Brackets in orthodontics /certified fixed orthodontic courses by Indian dental academy

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

What is a bracket???


What is a bracket???


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


Ancient orthodontics

splint of ivory

E.H ANGLE


Father of orthodontics



Valuable contributions



Latest – edgewise app



Angle’s line of occlusion


E.H ANGLE


All you can do is push, pull or turn a tooth.



Edgewise appliance - ‘‘Latest and the best’’



Evolution of edgewise appliance….


Evolution of edgewise appliance


Angle graduated in 1878



1888 – angle system



Standard Orthodontic appliance should have 5
properties




Simplicity



Stability



Efficiency



Delicacy



Inconspicuousness


Angle patented the jackscrew – he gave the
credit for the regulating screw to dwinelle
1849- did not give credit to farrar who had
described a similar appliance in 1876 – his
rival.



1907 – angle discontinued the use of jack screws

E Arch




Heavy archwires supplied in 4 designs
Basic E arch
Ribbed E arch
E arch without threaded ends
E arch with hooks



Basic E arch


Ribbed E arch


E arch without threaded ends


E arch with hooks




Problems with Angle’s E arch appliance

1.

Removal of retention app – malocclusion.
Axial relationship of teeth can not be accomplished
Unstable results

2.
3.

Teeth should be moved bodily

Pin and tube-1910


Pin and tube-1910
Adv - root movement
Disadv – technique sensitive and time consuming
- rotational adjustments difficult to achieve


The Ribbon Arch-1915

Brackets




Advantages



Disadvantages

1.

Rotations readily
accomplished
Incisogingival
Labiolingual

1.

Enmasse movement of
teeth
Mesial and distal
tipping bends

2.
3.

2.


contrast to ribbon arch???
0.022×0.028
0.050 Inch wide
Gold bracket
Gold band
Ligature tie



Gold alloy archwires
First order bends
Second order bends
Third order bends


Cornerstones of modern edgewise
orthodontics


Tooth movement in all 3 planes



Philosophy of treating to ideal arch form



Use of rectangular arch wires


Single width bracket


Siamese twin bracket

swain
Interbracket span 050’’


Posterior brackets


Twice the width of
single width bracket
010’’


Curved base twin bracket

Positive control

Mechanism of action

Twin bracket – important points



Rotational control : mainly by deflection of arch wire
Positive control
Disadvantages

1.
2.
3.
4.

10% play of arch wire
Inter bracket span is reduced  Resiliency
Closing loop arch wires
Second order bends

Lewis bracket

Soldered auxiliary rotation arms
Single width feature- retained

Lewis bracket


Types:


Lewis bracket


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

Wings though rigid can be bent


Curved base lewis bracket

Increase contact with band .
Reduces trapping of the food.


Vertical slot Lewis bracket

020 x020 vertical slot

Steiner bracket


Flexible rotation arms - did not rely entirely on the
resiliency of archwire for tooth rotation.



Single width edgewise bracket


Broussard bracket

Grayford broussard
Modified edgewise bracket
in which there is addition of
0.0185 x 0.046 slot –to
accept doubled 0.018
auxiliary wire

Tweed-Merrifield appliance






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


Andrews straight wire appliance





BRACKETS stand in between tooth and the
orthodontist
1960 – concept of fully programmed appliance
Advantage of FPA
ELIMINATES WIRE BENDING


Andrews


Driving force for FPA

1.

Analysis of orthodontically treated final occlusion
Analysis of naturally occurring optimal occlusion
Six keys to normal occlusion

2.
3.


Andrews

Andrews plane

Andrews

FACC
FA point
Angulation


Andrews

Inclination


Interarch relationship


Crown angulation


Crown inclination


Crown inclination of posteriors


Absence of rotations

Curve of spee

Tight contacts


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

3.

Fully programmed appliance- a set of brackets
designed to guide teeth directly to their goal
positions with unbent wires.

Features of Edgewise Bracket


Non programmed bracket


Angle’s edgewise app

FA point on FACC

All crowns will have equal facial prominences
Extensive Wire bending



Design shortcomings

1. Bracket base perpendicular to bracket stem.
2. Bracket bases are not contoured.
3. Slots are not angulated
4. Bracket stem are of equal faciolingual thickness.
5. Maxillary molar offset is not built in.
6. Bracket siting techniques are unsatisfactory.


1.

Bracket base perpendicular to bracket stem.




Bracket bases are not contoured occlusogingivally.



Greater than 2°
Greater than 0.5 mm



Mesio-distal base contour



Slots not angulated




Bracket stem are of equal faciolingual thickness


Maxillary molar offset is not built in.


Bracket siting techniques are unsatisfactory.
Angulation
-Long axis-crown
-Long axis-tooth
-Incisal edges- curved ,worn
-Marginal ridges
-Contact points



Holdaway advocates that the bracket siting should
be altered according to the malocclusion.



Tweed recommends siting brackets in specified
number of millimeters from the incisal edge.



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 the middle third
of the crown.



Lindquist brackets according to the ht of marginal
ridges on posteriors.


Accuracy-

Bracket base along FACC
At FA point

1.

2 degrees

2.

.5 mm of the FA point.


Wire bending


Primary wire bends (1st, 2nd, 3rd order )



Secondary wire bends



tertiary wire bends


Wire bending

angulation


Wire bending

Occlusogingival slot positioning

Wire bending

Inclination

Wire bending

Prominence differences

Wire bending

Total 76 bends

Fully programmed appliance

Thank you
For more details please visit


Brackets in orthodontics /certified fixed orthodontic courses by Indian dental academy

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