Evolution of straight wire appliance 1

Evolution of straightEvolution of straight
wire appliancewire appliance
www.indiandentalacademy.com

ContentsContents
1. Introduction
2. History
3. Works of Andrew's
4. The new torqued appliance
5. Vari simplex discipline
6. Bioprogressive system
7. Roth prescription
8. MBT system
9. Combination anchorage technique
10.Level anchorage technique
11.Tip edge bracket system

12. Bioefficent bracket system
13.Butterfly bracket system
14.Élan –Ortho's system
15. Conclusion

IntroductionIntroduction
-Orthodontics is a dynamically growing science. It is constantly
undergoing development and is evolving through the discovery
of newer techniques and improvements over the older ones.
-One of the most important events in evolution of orthodontic
appliances was the introduction of fully programmed appliance
to fulfill the drawbacks of earlier techniques.
-This was the direct result of the pioneering work by Andrew's
in the 1970’s and since there has been many developments in the
technique.

What is straight wire appliance ?
The term straight wire in the present context refers to
an archwire that is given the arch form and often the
curvature to open the bite –but which is free from the first,
second or third order bends. It is a formed but ‘ unbent’
archwire.
Meyers and Nelson – 1978 – P A E
Briefly about straight wire appliance:-
Andrew's endeavor to develop an appliance that would
permit the use of such an archwire by transferring most of
the tooth guidance functions from the archwires to the
brackets was based on following reasoning:

1. Eliminating primary bends
2. Secondary bends
3. Variability in archwire bends from operator to operator
4. Some of the bends influence the actions of other bends
E.g.:- wagon wheel effect.
However, it should be noted that in only few cases, the entire
treatment could be completed using straight archwires.
Andrews stated that straight wires in progressively larger
dimensions take the treatment close to the treatment
objectives, but in many cases would require some wire
bending in the final archwires to fine tune the results.www.indiandentalacademy.com

HISTORYHISTORY
There were hundreds of different ways to treatThere were hundreds of different ways to treat
patients, which began nowhere and endedpatients, which began nowhere and ended
nowhere.nowhere.
Pierre Fauchard’s Orthodontic appliance-1728Pierre Fauchard’s Orthodontic appliance-1728

Dwinelles Jackscrew-1849Dwinelles Jackscrew-1849

According To AngleAccording To Angle
- in 1887- in 1887
A standard appliance must have five importantA standard appliance must have five important
properties-properties-
SimpleSimple
StableStable
EfficiencyEfficiency
DelicateDelicate
InconspicuousInconspicuous

The E Arch appliance - 1907The E Arch appliance - 1907
The basic E – arch appliance the ribbed E -arch

E Arch Without Treaded EndsE Arch Without Treaded Ends

E Arch With HooksE Arch With Hooks

DrawbackDrawback
Once the retention appliance was discarded variousOnce the retention appliance was discarded various
degree of malocclusion resulteddegree of malocclusion resulted
This appliance failed since it could not correct the axialThis appliance failed since it could not correct the axial
Relationships of teeth.Relationships of teeth.

Pin and tube-1910Pin and tube-1910
First appliance that employed
a bracket and used bands on
most of teeth.
Each band of the tooth had a
vertical tube that paralleled long
axis of the crown of a tooth.
Adv:- good axial control
Disadv :- limited mesiodistal control

The Ribbon Arch-1915The Ribbon Arch-1915
Brackets were introducedBrackets were introduced
with appliance.with appliance.
Tube of the pin was modified to provideTube of the pin was modified to provide
vertically positioned rectangular slot.vertically positioned rectangular slot.
A ribbon arch of 10x20 gold wireA ribbon arch of 10x20 gold wire
was placed in this slot .was placed in this slot .

Edgewise ApplianceEdgewise Appliance
Angle oriented the slot fromAngle oriented the slot from
vertical tovertical to
horizontal and insertedhorizontal and inserted
rectangular wire into it.rectangular wire into it.
This was one of the angleThis was one of the angle
final achievements.final achievements.

Single width bracketSingle width bracket
Original angle bracketOriginal angle bracket
was made up of a softwas made up of a soft
gold with .022 x .028 slot.gold with .022 x .028 slot.
It was .050 wide and wasIt was .050 wide and was
soldered to gold bandsoldered to gold band
material .material .
Angle soldered goldAngle soldered gold
eyelets in appropriateeyelets in appropriate
positions on the band.positions on the band.

Twin BracketTwin Bracket
Joining together of two edgewiseJoining together of two edgewise
bracketsbrackets
““SIAMESE TWIN BRACKET”SIAMESE TWIN BRACKET”
The space between two bracketsThe space between two brackets
was approx 0.050was approx 0.050
Initially for upper central incisorsInitially for upper central incisors
and molars.and molars.

They are available inThey are available in
four sizes-four sizes-
Extra wideExtra wide
StandardStandard
IntermediateIntermediate
JuniorJunior

Curved Base Twin BracketCurved Base Twin Bracket
It has the advantage of twinIt has the advantage of twin
bracket offering rotationalbracket offering rotational
and greater axial controland greater axial control

This was the next development for bringing aboutThis was the next development for bringing about
efficient tooth rotation.efficient tooth rotation.
He soldered auxiliary rotation arm that abuttedHe soldered auxiliary rotation arm that abutted
against the bracket itself and thus offered a lever armagainst the bracket itself and thus offered a lever arm
to deflect archwire and rotate the teeth.to deflect archwire and rotate the teeth.
Present day Lewis bracket is a one piece bracket withPresent day Lewis bracket is a one piece bracket with
rotational wings which is equivalent to originalrotational wings which is equivalent to original
edgewise bracket with single width feature.edgewise bracket with single width feature.
Lewis bracketLewis bracket

Lewis bracketLewis bracket

Advantage –Advantage –
100% desired tooth100% desired tooth
rotation .rotation .
Disadvantage – lessDisadvantage – less
control of axialcontrol of axial
inclination.inclination.
Curved Lewis bracketCurved Lewis bracket
advantage-advantage-
Increase contact withIncrease contact with
band .band .

Steiner bracketSteiner bracket
Introduced by CECIL STEINERIntroduced by CECIL STEINER
This bracket incorporated flexible rotation armsThis bracket incorporated flexible rotation arms
and therefore did not rely entirely on theand therefore did not rely entirely on the
resiliency of archwire for tooth rotation.resiliency of archwire for tooth rotation.
It uses a single width edgewise bracket and hasIt uses a single width edgewise bracket and has
the inherent advantage and disadvantage of thethe inherent advantage and disadvantage of the
same .same .

BROUSSARD BRACKETBROUSSARD BRACKET
Was designed by “GrayfordWas designed by “Grayford
broussard”broussard”
Modified edgewise bracket inModified edgewise bracket in
which there is addition ofwhich there is addition of
0.0185 x 0.046 slot –to accept0.0185 x 0.046 slot –to accept
0.018 auxiliary wire0.018 auxiliary wire

BURSTONE CANINE BRACKETBURSTONE CANINE BRACKET
Burstone added a vertical tube to
canine bracket for the insertion of retraction spring.

