° of tip for
the lowers.

Recommended tip

Torque specification

Versatility of MBT appliance
 The system's full name is MBT Versatile+ and as the name implies,
it is designed to be versatile, in order to deal with most treatment
challenges.
 This versatility is useful in both controlling inventory costs and
avoiding needless wire bending.
 This reduces the need for first-, second- and third-order bends later
in treatment, and improves efficiency.

Seven features are :
1. Options for palatally displaced upper
lateral incisors (-10°)
2. Three torque options for the upper
canines (-7°, 0°, and +7°)
3. Three torque options for lower canines (-
6°, 0", and +6").

3. Interchangeable lower incisor brackets - the same tip and
torque.
4. Interchangeable upper premolar brackets - the same tip
and torque.
5. Use of upper second molar tubes on first molars in non-
HG cases.

7. Use of lower second molar tubes for the
upper first and second molars of the
opposite side, when finishing cases to a
Class II molar relationship.

Accuracy in bracket positioning
 When direct bonding brackets, it is helpful lo avoid viewing
teeth from the side, or from above or below.
 To properly view the teeth during bonding procedures it will
be necessary for
1. the patient to turn the head
2. the orthodontist to change seating position from time to
time.

 Incisor regions: gauge is
placed at 90° to the labial
surface.
 Canine and premolar
regions: gauge is placed
parallel with the occlusal
plane.
 Molar region: gauge is
placed parallel with the
occlusal surface of each
individual molar.

Light continuous forces
 The most effective way to move teeth, being comfortable for
the patient and minimizing the threat to anchorage.
 Forces in the range below 200 gm - light forces
 Forces in the range above 600 gm - heavy forces
 The signs of excess force, such as tissue blanching, patient
discomfort, and unwanted tooth movements (for example
roller coaster effect)

.022 versus the .018 slot
 With the .018 slot, the main working wire is normally .016/.022
or .017/.025.
 These wires are more flexible and hence show greater
deflection.

 Only one size of steel rectangular wire
is used in normal treatment, and this is
.019/.025.
 There is approximately 10° of 'slop'
between the .019/.025 wire and the
.022 slot

Anchorage control
 The main threat to anchorage comes from the influence of
anterior bracket tip.
 MBT brackets have reduced tip compared with earlier
generations
 Combined with light archwires, results in reduced anchorage
needs in the all- important opening stages of treatment.

Lacebacks :
1. assist control of canine crowns in premolar extraction cases, and in
some nonextraction cases.
Bendbacks :
1. used in most cases at the start of treatment, except where there is a
need to increase arch length.
2. ensure that the ends of the archwire are comfortable in the molar
area, and help to prevent mesial movement of the anterior teeth.

Group movement
 In preparation for group movement in premolar extraction cases,
lacebacks are used to control canines and retract them sufficiently to
allow alignment of the incisors.
 However, it is important to maintain a Class I canine relationship.
 Therefore, a laceback should be continued in the upper arch to
maintain the Class I canine relationship, even if it means moving
the canine away from the lateral incisor.

 Where possible, group movement is carried out, and
the upper and lower anterior segments are managed as
a group of six or eight teeth.

THREE ARCH FORMS
 It is generally accepted that the dental arch form is initially
shaped by the form of the underlying bone.
 Then after eruption of the teeth, the shape becomes influenced by
the oral musculature.
 Genetic and environmental differences produce great variability,
which is confirmed in day-to-day clinical observation.

