EVOLUTION OF BRACKETS.ppt

EVOLUTION OF BRACKET
SYSTEM
DR NIVYA KRISHNA
POST GRADUATE STUDENT
DEPT OF ORTHODONTICS
MAR BASELIOS DENTAL COLLEGE
,KOTHAMANGALAM
1

CONTENTS
INTRODUCTION.
HISTORY OF BRACKETS
CLASSIFICATION OF BRACKETS.
EVOLUTION OF BRACKET MATERIAL.
EVOLUTION OF FIXED APPLIANCES &
BRACKETS.
EDGEWISE APPLIANCES.
MODIFICATIONS OF EDGEWISE
APPLIANCE.
UNIVERSAL BRACKETS.
LIGHT WIRE EDGEWISE TECHNIQUE.
ANDREWS SYSTEM.
ROTH SYSTEM.
MBT.
VARI SIMPLEX DISCIPLINE.
DUAL ENVIRONMENTAL BRACKETS.
ORIGINAL BEGG SYSTEM.
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES.
MODERNIZED BEGG COMBINATION
SYSTEM.
2

THE BEDDTIOT APPLIANCE.
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF- LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT GENERATION
CONCLUSION.
BIBLIOGRAPHY.
3

INTRODUCTION
Brackets are the basic components of fixed orthodontic appliances. They act as
an intermediary between the teeth and the active components of the appliance.
However, design of brackets is an important factor for efficient tooth movement
and control of the complex force system .
The term bracket came into use in orthodontics when Dr. Angle introduced the
“Ribbon arch appliance” in 1916.
Bracket may be defined as an orthodontic attachment secured to a tooth for the
purpose of engaging an arch wire .(Thurow)
It acts as a handle that transmits the force from the
active components to the teeth and serves to deliver the necessary tooth moving
forces.
Thus, Orthodontic brackets provide the means to transfer the force applied by the
activated archwire to the tooth. 4

HISTORY OF BRACKETS
Angle was first to design and use a bracket-like attachment by
introducing his pin and tube appliance.
Initially, soft gold was used for manufacturing brackets which was
replaced by rigid stainless steel.
Later, this attachment was modified and introduced as
Ribbon arch Appliance .
Finally, Angle introduced the Edgewise appliance which was
designed to allow the orthodontists to place the teeth into Angle’s
concept of the “line of occlusion”.
With few exceptions, the fixed appliance used in contemporary
orthodontics is based on Angle’s designs from the early 20th century.
5

Angle developed four major appliance system:
E-Arch.
Pin and tube.
Ribbon Arch Appliance.
Edgewise Appliance.
Over the years, brackets have undergone many modifications.
6

1728 : Pierre Fauchard’s orthodontic appliance - Bandelette.
1849: DWINELLE: Jack Screw.
1889: John Farrar: Introduced concept of Lingual Removable Arch.
1905: E-ARCH.
1910: Pin and Tube.
1915: Ribbon Arch.
1928: Dr. Edward Angle: Edgewise Appliance.
1931: Dr. Spencer Atkin: Universal Appliance.
1933: Dr. Begg; Begg’s Bracket.
1952: Holdaway first used pre-adjusted brackets in order to reduce bending of archwires.
1952: Swain: Introduced Siamese Twin Brackets.
7

1960s: Jarabak and Fizzel: Twin Edgewise Brackets.
Early 1960s: Ivan Lee introduced pre-torqued bracket design in order to eliminate complicated
torquing bends used in conventional edgewise archwire.
1967: Dr. Jack Perlow: Modified Edgewise Bracket.
1968: Jarabak introduced pre-angulated and pre-torqued brackets for upper anteriors.
1968: P.C.Kesling introduced tip-edge bracket.
1970: Dr. H.L. Eirew: Bracket using Unitek AlastiK tie rings .
8

1970: Dr. F.F Schudy and G.F. Schudy: Bimetric System of edgewise.
1971: Andrews introduced SWA (Straight Wire Appliance ) Technique.
1972: Dr. Kameda: Kamedanized Begg Brackets.
1972: Wildman : Edgelock Appliance.
1975: Dr. Kurz: Near-conventional edgewise approach to lingual
mechanics.
1976: ROTH: Introduced modified SWA technique.
9

1976: R.M.Ricketts used pre-angulated and pre-torqued brackets and introduced Bioprogressive
Technique.
1976: Dr. Craven Curz – Lingual Straight wire appliance.
1980: Herbert Hanson: SPEED Appliance.
1981: W.J. Thompson: Combination Anchorage Technique or Modern Begg.
1982: William Thompson developed Combination brackets that involved vertical and horizontal
slots.
1982: Dr. Kinya Fujita: Mushroom Arch (Lingual Orthodontics).
1983: Dr. R.G. Alexander: Vari Simplex Discipline.
10

1985: Dr. Richard Hocevar: BEDDTIOT Technique.
1989: Thomas Creekmore: Lingual Mechanical Appliance (CONCEAL).
1990: Dual Environmental Bracket.
1991: Dr. V. P. Jayade : J-Bracket
1992: Kazuto et al, 1994: Friction Free Bracket.
1993: Irwin Fletcher : ACTIVA Appliance.
11

1996: Time Bracket.
1997: John C. Voudoris: Interactive Twin Bracket.
1997: Deva Devanthan and James Chudzynski: Nu-edge Bracket.
1998: Viazis : Viazis System.
12

CLASSIFICATION OF BRACKETS
ACCORDING TO THE TYPE OF SLOT .
ACCORDING TO THE MODE OF ATTACHMENT .
BASED ON THE MATERIAL USED .
BASED ON THE MORPHOLOGY OF THE BRACKET .
BASED ON THE TECHNIQUE FOR WHICH IT IS USED
13

ACCORDING TO THE TYPE OF SLOT :
Ribbon Arch brackets.
Edgewise brackets.
ACCORDING TO THE MODE OF ATTACHMENT :
Weldable brackets.
Bondable brackets.
A. with mesh and
B. with grooves
ACCORDING TO MATERIAL USED :
Metal Brackets
Stainless steel brackets.
Gold – coated brackets.
Platinum coated brackets.
Titanium brackets.
14

Plastic Brackets
PolyCarbonate brackets
Poly urethane – composite bracket
Thermoplastic – polyurethane bracket.
Ceramic Brackets
Monocrystalline Alumina(Sapphire).
Polycrystalline Alumina.
Polycrystalline Zirconia (YPSZ).
15