Universal applianceUniversal appliance
Spencer Atkinson - 1928Spencer Atkinson - 1928
Design-Design-
-vertical hallow shaft with two-vertical hallow shaft with two
laterallateral
welding tabswelding tabs
-central shaft has two slot-central shaft has two slot
openingsopenings
HorizontalHorizontal – opening labially at– opening labially at
gingival thirdgingival third
VerticalVertical –opens incisally near the–opens incisally near the
base andbase and
extends one third of the bracketextends one third of the bracket
heightheight www.indiandentalacademy.com

The incisal slot can hold-.008-.016 round or .008The incisal slot can hold-.008-.016 round or .008
x.020 up to .015 x .028 wire .x.020 up to .015 x .028 wire .
- corrections of rotations ,leveling or- corrections of rotations ,leveling or
torque.torque.
Gingival slot can only hold round wire ranging fromGingival slot can only hold round wire ranging from
.008 - .016.008 - .016
-mesiodistal axial inclinations ,act as a guide when-mesiodistal axial inclinations ,act as a guide when
teeth are moved bodily in mesial or distal directionteeth are moved bodily in mesial or distal direction

Five Archwire CombinationsFive Archwire Combinations
AvailableAvailable

The 3-D Universal Bracket(1974)The 3-D Universal Bracket(1974)
- Jorge Fastlicht
3-D universal bracket is wider mesiodistally and slightly deeper
buccolingually

-1927 Angle had suggested angulating the entire bracket
-Holdaway – 1952 suggested bracket overangulation for teeth
on either side of the extraction site
-Jaraback – 1957 incorporated slot inclination to reduce 3rd
order archwire bends
-John. j. Stifter - 1958
-By early 1960s, there were individualized bands for each
tooth type.

Works of AndrewsWorks of Andrews
After his graduation in 1959, Laurence Andrews
was looking for a topic to write a thesis that was
required for certification by the American Board of
Orthodontics. The theme that he chose was the
prevalent quality of American Orthodontic practice
with respect to static occlusion. He started an
assessment of post treatment study models exhibited
at the meetings of American Board of Orthodontics,
Angle Society and Tweed Foundation.

He collected study models of 120 non-treated individuals
whose occlusion was considered to be ideal by him and
his peers. With a keen eye and logical mind he picked out
the six consistent features related to the clinical crowns,
which were common to all the study models. He named
these as the six keys to normal occlusion

TerminologiesTerminologies
1.Andrews plane
2.Clinical crown

FACCFACC
For all teeth except molars, it is located at the
mid-developmental ridge that runs vertically and is the most
prominent portion in the central area of the labial or buccal
Surface.

Andrews reexamined the treated cases applying the criteria for six
keys. This study revealed that most of them failed to attain
many, If not all.
He started analyzing the causes for the above shortcomings and
came to the conclusion that the standard edgewise appliance
had too many deficiencies to obtain consistent results. These
were in the form of
1. Variability in wire bending from operator to operator and even
with the same operator
2. Deficiencies in the standard edgewise bracket design.
3. Variations in the bracket siting procedures.

The six keys to normal occlusion contribute
individually and collectively to the total scheme of
occlusion and, therefore, are viewed as essential to
successful orthodontic treatment.
Lack of even one of the six is a defect predictive of
an incomplete end result in treated models.
The six keys

The nonorthodontic normal models consistently
demonstrated that
The distal surface of the distal marginal ridge of
the upper first permanent molar contacts and
occludes with the mesial surface of the mesial
marginal ridge of the lower second molar.
Key I. Interarch relationships

-The mesio-buccal cusp of the upper first permanent
molar falls within the groove between the mesial and
middle cusps of the lower first permanent molar.
- The mesio-lingual cusp of the upper first molar seats
in the central fossa of the lower first molar.
-The premolars enjoy a cusp-embrasure relationship
buccally, and a cusp fossa relationship lingually.
-Max. canine has a cusp-embrasure relationship with
mand. canine & 1st PM. The cusp tip is slightly mesial to
embrasure
-Max. incisors overlap mand. Incisors & midlines of
arches match

Key II. Crown angulation (tip)Key II. Crown angulation (tip)
The degree of crown tip is the angle formed by
the FACC and a line perpendicular to the occlusal
plane.
A “+ reading" when the gingival portion of the
FACC is distal to the incisal portion.
A “- reading" when the gingival portion of the
FACC is mesial to the incisal portion.

Each normal model had a distal inclination of the
gingival portion of each crown, It varied with each
tooth type, but within each type the tip pattern was
consistent from individual to individual.

Key II. Crown angulation (tip)Key II. Crown angulation (tip)
Normal occlusion is dependent upon
proper distal crown tip, especially of
the upper ant. teeth ( longest crowns).
Degree of tip of incisors, determines
the amount of MD space they
consume & has a considerable effect
on post. occlusion as well as ant.
esthetics.

Key III. Crown inclination (torque)Key III. Crown inclination (torque)
Crown inclination angle formed by a
line which bears 90°to the occlusal
plane and FACC (as viewed from the
mesial or distal).
A + reading is given if the gingival
portion of the tangent line (or of the
crown) is lingual to the incisal portion,
A - reading is recorded when the
gingival portion of the tangent line (or
of the crown) is labial to the incisal
portion

ANTERIOR CROWN INCLINATION.
In upper incisors + crown inclination.
In lower incisors - crown inclination
The average inter-incisal crown
angle - 174°.

If the inclination of the anterior crowns is
not sufficient, space, in treated cases,
is often incorrectly blamed on tooth size discrepancy

POSTERIOR CROWN
INCLINATION— UPPER.
A minus crown inclination for each
crown from the U canine through the
U-2nd PM.
A slightly more negative crown
inclination existed in the U-1st & 2nd
molars
POSTERIOR CROWN INCLINATION
— LOWER. A progressively greater
"minus" crown inclination existed from the
lower canines through the lower second
molars

Wagon wheel effectWagon wheel effect

Key IV. RotationsKey IV. Rotations
Teeth should be free of
undesirable rotations
Rotated molar, would occupy
more space than normal,
creating a situation unreceptive
to normal occlusion.

Key V. Tight contactsKey V. Tight contacts
Contact points should be tight (no spaces).
Persons who have genuine tooth-size
discrepancies pose special problems.
Serious tooth-size discrepancies should be
corrected with jackets or crowns, so the
orthodontist will not have to close spaces at
the expense of good occlusion.

Key VI. Occlusal plane (curve ofKey VI. Occlusal plane (curve of
Spee)Spee)
Depth of curve of Spee ranges from flat plane to slight
concave surface (0- 2.5 mm)
A flat plane should be a treatment goal as a form of
over treatment.
There is a natural tendency for the curve of Spee to
deepen with time.