TAPERED SQUARE OVOID

Lingual brackets
 Kinya Fujita was the first to develop the lingual multibracket
technique using the mushroom- shaped archwire.
 The Fujita bracket had three slots- occlusal, horizontal, and vertical.
Evolution of Orthodontic Brackets by Dr. Tamizharasi1, Dr. Senthil Kumar; JIADS VOL -
1 Issue 3 July - September,2010 |25|

 Engineers Craig Andreiko and Frank Miller began their re-
search with orthodontist Jim Wildman, who in 1976 treated the
first patient in the United States by using a lingual appliance.
 Later, Craven Kurz and these two engineers developed the first
generation of the Kurz lingual bracket.
 The principal characteristics of this bracket were
1. Bite plane,
2. Base pad
3. Preangulated slot

 To test and continue their research in this field,
Ormco founded a ”Task Force” and the Kurz
lingual bracket developed and evolved to the 7th
Generation Ormco Lingual Bracket in 1990.
 In 1994, Massimo Ronchin developed, a self-
ligating lingual bracket based on the Begg
technique.

 First generation(1976) –
 First lingual Kurz appliance developed with Flat maxillary
occlusal bite plane from Canine to canine
 Lower incisor and premolar bracket had low profile and half
round.
 Had no hooks.
Rafi Romano, Lingual Orthodontics

 Second generation 1980 –
 Hooks were added to canine bracket
 Third Generation 1981 –
 Hooks were added to all brackets and to
molar tubes.
 The second molar had a terminal sheath
without a hook but had a terminal recess for
elastic traction

 Fourth Generation - 1982-84
 The turning point in the development of the appliance was the
addition of low profile anterior inclined plane as an integral
part of maxillary anterior teeth facilitating insertion of the
archwire.
 Hooks were optional

 Fifth Generation 1985-86
 Anterior inclined plane became pronounced with an
increase in labial torque in maxillary anterior region.
 The canine also has inclined plane which is bibevelled to
allow intercuspation.
 Attachment for TPA provided in 1st molar tubes.

 Generation # 6 - 1987-90
 Inclined plane became more square in shape.
 Hooks on anteriors and premolars were elongated
 Hooks on all brackets

Generation # 7 – 1990 to present
 Maxillary anterior inclined plane is now heart shaped with
short hooks
 The lower anterior brackets have larger inclined plane with
short hooks
 The premolar brackets were widened mesio-distally and hooks
were shortened

Self ligating brackets
 Self-ligating brackets by definition do not require an elastic or
wire ligature but have an inbuilt mechanism that can be opened
and closed to secure the archwire. .
 First self ligating bracket, the Russell Lock edgewise attachment
was introduced by Stolzenberg in the early 1930s.
Self-ligating Brackets in Orthodontics ;Current principles and techniques by Bjoern Ludwig
Dirk Bister and Sebastian Baumgaertel

Qualifications
1. Allows for simple removal and insertion of appliance.
2. Slot E can be used for round wire up to 0.022 inch, or flat wire up
to 0.022 by 0.028 inch.
3. A simple turn of the key permits the fixation or freedom of the
arch wire by manipulation of the threaded nut
4. Not cumbersome.
5. Has a hole in the vertical center for ligatures .
6. Can be used for universal movement of the teeth.

 Original Russell’s attachement
 A- Key B- Nut, C- Archwire
 D- Hole passing through vertical section of
attachment ; E, slot.

Passive bracket
 In the slot is locked or shut with a
rigid locking mechanism.
 Once it is engaged, the bracket is
effectively turned into a tube, ideally
allowing archwires to slide freely
within the tube.

 Consists of a flexible but resilient clip.
 Can actively engage wire into the bracket slot
once the archwire reaches a certain size or
deflection.
Active bracket

 In 1972, Wildman introduced the passive EdgeLok
bracket which in its earlier incarnations had a round
bracket body as well as a labial sliding door.
 Drawbacks:
a. Inadequate rotational control.
b. Bulkiness.
c. Inconvenience with opening and closing the slide.

 (1973)Mobil-Lock bracket was
introduced by Sander.
 This was the first self-ligating twin
bracket that had a variable slot.
 It has a rotating cam that was
turned with a “screwdriver,” thus
covering part of the labial surface
of the slot.

 Due to the eccentric movement of
locking system
 The wire could either be locked
tightly into the bracket or kept
passive
 With proper adjustment, achieve
partial ligation, which was designed to
allow the wire to glide freely through
the slot.

