The presentation is about the history of orthodontics in details.

1. History of
Orthodontics
Dr.Ishfaq Ahmad
BDS, BCS
MS RESIDENT
Department of Orthodontics and Dentofacial
Orthopedics
Dhaka Dental College

2. “Nobody can know much
of a science unless he
understands its history”
Edward H Angle

3. Contents
• Introduction
• Ancient Origins
• Eighteenth Century
• Nineteenth Century
• Orthodontic Pioneers Of The Late 19th
Century
• The Professionalization Of Orthodontics In
The Early 20th Century
• Women in orthodontics
• Post-war developments
• 21st century
• Conclusion

4. Introduction

5. Ever since Eve flashed Adam her first grin,
we have been concerned about our smile.

6. Appliances for aligning teeth go as far back as
the Egyptians even more ancient.

7. From evidence found in human skulls, crooked teeth
have been around since the time of Neanderthal man
(about 50,000 bc), but it was not until about 3000
years ago that we had the first written record of
attempts to correct crowded or protruding teeth.

8. Primitive (and surprisingly well-designed)
orthodontic appliances have been found with
Greek and Etruscan artifacts.

9. Archaeologists have discovered Egyptian
mummies with crude metal bands wrapped
around individual teeth. It is speculated that
catgut was used to close the gaps

10. Ancient Origin
The Etruscans
The Ancient Greek
The Romans

11. The Etruscans
The earliest evidence of appliances being used to
straighten teeth is from around 1000 BC
(Weinberger, 1934).
The Etruscans, an ancient civilization predating the
Romans, buried their dead with appliances that were
used to maintain space and prevent collapse of the
dentition (Guerini,1909).

12. The Ancient
Greek
Hippocrates (c460 BC–
370 BC), considered to
be one of the most
exceptional figures in
the history of medicine,
published his ideas
regarding the
correction of tooth
irregularities in 400 BC
(Hippocrates,400BC).

13. The Romans
Teeth bound with a gold wire, presumably an
ancient precursor to modern ligature wire, have
been found in a Roman tomb in Egypt (Ruffer,
1921). The Romans saw teeth as precious—the first
code of Roman law (450 BC) stated that ‘special
penalties [would be exacted] for knocking out the
teeth of an individual, either freeman or slave’.

14. Aulus Cornelius Celsus
A great Roman philosopher
and physician (c25 BC–c50
AD) recommended
extracting deciduous teeth
to allow the eruption of
the permanent dentition in
his medical encyclopedia
De Medicina. In addition,
Celsus was the first to
record the use of finger
pressure for the treatment
of incorrectly positioned
teeth and said that this
finger pressure should be
applied to new teeth every
day to ensure correct tooth
alignment.

15. Pliny the Elder
Probably the first
mechanical
treatment was
advocated by Pliny
the Elder (ad 23-79),
who suggested filing
elongated teeth to
bring them into
proper alignment at
chapter 49 named
Remedies for
Toothache in
Naturalis Historia.
This method
remained in practice
until the 1800s.

16. The Renaissance
The evidence suggests
that no further
developments were
made until the 18th
century. However, the
European Renaissance of
the 14th–17th centuries
heralded scientists who
studied dental anatomy,
most notably the Italian
Renaissance polymath
Leonardo da Vinci
(1452–1519). His
drawings included
detailed studies on body
proportions and he used
details such as lip–dental
relationship, facial
proportions and tooth
size ratios in his
paintings.

17. A skull and arrangement of teeth in mouth
sectioned by da Vinci.

18. Eighteenth century

19. Pierre Fauchard (1678-1761)
Beginning in the 18th
century, the leading
country in the field of
dentistry was France. This
was due, in large measure,
to the efforts of a single
man Pierre Fauchard
(1678-1761).
He has been called the
“Father ofOrthodontia.”
He was the first to remove
dentistry from the bonds of
empiricism and put it on a
scientific foundation. In
1728, he published the first
general work on dentistry;
a 2-volume opus entitled
The Surgeon Dentist: A
Treatise on the Teeth.

20. Pierre Fauchard
He described methods
of straightening teeth
and devoted a chapter
to the subject the first
comprehensive
discussion of
orthodontic appliances
in his book Le
Chirurgien Dentiste
(Fauchard, 1728).
He described the use of
ligature wires to
straighten teeth, as
well as the first
expansion appliance,
known as a bandeau.

