The straight wire concept /certified fixed orthodontic courses by Indian dental academy

The Straight Wire
Concept
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

The straight wire concept
“The birth of a new concept is never an all or none phenomenon. It
is a slow evolution with contributions from many. A new principle is
an inexhaustible source of new views”
“Nothing in education is more astonishing than the amount of
ignorance it accumulates in the form of inert facts.. However , it is
the amalgamation of these inert facts, put forward by the genius’ of
our profession, that has led to the high standard of the Preadjusted
Appliance system which it has acquired today”
“The beauty of this concept is that a more consistent, more ideal
result can be obtained with less physical and mental drain on the
operator in less overall time and minimal discomfort to the patient.”


The Straight Wire Concept
“The straight wire concept is not a product of serendipity,
but is a poetry in design. It is an appliance fully
programmed to combine simplicity and effectiveness
required for the road to success”
The genesis of the straight wire appliance was not a
result of a single stray discovery, but rather the result of
numerous experiments. Many individual innovations
were distilled and combined to form this intricate design.


EVOLUTION OF THE BRACKET
 E-

ARCH (1900)
 PIN AND TUBE
APPLIANCE (1910)
 RIBBON ARCH
BRACKET (1915)
 EDGEWISE
BRACKET(1925)

# SINGLE WIDTH BRACKET
# 2 SINGLE WIDTH BRACKETS
# TWIN BRACKETS
# LEWIS BRACKET
# VERTICAL SLOT LEWIS BRACKET
# LANG BRACKET
# TIP EDGE BRACKET
# CONVERTIBLE BRACKET
# EDGELOCK / SELF LIGATING
BRACKET

THE E- ARCH















THE FIRST FIXED APPLIANCE
DESIGNED BY ANGLE IN 1900
USED STATIONARY
ANCHOAGE
TIPPED TEETH INTO NEW
POSITION
EXCPANDED THE ARCH
X MESIO DISTAL TOOTH
MOVEMENTS
X INDIVIDUAL TOOTH
MOVEMENTS
X ROOT MOVEMENTS


THE PIN AND TUBE
APPLIANCE










BANDS ON ALL TEETH
TUBES SOLDERED TO
BANDS
ARCH WIRE SOLDERED TO
TUBE WITH PINS
COULD BRING ROOTS INTO
AXIAL ALIGNMENT
VERY DIFFICULT TO
PARALLEL
TUBE AND PINS
SOLDERING AND
UNSOLDERING PINS
ROTATIONAL
ADJUSTMENTS

THE RIBBON ARCH
BRACKET











THE FIRST BRACKET
DEVISED IN 1915 BY ANGLE
BIG STEP IN EVOLUTION OF
BRACKETS
ROTATIONAL MOVEMENTS
BUCCO-LINGUAL AND INCISOGINGIVAL
MOVEMENTS
X DISTAL TIPPING OF BUCCAL
SEGMENT
X MESIODISTAL AXIAL MOVEMENT
X ARCH WIRE DID’NT PROVIDE
STABILIZATION


THE EDGEWISE
BRACKET








FINAL BRACKET DESIGN BY ANGLE
(1925)
BASED ON HIS “LINE OF OCCLUSION”
CONCEPT
BRACKET WITH RECTANGULAR SLOT
0.022”X0.028”
ORIENTATION OF WIRE AT 90* ALONG
THE EDGE
OF THE RECTANGULAR WIRE



MOVEMENT IN ALL 3 PLANES OF SPACE
TWIST AND TORQUE POSSIBLE



GOLD BRACKET AND WIRE DEFORMED




SINGLE WIDTH BRACKETS


THESE WERE ANGLES ORIGINAL EDGEWISE BRACKET DESIGN
BRACKET WIDTH WAS 0.050”