BASED ON THE TECHNIQUE FOR WHICH IT IS USED
Begg light wire appliance.
Edge wise appliance.
Straight wire appliance.
Tip Edge appliance.
Lingual force adjusted Edge wise appliance.
Vari simplex.
Butterfly system.
BASED ON THE MORPHOLOGY OF THE BRACKET
Siamese
Mini – twin
Single wing
Self ligating
16

EVOLUTION OF BRACKET MATERIAL
Initially soft gold was used to manufacture brackets but was soon
replaced by rigid stainless steel.
Later Plastics were introduced in late sixties followed by introduction of
Ceramics in mid eighties.
17

ANGLE’S ERA
Initially all attachments were made in noble metals and their alloys
- gold (75%)
-platinum
-iridium
-silver
In 1887 Angle tried replacing the noble metals with German silver (Cu, Ni, Zn) but
ultimately stainless steel replaced these materials.
18

METAL BRACKETS
Advantages of the metal brackets –
1. Excellent strength.
2. Reduced friction .
3. Smooth surface finish.
Disadvantages of the metal brackets –
1. Corrosion
2. Not biocompatible.
3. Unesthetic .
19

GOLD BRACKETS
Advantages;
Biocompatible.
Disadvantages:
Pure gold is soft and cannot be used to make rigid brackets.
Deform under prolonged forces due to low hardness and
stiffness.
Poor Esthetics.
20

STAINLESS STEEL BRACKETS
Mainly austenitic steel used.
Advantages:
Smooth surfaced brackets with decreased friction.
Good Bond Strength.
Disadvantages:
Un-esthetic.
Corrosion of metal brackets: failure of joint during treatment.
21

PLASTIC BRACKETS
Introduction of new materials like polycarbonates and
polysulfones .
Advantage –
Esthetically acceptable when compared to steel.
Disadvantages-
1. Staining and discoloration.
2. Poor dimensional stability.
3. Undue friction between the bracket slot and the wire,
making sliding mechanics difficult.
4. Need for compatible bonding resin.
5. Cannot be re-cycled.
22
Tooth colored or clear brackets.

Plastic brackets
Silkon/Silkon Plus (American Orthodontics)
Elation (GAC)
Spirit MB (Ormco)
Composite bracket
Aesthetik line/Brilliant (Forestadent)
23

MAGNETIC BRACKETS
Produce minimum stress that occurred as a result of tooth movement.
When applied to tooth movement, initially the forces are light and once tooth starts moving,
the forces increase as the distance between magnets decreases.
Advantages:
Decreased treatment time.
Bone remodeling due to production of electro-current.
Painless.
Disadvantages:
Increased cost .
Magnetic force alone is insufficient to move teeth more than 3mm. Elastic chain must be
added.
24
Aluminum-Nickel-Cobalt magnets used.

CERAMIC BRACKETS
These were introduced in early 1980’s
Zulauf’s brackets: opaque and bulky .
Earlier ceramic brackets were made of alumina( Brittle)
Later Zirconia brackets were introduced -
-Surface hardening treatment was done
-Lower Young’s modulus
-Higher overall strength
Disadvantage –
Increased coefficient of friction
25

Ceramic Brackets
Mystique/ In-ovation (GAC)
INVU (TP Orthodontics)
Clarity (3M Unitek)
Radiance (American Orthodontics)
Inspire Ice (Ormco)
Pure (Orthotech)
Signature (Rocky mountain)
26

Advantages of ceramic brackets over plastic-
1. Stain resistant.
2. Durable .
3. Good dimensional stability.
4. Custom moulded for individual teeth.
5. Allowed incorporation of the SWA
feature.
27

Disadvantages
1. Fracture
2. Hardness: low
3. Bulkier
4. High friction
5. Enamel damage at the time of removal
28

COMPOSITE BRACKET
Two or more polymers.
These have properties intermediate between those of the constituents .
Materials should be so chosen that the property of one constituent improves the
deficient property of others .
29

30
TITANIUM BRACKETS
Alternative to stainless steel
- in patients who had sensitivity to Ni.
Advantages-
- Greatest Corrosion Resistance.
- Excellent biocompatibility.
- Small size
- Matte finish ,blends better
with the tooth.
- Low thermal conductivity
- No metallic taste.
.
REMATITAN BRACKETS

Disadvantages –
- Difficult to fabricate.
- Not as esthetic as stainless steel.
- Fluoridated toothpastes corrode titanium
31

EVOLUTION OF
FIXED APPLIANCES
&
BRACKETS
32

33
PIERRE FAUCHARD’S ORTHODONTIC APPLIANCE(Bandellette) : 1728
DWINELLE’S JACK SCREW: 1849

34
ANGLE’S RETRACTION SCREW :1887

ANGLE SYSTEM
35
A standard appliance must have five important properties-
1.Simple
2.Stable
3.Efficiency
4.Delicate
5.Inconspicuous
Patient Orthodontist
Manufacturer / supplier

E Arch -1905
36
Basic E arch
•Used for tipping tooth crowns into proper
alignment.
Disadvantage:
Provides no axial tooth control.

E ARCH WITHOUT THREADED ENDS
38

PIN AND TUBE-1910
40
•Can precisely position each
tooth.
•Vertical Tube parallel to long axis
of tooth.
Disadvantages:
Limited mesio-distal crown
displacement.

42
• First appliance to provide three axis control of tooth movement.
• A Light-wire appliance.
• Widest cross-section: 0.9mm.
• Had vertical slot .
• Held in place by a lock-pin in each bracket with arch ends in molar
tubes.
Advantages:
• Rotations were obtained.
• Offered control over occluso-gingival movements.
Disadvantages:
• Difficult mesio-distal axial movement .
• Poor stabilization or anchorage for posterior teeth.

EDGEWISE APPLIANCE & BRACKETS
43
Edgewise Appliance: It is a fixed, multi-unit orthodontic appliance using a rectangular labial
arch wire ligated to brackets cemented to individual teeth or to bands encircling the teeth.
So called because the bracket is machined such that the rectangular arch wire is inserted with
its long cross section horizontal instead of vertical as in the ribbon arch bracket.
It was introduced by Edward Angle in 1928.
It offers complete control over axial inclination of all teeth in all directions. Thus, the appliance
controls horizontal tooth movements of root and corrects abnormal inclinations of teeth.
Instead of using lock pins, the archwire was held to slots using ligature wire.
Both rectangular and round wires might be used for mesial or distal tipping but for bucco-
lingual tipping, rectangular wires are preferred.