21. Etienne Bourdet
Fauchard’s bandeau was refined
by Etienne Bourdet (1722-
1789). He published The
Dentist’s Art (1754), which, like
Fauchard’s book, included a
chapter dedicated to tooth
alignment. His was the first
record of recommending serial
extraction (1757) and of
extracting premolars to relieve
crowding. He was also the first
to practice “lingual
orthodontics,” expanding the
arch from the lingual. There
followed a long line of lingual
appliances, including the
jackscrew, the expansion plate,
and, closer to our time, the
lingual arch.

22. John Hunter
John Hunter (1728- 1793)
made the greatest advances
in dentistry of his time. An
English anatomist and
surgeon, Hunter took a
particular interest in the
anatomy of the teeth and
jaws. His text, The Natural
History of the Human Teeth
(1771), presented the first
clear statement of
orthopedic principles. He
was the first to describe
normal occlusion to attempt
to classify the teeth. He
established the difference
between teeth and bone. He
was the first to describe the
growth of the jaws, not as a
hypothesis, but as a sound,
scientific investigation. His
findings have never been
successfully challenged

23. Nineteenth
century

24. Joseph Fox
Joseph , a student of
Hunter devoted 4 chapters
of his book, The Natural
History and Diseases of
the Human Teeth (1814),
to that topic. He was the
first to classify
malocclusion (1803).
According to Weinberger,
Fox “was the first to give
explicit directions for
correcting the
irregularities” of teeth. He
was particularly interested
in the judicious removal of
deciduous teeth,
treatment timing, and the
use of bite blocks to open
the bite. His other
appliances included an
expansion arch and a chin
cup (about 1802).

25. Joachim Lefoulon
The term orthodontics
was coined by Joachim
Lefoulon, who used the
word ‘orthodontosie’ in
1841 which roughly
translates into
orthodontia. He was also
the first to combine a
labial arch with a lingual
arch.

26. Friedrich Christoph Kneisel
He was the first to use
plaster models to record
malocclusion (1836).
That same year, when he
fitted his prognathic
patient with a chin strap,
he became the first to use
a removable appliance.
Very early appliances were
made out of ivory with
hickory wood pegs often
used for tooth movement.

27. Orthodontic
Pioneers Of The
Late 19th Century

28. Norman W. Kingsley
Norman W. Kingsley (1825-
1896) was the first of those
dental pioneers who made
the last half of the 19th
century a period of great
advancement. A splendid
thinker and skilled artisan,
he introduced several
innovations, including
occipital traction (1879).
After 1850, the first texts
that systematically
described orthodontics
appeared as Kingsley’s
book, A Treatise on Oral
Deformities (1880), the
first to recommend that
etiology, diagnosis, and
treatment planning should
be the foundations of
practice. It was also the
first to discuss cleft palate
treatment in terms of
orthodontics.

29. Amos Westcott
Amos Westcott made
the first reported
effort to use a
telescopic bar in the
maxilla to correct a
crossbite (1859). In the
1840s, he placed
chincups on his Class III
patients

30. C. R. Coffin
C. R. Coffin, Kingsley’s
student, reported on a
new design for an
expansion appliance,
which still bears his
name . He embedded
spring-action piano
wire, bent into the
shape of “W,” into a
vulcanite plate,
separated the plate in
the middle, and
activated the spring so
that its halves pressed
the alveolar process to
the outside.

31. John
Nutting
Farrar
(1839-1913)
The investigations of
John Nutting Farrar
(1839-1913, Fig 4) began
the era of biologic tooth
movement.
His Treatise on
Irregularities of the
Teeth and Their
Correction (1888) is
considered the first
great work devoted
exclusively to
orthodontics. For these
reasons, he has been
called the “Father of
American Orthodontics.”

32. John
Nutting
Farrar
In an 1876, he
advocated specific limits
for the movement of
teeth and, in so doing,
laid the foundation for
“scientific”
orthodontics. He was
among the first (1850) to
use occipital anchorage
to retract anterior teeth.
He recommended the
bodily movement of
teeth (1888). Based on
animal studies, Farrar
originated the theory of
intermittent force and
developed a screw to
deliver this force in
controlled.