A deep curve of Spee results
in a more contained area
for the U teeth, making
normal occlusion impossible
A reverse c.o.s is an extreme
form of over treatment,
allowing excessive space for
each tooth to be intercuspally
placed

Key VII. Correct tooth size
Discrepancy may exist prior to treatment but
frequently not noticed until the finishing stage
The potential need for interproximal reduction to ↓
tooth size in one arch or restorative procedure to
↑tooth size in opp. arch should be discussed with
patient/parents before trt.
Bennett & McLaughlin
If Andrews’ non orthodontic models have shown tooth
size discrepancy, it would have resulted in either spacing
or crowding in either of arches, until compensated by tip
& torque in ant. segment.

ConclusionConclusion
-The 120 nonorthodontic normal models
differed in some respects, but all shared the six
characteristics.
-Compromise treatment is acceptable when patient
cooperation or genetics demands it, but should not
be acceptable when treatment limitations do not
exist.
-When possible, six keys should be our measure of
the static relationship of successful orthodontic
treatment.

Deficiencies in Edgewise BracketDeficiencies in Edgewise Bracket
The conventional edgewise brackets are identical for all
teeth except some mesio-distal width differences. However
different teeth have different relative prominences,
angulations and inclinations. This necessitates giving first,
second and third order bends in the archwire.

The non programmed applianceThe non programmed appliance
A set of brackets designed the same for all tooth types,
relying totally on wire bending (except possibly for
angulation if the bracket is angulated) to achieve the
optimal position for each individual teeth.

Base point bracket base base stem
Slot base
Slot point

Design shortcomingsDesign shortcomings
Bracket base perpendicular to bracket stem.Bracket base perpendicular to bracket stem.
Bracket bases are not contoured.Bracket bases are not contoured.
Slots are not angulatedSlots are not angulated
Bracket stem are of equal faciolingualBracket stem are of equal faciolingual
thickness.thickness.
Maxillary molar offset is not built in.Maxillary molar offset is not built in.
Bracket sitting techniques areBracket sitting techniques are
unsatisfactoryunsatisfactory..

Bracket base perpendicular to bracket stem.Bracket base perpendicular to bracket stem.
Bracket base is perpendicular to the facio-lingualBracket base is perpendicular to the facio-lingual
axis, and the slot is cut parallel to the facio-lingualaxis, and the slot is cut parallel to the facio-lingual
axis. This leads to targeting the bracket slots toaxis. This leads to targeting the bracket slots to
different inclinations and occluso–gingival levels,different inclinations and occluso–gingival levels,
when placed on different teeth with varyingwhen placed on different teeth with varying
curvatures. The latter may result in functionalcurvatures. The latter may result in functional
interferencesinterferences

Bracket bases are not contoured.Bracket bases are not contoured.
Occlusogingivally the base of a non-Occlusogingivally the base of a non-
programmed brackets is flat .programmed brackets is flat .
Ex: mandibular 1st
premolars

MESIODISTAL

Slots are not angulated.

Stems of equal prominence
Stems of equal prominence
necessitate the first order
bends
such as the bends required
between the upper central
and lateral incisors

Maxillary molar offset not built- in

Bracket sitting techniques are unsatisfactory.Bracket sitting techniques are unsatisfactory.
Various authors have their own way of positioningVarious authors have their own way of positioning
the brackets.the brackets.
--TweedTweed recommends sitting brackets inrecommends sitting brackets in
specified number of millimeters from the incisalspecified number of millimeters from the incisal
edge.edge.
--HoldawayHoldaway advocates that the bracket sittingadvocates that the bracket sitting
should altered according to the malocclusionshould altered according to the malocclusion

According toAccording to JarabakJarabak bracket sites for inclinationbracket sites for inclination
should be determined by the shape of the crown.should be determined by the shape of the crown.
SaltzmanSaltzman recommends except for the maxillary lateralrecommends except for the maxillary lateral
incisor ,brackets should be located in the middle thirdincisor ,brackets should be located in the middle third
of the crown.of the crown.

Fully programmed bracketsFully programmed brackets
Andrews designed brackets that are affixed to the teeth
such that their bases should reflect the planes of
the teeth crowns
Hence he set about designing a new system of edgewise
brackets.

1. Every tooth type had a specifically designed bracket
2. Slots were cut at an angle to the vertical edges for
attaining built- in angulation in the bracket.
3. The base of the brackets were inclined in order to
effect the torque needed for a particular tooth type.
4. The thickness of the bracket stem was varied
according to the facial prominence of each tooth.
5. The bracket bases were contoured.
Thus it became possible to use unbent archwires in the
appliance through most of the treatment.www.indiandentalacademy.com

Fully programmed appliance-Fully programmed appliance-
- Slot-siting features- Slot-siting features
- Convenience features- Convenience features
- Auxiliary features- Auxiliary features
Two types of bracket configuration were originally made
available. The vertical edges were always parallel to the FACC
While the horizontal edges were perpendicular to vertical
edges – square brackets
At different angle – rhomboid shaped

Feature 1- mid transverseFeature 1- mid transverse
planes of the slotplanes of the slot
stem and crown muststem and crown must
be the samebe the same
Feature 2-base of the bracketFeature 2-base of the bracket
for each tooth type must havefor each tooth type must have
same inclination as the facialsame inclination as the facial
plane of the crown.plane of the crown.
Feature 3-each bracketFeature 3-each bracket
inclined base must beinclined base must be
contoured occlusogingivallycontoured occlusogingivallywww.indiandentalacademy.com

Feature 4- mid sagittal plane ofFeature 4- mid sagittal plane of
the slot stem and crown mustthe slot stem and crown must
be same.be same.
Feature 5 -the plane of theFeature 5 -the plane of the
bracket base at its base pointbracket base at its base point
must be identical to the facialmust be identical to the facial
plane of the crown at theplane of the crown at the FAFA
point.point.
Feature 6 - base should matchFeature 6 - base should match
the mesiodistal contour of thethe mesiodistal contour of the
tooth.tooth.

Feature 7 - the vertical component shouldFeature 7 - the vertical component should
be parallel to one another.be parallel to one another.
Feature 8 – all slots point must have sameFeature 8 – all slots point must have same
distance between them and the crowndistance between them and the crown
embrasure line.embrasure line.