EDGEWISE APPLIANCE
Slot=0.022”X0.028”
0.050 Inch wide
Gold bracket
Gold band
Ligature tie
44
ORIGINAL EDGEWISE ATTACHMENTS
A. WINGLESS ANTERIOR BRACKET
B. PROTOTYPE OF PRESENT
EDGEWISE BRACKETS.
E. STAPLES.
G. WASHERS THAT CAN BE THREADED ON ARCH TO CONTROL SPACE.

EDGEWISE BRACKETS
They are used on the labial or buccal surfaces of every tooth (except last molar).
The brackets have horizontal slots for the archwire, with upper and lower wings
for ligation .
The archwire is tied to the bracket by means of a soft ligature wire with the
wings.
45

THREE DIMENSIONAL CONTROL OF
TOOTH
 First order bends: In & Out.
 Second order bends: Tip.
 Third order bends: Torque.
46

MODIFICATIONS
IN
ORIGINAL EDGEWISE
47

1. SINGLE WIDTH.
2. TWIN BRACKET.
3. REVERSE BASE CURVED TWIN.
4. LEWIS BRACKET.
5. ANTI TIP LEWIS BRACKET
6. VERTICAL SLOT LEWIS BRACKET.
7. CURVED BASE LEWIS BRACKET.
8. STEINER.
9. BROSSAURD.
48

SINGLE WIDTH BRACKET
Angle advised soldering of gold eyelets which were placed on orthodontic band to bring about
tooth rotation.
Ligature wires were tied from the eyelet to the archwire and rotated the tooth.
Disadvantage:
There was need of repeated tying of eyelets throughout the treatment in order to prevent
relapse of rotation.
49

TWIN BRACKETS
Two edgewise brackets were joined together on the same base during manufacturing
process.
They were named as ‘Siamese Twin Brackets’ by Dr. Brainerd Swain:1952.
Space between two brackets: 0.050” i.e. equal to the width of one bracket.
Advantage:
Ability to bring about rotation without using auxiliary eyelet ties.
Initially, could be used only on maxillary central incisors and molars.
Later four more designs were introduced so that they could be used on all the teeth.
50

52
TWIN BRACKETS
ADVANTAGES
• Effective tooth rotation.
• Good control on axial inclination.
• Once the tooth is rotated, mere tying of bracket ligature wire would maintain the
tooth in its corrected position rather that re-tying the ligature, in order to prevent the
relapse.
• Frictional resistance is more and tendency for forward tipping is decreased.
DISADVANTAGES
• Loss of inter-bracket distance creates insufficient space of first and second order
bends.
• Decreased resiliency of wire between brackets.

CURVED BASE TWIN BRACKETS
The base of twin bracket was curved to adapt to the curvatures of canines
and pre-molars.
53

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
54

LEWIS BRACKET
Advantages:
Does not interfere with resiliency ,closing loops &second order bends.
100% correction & over corrections.
Quick and easier method than twin brackets.
Disadvantage:
Less control of axial rotation than twin brackets.
55

ANTI-TIP LEWIS BRACKET
It has notches or slots in the ends of the wings of brackets and therefore attach to a
wider area of contact.
Used mainly adjacent to extraction spaces and maxillary lateral incisors.
Advantages:
Control over axial inclination good.
Available in both large and short sizes to
accommodate small and big teeth.
56

CURVED WING LEWIS BRACKET
There was curving of the base and
wings of the bracket to adapt to
canines and pre-molars.
ADVANTAGES
1.Increase contact with band .
2.Reduces trapping of the food.
57

VERTICAL SLOT LEWIS BRACKET
Here further refinement was done by incorporating a .020 x .020 vertical slot.
Use of uprighting spring to correct axial inclination possible.
58

BURSTONE SEGMENTAL ARCH
TECHNIQUE BRACKETS
He modified canine brackets by inserting a vertical tube for insertion of
retraction assemblies.
Molar and Second Pre-molar brackets were designed.
59
Edgewise slot: .022 x .028 .
Auxiliary Vertical Tube: .017 x .025 vertical
auxiliary tube.

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.
60
STEINER BRACKET

BROUSSARD BRACKET
Designed by “Grayford Broussard”, 1978.
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˚
Features –
- quick wing .
- vertical slot.
- round corners, smooth surface.
- horizontal slot.
- insert pin.
61

THE UNIVERSAL BRACKET
Developed by Dr. Spencer R. Atkinson, 1931.
It is a multi-banded appliance having brackets and buccal and
lingual sheaths as its principal attachments.
It has been called Universal since, different techniques can
be used with it.
It has been designed to produce tooth movement in the
three planes of space.
Central shaft too narrow and shallow.
Appliance has undergone periodic refinements without
losing its essential features.
62

Design-
-Vertical hollow shaft with two lateral welding tabs.
-Central shaft has two slot openings :
1. Horizontal – Opens labially at gingival third.
2. Vertical –opens incisally and extends gingivally
one third of the bracket height.
 Gingival slot can only hold round wire (.008 - .016)
Incisal slot can hold single round, double round, twisted bundle of round, single
ribbon flat wire (.008x.020 up to .016x.028)
Wider mesiodistally and deeper buccolingually.
63

Combination of vertical and horizontal slots provides the appliance with full control in three
planes of space.
Incisal wire:
Rotations
Levelling
Torque
Guiding rail when coil springs are used at gingival level.
Gingival wire:
M-D axial inclinations
Guide when teeth are moved bodily
Fulcrum for labio-lingual movements
Leveling
64

To exert extra force, ‘Double action’ type of
brackets can be used which have tabs or
wings between the occlusal and gingival
wire slots
Root Torquing type: Tabs extend outward to
allow extra ligation for excessive rotations
and provide extended leverage for mesio-
distal axial uprighting of teeth.
Two Curved brackets are used on maxillary
central incisors. In others, single curved
bracket is used.
65

Double Molar Sheaths : Used on molars to receive ribbon arch wires .
Horizontal Lingual Sheaths: Used on lingual surfaces of molars to receive ribbon
arch wires.
66