33. Calvin S. Case (1847-1923)
He was the first to use (about
1893), along with Henry Baker,
Class II elastics and was the first
to attempt bodily movement. He
was also the first to use light
wires (.016 and .018 in). Case
advocated extraction to correct
facial deformities.
In so doing, he incurred the
wrath of Angle and his disciples.
Case’s(1911 )paper provoked an
acrimonious debate that came to
be known as the “Great
Extraction Debate.”
Case used headgears for cleft
patients and others.
Because of his modesty and
Angle’s forcefulness and
charisma, Case’s
accomplishments were slow to be
recognized, but he is now
considered one of the “Big Four”
in orthodontics.

34. Edward H. Angle (1855-1930)
The most dominant, dynamic, and
influential figure in orthodontics
was Edward H. Angle (1855-1930).
He is regarded as the “Father of
Modern Orthodontics.” Probably no
other man in dentistry did more to
foster this branch of dental science
as a specialty, causing its
separation from general practice
and advocating it as a recognized
and distinct science.
His address at the Ninth
International Medical Congress in
Washington, DC (1887), calling for
the separation of orthodontics
from dentistry, was the beginning
of a new era of dentistry.
He founded (1900) the first
postgraduate school of
orthodontics (Angle School of
Orthodontia).
He also founded the first
orthodontic journal, The American
Orthodontist, in 1907,

35. Angle’s classification
Angle’s classification, published in Dental Cosmos
(1899), remains the most widely accepted
classification of malocclusions.
Based on the relationship of the maxillary to the
mandibular first molars, it provided the first orderly
means of characterizing malocclusions, and its
universal acceptance by the dental profession is a
testament to its practical simplicity.

36. Angle’s Appliances
Angle held 37 patents; his
most noteworthy
appliances are the E-arch
(1900), the pin-and-tube
appliance (1910), the
ribbon arch (1916), and
the edgewise appliance
(1925).
Angle organized the first
orthodontic society
(1900), the American
Society of Orthodontists
(now the American
Association of
Orthodontists),19 and
became its first
president.

37. Anna Hopkins (1872-1957)
About 1908, Angle
married his
longtime
secretary, Anna
Hopkins (1872-
1957).
“Mother Angle”
became secretary
of the American
Society of
Orthodontists, a
founding coeditor
of the Angle
Orthodontist, and
honorary chair of
the Angle Society
executive
committee.

38. THE
PROFESSIONALIZATION
OF ORTHODONTICS
IN THE EARLY 20TH
CENTURY

39. Benno Lischer
Benno Lischer (1876-1959),
was once turned away from
admission to Angle’s school
became a leading figure in
the specialty.
He wrote Elements of
Orthodontia (1909),
Principles and Methods of
Orthodontics (1912), and
Time to Tell (1955).
He was the first to use the
term cephalometrics (1922);
he championed the term
orthodontics in place of
orthodontia; and he coined
mesiocclusion, distocclusion,
and neutrocclusion,
promoting their use in lieu of
Angle’s Classes I, II, and III.

40. John V. Mershon
John V. Mershon (1867-1953;
Angle School, 1908) was head of
orthodontics at the University
of Pennsylvania from 1916 to
1925.
When he took over the newly
formed graduate department,
he tried to present orthodontics
from the biologic rather than
the mechanical viewpoint.
His study of the relapse
phenomenon led to his
memorable quote, “You can
move teeth to where you think
they belong; nature will place
them where they will best
adapt themselves to the rest of
the organism.”

41. Spencer R. Atkinson
Spencer R. Atkinson
(1886-1970;
Angle School, 1920) who
was Orthodontist,
teacher, inventor,
innovator, anatomist,
and skilled
photographer, was
originally a children’s
dentist. Atkinson’s
interest in the growth
and development of the
head led to a
collection of some 1400
skulls that are now
housed at the University
of the Pacific School of
Dentistry. He originated
the term key ridge.

42. Holly Broadbent
The introduction of the
cephalometer by Holly
Broadbent in 1931 was another
important milestone that
placed orthodontic research on
a scientific foundation.
Broadbent’s original work on
the “face of the normal child”
and Brody’s classic research
“on the growth pattern of the
human head from the third
month to the eighth year of
life” were among the earliest
contributions.
These were followed by the
research of Down’s “Variations
in Facial Relationships,” the
work of Thompson in
“Functional Analysis of
Occlusion,” Wylie’s
“Assessment of Anterior-
Posterior Dysplasia,” and the
work of Margolis’ “Basic Facial
Pattern and Its Application in
Clinical Orthodontics.”