Convenience features

Bracket identification featuresBracket identification features
Factor to be identifiedFactor to be identified identifying featureidentifying feature
Arch - maxillaryArch - maxillary
mandibularmandibular
Dot on brackets faceDot on brackets face
Dash on brackets faceDash on brackets face
Quadrant – maxillaryQuadrant – maxillary
mandibularmandibular
Dot on distogingival portion of bracket faceDot on distogingival portion of bracket face
Dash on ”Dash on ”
Class – maxillary incisorsClass – maxillary incisors
caninescanines
premolarspremolars
Least base contourLeast base contour
Most slot angulationMost slot angulation
Prominent gingival tie wingsProminent gingival tie wings
Mandibular incisorsMandibular incisors
caninescanines
premolarspremolars
Greatest faciolingual thicknessGreatest faciolingual thickness
Most slot angulationMost slot angulation
Prominent gingival tie wingsProminent gingival tie wings
TypeType
Maxillary central from lateralMaxillary central from lateral
Central less faciolingual thicknessCentral less faciolingual thickness
Central 5°angulation lateral 9°angulationCentral 5°angulation lateral 9°angulation
MandibularMandibular Both are alikeBoth are alikewww.indiandentalacademy.com

Auxiliary features –Auxiliary features –
Power armsPower arms
HooksHooks
Face bow tubesFace bow tubes
Utility tubesUtility tubes
Rotational wingsRotational wings

Non-
orthodontic
Normal
values
5/17 9/10 11/-7 2/-7 2/-7 5/-9 5/-9
Maxillary Central
incisor
Lateral
incisor
canine First
premolar
Second
premolar
First
molar
second
molar
Angulation 5 5 11 2 2 5class I
0classII
10-class I
0-classII
Inclination
Class II
Class I
Class III
2
7
12
-2
3
8
-7 -7 -7 -9 -9
Tip and torque values of Andrew's prescription
prominenc
e
1.8mm 1.4mm 1.5mm 1.5mm 1mm 1mm

Mandibular Central
incisor
Lateral
incisor
Canine First
premolar
Second
premolar
First
molar
Second
molar
Angulation 2 2 5 2 2 2 2
Inclination
Class II
Class I
Class III
4
-1
-6
4
-1
-6
-11 -17 -22 -30 -35
prominence 2.3mm 2.3mm 1.6mm 1.15mm 1.15mm 1mm 1mm
Non-
orthodontic
Normal
values
2/-6 2/-6 5/-11 2/-17 2/-22 2/-26 2/-35

Bracket siting proceduresBracket siting procedures
Andrews emphasized that the accurate placement of the
brackets was an integral part of the straight wire appliance.
He suggested a bracket siting procedure, which was aimed
at targeting the slot within 2 degrees and 0.5 mm of the
precise placement over the slot site. (This is the area on a
tooth that would accept the bracket such that the bracket slot
would receive a ‘straight’ arch wire passively when the tooth
gets optimally positioned).

Hence he reasoned that it should be possible for anyone with
average skill to draw with a pencil the FACC of crowns of all
the teeth, mark their midpoints and align the midpoint of the
base of each bracket with the FA point in such a way that the
sides of the brackets are parallel with the FACC.
He demonstrated that most of the people are able to
mark the midpoint of a line about 10mm in length (a
figure close to the length of FACC of a maxillary
central incisor) to the accuracy of within 0.5 mm.
Further, they can also judge the parallelism of two or
more lines within the accuracy of 2 degrees

Fully programmed translation bracketsFully programmed translation brackets
As the teeth are translated, they tend to tip mesio-
distally and rotate into the extraction spaces since the force
acts at the brackets away from the center of resistance, both
in the lateral as well as occlusal perspectives.
New features were added to counter these effects to an
extent that would correct them.

Translating problems
TranslatioTranslation- “uniformn- “uniform
movement of the body in amovement of the body in a
straight line”.straight line”.
For translation to occur, theFor translation to occur, the
force must be applied at theforce must be applied at the
object’s centre of resistanceobject’s centre of resistance
However bracket is placed inHowever bracket is placed in
wrong place in two ways-wrong place in two ways-
It is occlusal .It is occlusal .
It is located laterally .It is located laterally .

Translation

Translating solutions
Levers
Optimal lever lengths are dictated by the distance between
the bracket site and tooth's centre of resistance.

The slot of edgewise bracket should be thought of three levers.
The levers that all edgewise brackets have in common are
contained with in the slot activated by the arch wire.

Counter rotation adjustments
The slot siting feature for counter rotation involves rotating
the slot in one of the three specified amounts around its
vertical axis
Slot rotation+ mesiodistal slot length + archwire flex+ mesial
Or distal force = counter rotationwww.indiandentalacademy.com

Counter mesiodistal tipCounter mesiodistal tip
The slot siting features for counter mesiodistal tip involves
Rotating the slot in one of three specified amounts in
faciolingual axis

Slot angulation+ mesiodistal length + activated archwire +
power arm = counter mesiodistal tip

Counter buccolingual tip
Rotating the base of the bracket in one of three specified
amounts around its mesiodistal axis.
Base inclination+ faciolingual slot length+ archwire flexion +
mesial or distal force = counter buccolingual tipwww.indiandentalacademy.com

Translation bracket categories –Translation bracket categories –
Minimum translation bracketsMinimum translation brackets –requiring a–requiring a
translation of 2 mm or lesstranslation of 2 mm or less
Medium translation bracketsMedium translation brackets – requiring a– requiring a
translation of more than 2mm but less thantranslation of more than 2mm but less than
4 mm4 mm
Maximum translation bracketsMaximum translation brackets -requiring a-requiring a
translation of more than 4 mm.translation of more than 4 mm.

Maxilla 1 2 3 4 5 6 7
Angulation
Medium
translation
Minimum
Maximum
14(std11
+
counter
3)
15(11+4)
5(2+3) -1(2+-3)
0(2+ -2)
-2(2+-4)
2(5+-3)
3(5+ -2)
1(5+-4)
2(5+-3)
3(5+-2)
1(5+-4)
Rotation
Medium
Minimum
Maximum
4 (0+4)
6(0+6)
4(0+4) 4(0+-4)
2(2+ -2)
-6(0+-6)
14(10+4)
12(10+-
2)
16(10+6)
14(10+4)
12(10+2)
16(10+6)
Inclination
Medium
Minimum
Maximum
-7(std -7)
-7
-7 -7
-7
-7
-14(-9+-
5)
-13(-9+-
4)
-15(-9+-
6)
-14(-9+-
5)
-13(-9+-
4)
-15(-9+-
6)

Mandibular L1 L2 L3 L4 L5 L6 L7
Angulation
Medium
Minimum
Maximum
8(5+3)
9(5+4)
5(2+3) -1(2+ -3)
0(2+ -2)
-2(2+ -4)
-1(2+-3)
0(2+ -2)
-2(2+ -4)
-1(2+-3)
0(2+ -2)
-2(2+-4)
Rotation
Medium
Minimum
Maximum
4(0+3)
6(0+6)
4(0+4) 4(0+4)
2(0+2)
6( 0+6)
4(0+4)
2(0+2)
6(0+6)
4(0+4)
2(0+2)
6(0+6)
Inclination
Medium
Minimum
Maximum
-11(-11)
-11(-11)
-17(-17) -22(-22)
-22(-22)
-22(-22)
-30(-30)
-30(-30)
-30(-30)
-35(-35)
-35(-35)
-35(-35)

Partly programmed brackets-Partly programmed brackets-
By definition partly programmed brackets are theBy definition partly programmed brackets are the
one which lack at least one slot sitting featureone which lack at least one slot sitting feature
because of which it would fail to fully direct eachbecause of which it would fail to fully direct each
slot to its tooth slot site.slot to its tooth slot site.
1. Slot inclination .1. Slot inclination .
2. Slot angulation.2. Slot angulation.
3. Slot prominence.3. Slot prominence.
4. Horizontal base contour.4. Horizontal base contour.