 Drawbacks:
1. Poor rotational control
2. Difficulty of access to
open and close
premolar brackets with
the straight
“screwdriver.”

 In the 1980s, Dr. G. Herbert Hanson
developed a completely new
approach to self-ligation: the
SPEED bracket. The name is
derived from the descriptive term
spring-loaded, precision, edge-wise,
energy and delivery
 This was the first active self-
ligating bracket. The locking
mechanism is formed by a flexible
clip.

 Drawbacks of Speed bracket:
1. Early brackets had clips that could be easily
broken or displaced.
2. No tie- wings.

 Plechtner introduced the Activa bracket in 1986
 A rotating slide that therefore gave a concave inner
radius to the labial surface of the slot.
 Wider brackets mesiodistally.
 Drawbacks:
1. Increased buccolingual
dimension .
2. Less interbracket span.
3. No tie- wings.
4. Slide was more prone to breakage.

 In the 1990s, Heiser developed the
Time bracket, which is also an active
system.
 A hinging movement opens the locking
mechanism in the direction of the
gingiva.
Flair bracket(2005)
 It is significantly smaller than the Time
bracket and has different in–out values
and an improved locking mechanism.

 The twinlock bracket in 1998.
 In this twin bracket, the flat, rectangular door sits
between the two tie-wings.

 Dwight Damon first introduced in 1999
 They retained the same vertical slide
action and U-shaped spring to control
opening and closing, Thus hindering
archwire removal or placement
 To further develop and satisfy the
demand for an esthetic self-ligating
bracket, the Damon 3 bracket was
introduced in 2004. The bracket consists
of a tooth-colored acrylic base material
but the locking mechanism remained.
 Thus Opening and closing the slot was
made very easy

 A hybrid between a conventional twin bracket
and a SPEED bracket, known as the In-Ovation
bracket, was developed by Voudouris in 1997
 In-Ovation R(2002)
 An esthetic version of this system, In-Ovation C
was introduced in 2007

 The Opal bracket, by Abels in 2004.
 In 2007 a metal bracket based on the same
principle, the Opal M was introduced.

 Introduced by Forestadent in 2005.
 Quick brackets have a labial hole or
notch in the clip in which a probe or
similar instrument can be inserted to
open a clip.
 An esthetically improved version
(QuicKlear) has been available since
2008

 The Vision LP bracket a relatively small
metal twin bracket(2005).
 The NiTi clip is opened with a rotational
movement towards the gingiva.
 An alternative locking mechanism was
introduced in 2008 in the Discovery SL
bracket .

Advantages
 Longer treatment intervals with fewer appointments
 Chair time savings, less chair-side assistance and Improved
ergonomics
 Better infection control and Improved oral hygiene
 Full and secure wire ligation
 Better sliding mechanics

Disadvantages
 Possible breakage of the clip or the slide
 Higher profile because of the complicated mechanical design.
 Potentially more occlusal interferences and lip discomfort
 Difficulty in finishing due to incomplete expression of the
archwires.
 Higher cost

Self ligating lingual brackets
 The use of self-ligating brackets in lingual orthodontics was
first presented by Neumann and Holtgrave ,who suggested the
use of SPEED self-ligating labial brackets for application in
the lingual technique
 Philippe 2D self-ligating lingual brackets providing 2-
dimensional control, were suggested for the correction of
simple malocclusions, such as minor crowding or spacing with
the lingual technique
Self-Ligating Brackets in Lingual Orthodontics. Silvia Geron. Seminars in
Orthodontics, Vol 14, No 1 (March), 2008: pp 64-72

 The Forestadent 3D Torque-Lingual self-
ligating brackets
 The brackets are designed with 45° of torque
for all the upper and lower incisors, and with
0° of torque for all the bicuspids and molars
 According to the requirements of the
orthodontist, is done in the laboratory by an
indirect bracket positioning technique based
on a lingual setup and bracket positioner,
using specially designed jigs to hold the
brackets