Thus, by exerting double action and with both the wires (in
occclusal & gingival slots) acting along with each other , the
Universal Brackets become a four dimensional appliance that
offer:
Tooth movement and guidance in a mesio-distal and bucco-
lingual aspects;
Rotation on its axis and
Movement in a vertical plane.
67

LIGHT WIRE EDGEWISE TECHNIQUE
Jarabak and Fizzel: 1960.
It incorporated second and third order mechanics (tip and torque) in the
original edgewise appliance.
It controlled forces obtained from high deflection spring orthodontic
devices.
68

It consists of two edgewise brackets:
One; Long, cervical wing twin edgewise bracket.
Second: Jarabak Edgewise Force Control Bracket: Long, edgewise bracket that is
slotted vertically at one end and horizontally at the other end.
Horizontal and Vertical brackets are used only on maxillary and mandibular anterior
teeth.
Advantages:
Exerts accurate force control for tipping, rotation and bodily movement of teeth.
Positive axial control over canines eliminates the need for uprighting mechanics.
69

ANDREWS SYSTEM
ANDREWS-father of preadjusted bracket system
The original SWA was introduced by Andrews in 1972 and it had the
features of Siamese edgewise bracket.
Study of 120 non-orthodontic normal cases, 1972
1st generation of preadjusted brackets
He recommended a wide range of brackets.
- For extraction cases, canine brackets with anti-tip, anti-rotation, and
power arms for control space closure.
-Three sets of incisor brackets with varying degrees of torque for different
clinical situation.

However, early results with Straight-wire Appliance were disappointing.
Traditional heavy edgewise forces continued to be used
WAGONWHEEL EFFECT
Tip is lost as torque is added(1:4)

Andrews described 3 system of brackets
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
75

Features of standard brackets
1. Slot siting feature
2. Convenience feature
3. Auxiliary feature
76

1) Slot siting feature  They are described in 3 planes of space.
a) Mid transverse plane : The mid transverse plane of slot and crown should
be the same.
To achieve this, the following siting features are required –
Feature 1 : The mid transverse planes of the slot, stem and crown must be the
same.
77

Feature 2 : The base of the bracket for each tooth type must
have the same inclination as the facial plane of the crown at
the FA point.
78

Feature 3 : Each brackets inclined base must be contoured
occlusogingivally to match the curvature of the crown.
79

b) Mid Sagittal plane : The mid sagittal plane of each slot
much superimpose on a facial extension of the crowns mid
sagittal plane.
c) Mid frontal plane : The mid frontal plane of each slot
must superimpose on its crown’s prominence plane.
80

2) Convience feature :
These features make the appliance easier for the orthodontist to use and
sometimes more comfortable for the patient.
The gingival bases on posterior brackets are designed to extend laterally thus
facilitating ligation and eliminating gingival impingement.
81

Since the bases are inclined, the stem and the wings of mandibular
premolars and molars are directed more gingivally. This eliminates
occlusal interferences.
Identification : Fully programmed brackets are tooth types because they
are so much smaller than teeth, their differences are not always readily
visible without special markings.
82

3) Auxiliary features :
These contribute to the biologic aspect of treatment
For Eg:
Power arms
hooks
face bow tubes
utility tubes
rotation wings.
83

ANDREWS SYSYEM
Andrews described 3 system of brackets
Non programmed.
Partially programmed.
Fully programmed.
The fully programmed Bracket system represents the true pre-adjusted appliance
and consists of 2 series of bracket systems:
Standard brackets.
Translation / Extraction series brackets.
84

Translation / Extraction series :
Translation is defined as uniform motion of a body in a straight line. For such a
movement to occur the force must be applied to the objects CR. Unfortunately CR
of tooth is in roots from the standard point of physics, bracket located on the
crown of a tooth is in the wrong place to bring about translation.
The bracket is occlusal / incisal to the tooth CR, so when a force is applied, tooth
instead of translation, will tend to rotate around center of rotation.
Thus when the teeth were translated, to overcome problems like mesial / distal tip
and rotation of teeth adjacent to the site, Andrews introduced the translation
series of brackets in 1972.
85

These brackets had all qualities of standard brackets and some additional
features like –
1) Counter rotation :
This factor is built by rotation of the slot around its vertical axis in the
direction it has to be translated.
For an efficient transfer of force from the bracket slot to the center of the
crown for rotation, the mesial or distal length of the bracket should be equal
to distance from the slot point to the tooths vertical axis.
< 2mm  Minimum translation bracket  - 2°
2-4mm  Medium translation bracket  -4°
> 4mm  Maximum translation bracket  -6°
86

2) Counter Mesiodistal tip :
This was incorporated to prevent the crown from rotating when translated. It was
done by increasing or decreasing the angulation of the slot.
Minimum translation  2°
Medium translation  3°
Maximum translation  4°
The counter Mesiodistal tip of the bracket will not be sufficient to oppose
the tip of the teeth during translation, because the mesiodistal width of the
bracket is not equal to the distance from the slot point to the CR of tooth. Thus a
gingival extension (power arm) is added for deficient length of the bracket.
87

Identification:
Brackets are colour coded based on Quadrants.
U – Right Quadrant  Black dot on distogingival wing.
U – Left Quadrant  Green dot on distogingival wing.
L – Right Quadrant  Red dot on distogingival wing.
L – Left Quadrant  White dot on distogingival wing.
Lower central and lateral brackets do not have colored dots, but instead are
bevelled occlusally.
88

PART 2
CONTENTS
ROTH
MBT
TIP EDGE
ALEXANDER
DUAL ENVIRONMENTAL BRACKET
BEGG APPLIANCE
REFINED BEGG SYSTEM.
KAMEDINIZED BEGG.
RIBBON ARCH BUCCAL TUBES
.
MODERNIZED BEGG
COMBINATION SYSTEM
THE BEDDTIOT APPLIANCE.
CAT TECHNIQUE.
BRACS TECHNIQUE.
J-BRACKETS.
SELF- LIGATING BRACKETS.
LINGUAL ORTHODONTICS.
STRAIGHT WIRE APPLIANCE-NEXT
GENERATION
CONCLUSION.
BIBLIOGRAPHY.
91