Criticism on straight wire applianceCriticism on straight wire appliance
The main drawback of the SWA is that it overlooks
biological variations in the anatomy of teeth of different individuals.
1. Dellinger - the basic data should have been collected from
individuals having malocclusion and not from ideal occlusion casts
as was done by Andrews
2.One of the important features of SWA (and other PEA) is the
torque built in the brackets, which ideally should eliminate third
order bends in the arch wire. A uniform torque value in the bracket
slots for any given tooth of all the patients is based on the premise
that individual teeth of any given type would exhibit identical
curvatures.
Curvature could vary 5.2 to 10.4 for teeth with low variation
12.8 to 25.6 for teeth with high variation

3. Andrews had laid great stress on the consistency of the long
axis (L.A.) point
This is also not accepted by these authors. Dellinger found
it erratic and inconsistent. Germane et al also questioned
Andrews’ contention that the facial surface contour is more
consistent when L.A. point is used to locate the brackets
and that the clinicians can place the brackets within
an error of +_2 degrees torque.
4. The collum angle i.e., the angle between the long axis of
crown and the long axis of root differs from tooth to tooth
and also for the same tooth in different persons. In class II
Div. 2 cases the central incisors have a more acute collum
angle than that seen in Class II Div. I cases. Hence, even whenwww.indiandentalacademy.com

5. Different vertical growth patterns have different inclines of
occlusal planes with respect to the cranium. The inclination
values of the maxillary incisors are preadjusted with respect
to the occlusal plane.
a uniform built-in torque value for all the patients would
place the upper incisors in positions other than optimum
in high or low angle case
6. Not using full size archwires.
7. Abuse by the general dentist.
It is not clear that “one appliance fits all”

New torqued applianceNew torqued appliance
- Creekmore- Creekmore
The basis for this technique is the Steiner spring wire bracket
which is supplied with 0.018 and 0.025 channels.

maxillarymaxillary 11 22 33 44 55 66
TorqueTorque +7+7 +3+3 -7-7 -7-7 -7-7 -10-10
TipTip 2 ½2 ½ 55 2 ½2 ½
Distal rootDistal root
tiptip
00 00
MandibularMandibular
TorqueTorque
00 00 77 1515 1515 23 or 3023 or 30
TipTip 1 ½1 ½ 2 ½2 ½ 2 ½ distal2 ½ distal
root tiproot tip
2 – non2 – non
extractionextraction
5 – distal5 – distal
root tip-root tip-
22ndnd
premolarpremolar
2 mesial2 mesial
root tip –root tip –
11stst
premolarpremolar
Creek more prescription

2. -Torqued brackets have a horizontal scribe line to identify
the torque angle. For lingual root torque, the scribe line goes to
Gingival. For labial root torque, the line goes to the occlusal.
3. Maxillary bicuspids have 0 angulation.
4. Mandibular bicuspids have two different angulations and are
labeled extraction or non extraction right or left.
5. Mandibular incisor bands have angulations to tip the roots
distally
1. All brackets are torqued except mandibular centrals and
laterals

6. - Maxillary molars can have the following choices;
a. 0.018 .0.025 tubes with 10 torque, 6 rotation
b. ” tubes with 10 torque, 6 rotation plus 0.051
or 0.045 round tube with no rotation for face bow.
7. - Mandibular molar tubes are torqued 30, with 0 rotation,
distal extension and mesial hook.
8. Attachments for first molars when 2nd
molars are banded
are torqued Lewis brackets with rotation levers. The mesial
wing is removed on maxillary first molars to attain desired
molar rotation easily.

Vari simplex disciplineVari simplex discipline
It is one of the pre adjusted edge wise system. It was introduced
in 1978 by Dr. R. G . Wick Alexander.
The name vari – simplex discipline was chosen after very much
thought
“VARI” means the variety of bracket types used ( twin, lewis an
lang)
Simplex refers to the KISS principle.
Discipline instead of appliance.

In this archwire fabrication is simplified
1. with 1st,
2nd
and 3rd
order, effects placed in the bracket instead
of bending them into arch wire.
2. simpler arch wire afford fewer arch wire changes, and easier
ligation and activation.
3. This rarely employs multiloop arches, because they are time
consuming, create food trap and often impinging upon the
gingival tissue.
4. Hooks are usually not soldered to the archwire because
soldering is time consuming and can reduce arch wire
effectiveness.
Ligature hooks or ball hooks attached to the brackets are used
instead. www.indiandentalacademy.com

From Tweed to Vari simplex
In the tweed technique, preserving anchorage of the posterior
Teeth is of primary concern.
Application of tweed concepts:-
1. Uprighting the mandibular 1st
molars. (anchorage preparation)
2. In vari simplex 5 degree torque is placed in the mandibular
central bracket to prevent incisors from flaring labially.
3. Retractor ( headgear) is an important element of the vari
simplex discipline.

Philosophical basis of the vari simplexPhilosophical basis of the vari simplex
disciplinediscipline
The general philosophy which spawned vari- simplex is
based upon two key tenets.
1. E= R
in all areas of life there are efforts and there are results.
The strength of the effort is the measure of the result.
2. “ attruistic egoism”
Orthodontist will perform treatment which is beneficial
to the patient and rewarding to the doctor
The basic goal of the vari – simplex discipline is to
produce a quality result easily and efficiently as
possible. www.indiandentalacademy.com

Vari- simplex appliance designVari- simplex appliance design
Different bracket styles are employed on various teeth.
The most important factors to determine the design of the
Vari- simplex appliance are:
1.Sizes and shapes of the teeth.
2. Mesio distal width and curvature.
3.Selecting the proper bracket style to fit the size and shape to
each tooth.
4. Accessibility of the tooth whether it is located in a curved or
straight area of the arch.