ROTATIONAL MOVEMENTS WERE DIFFICULT



TO OVERCOME THIS LIMITATION ANGLE SOLDERED EYELETS ONTO
BANDS
THESE EYELETS WERE TIED WITH LGATURES TO ALLOW ROTATION



REPEATED ADJUSTMENT OF LIGATURES
RELAPSE IF TIES NOT CONTINUED


TWO SINGLE WIDTH BRACKETS


GREAT ROTATIONAL CONTROL



ALIGNMENT OF BOTH BRACKETS


TWIN BRACKETS
















“SIAMESE TWIN BRACKETS”SWAIN
2 BRACKETS ON A COMMON BASE
DISTANCE BETWEEN THE 2
BRACKETS -0.050”
EXCELLENT ROTATIONAL
CONTROL
POSITIVE CONTROL ON THE
TOOTH
4 SIZES- EXTRAWIDE,STANDARD,
INTERMEDIATE,JUNIOR
DECREASED INTERBRACKET SPAN
THUS DECREASE RESILIENCY OF
THE WIRE
DIFFICULTY IN CLOSING LOOPS

LEWIS’ BRACKET
SINGLE WIDTH BRACKETS WITH AUX UPSWEPT ROTATION WINGS FOR
ROTATIONAL CONTROL

MISCELLANEOUS
LANG’S BRACKET
VERTICAL SLOTS
BROUSSARD’S BRACKET
TIP EDGE BRACKET
SELF LIGATING BRACKET
CONVERTIBLE BRACKETS


Straight wired!


BUILDING TREATMENT INTO
EDGEWISE BRACKETS


ANGLE (1929)



ANGULATED BRACKETS TO PRODUCE
TIPPING
ANGULATED POSTERIOR BRACKETS
FOR ROOT MOVEMENTS





TWEED (1941)



“ARTISTIC POSITIONING BENDS” IN
WIRES
FOR CORRECT AXIAL RELATIONSHIPS


EDGEWISE BRACKETS




HOLDAWAY (1952)
PUBLISHED A LANDMARK ARTICLE IN 1952 DESCRIBED 3
USES OF BRACKET ANGULATION
AIDS IN PARALLELING ROOTS ADJACENT TO EXTRACTION
SITES



METHOD OF SETTING UP POSTERIOR ANCHORAGE



TO OBTAIN CORRECT AXIAL INLINATIONS.


HOLDAWAY


EDGEWISE BRACKETS


JOHN STIFTER
(1958)
BRACKETS WITH MALE AND
FEMALE ATTACHMENT



IVAN LEE(1960)
BRACKETS OF UPPER
ANTERIORS AND LOWER
POSTERIORS HAD TORQUED
SLOTS



JARABACK (1962)
SUGGESTED THAT UPPER
ANTERIORS BE TORQUED AND
ANGULATED

EDGEWISE BRACKETS






IN 1960’S
MANUFACTURERSRAISED THE BASE
OF UPPER LATERAL
INCISORS TO
ELIMINATE
LATERAL OFFSET
MOLAR TUBES
WITH 10* OFFSET
AND TORQUE FOR
ROTATIONAL


MANUFACTURER’S


EDGEWISE BRACKETS
LAWRENCE F. ANDREWS’ STRAIGHT
WIRE APPLIANCE (1976)
2 PRESCRIPTIONS
 STANDARD (NON EXTRACTION)
 TRANSLATION (EXTRACTION)



CONCEPT OF THE PEA
APPLIANCE








THE CONCEPT OF THE PEA APPLIANCE EVOLVED
FROM A SERIES OF 5 STUDIES CONDUCTED BY L.F.
ANDREWS.
EXAMINATION OF POST TREATMENT OCCLUSION
STUDY OF NATURALLY OCCURING OPTIMAL
OCCLUSION
THE SIX KEYS TO OPTIMAL OCCLUSION
CROWN MEASUREMENTS
COMPARISON OF TREATED AND NATURAL
OCCLUSION

EXAMINATION OF POST TREATMENT
OCCLUSION
 The

first experiment was conducted in
1960
 Study models of hundreds of treated
cases submitted to the ABO, E. H. Angle
Soc and Tweed Foundation considered to
be the state of the art in static occlusion in
the US.