ROTH PRESCRIPTION
It was introduced in early 1970’s after a five year clinical evaluation
of the Andrews Straight Wire Appliance
WORK OF ROTH
To avoid inventory difficulties of multiple bracket system,
ROTH recommended a single appliance system to manage
both extraction and non-extraction cases.
92

MBT SYSTEM
Range of bracket : The modern orthodontist expects to have 3 main bracket
system available to meet the needs of a typical case load.
Standard size metal brackets  where control is the main requirement.
Mid sized brackets  Gives less control ,used on average small teeth.
Esthetic brackets  needed for older patients, where metal appearance is not
acceptable.
Rhomboidal shape :
The original rectangular shape is converted into Rhomboidal shape so that the
bulk of the bracket is reduced and allows references lines in both the Horizontal
and Vertical planes thereby arresting the accuracy of bracket placement.
95

MBT SYSTEM
Work of Mclaughlin & Bennet between 1975 & 1993

WORK OF MCLAUGHLIN,BENNET& TREVISI
BETWEEN 1997 & 2001

TIP EDGE
Introduced by Peter Kesling ,1988 based on his experiences with differential
tooth movement
Brackets designed to promote distal crown tipping on all teeth except those
distal to the extraction site.
The slot is programmed to bring about mesial or distal crown tipping at the same
time control final crown inclination.
However, the bracket exerts automatic control due to its slot design and also
application of a unique elastomeric tip-edge ring,
an uprighting spring and a rectangular arch wire.
103

BASIC DESIGN
It has a unique arch wire slot: Bevelled diagonally opposed corners of the
conventional edgewise archwire slot.
- slot size is .022 x.028
- lateral extensions or wings
- vertical slot .020 x.020
- deep grooves
104
TS: TIPPING SURFACE
US: UPRIGHTING SURFACE
CR: CENTRAL RIDGES

Advantages of Tip-Edge Brackets
Can stop free distal tipping of canines.
Provides automatic mesio-distal tip control.
Absence of parallel surfaces in arch wire slot reduces the action of undesired
mesial or distal root torquing forces during overbite correction.
Permits retraction of both dental arches, wherever required (Class I bimaxillary
malocclusion).
Permits closure of extraction spaces.
The unique slot can stop mesial or distal crown tipping at a pre-determined
inclination and thus, increase the anchorage potential of teeth.
The slot may also function as shock absorber to high levels of torque and mesio-
distal uprighting forces
105

Tipping surfaces limit degree of initial crown tipping; uprighting
surfaces control final tip and torque.
106

Molar tubes –
.036 round gingival tube.
.022 x .028 occlusal tube.
They are available with –
1. Extraction and non extraction kits.
2. Torque in base/ face.
3. Over rotation bracket.
4. Positioning jigs .
5. Tip edge rings.
107

108
TIP EDGE BRACKETS FOR DIFFERENT TEETH

THE ALEXANDER DISCIPLINE
(VARI SIMPLEX DISCIPLINE )
This system is based on Edgewise philosophy that was developed by
Dr. R.G. Alexander.
VARI refers to the variety of bracket types used whereas
SIMPLEX relates to the kiss principle (keep it simple, sir)
PHILOSOPHY OF THE VARI’S SIMPLEX DISCIPLINE:
The sizes and shapes of the teeth especially the mesiodistal width and curvatures
influence the appropriate inter bracket width.
The brackets should be selected so that they will provide for dental rotation and
arch leveling without the necessity of time consuming vertical springs, multiloops or
extra arch wires.
109

Bracket Selection
Specific bracket types are associated with specific teeth.
Twin Brackets : Flat and large surface of maxillary central and laterals
allows full arch wire engagement in the twin bracket.
Lang Brackets : Introduced by Howard Land
Used on large round surfaced teeth located at the corners of the arch,
the maxillary and mandibular cuspids.
The lang bracket is constructed in the diamond form, but it is a single
bracket with flat rotational control wings, each containing a
mandibular hole.The hole increase the flexibility of the wing and could
be used for ligation.
Lewis Bracket : Redesigned Lewis bracket are used on round
surfaced teeth not located at the corners of the arches. (Maxillary
and Mandibular bicuspids) as well as small, flat surfaced teeth
(mandibular incisors).
110

DUAL ENVIRONMENTAL BRACKET
Introduced in 1990.
A new bracket was designed to capitalize on the computer modeling that
demonstrated the advantages of small wires and greater intra-bracket space.
This new bracket has a larger outer slot, for maximum arch wire flexibility in
the initial phase, and a small inner slot that accepts small rectangular wires
for maximum control later in the treatment.
The outer slot measures 0.040” for twin brackets and 0.030” for single
brackets.
The inner slot can be either 0.016” or 0.018”.
111

Advantages :
Faster leveling of arches with fewer arch changes.
The large posterior intra bracket space allows less friction with working arches,
permitting the teeth to move more easily both vertically and horizontally.
Easier torquing of teeth with less discomfort.
The working arch is not closely held in the posterior brackets; it flexes within the
slot and acts as a shock absorber to prevent strain on the wire from chewing.
112

MODERN BEGG’S
TECHNIQUE.
113

BEGG APPLIANCE
It utilized 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.
114
Dr P.R.Begg ,1956.

REFINED BEGG
Brackets used are TP-256-00,
With a depth of .020 and Height of .045
Molar tubes –
Round molar tubes .036 and 6 mm length.
Oval tubes .072 x .024 and 5mm length.
Combination tube (TP Lab)
They consist of a round gingival tube of .036 and 6.2 mm length.
Rectangular .025 x .018 -5.5mm long
115

BUILT IN ADJUSTMENTS
Anti rotational brackets
Built in torque.
Additional round tubes and pins used in Refined Begg
116

KAMEDANIZED BEGG
Introduced by Dr Akira
Kameda, 1983.
He introduced torquing and
reverse torquing brackets in
1983
Ribbon arch buccal tube in
1986.
117

In 1983 , he introduced torquing and reverse torquing brackets .Built in torque
adjustments is obtained by raising the incisal or gingival edge of the bracket base
away from the tooth surface.
Advantage of using round buccal tube with a round wire .But it had its own pitfalls-
Free tooth movement is possible ,but anchor molars tend to roll in.
Correcting lingually inclined molars is difficult.
Directing the forces of anchorage bends and bite opening bends is difficult.
118