Factors determining bracket systemFactors determining bracket system
1. Bracket types
2. Placement positions
3. Angulations
4. Torque
5. in/outs.
The placement of these factors into bracket, as pioneered by
Dr. Ivan lee Dr. Larry andrewswww.indiandentalacademy.com

Brackets used in vari simplexBrackets used in vari simplex
1.Twin bracket-1.Twin bracket-
- Used on large flat surfaced- Used on large flat surfaced
teeth.teeth.
-Mini –Diamond bracket in-Mini –Diamond bracket in
rhomboid design.rhomboid design.
Advantage –Advantage –
Flat surface .Flat surface .
Easy accessibility .Easy accessibility .
Vari Simplex DisciplineVari Simplex Discipline

Twin bracket on the lateral incisor areTwin bracket on the lateral incisor are
provided with additional tie wing for easyprovided with additional tie wing for easy
initial wire placement.initial wire placement.
Additional handlesAdditional handles
Patient comfortPatient comfort

Lang bracket-Lang bracket-
Was invented by Dr HowardWas invented by Dr Howard
LangLang
Used round surfaced teeth at theUsed round surfaced teeth at the
corners of the arch .corners of the arch .
Design-Design-
-single bracket a flat rotational-single bracket a flat rotational
control wingcontrol wing
-each wing has a circular hole .-each wing has a circular hole .
- Wedge shape in profile- Wedge shape in profile

Reasons for using Lang bracket on cuspids-Reasons for using Lang bracket on cuspids-
1.Twin bracket reduces the inter-bracket distance.1.Twin bracket reduces the inter-bracket distance.
2.Better rotational control.2.Better rotational control.
3.Full bracket engagement with a twin bracket is3.Full bracket engagement with a twin bracket is
difficult on a round surfaced tooth.difficult on a round surfaced tooth.
4.Prevents attrition on the maxillary cuspid.4.Prevents attrition on the maxillary cuspid.

Lewis bracket-Lewis bracket-
They are used for large roundThey are used for large round
surfaced teeth that are not atsurfaced teeth that are not at
the curve of the arch - bicuspidsthe curve of the arch - bicuspids
..
Small flat surface teethSmall flat surface teeth
- mandibular incisors.- mandibular incisors.

Design –Design –
Consists of fixed wing single bracket with built in labialConsists of fixed wing single bracket with built in labial
curvature of the rotational wings .curvature of the rotational wings .
Bracket is wedge shape in profile viewBracket is wedge shape in profile view which puts the
tie wing close to the tooth occlusally and far out
gingivally.

Advantages of using fixed Lewis wing overAdvantages of using fixed Lewis wing over
flexible Steiner wing-flexible Steiner wing-
Additional force .Additional force .
Save adjustment time.Save adjustment time.
Edges of the Lewis bracket are less sharp .Edges of the Lewis bracket are less sharp .
Breakages are less .Breakages are less .
On a badly rotated tooth the wing in theOn a badly rotated tooth the wing in the
direction of rotation can be removed.direction of rotation can be removed.

Other attachmentsOther attachments
The twin bracket with a convertible sheath is used on each
maxillary and mandibular first molar.
Headgear tubes are placed occlusally on the maxillary first
molar appliances.
Ball hooks are attached to the upper and lower first molar
brackets.

Bracket height :-
each bracket is placed at a predetermined position on each tooth
relative to the other teeth.
Bicuspid bracket height is the key because its clinical crown height
is so variable. Its normal bracket slot height is 4.5mm
Maxillary arch:-
Centrals – x
Laterals – x – 0.5
Cuspids – x+0.5
Bicuspids – x
First molars – x-0.5
Second molars – x-1
Mandibular arch
Centrals – x-0.5
Laterals – x-0.5
Cuspids – x+ 0.5
Bicuspids – x
First molars – x- 0.5

BRACKET ANGULATIONBRACKET ANGULATION

Banding Bonding
(Incisal edge (Long axis
reference) reference)
Centrals 3° 5°
Laterals 6° 8°
Cuspids 6° 10°
Bicuspids and
Molars 0° 0°
Mandibular Arch
Centrals 2° 2°
Laterals 2° 2°
Cuspids 6° 6°
Bicuspids 0° 0°
1st Molars – 6° – 6°
2nd Molars 0° 0°

Bracket torque

Bracket torque:-
Maxillary Arch
Centrals -14°
Laterals -7°
Cuspids – 3°
Bicuspids – 7°
Molars –10°
Mandibular Arch
Incisors – 5°
Cuspids – 7°
1st Bicuspids– 11°
2nd Bicuspids – 17°
1st Molars – 22°
2nd Molars 0° or – 27°

BRACKET IN-OUT
Maxillary Arch Base
Centrals Standard
Laterals Thick
Cuspids and Bicuspids Thin
Molars Thinnest
Mandibular Arch Base
Anteriors Thick
Cuspids and Bicuspids Thin
Molars Thinnest

Salient features-Salient features-
-3˚ torque on maxillary cuspid-3˚ torque on maxillary cuspid
No torque in the second molar tube.No torque in the second molar tube.
-5˚ lingual crown torque in the-5˚ lingual crown torque in the
mandibular incisorsmandibular incisors

Extra oral forcesExtra oral forces
The retraction ( headgear) is one of the most important
elements of the vari- simplex discipline. The term retractor
refers to a face in with inner and outer bows.
It is the only appliance with which the orthodontist can
control all three dimensions vertical, sagittal and transverse
both skeletally and dentally.

Roth’s prescriptionRoth’s prescription
In 1968, R . H ROTH was introduced to Dr. L.F.
ANDREWS.
He started designing his own prescription as a clinical
trial and error evaluation that lasted severed years.
Cases were evaluated by the use of
Intra oral photographs and
Mounted models for tooth positions
During treatment and at the end of
appliance therapy
( the straight wire appliance – 17 yrs later – Ronald H Roth Jco vol 1987sep(632-42)

According to him teeth tend to relapse back from which
they started.
if counter-tip, counter-rotation, counter-torque, and leveling of
the curve of Spee were applied to the SWA in every possible
direction, then it should be possible to use primarily one
prescription for most cases, and to finish to an "END OF
APPLIANCE THERAPY" goal in which all tooth
positions are slightly overcorrected and from which the
teeth will most likely settle into non-orthodontic normal
positions
So with the concept of overcorrection he designed his
comprehensive prescription using the available Andrews extraction
brackets

In 1979, Roth introduced a
bracket setup containing
modifications of the tip, torque,
rotations and in out movement
of the Andrews standard setup
brackets.

The major difference :-
with the manner in which the teeth are moved and not necessarily the
desired end result or the result attained.
ANDREWS attempts to translate teeth throughout
treatment without ever tipping teeth..
In the ROTH approach, tipping of teeth is allowed, by using
round wires in the initial phase of the treatment, but the
attempt is to keep the tipping to a minimum wherein it is not
necessary to resort to complex mechanics to do the
uprighting

Andrews' occlusion study was based purely upon
anatomical measurements of tooth positions on untreated
normals.
According to him teeth should be positioned from an
“ANATOMICAL STANDPOINT’”
Roth’s occlusion study was based purely upon
pantographically recorded and a large number of post-
treatment orthodontic cases.

what made Roth to modify Andrews SW appliance
 Inventory problem-To treat different cases clinicians
were to buy band kits for all Andrews sets and series..
 Anchorage loss -When mesially angulated brackets
are placed on the posterior teeth, the teeth tend to tip
mesially and migrate forward that resulted in anchorage
loss.
 Problem in finishing - To achieve desired tooth
positions with the standard SWA, it was necessary to
finish the mechanotherapy phase of treatment by
placing compensating and reverse curve in the upper
and lower archwire

Roth's rationale for his bracket set up.
 The purpose of the Roth setup was to provide over
corrected tooth positions prior to appliance removal that
would allow the teeth in most instances to settle to what was
found is non orthodontic normals studied by Andrews.
With the appliance in place, it is virtually impossible, because
of bracket interference, to position the teeth precisely into the
occlusion shown by the non orthodontic normal sample.