EXAMINATION OF POST TREATMENT
OCCLUSION





All models showed some common trendsMolars were in Class I relationship
Incisors were not rotated
No overjet/ crossbite

But there were several inconsistencies like Articulation?
 Long axes of teeth adjacent to extraction sites
 Inclinations and angulations varied
 2nd molar not included
 Interdental spacing due to incomplete treatment
 Rotation of teeth requiring translation
 No mounting to check functional occlusion
 Co-Cr coordination










STUDY OF NATURALLY
OCCURING OPTIMAL
OCCLUSION
2 experiment, 1964, Help of
nd

A.G.Brodie (Univ of Illinois)
With the presumption that
naturally occuring optimal
occlusion is worth emulating.
120 casts of patients with
following featuresNever had undergone
orthodontic treatment
Well aligned teeth, pleasing
appearance
Excellent occlusion
Would not benefit from
orthodontic treatment

The facial axis and mid point of
clinical crown of each tooth
was marked

THE SIX KEYS TO OPTIMAL
OCCLUSION








The third and most important experiment in the
development of the preadjusted appliance
The 6 keys individually were not new but put together
were of special value asComplete set of indicators of optim al occlusion.
Judged by tangible landmarks
Judged from facial/ occlusal view


TERMINOLOGY
 Andrews

 Clinical

Plane

Crown


TERMINOLOGY
 Crown

Angulation

 Crown

Inclination

 FACC
 FA

Point
 Class
 Type

Six Keys


Key 1
Molar Interarach
relationship



Mesiobuccal cusp of the permanent
maxillary molar occludes in the buccal
groove of the perm mand molar
Distal marginal ridge of the upper 1st molar
occludes with the mesial marginal ridge of
the lower 2nd molar
Mesiopalatal cusp of the upper 1st molar
occludes in the central fossa of the lower ist
molar
Buccal cusps of upper premolars in the
embrasures of the lower premolars
Palatal cusps of upper premolars in a cuspfossa relationship with lower pms
Upper canines in cusp embrasure with lower
canines
Upper anteriors overlap the lower anteriors











Six Keys
 Key

2
Crown Angulations











Essentially all crowns have
positive angulation
Gingival potion of FACC distal
to occlusal portion
All crowns of tooth type have
similar angulations
Tip pattern is consistent for all
individuals
Important esp anteriorly


Six Keys
 Key

3Crown Inclination










Maxillary incisors have positive
inclination
Mandibular incisors have slight
negative inclination
Interincisal angle<180*
Max incisor +ve inclination >
mand incisor –ve incl
Upper Central> Lateral
Upper 345 –ve
Upper 67 more –ve
Mand= progresively -ve

Six Keys
 Key

4Absence of rotations
Key 5Tight contacts
Key 6slight to flat curve of
spee

CROWN MEASUREMENTS


4th study involved the
measurement of crowns
in the sample for-

•

Bracket area of tooth type
Vertical crown contour
Crown angulation
Crown inclination
Maxillary molar offset
Horizontal crown contour
Facial prominence
Depth of Curve of Spee

•
•
•
•
•
•
•


CROWN MEASUREMENTS
Upper
Angulation
Inclination
Prominence
Molar Offset
Lower
Angulation
Inclination
Prominence
Curve of Spee

1
5
7
2.1

2
9
3
1.65

3
11
-7
2.5

1
2
-1
1.2

2
2
-1
1.2

3
5
-11
1.9


4,5
2
-7
2.4

6
5
-9
2.9
10*
4,5
6
2
2
-17,-22 -30
2.35
2.5
0-2.5

COMPARISON OF TREATED AND
NATURAL OCCLUSION
 The

5th study compared 1150 treated
cases with the measurements and the six
keys.
 KEY 1- Most cases showed Angle’s Class I molar relationship.