TO OVERCOME THIS PROBLEM KAMEDA INTRODUCED –
RIBBON ARCH BUCCAL TUBES -1986
119

RIBBON ARCH BUCCAL TUBES -1986
In 1992 JIOS –mentioned that efforts are going on to develop a new type of
KB bracket with a built in T-Pin. Also labio lingual thickness of these KB
brackets are same as non torque brackets, regardless of the 10 ˚ or 20˚built
in torque.
120
TORQUE REGULAR Reverse T

MODERNIZED BEGG-COMBINATION TECHNIQUE:
WILLIAMJ. THOMPSON: 1981.
The rationale behind this approach was to develop a
technique and a bracket system that uses the advantages of both
Begg and Straight wire at the same time minimizing the
disadvantages.
To understand the rationale behind the development of this
appliance, one must understand the advantages and disadvantages
of both the Begg and Straight Wire Appliance Systems.
121

The Begg appliance is rapid in early treatment but becomes more cumbersome in the
finishing stages. The straight wire system is prone to complications in early periods of
treatment but is efficient in the final finishing adjustments.
An appliance that captures the advantages of both systems and reduces the
disadvantages of both is the combination bracket.
The new appliance enables the orthodontist to combine both the tipping and bodily
movement principles of mechanics.
The dual capability of the appliance is due to the combination design in which the
lower third of the bracket is a type 256 Begg bracket and the upper two thirds of the
bracket is a .018” x .025” straight wire slot with in-out positioning and pre-angulated
and pre-torqued.
122

BEDDTIOT Stands for Begg Edgewise Diagnosis Determined Totally
Individualized Orthodontic Technique.
These brackets are narrow, single-width (0.050 inch or 1.3 mm) edgewise
brackets with 0.022 inch x 0.028 inch horizontal arch wire slots.
On the lingual side of the bracket is a 0.020 x 0.020 inch vertical slot.
Except for torque, the brackets are all identical. Therefore, they are
interchangeable.
The brackets are small in all dimensions to ensure optimal appearance and
minimal lip and cheek irritation. This also lessens occlusal interference, enamel
surface involved in bonding, and problems with gingival proximity and oral
hygiene.
.
123
THE BEDDTIOT APPLIANCE
RICHARD HOCEVAR: 1985

The vertical can accommodate ligatures, elastic hooks, rotation devices, and
various other auxiliaries.
The basic buccal tubes are conventional 4.5 mm long, 0.022 x 0.028 inch
"edgewise" tubes with 25° lingual crown torque for lower and 10° for upper
first molars.
An additional rectangular tube(outer tube) is carried diagonally across the
buccal surface of the basic tube, its mesial end pointing gingivally. The outer
tube crosses the inner tube at an angle of approximately 15° and is somewhat
gingival to the inner tube.
124

COMBINATION ANCHORAGE TECHNIQUE
(CAT) BRACKETS:
WILLIAMJ. THOMPSON: 1988
The CAT bracket is comfortable and esthetically pleasing to the patient.
It has a .022” x .035” gingival or ribbon arch slot and either a .018” x .025”
or .022” x .028” straight wire edgewise slot.
An enclosed vertical slot is also incorporated into the bracket for use with up
righting and rotating springs, elastic or surgical fixation hooks and for
attachment of tandem or double archwires.
All brackets are identified by color coding dots at the disto-gingival aspect.
Maxillary brackets are red and mandibular brackets are blue.
Molar attachments now have convertible double tubes to facilitate extending
the straight wire into second molar tubes.
125

BEGG-RIBBON ARCH COMBINATION SYSTEM (BRACS):
NIKHIL S. VASHI
The Begg-Ribbon Arch Combination System is an appliance that combines the
advantages of Begg appliance like rapid bite opening, use of light tipping forces for
retraction with those of Edgewise and preadjusted appliances like precise finishing
and total control over tooth movements .
The bracket has one gingival ribbon-wise slot (.018” x .027”) for round and
rectangular archwires and two vertical slots for lockpins and ligature wires.
It also has an incisal slot (.020” x .020”) for ligature wire or elastic modules. This
slot can also be used for a stabilizing archwire if needed.
126

The molar tube is rectangular ribbonwise for ribbon arch. It is placed at a 6
degree offset for distal rotation to achieve better molar control.
The bracket design is such that it would allow free tipping, controlled
tipping or bodily translation of teeth as required.
127

Advantages-
Rapid differential movements of teeth with better control and less friction.
Helps in proper finishing of the case.
Need for patient co-operation is minimal.
Eliminates the need for heavy elastics.
Reduced the treatment duration.
128

‘J’ BRACKET- A NEW DESIGN OF BEGG (COMBINATION) BRACKET
The ‘J’ bracket was introduced by Dr. V. P. Jayade in 1991. This bracket attempts to
harness the advantages of both the ribbon arch and edgewise brackets at the
same time eliminating their disadvantages.
Advantages of Multiple Slot Brackets over Single Slot Brackets:
A combination bracket with more than one slot is much more efficient than a
single slot bracket because many of our treatment requirements are diametrically
opposite
They offer the possibility of applying forces to the teeth at different areas eg. One
can apply crown-tipping forces closer to the incisal margin and root moving forces
closer to the cervical margin of the crowns.
Switching slots helps in altering or reinforcing anchorage.
Segmental wires, which offer greater versatility in force distribution can be used
whenever necessary.
Tandem wires can also be used
129

Twin slot arrangement also has its peculiar disadvantages:
They drastically reduce mesiodistal tipping due to increased width
They reduce the inter-bracket wire span which reduces the working range of the inter-bracket
section of the wire
Net effect of the changed orientation of the slots:
Permits adequate mesio-distal crown tipping but restricts excessive crown tipping
Affords good rotational control
Allows to fully utilize the torquing abilities of rectangular wires
130

RUSSELL ATTACHMENT
The first self-ligating bracket, the Russell attachment, was developed by
Dr. Jacob Stolzenberg in 1935.
Design –
- A flat-head screw seated snugly in a circular ,threaded opening in the
face of the bracket.
- The horizontal screw could be loosened or tightened .
132

EDGELOCK BRACKET
1971- Dr Jim Wildman.
This was the first “passive” self-ligating bracket
Design –
-Bracket had a round body with a rigid labial sliding cap
-A special tool was used to move the slide occlusally to facilitate arch wire
insertion.
133