 Play or tipping freedom - Due to the play between
the archwire and bracket, the delivered tip, torque and
rotation forces are less than the designated amount “built
in” the slot which need over correction to compensate for
play.
 The curve of Spee will return or deepen after
appliance removal.
Teeth adjacent to an extraction site will tend to rotate
and tip towards the extraction site.
 As teeth in the buccal segments settle they will rotate
and tip mesially, so if they are overcorrected and slightly
tipped distally, they will tend to settle better than teeth
that are already mesially inclined.
 As band spaces close, there is a corresponding loss of
torque of the anterior teeth.

Extracted teeth with Roth
Rx SWA brackets, showing
over correction built in to
the brackets
Extracted teeth with
Andrews SWA brackets
showing non – orthodontic
normal tooth position.

ROTH SETUP
Roth setup is available in both 0.018 and 0.022 slot
Roth preferred 0.022 slot brackets because it offered
more advantages
1.In terms of wire size selection,
2.In terms of stabilizing arches as anchor units and for
orthognathic surgery and
3.For control of torque in the buccal segments, which
is very important from the standpoint of functional
occlusion.

The Roth setup incorporated into it a member of
hooks for various types of elastic configuration and
also double triple and lip bumper tube for the use of
auxiliary wires and attachments.

Upper arch
Central tip torque rotation
Andrews 5 7 0
Roth 5 12 0
Lateral
Andrews 9 3 0
Roth 9 8 0
If tip is increased the resultant axial inclination is esthetically
and functionally undesirable
The 5° increase in torque improves
Esthetics by preventing flattened profile, straight upper lip and
obtuse nasolabial angle.

Upper canine
tip torque rotation
Andrews 11 -7 0
Roth 13 -2 4
Tip is Increased because they are being retracted in most
treatment.
Less negative torque to offset the reciprocal effect of
building more positive torque into the incisors.

I&II PM tip torque rotation
(A) 2 -7 0
(R) 0 -7 2D
IM &IIM (A) 5 -9 10
(R) 0 -14 14D
Elimination of the mesial tip on all buccal segment teeth strengthened
anchorage control significantly (but burning anchorage can be difficult).

LOWER ARCH
CENTRAL &LATERAL
tip torque rotation
(A) 2 -1 0
2 -1 0
CANINE
(A) 5 -11 0
(R) 7 -11 2M

I PM tip torque rotation
(A) 2 -17 0
-1 -17 4D
II PM 2 -22 0
-1 -22 4D
I M 2 -30 0
-1 -30 4D
II M 2 -35 0
-1 -30 4D
Because these teeth settle more mesially than the upper and
simultaneously rotate mesially thus necessitating extra distal
rotation
No change in the torque-To establish proper functional
occlusion

ROTH TRU-ARCH FORM
Roth Tru-Arch form was derived from his extensive
clinical testing and recording of jaw-movement patterns
in treated patients who were out
of retention and had remained stable.

ROTH’S CONCLUDING STATEMENT
“I have tried to present a philosophy of treatment
with the concept of overcorrection, based on the
specific set of goals stated at the outset, taking in to
account existing conditions, facial types, and reaction
to treatment mechanics.
Naturally there are always exceptions to the way one
approaches treatment”

MBT PHILOSOPHYMBT PHILOSOPHY
The MBT philosophy of orthodontic treatment has been
developed over a twenty yr period of time and has involved
the combined efforts of its three principle clinicians, Dr. Mc
Laughlin, Dr. Bennett, Dr. Trevisi
Their philosophy places emphasis on
1. Treatment mechanics
2. The preadjusted appliance
3. Bracket placement technique
4. Arch form and arch wire sequencing.
(Systemized orthodontic treatment mechanics McLaughin Bennet . Trevisi)

The old mechanics and heavy force levels, developed
for standard edgewise brackets, simply did not transfer
to the new, sophisticated bracket systems
ROLLER COASTER EFFECT:-
-Another frequent observation was in the area of the
premolars and canines which tend to tip and rotate into
the extraction sites.

MBT appliance bracket systemMBT appliance bracket system
Tip specifications:-
Reduced upper and lower anterior tip
Original SWA MBT
5 2 2

Upper posterior tip:-
0 of tip , as opposed to 2 of tip, was selected for all upper
bicuspid brackets to place the crowns in a slightly more
upright position.
The buccal groove shows a 5 angulation to a line drawn
perpendicular to the occlusal plane

Lower posterior crown tip:-
For the lower premolars, the 2 of mesial crown tip in the
original SWA brackets works well, keeping the crowns
inclined forwards in a class I direction

Torque specificationsTorque specifications
Expression of torque:-
torque is not efficiently expressed by the preadjusted bracket
System, due to two mechanical reasons.
1.The area of torque application is small,
2.In order to slide teeth, it is normal practice to use
0.019/ 0.025 steel wires in a 0.022 slot, because a full- thickness
wire prevents sliding.

Incisor torqueIncisor torque
It is helpful clinically to have torque which moves upper incisor
roots palatally and lower incisor roots labially.
This treatment requirement is necessary for many types
of malocclusion.

Canine torqueCanine torque
The finding of -7°torque for the upper canines has
proved to be satisfactory for most cases, but the original SWA
value of -11 torque for the lower canines has not been
satisfactory, as it tends to leave the lower canine roots in a
prominent position in most cases.
Versatility is needed for canine torque values.
A range of -7, 0, +7 torque is therefore available
for the upper canines and -6, 0, +6 for lower canines.

Upper premolar and molar torqueUpper premolar and molar torque

Lower posterior torqueLower posterior torque

In –out modificationsIn –out modifications
The in-out feature of preadjusted brackets is
100% fully expressed, because the archwire lies snugly
in the slot
. The labio- lingual movement is rapid, and normally
occurs in one visit.
But the upper premolar bracket has been provided
with additional 0.5mm thickness.www.indiandentalacademy.com

MBT versatilityMBT versatility
1. Inversion of upper lateral incisor brackets
2. Same tip and torque in lower incisor brackets

3. Inversion of cuspid brackets with prominent cuspid roots
+7 upper and+6 lower brackets are used.
4. 0 cuspid brackets with hook for extraction cases
0 brackets tend to maintain the canine roots in cancellous
bone.
5. Inversion of upper cuspid brackets when cuspids are in the
lateral incisor position
+7 upper brackets are used.
Canine brackets are available in 3 prescriptions

6. Same tip and torque in upper bicuspid brackets
7. Additional 0.5mm of in-out in upper second bicuspid brackets
8. Upper second molar bands and brackets on upper first molars
in non- headgear cases.
9. Lower second molar bands and brackets on lower first molars.
10. Lower second molar brackets on upper first and second
molars of opposite side when finishing in a class II molar relation
The lower molar bracket has 10 of torque which place the
class II upper first molar in a correct relationshipwww.indiandentalacademy.com

Bracket placementBracket placement
When preadjusted appliance was developed, the center of the
clinical crown became the vertical reference for bracket
placement
The brackets were placed by visually selecting the center of the
clinical crown. unfortunately, this method resulted in significant
errors relative to vertical placement.
for example:-
gingival variations, such as partially erupted teeth, labially and
lingually displaced roots , and gingival inflammation led to
placement errors.