However,
The distal marg ridge of upper 6 x mmr of lower 7
Pm’s and canines didn’t show a cusp- embrasure
relationship

NATURAL OCCLUSION


KEY 2-

Values= +/- 2 was considered incorrect
91% of cases had 1 or more teeth with incorrect angulation
Upper laterals and canines showed –ve ang
Upper 6 ranged from -ve in non ext to +ve in ext cases


KEY 3-

Values +/- 2 was considered incorrect
Interincisal angle on FACC > 180* in 78% cases
Upper 456 not always -ve

NATURAL OCCLUSION


KEY 4-

Rotational errors were measured using angle between
contact points and arch form.
Values= +/- 2 was considered incorrect
67% of cases had rotations esp. teeth that were translated


KEY 5-

47% showed spacing due to incorrect angulation


KEY 656% showed excessive curve of spee

CONCLUSIONS
 FEW

TREATED CASES FOLLOWED
THE 6 KEYS
 INTER ORTHODONTIST TREATMENT
PRIORITIED VARIED
 NO CHANGE IN 10 YEARS


PRINCIPLES










ALL TEETH OF SAME TYPE WERE SIMILAR IN SIZE
AND SHAPE
SIZE OF CROWN HAS NO EFFECT ON ANGULATION,
INCLINATION OR PROMINENCE
MOST PEOPLE HAVE NORMAL TEETH
REGARDLESS OF OCCLUSION
JAWS MUST BE CORRECTLY RELATED FOR
OPTIMAL OCCLUSION
DENTITIONS WITH NORMAL TEETH IN JAWS THAR
ARE/ CAN BE CORRECTLY RELATED CAN BE
BROUGHT TO OPTIMAL OCCLUSION

SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
1.

BRACKET BASES
PERPENDICULAR
TO THE STEM



PROBLEMS IN SLOT
INCLINATION
PROBLEMS IN
OCCLUSO-GINGIVAL
POSITION




SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE

2. BRACKETS NOT
CONTOURED
OCCLUSOGINGIVALLY




PROBLEMS IN SLOT
INCLINATION
PROBLEMS IN
OCCLUSO-GINGIVAL
POSITION


SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
3. BRACKETS NOT
CONTOURED
MESIO DISTALLY


PROBLEMS IN SLOT
SITING


SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
4. SLOTS NOT
ANGULATED





EACH CROWN HAS
ANGULATION.
WHEN A FULL SIZE
WIRE IS INSERTED
RESULTANT
ANGULATION
INCORRECT.
IF BRACKET
ANGULATED ONLY 2
POINT CONTACT. www.indiandentalacademy.com

SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
5.

6.



BRACKETS STEMS
OF EQUAL
PROMINENCE
MAXILLARY
MOLAR OFFSET
NOT BUILT IN
IST ORDER BENDS
REQUIRED.

7.








SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
ANGULAGTION
LANDMARKS DIFFERED
LONG AXIS OF CROWN –
NOT VISIBLE
LONG AXIS OF TOOTHNOT VISIBLE
INCISAL EDGETOO FAR AWAY,
MAY BE CHIPPED
LATERAL CURVED
CUSP TIPS?
MARGINAL RIDGES – TOO
FAR AWAY
CONTACT POINTS– NOT
VISIBLE


SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE

8. INCLINATION




LANDMARKS
DIFFERED
LONG AXIS OF
CROWN –NOT VISIBLE
BRACKET HEIGHT
FRON CUSP TIP


SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE

8. EXCESSIVE WIRE BENDING REQUIRED







TO INITIATE/ MAINTAIN TOOTH MOVEMENT
TO COMPENSATE FOR SLOT SITING
ERRORS
TO COMPENSATE FOR ERRORS IN WIRE
BENDING
TO COMPENSATE FOR SIDE EFFECTS
OFWIRE BENDING