MOBIL- LOCK BRACKET
About 2 years later, in 1973, Dr. Franz Sander introduced the Mobil-lock
bracket.
Design-
-Semi circular labial disc .
-A special tool was used to rotate the disc into its closed or open position
134

SPEED BRACKET
“Speed” bracket introduced by Dr Herbert Hanson in 1976
and became available in the market in 1980.
Stands for-
S - Spring loaded
P - Precision
E - Edgewise
E - Energy
D - Delivery
135

Bracket Design-
 Consists of a narrow single width bracket body.
 Multislotted with 3 horizontal slots:
1. Arch wire slot
2. Auxiliary slot
3. Spring retainer slot
136

Curved, flexible “Super-Elastic Spring Clip”
that wraps occluso-gingivally around the
bracket body.
Opens and closes in a vertical manner.
Labial arm of the spring clip forms the
flexible fourth wall.
137

The Speed Appliance Function-
The highly resilient spring clip controls tooth movement in all the three
planes of space
Rotational Control:
On arch wire engagement, the spring clip is activated by displacement from
the resting position
-Rotational correction is achieved through torsional component of the
deflection.
- Deflection creates a rotational couple consisting of a fulcrum and spring clip
force.
138

Tip control:
Tip correction is achieved through the labial deflection and subsequent
return of the spring clip to its resting position.
139

Torque Control:
Resides in combination of the mechanical action of the arch
wire in the slot with constant force application from the spring
clip.
140

Further enhanced with the use of beveled SPEED arch wires.
Helps the operator in saving as much as 5 minutes per arch wire
change .
Offers full control even with the most undersized arch wires.
141

ACTIVA
In 1986, Dr. Erwin Pletcher introduced the Activa bracket
Had an inflexible curved arm that rotated occluso-gingivally around the cylindrical
bracket body.
Arm could be moved into a “slot-open” or “slot-closed” position with finger
pressure alone
Drawbacks:
1. Ease with which patients could open the bracket.
2. Large mesiodistal width
142

TIME BRACKET
In 1995, Dr Wolfgang Heiser introduced the Time
bracket.
Design-
Rigid ,curved arm that wraps occlusogingivally
around the labial aspect of the bracket body
A special instrument is used to pivot the arm
gingivally into the slot open position or occlusally
into the slot closed position.
Stiffness of the bracket arm prevents interaction
with the arch wire.
143

TWIN LOCK BRACKET
The Twin Lock bracket was introduced by Dr. Jim Wildman, in 1998.
It had a flat, rectangular slide, housed between the tie wings of an
edgewise twin bracket.
The slide is opened occlusally with a universal scaler .
144

DAMON SL I AND DAMON SL II
Between 1996 and 1999, Dr. Dwight Damon introduced the Damon SL I and
Damon SL II brackets
The basic difference is that the first had a labial cover that straddled the tie wings,
while the second incorporates a flat, rectangular slide between the tie wings .
Slide moves incisally on the maxillary and gingivally on the mandibular brackets.
Special opening and closing pliers are required.
145

IN-OVATION BRACKET
Introduced in year 2000.
► It is a self-ligating bracket system consisting of a twin bracket for
rotational control and has an “active” clip for seating arch wire.
► The bracket design not only combines all the important features of an
effective self- ligating system, it goes even further to provide the highest
level of versatility, function and comfort
Advantages:
► Shorter office visits.
► Shorter overall treatment time.
► Use of lighter forces.
► Increased patient comfort.
146

Four full tie wings.
Slot blocker.
Horizontal V Slot .
Compound contoured base.
Torque in base .
147

Recent advances in self ligating
brackets
Damon 3 brackets (2004)
Smart clip( 2004)
Damon 3MX brackets (2005)
Smart clarity SL
bracket(2007)
Discovery brackets(2007)
Damon Q (2009)
Smart clip SL3 (2009)
Harmony lingual self-ligating
bracket system (2011)
Sensation active ceramic
self-ligating bracket(2012)
BioQuick self-ligating bracket
(2014)
Carriere SLX self-ligating
bracket system (2014)
Empower 2(2016)
In-Ovation X (2017)
148

Brackets Used in Lingual
Orthodontics
149

Lingual Light Wire Technique
Stephen F Paige –Aug,1982
Fujita confirmed that orthodontic treatment with brackets placed on the
lingual is possible.
An obvious disadvantage to the lingual appliance is the difficulty of insertion
and removal of archwires.
150

Bracket Design Criteria:
1. Interbracket distance is reduced on the lingual. Therefore, the
bracket must be designed to be as narrow as possible mesiodistally.
2. Mesiodistal root control becomes more difficult –vertical slot for arch
auxiliaries.
3.Topography of the lingual surfaces of the maxillary and mandibular
anterior teeth vary a great deal.
151

Archwire Design
Archwires of approx. .002"
smaller diameter.
General shape of the
archwires resembles the
mushroom shape.
152

Molar Tube Design
-Oval tube with mesiogingival hook.
- Increases patient comfort, allows molar control, and will
accept a ribbon arch
153

Lingual Begg Light Wire Technique
Peter K Yen, Nov 1986.
Developed a technique that uses regular Begg labial brackets .
TP 256-500 mini-mesh lower incisor labial brackets, are used for both
upper and lower incisors.
Upper lateral incisor labial brackets are adapted to the cuspids, and the
curved upper cuspid labial brackets to the bicuspids.
.036” tube with a mesio-gingival hook.
The mushroom-shaped archwire should have horizontal loops distal to
the cuspids.
154

CONCEAL SYSTEM
Aug 1989 -Thomas Creekmore.
Developed by Unitek Corp.
An acceptable lingual orthodontic appliance system must
include the following key elements -
◦ It should align teeth from the lingual side as efficiently as from the
labial side.
◦ A means of positioning brackets precisely to create a “near” SWA on
the lingual side.
155

The foundation of the design is the opening of the wire slot to the occlusal
aspect rather than to the lingual aspect.
156

Decrease in interbracket distance on the
lingual side necessitates the use of smaller
arch wires. Hence, slot size is .016”x.022”.
Anterior brackets have a Y configuration
with a single tie wing projecting gingivally
and twin tie wings projecting occlusally
157

Friction Free Bracket
Kazuto et al, 1994.
Basic idea of the design was to reduce friction between the
bracket slot and the archwire.
Ligature does not press against the arch wire in the FF bracket
158

