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FIXED ORTHODONTIC APPLIANCES
DENT 657
Removable vs. Fixed Appliances
REMOVABLE Tipping only No control over root
movement Pt’s co-operation Hygienic
FIXED Bodily translation Control of root
movement Less dependent on pt’s
co-op Less hygienic
DEVELOPMENT OF FIXED ORTHODONTIC APPLIANCES
Development of Fixed appliances
Early fixed appliances Late 1800s Edward Angle
EARLY FIXED APPLIANCES
Development of Fixed appliances
Standard Edgewise appliance Early 1900s
Development of Fixed appliances
Pre-adjusted edgewise appliance 1970s Refined manufacturing process with “built-
in” adjustments specific for each tooth Advances in material sciences made
attachment much smaller
BANDED APPLIANCES
Bonding to Enamel
Bonding Surface - Bracket Base
BONDED APPLIANCES
Lingual Appliance
CERAMIC APPLIANCES
Self Ligating Appliance
PASSIVE FIXED APPLIANCES
Components of the Fixed Appliance Bands Molar Tubes Brackets Buccal Tubes Arch Wires Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral appliances
Posterior attachments
MOLAR TUBES
Components of the Fixed Appliance Bands Molar Tubes Brackets Arch Wires Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral appliances
Anterior Attachments
Brackets
Components of the Fixed Appliance Bands Molar Tubes Brackets Arch Wires Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral appliances
ARCH WIRES
Maxillary and mandibular Arch form described as “parabolic shaped” Size and cross-section of wires vary Material varies eg. Nickel Titanium alloy
(NiTi), Titanium Molybdenum Alloy (TMA), Stainless Steel
Components of the Fixed Appliance Bands Molar Tubes Brackets Arch Wires Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral appliances
Elastics
EXTRA ORAL FORCES - HEAD GEAR
Coil Spring
Closed or open coil springs
Pre-Adjusted Edgewise Appliance or The Straight Wire Appliance
Larry Andrews - studied normal occlusion and individual tooth positions
Developed prescriptions for individual tooth position
Elements of “ideal” tooth position are built into the appliance
Minimizing active “wire manipulation” - The Straight Wire Concept
Pre-adjusted edgewise appliance
First order / in-out - Horizontal plane Second order / tip - Mesio-distal angulation Third order / torque - Labio-lingual
angulation
3 - Dimensional control of tooth position
First order or In-out
Pre-adjusted edgewise appliance
First order / in-out - Horizontal plane Second order / tip - Mesio-distal angulation Third order / torque - Labio-lingual
angulation
Second order or Tip
4
Pre-adjusted edgewise appliance
First order / in-out - Horizontal plane Second order / tip - Mesio-distal angulation Third order / torque - Labio-lingual
angulation
Third order or Torque
4
To “Torque” is the least efficienttooth movement using orthodonticappliances
Significance of accurate bracket/band positioning
Precise tooth positioning Optimal effect of “pre-adjustment” Occlusion Esthetics Stability
POSITIONING BRACKETS - GENERAL INSTRUCTIONS
Rhomboidal shapeDisto-lingual wing markCentral scribe line (long axis)
Maxillary Central Incisors
4
Distance from the slot to theincisal edge = 4mm
From the occlusal, the bracketis centered mesio-distally.
As a guide, approximate theincisal edge of the incisor withthe base of the bracketperpendicular to the clinicalcrown long axis.
4
Maxillary Lateral Incisor
3.5
Distance from the slot to the incisal edge= 3.5mm
3.5
Maxillary Cuspids
4.5
4.5 mm
Distance from cusp tip to bracket slot =4.5 mm
The severe angulation and prominentanatomy of cuspids (10o) can makeplacement difficult
From the occlusal view, the bracket iscentered mesio-distally on the prominentbuccal developmental ridge. This alsocorresponds to the clinical crown longaxis. This will usually be mesial to thecenter of the contacts
Maxillary Bicuspids
Distance from cusp tip to bracket slot =4 mm
From the occlusal view, the bracket iscentered mesio-distally on the prominentbuccal developmental ridge. This alsocorresponds to the clinical crown longaxis.
Mandibular Incisors
Mandibular Cuspid
Mandibular Bicuspids
Maxillary first molar bands
Mandibular first molar bands
Palmer notation used in Orthodontics
Right Left
Upper 7 6 5 4 3 2 1 1 2 3 4 5 6 7 UpperTooth # 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Tooth # 31 30 29 28 27 26 25 24 23 22 21 20 19 18
Lower 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Lower
The bracket height chart is written in Palmer Notation. This notation numbers the teeth startingwith the central incisors as 1. The laterals are then 2. The canines are 3. The 1st and 2nd
premolars are 4 and 5 respectively, the 1st molars are 6 and the 2nd molars are 7.
Bracket Heights from Cusp tip or Incisal Edge
Right 2nd
M1st
M2nd
B1st
BCu LI CI CI LI Cu 1st
B2nd
B1st
M2nd
MLeft
Upper 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Upper
Bracketheight
3.54 4 4
4.5
3.54 4
3.5
4.54 4 4
3.5
In mm
Occplane
Bracketheight
3.54 4 4
4.54 4 4 4
4.54 4 4
3.5 In mm
Lower 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Lower
Recommended