 The Adenta Evolution lingual
bracket is designed as a one piece
bracket with a clip that opens at the
incisal edge and allows insertion of
the archwire from the occlusal
direction.
 The clip can serve also as a bite
plate, and consequently presses the
archwire further into the slot when
biting

Recent advances in orthodontics
 Quantitative knowledge of the three dimensional (3D) force
moment systems applied for orthodontic tooth movement is of
utmost importance for the predictability of the course of tooth
movement as well as the reduction of traumatic side effects
 The concept of a smart bracket with integrated
nanomechanical sensor system for 3D force and moment
measurement has recently been published.
Smart Bracket for Multi-dimensional Force and Moment Measurement, B.G. Lapatki
, J Dent Res 86(1) 2007

 Nanomechanical sensors can be fabricated and be incorporated
into the base of orthodontic brackets in order to provide real-time
feedback about the applied orthodontic forces.
 This real-time feedback allows the orthodontist to adjust the
applied force to be within a biological range to efficiently move
teeth with minimal side effects
Smart Bracket for Multi-dimensional Force and Moment Measurement, B.G. Lapatki
, J Dent Res 86(1) 2007

References
 Milton B. Asbell A brief History of Orthodontics Am J Orthod
Dentofac Orthopedics ;1990,98,176-183
 Combination anchorage technique: An update of current mechanics
, American Journal of Orthod and dentofacial orthop , Volume 93,
Number 5 May 1988
 The Butterfly System, S.jay Bowman , JCO/MAY 2004 , Vol
XXXVIII No. 5

 Systemizes orthodontic treatment mechanics by Richard P.
McLaughlin, John C. Bennett and Hugo J. Trevisi
 Orthodontics in the past millenium by Vijayalakshmi PS &
Veereshi AS ;Journal of Advanced Dental Research Vol : Issue
I: October, 2010
 Roth, R.H.: Five Year Clinical Evaluation of the Andrews
Straight-Wire Appliance, J. Clin. Orthod.10:836-850, 1976.
 The Straight-Wire Appliance -17 Years Later - RONALD H.
ROTH JCO, Volume 1987 Sep(632 – 642)

 Evolution of Orthodontic Brackets by Dr. Tamizharasi1, Dr.
Senthil Kumar; JIADS VOL -1 Issue 3 July - September,2010 |25|
 Bioprogressive therapy as an answer to orthodontic needs ;Part I
;Robert Murray Ricketts, AJO Volume 70, Number 3, September,
1976
 Self-ligating Brackets in Orthodontics ;Current principles and
techniques by Bjoern Ludwig, Dirk Bister and Sebastian
Baumgaertel
 Orthodontics: Current principles and Technique by Thomas
M.Graber and Robert L. Vanarsdall Jr.;3rd edition

 Yudelson R. The universal appliance. American journal of
orthodontics.1967 Mar 1;53(3):159-81
 Rafi Romano, Lingual Orthodontics
 Root TL. The level anchorage system for correction of orthodontic
malocclusions. American journal of orthodontics. 1981 Oct
1;80(4):395-410
 Alexander RG. The 20 Principles of the Alexander Discipline

 Smart Bracket for Multi-dimensional Force and Moment
Measurement, B.G. Lapatki , J Dent Res 86(1) 2007
 Self-Ligating Brackets in Lingual Orthodontics. Silvia Geron.
Seminars in Orthodontics, Vol 14, No 1 (March), 2008: pp 64-
72
 Current products and practice: Tip-Edge Plus Richard C.
Parkhouse . Journal of Orthodontics, Vol. 34, 2007, 59–68
 Brantley orthodontic materials scientific and clinical aspects ,1st
edition

Evolution of brackets

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

Similaire à Evolution of brackets

Similaire à Evolution of brackets (20)

Dernier

Dernier (20)

Evolution of brackets

Notes de l'éditeur