43. Charles Tweed and Raymond Begg
The extraction of teeth
(typically the bicuspids)
to achieve occlusal
stability and periodontal
health was reintroduced
into American
orthodontics during the
1930s by Charles Tweed
and simultaneously into
the United Kingdom
(Australia) by Raymond
Begg.

44. Lawrence F. Andrews
Dr. Andrews was one of the
first orthodontist to clarify
the importance of addressing
both facial and dental
harmony from the beginning
of treatment to achieve the
best facial form and head
and neck function for each
patient. Dr.

45. Andrews stated that, for the maxillomandibular
complex to be in harmony (i.e., to have all elements in
alignment) with the overall face, the following must be
present:
Element I: Proper arch shape and positioning of the
maxillary and mandibular teeth (roots) over the basal
bone
Element II: Proper horizontal (sagittal) projection of
the maxilla
Element III: Proper width of the maxillary and
mandibular arches
Element IV: Proper vertical height of the maxilla
Element V: Proper prominence (shape) of the chin (i.e.,
pogonion prominence)
Element VI: Establishment of the Six Keys to Optimal
Occlusion
He studied each of these Six Elements and defined both
qualitatively and quantitatively how the orthodontist
and the surgeon can work together to achieve these
objectives for each patient.

46. Women in
orthodontics

47. Pioneers
Guilhermena G. Mendell (d.
1946; Angle School, 1902) was
the first woman graduate and
the first woman instructor at
the Angle School (1902). She
later taught at the Pasadena
school and practiced with her
husband, Harvey Stallard
(1888- 1974), a pioneer in
gnathology.
Josephine M. Abelson (1901-
1987; Dewey School, 1923)
was the first femaledirector
of the Dewey School clinic
(Fig 1). She married Sidney E.
Riesner (1900-79), a pioneer
in radiography and
temporomandibular joint
treatment. Both Mendell and
Abelson influenced their
husbands to study
orthodontics.

48. Pioneers
Other early 20th-century pioneer
women included Gertrude Locke
(1869-), a founding member of
the American Society of
Orthodontists (ASO) (1901);
Jane G. Bunker (Angle School,
1904), founding member,
European Orthodontic Society
(1907) and the Eastern
Association of Graduates of the
Angle School of Orthodontia
(1909);
Genette Harbour (1865-1936;
Angle School, 1911), first woman
orthodontist in Los Angeles
(1911) and founding member,
Pacific Coast Society of
Orthodontists (1913);
Eda B. Schlencker, the first
woman to be certified by the
American Board of Orthodontics
(ABO) (1933).

49. Post-war
developments

50. Direct Bonding
The concept of directly bonding brackets to the surface of
the teeth was first described by Newman in 1965 and meant
that brackets could be fitted to teeth without metal bands
for the first time.

51. Self-ligating brackets
Self-ligating brackets were first proposed by Alexander Wildman
(1972). Self-ligating systems have risen in popularity with the
introduction of the Damon bracket (Damon, 1998).

52. 21st century

53. 3D computer imaging
The adoption of 3D computer imaging
in orthodontics has been the most
fundamental development of the 21st
century. As well as using the
technology to plan treatment and
create virtual study models,
computeraided design and computer-
aided manufacture can be used to
design and create custom-made
brackets to make appliances more
comfortable and enable more
accurate results.

54. Ceramic Brackets
With the aim of
making appliances
less visible, ceramic,
tooth-coloured
brackets have been
developed in recent
years.

55. Invisalign
Invisalign aligners are
the clear alternative to
metal braces for adults
and teens. These clear
aligners are the
virtually invisible way
to improve your smile.

56. Lingual braces
Lingual braces are one of the
many types of the fixed
orthodontic treatment
appliances available to
patients needing
orthodontics. They involve
attaching the orthodontic
brackets on the inner sides of
the teeth. The main
advantage of lingual braces is
their near invisibility
compared to the standard
braces, which are attached on
the buccal sides of
the tooth Lingual braces were
invented by Craven Kurz in
1976

57. Conclusion

58. After more than 3,000 years of advancements, orthodontic
appliances have come a long way and have developed quickly
over the last two centuries to become the appliances we know
today. The increased use of digital technology means that this
progress should continue for years to come.
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