Recent advances in lingual brackets
Fujita lingual Bracket(Forstadent)
Stealth Brackets (American orthodontics)
Philippe self ligating lingual bracket -Massimo Ronchin in 1994
Kelly Bracket
Kurz lingual bracket
In –ovation l bracket (GAC)
Braces(Incognito)
159

Straight Wire: The Next Generation
Introduced by Creekmore and Randy in 1993.
Frequently, anticipated results are not achieved by using preadjusted
appliances and straight wires .
There are at least five reasons –
1. Inaccurate bracket placements
2. Variations in tooth structure
3. Variations in antero-posterior and vertical jaw relations require
variations in the position of the maxillary and mandibular incisors
4. Need for overcorrection
160

5. Mechanical deficiencies of the edgewise appliance
a. Force application away from CRes.
b. Play between arch wire and slot
c. Force diminution.
161

THE SLOT MACHINE
Thomas Creekmore has designed the slot machine in such a way for placement of
both conventional and lingual brackets directly on to the malocclusion model
Each tooth will be designated with specific tip and torque value.
The bracket slot is oriented to the machine.
The placement of brackets having either horizontal or vertical access arch wire
slots is done by the slot machine
162

CONCLUSION
Understanding and use of historic evolution of brackets aid in better understanding of
present-day Brackets and predict their future developments.
Presently, five brackets have withstood the test of time:
a.) Standard Edgewise Bracket b.) Pre-adjusted Edgewise Bracket c.) Begg d.)
Combination Edgewise or Modern Begg e.) Tip Edge.
Today’s preferences are towards pre-adjusted, machined, four component twin
brackets with rounded forms and certain aiding features like torque, in-and –outs and
counter-rotation features.
Thus, with new era precision brackets are evolving that involve efficient force
distribution to the tooth to bring about different tooth movements in less time
163

BIBLIOGRAPHY
1. Begg PR and Kesling PC. Orthodontic Appliances. Begg’s Orthodontic Theory and Technique, edn 2,
Philadelphia, Saunders, 1971, 158- 174.
2. Raymond Thurow, Edgewise Orthodontics, Edn 3, Mosby, 1972, 16-20, 145- 151, 160-189.
3. Graber TM. Orthodontic appliance and treatment philosophy; Orthodontic Principles and Practice, edn 3,
Philadelphia, Saunders, 1995:535- 539.
4. Devnathan D and Chudzynski J. Technical evaluation of a new orthodontic bracket. JCO, 1997; 31.
5. Graber and Swain: Biomechanical Principles and Reactions: Orthodontic current Principles and
Techniques, 1st edn., JayPee Publishers, 1991: 150-168.
6. Creekmore T. Lingual Orthodontics- Its renaissance, Am J Orthod Dentofac Orthop 1989 (96) : 120-137.
7. Proffit WR, Mechanical Principles in Orthodontic force control; Contemporary Orthodontics. Edn
2,Mosby, 1993: 385- 391, 410-414.
8. Dewel BF. The Ribbon Arch – Its influence in the development of Orthodontic Appliances. Angle Orthod 1981;
51: 264-68.
164

9. Hocevar RA. Begg-edgewise Diagnosis-Determined Totally Individualized Orthodontic Technique:
Foundation, Description and Rationale. Am J Orthod Dentofac Orthop, 1985 (88) : 31-46.
10. Thompson W.J: Combination Anchorage Technique: An Update of Current Mechanism, Am J
Orthod Dentofac Orthop , 1988; 93;363-79
11. Kameda A. KB Technique- Its theory and Practice: Part I, J.I. Orthod Soc, 1992; 23: 51-56.
12. Hamula DW, Hamula W and Sernetz F: Pure Titanium Orthodontic Bracket, J Clin Orthod ,1996 ( 30)
: 140-144.
13. Lindquist JT. The edgewise appliance, In Graber TM: Orthodontics Current Principles and
Techniques, Edn 3, C.V. Mosby, 1985: 456-460, 676-687.
14. Kesling: Expanding the horizons of edgewise Archwire slot, Am J Orthod Dentofac Orthop , 1988
(94) : 26-37.
15. Swartz ML. Ceramic Brackets. J Clin Orthod, 1988 (22) : 82-88.
165

16. Alexender, Gorman, Hilger; Lingual orthodontics: a status report: part 5- lingual mechano-
therapy, J Clin Orthod, 1983, 17 (1): 99- 115.
17. Milton Rabine: The Rationale of Begg Therapy; J Clin Orthod, 1968, 2 (9) : 338-341.
18. Wofgang Heiser: TIME: A New Orthodontic Therapy; J Clin Orthod, 1998, 32 ( 1): 44- 53.
19. Alexander: The Vari Simplex Design: Part 1- Concept and Appliance Design; J Clin Orthod,
1983, 17 (6) : 380- 392.
20. Stephen H. Paige: The lingual Light Wire Technique; J Clin Orthod, 1982, 16 (2) : 534- 544.
21. Broussard, Shia: The Broussard Hook and Eye Clasp Fixed-Removable Appliance; J Clin Orthod,
1978, 12 (6): 412- 420.
22. Jorge Fastlicht: The Universal Appliance Today- Part 1; J Clin Orthod, 1969, 3 (1) : 582- 589.
23. Swain and Ackerman: An Evaluation of Begg Technique; Am J Orthod, 1969 ( ) : 122- 141.
166

24. Thompson: Combination Anchorage Technique: An Update of Current Mechanics; Am J
Orthod Dentofac Orthop, 1988, 93 (5) : 363- 379.
25. Hocevar: BEDDTIOT: Introduction to Clinical Applications; Am J. Orthod Dentofac Orthop,
1987, 92 (1): 50- 69.
26. Harradine: The clinical use of Activa self-ligating bracket; Am J. Orthod Dentofac Orthop,
1996, 109 (3) : 319- 328.
27. RH Roth: The Straight Wire Appliance: 17 yrs later; J Clin Orthod, 1987, 24 (2 ) : 632- 642.
167

EVOLUTION OF BRACKETS.ppt

More Related Content

What's hot (20)

Similar to EVOLUTION OF BRACKETS.ppt (20)

Recently uploaded (20)

EVOLUTION OF BRACKETS.ppt