SHORTCOMINGS OF THE
STANDARD EDGEWISE
APPLIANCE
PRIMARY BENDS
1ST ORDER -46 BENDS
2ND ORDER3RD ORDERERRORS- 30 BENDS
SECONDARY BENDS
FOR ERRORS IN
SLOT SITING
WIRE BENDING
JUDGEMENT
TERTIARY BENDS
LOOPS, STOPS ETC

DESIGN FEATURES OF THE
NEW APPLIANCE
 SLOT

SITING FEATURES

 CONVENIENCE
 AUXILLIARY

FEATURES

FEATURES


SLOT SITING FEATURES
 MID

TRANSVERSE PLANE

THE MID TRANSVERSE PLANE OF THE SLOT, STEM
AND CROWN MUST COINCIDE
 BASE SHOULD HAVE SAME INCLINATION AS THE
FACIAL PLANE
 BASE CONTOURED OCCLUSO GINGIVALLY TO
MATCH CROWN CURVATURE
THESE FEATURES ELIMINATEDX 2ND ORDER BENDS FOR OCC-GIN DISHARMONY
X 3RD ORDER BENDS FOR INCLINATION
X OTHER BENDS FOR SIDE EFFECTS



 MID SAGGITAL PLANE
 THE MID SAGGITAL PLANE OF THE SLOT, STEM AND CROWN
MUST COINCIDE
 THE PLANE OF BASE AT BASE POINT SHOULD BE IDENTICAL
TO FACIAL PLANE AT FA POINT
 BASE CONTOURED MESIODISTALLY TO FIT EACH TOOTH
 VERTCAL COMPONENTS PARALLELTO EACH OTHER
THESE FEATURES ELIMINATEDX 1ST ORDER BENDS FOR MOLAR OFFSETS AND M-D SLOT
SITING
X 2ND ORDER BENDS FOR OCC-GIN DISHARMONY AND
ANGULATION
X SECONDARY BENDS FOR SIDE EFFECTS


MID

FRONTAL PLANE

 THE

MID FRONTAL PLANE OF EACH
SLOT MUST SUPERIMPOSE ON IT’S
CROWN’S PROMINENCE PLANE
 ALL SLOTS SHOULD HAVE SAME
DISTANCE FROM EMBRASURE LINE
THESE FEATURES ELIMINATEDX 1ST ORDER BENDS

CONVENIENCE FEATURES
o

GINGIVAL TIE WINGS
LATERAL TO SEA



NO GINGIVAL IMPINGEMENT
EASY LIGATION



o

STEMS OF LOWER 456
GINGIVAL

•

NO OCCLUSAL INTERFERENCES

o

FACIAL SURFACES OF
UPPER 123 PARALLEL
TO BASES IN TURN
PARALLEL TO CROWN
FACE

o

LIP COMFORT

AUXILLIARY FEATURES
 COUNTER

BUCCOLINGUAL TIP IN UPPER 6’S
 COUNTER MESIODISTAL TIP
 COUNTER ROTATION
 TRANSLATION BRACKETS
 MAX TRANSLATION BRACKETS
 MEDIUM TRANSLATION BRACKETS
 MIN TRANSLATION BRACKETS
 POWER ARM


STAGES OF TREATMENT
 ANCHORAGE

CONTROL
 LEVELLING AND ALIGNING
 OVERBITE/ OVERJET CONTTROL
 SPACE CLOSURE
 FINISHING


ANCHORAGE CONTROL
 WITH

THE INCREASE IN THE TIP THERE IS A
GREATER TENDENCY OF THE ANTERIORS
TO PROCLINE
 UPPER>LOWER
SOLUTIONS
 OMEGA LOOP STOPS
 MOLAR TIE BACKS
 TPA, LINGUAL ARCH, HG
 CLASSIII ELASTICS
 ARCH WIRE BENT DISTALLY BEHIND MOLAR

LEVELLING AND ALIGNING
 TWO

PROBLEMS
ASSOCIATED WITH
THE PEA
 ROLLER COASTER
EFFECT
 NEED FOR
OVERCOMPENSATI
ON


OVERBITE CONTROL


A.

