Orthodontic brackets part 1 /certified fixed orthodontic courses by Indian dental academy

Orthodontic
brackets-part 1
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


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

Edward Hartley Angle


Angle system
A standard appliance must have
five important properties1.Simple

Patient

Orthodontist

2.Stable
3.Efficiency

Manufacturer/supplier

4.Delicate
5.Inconspicuous

E Arch -1907

Basic E arch

Ribbed E -arch


E arch without
threaded ends


E arch with hooks


Pin and tube-1910


The Ribbon Arch-1915


Edgewise Appliance






0.022*0.028
0.050 Inch wide
Gold bracket
Gold band
Ligature tie


Three dimensional
control of tooth










First order
bends
Second order
bends
Third order
bends
In & out
Tip
torque


Begg Appliance
Dr P.R.Begg 1956




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


Lock pins


Safety lock pins



Hook lock pins



High hat pins


Evolution of the edgewise
brackets





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

Twin brackets


Tweed-Merrifield
appliance








Double wide brackets
on 6 anteriors
Intermediate Single
width brackets on
Premolar bands
Twin brackets on
molars
0.022 tubes on
second molars


Twin brackets











ADVANTAGES
Rotational control : mainly by deflection of arch
wire
Positive control
DISADVANTAGES
10% play of arch wire
Decreased amount of arch wire ,Inter bracket
span & resiliency
Closing loop arch wires
Second order bends

Lewis bracket


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


Advantages of Lewis
bracket

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


Curved Lewis bracket

1.

2.

advantages
Increase contact
with band .
Reduces trapping
of the food.


Vertical slot Lewis
bracket

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

Creekmore Uni Twin
Bracket




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


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


Broussard bracket






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


Burstone’s canine & 2
premolar brackets

nd

This consists of a
basic .022 x .028
edgewise slot &
additional .017 x .
025 vertical
auxiliary tube for
insertion of
retraction
assemblies.

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

Deltoid brackets
Anthony B Viazis


Single type –
poor rotational
control



Twin bracketsreduced wire



Winged
brackets –poor
oral hygiene


Deltoid brackets






Rotational control
Sliding mechanics
Reduced friction
Orientation
Torque control


DUAL ENVIROMENT
BRACKET
Schudy 1990






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

.www.indiandentalacademy.com

Features of Edgewise
Bracket


Andrews classification
1.

Non programmed appliance-a set of
brackets designed the same for all tooth
types ,relying totally on wire bending.

2.

Partly programmed appliance- a set of
brackets designed with some in built
features ,but always require some wire
bending
Fully programmed appliance- a set of
brackets designed to guide teeth directly to
their goal positions with unbent wires.

3.

Design shortcomings of
Non programmed bracket
1.
2.
3.
4.

5.
6.

Bracket base perpendicular to bracket stem.
Bracket bases are not contoured.
Slots are not angulated
Bracket stem are of equal faciolingual
thickness.
Maxillary molar offset is not built in.
Bracket sitting techniques are unsatisfactory.

Perpendicular base & stem





Inclinations
Occlusogingi
val levels

Non contoured bases

Occlusogingival
Mesiodistal


Slots are not angulated


Bracket stem are of equal
faciolingual thickness.


Maxillary molar offset
is not built in


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

Wire bending


Primary Wire bending
 1st



,2nd & 3rd order bends

Secondary Wire bending
 Slot

irregularities
 Side effects
 Human errors


Tertiary Wire bending
 Loops

,&stops


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


Torqued

brackets

• Ivan Lee suggested torquing
of slots
• Torque in base
• Torque in face






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


Fully programmed
appliance


The Straight Wire Appliance

-

Slot-siting feature

-

- Convenience feature
- Auxiliary feature

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




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




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




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


Feature 5 -the plane of the bracket base
at its base point must be
identical to the facial
plane of the crown at the FA point.




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




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




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


Convenience features
1.

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




Base are inclined


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


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


Auxiliary feature
-

Power arms
Hooks
Face bow tubes
Utility tubes
Rotational wings


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




Translation problems
Counter buccolingual tip
Counter mesiodistal tip
Counter rotation


Translation brackets
1.

2.

3.

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

Vari Simplex Discipline
Alexander-1978

Factors defining the
bracket system-Type of bracket
-Placement positions
-Angulations
-Torque
-In /out compensations

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


Vari Simplex Discipline


Lewis brackets-Bicuspids & lower incisors
Twin brackets with convertible sheath-1st molars
Bracket positioning –X



Tip –0 all posteriors(-6 lower 1st molar)



Torque-negative with lower incisors (-5)
-3˚ torque on maxillary cuspid
No torque in the second molar tube









In out –thick for upper laterals & lower incisors

Roth Prescription




“Five year clinical evaluation of the
Andrews Straight Wire Appliance 1976
Inventory
– Tip canine upper 11-13,lower 5-7



Anchorage loss
– Tip posteriors upper 0 ,lower-1



Over correction
– Torque increased with upper incisors by 5

MBT


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

MBT Versatile+


Additional tip in upper anteriors caused
– Anchorage strain
( 8-11-13 canine)
– Bite deepening
– Upper canine root apex close to premolars



Overall increase in upper anterior torque



Three torque options for canines 7,0,-7



Square ,ovoid &tapered arch form

Slot size 0.022 / 0.018?








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

Begg today




Conventional Begg
Modified Begg
Refined Begg


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

Refined Begg
Anti rotational
brackets .

Pins used in Refined Begg


References










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

References









Begg orthodontic theory &techniqueBegg & Kesling
Refined Begg for modern times
-Dr V P Jayade
Systemized orthodontic treatment
-McLaughlin ,Bennett & Trevisi
New vistas in orthodontics –Kesling
K B technique its theory & practiceJIOS1992Dr Akira Kameda

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Orthodontic brackets part 1 /certified fixed orthodontic courses by Indian dental academy

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Orthodontic brackets part 1 /certified fixed orthodontic courses by Indian dental academy