B.

DEEP BITE DUE
TO CANINE TIP
WHEN CANINES
WERE UPRIGHT /
DISTALLY TIPPED
ROLLER COASTER
EFFECT


SPACE CLOSURE
 MOST

SIGNIFICANT
 SLIDING POSSIBLE BECAUSE OF THE
STRAIGHT WIRE


FINISHING









FINISHING REQUIRED MINIMAL WIRE BENDING TO
COMPENSATE FOR VARIATIONS IN TOOTH SHAPE,
SIZE, ERRANEOUS BRACKET POSITIONING OR
OVERCORRECTION
TIP CONTROL- ADJUSTMENT MAY BE NEEDED
TORQUE CONTROL-NEEDED IN UPPER AND LOWER
INCISORS.
LOWER MOLARS -VE TORQUE, UPPER MOLARS+VE ROOT TORQUE
ARCH WIDTH ADJUSTMENTS
ROTATIONAL CONTROL
CURVE OF SPEE CORRECTION

ORIGINAL PRESCRIPTION
M

A

X

M

A

N

TIP

TORQUE

OFFSET

TIP

TORQUE

OFFSET

CENTRAL

5

7

2

-1

LATERAL

9

3

2

-1

CUSPID

11

-7

5

-11

1ST PM

2

-7

2

-17

2ND PM

2

-7

2

-22

1ST MOLAR

5

-9

10

2

-30

0

2ND MOLAR

5

-9

10

2

-33

0


MAXILLARY STANDARD
TOOTH

TIP

TORQUE
CLASS I

TORQUE
CLASS II

TORQUE
CLASS III

CENTRAL

5

7

2

12

LATERAL

5

3

-2

8

CUSPID

11

-7

-7

-7

1ST PM

2

-7

-7

-7

2ND PM

2

-7

-7

-7

1ST MOLAR

5 CLASS I
0 CLASS II

-9

2ND MOLAR

5 CLASS I
-9
0 CLASS II

-9
-9

MANDIBULAR STANDARD
TOOTH

TIP

TORQUE
CLASS I

TORQUE
CLASS II

TORQUE
CLASS III

CENTRAL

2

-1

4

-6

LATERAL

2

-1

4

-6

CUSPID

5

-11

-11

-11

1ST PM

2

-17

-17

-17

2ND PM

2

-22

-22

-22

1ST MOLAR

2

-30

-30

-30

2ND MOLAR

2

-35

-35

-35


MAXILLARY TRANSLATION
TOOTH

A

N

G

R

O

MIN

MED

3

13

14

15

2

4

6

-7

-7

-7

4

6

5

4

2

4

6

-7

-7

-7

5

0

-1

-2

2

4

6

-7

-7

-7

6

3

2

1

12

14

16

-13

-14

-15

7

3

2

1

12

14

16

-13

-14

-15

MAX MIN MED

T

I

N

MAX MIN MED


C
MAX

MANDIBULAR TRANSLATION
TOOTH

A

N

G

R

O

MIN

MED

3

7

8

9

2

4

6

-11

-11

-11

4

4

5

6

2

4

6

-17

-17

-17

5

0

-1

-2

2

4

6

-22

-22

-22

6

0

-1

-2

2

4

6

-30

-14

-15

7

0

-1

-2

2

4

6

-35

-14

-15

MAX MIN MED

T

I

N

MAX MIN MED


C
MAX

Thank You


The straight wire concept /certified fixed orthodontic courses by Indian dental academy

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The straight wire concept /certified fixed orthodontic courses by Indian dental academy