2. Large teeth ( upper central incisors) and small teeth ( upper
lateral incisors) within the same patient led to obvious errors
when brackets were placed in the centre of the clinical crown.
3. Incisal and occlusal fractures and wear, as well as teeth with
extremely tapered and pointed cusps, led to bracket placement
errors.

The use of a bracket placement chart was developed in 1994,
as well as Dougherty gauges, dramatically reduces bracket
placement errors in the vertical dimension.

Bioprogressive therapyBioprogressive therapy
((Robert Murray Rickets, Bench et.all, Hilgers)Robert Murray Rickets, Bench et.all, Hilgers)
In this new approach, priorities were sought and hierarchies
of movements were selected in keeping with the forces of
occlusion, the forces of growth and the forces of nature.
“bio” being used to suggest the strong biologic implications
to be constantly born in mind with this technique.

One of the principles put forth by Rickets was mainly
based on growth.
Basically calculating expected growth we can determine
the amount of anchorage needed or not needed as growth
is utilized.
The second feature is the orthopedic movement.
-Bioprogressive therapy – applies the principle of cortical
anchorage in stabilizing teeth where limited movement is
required.

Lower molar anchorage enhanced by expansion of molar
roots into cortical bone.
Upper molars that are adjacent to the zygomatic ridge,
maxillary sinus and cortical bone shelves of the alveolar
process needs to be anchoraged and stabilized for in
orthopedic alterations.

Linear dynamic systemLinear dynamic system
Hilgers using recent advances in metallurgy and casting
process have created a miniaturized generation of brackets
called linear dynamic system.
He designed linear dynamic system in the percept of
“ begin with the end in mind”
The objective of the linear dynamic system is to allow the
dentition to be moved directly toward final positions by
establishing a mandibular occlusal table as early in
treatment as possible.
Key to class I – proper positioning of the lower 1st
molars.
(Bioprogressive simplified – the linear dynamic system –Jco- vol 1987 oct(716-734))

The criteria for each tooth are
1.Ideal orthodontic tooth position
2.Anticipated rebound and required overcorrection
3.Appliance design features that contribute to patient comfort,
clinical simplicity, and optimum utility.

Mandibular first molars:-
Torque Tip Rotation Thickness
Main slot – 27° – 5° 12° distal Thinnest
Auxiliary
Slot 0° – 5° 0°
A slight distal crown tip of 5° uprights the lower molars
to allow distal seating of the upper 1st molar and counteract
the forces of retraction mechanics and elastics.
The 12 distal rotation in the slot coordinates with a 15°
maxillary molar rotation to avoid conflicting inclined planes
and eliminate the need for bicuspid and molar offsets.

The main archwire torque should be sufficient to maintain
anchorage created by natural tooth position against cortical bone
of the external oblique ridge
The auxiliary tube should not be torqued, so that a 90 bend of
the auxiliary arch wire will avoid the soft tissue.
In class II deepbite cases:-
The lower 1st and 2nd molars tipped mesially - deepens curve of
Spee.
If the lower 1st molar is left mesially rotated, the inclined plane
effect of the lower molars will
tend to rotate the upper molar
mesially and re establish class II

Maxillary 1Maxillary 1stst
molarsmolars
Main slot -10° 0° 15° distal thinnest
AuxiIiary 0° 0° 0°
slot
The upper 1st
molar is rotated 15 distally, so that a line drawn
through its distobuccal cusp would point at the distal of the
opposite cuspid.

The roots of upper first molars should be inclined slightly to
the lingual, so that forces of occlusion will then be directed
across the heavy cortical bone of the palate and back through
the buttress of the key ridge.
The upper 1st molar triple tube incorporates several features.
The entire upper buccal segment should have 10° of buccal root
torque to compensate for the occlusogingival curvature of the
crowns of these teeth
The auxiliary tube, which is offset to the buccal to avoid
tissue impingement, has 0° torque and 0° rotation. This allows
for selective torque and rotation of the upper first molar with
initial utility arches, and it helps in placement of auxiliary arches.

Second molarsSecond molars
Maxillary -10° 0° 12° distal Thinnest
Mandibular -27° -5° 12° distal Thinnest
The lower 2nd
molar should be tipped distally during treatment
Because it will settle mesially as the disto buccal cusp of the upper
first molar settles into the lower first and second molar embrasure
As the lower arch comes in contact with each sequentially erupting
tooth, the forward-growing mandible, the inclines of the
mandibular teeth and the musculature act to "block in" the upper
molars and allow them to settle in the most functional position.www.indiandentalacademy.com

Mandibular 2Mandibular 2ndnd
bicuspidsbicuspids
Torque Tip Thickness
– 17° 0° Thin
The lower second bicuspid should have buccal root torque
symmetrical with the lower first and second molars, because
their main cortical bone support is through the external oblique
ridge.
The bracket should have a wedge shape to minimize
interference with the upper bicuspids, and the bracket base
should be as thin as possible to accentuate the buccal offset
of the lower first molar. In extraction cases it is helpful to have
a 5° mesial tip for root paralleling.

Mandibular 1Mandibular 1stst
bicuspidsbicuspids
– 11° 0° Thin
Transition tooth of the lower arch
Root support of the lower first bicuspid is mainly from
the lingual. (Root support of the lower second bicuspid is
mainly from the buccal.) Even so, there must be buccal root
torque in the bracket to passively accommodate the greater
buccal crown curvature. Wedge-shaped brackets prevent
occlusal interferences.

Mandibular cuspidsMandibular cuspids
7° 5° Thin
The root of the lower cuspid should contact the lingual
planum alveolare, which is the bony buttress supporting
disarticulation. Such a position is difficult to create if the
lower cuspid root is vertical or supported primarily from
the labial (0° to -10°).
Lingual root torque is also advantageous mechanically as
the lower cuspid is moved mesially or distally. This is especially
true in extraction cases.

Mandibular incisorsMandibular incisors
– 1° 0° Thin
The ideal torque of the lower incisor— as with the upper
incisor— varies with facial type. However, a torque of -1°
allows enough flexibility for increase or decrease in torque
as required by dolichofacial or brachyfacial types.
Bracket height should be somewhat incisal in deep bite
cases to assist in bite opening and intrusion

Maxillary bicuspidsMaxillary bicuspids
– 7° 0° Thin
Ricketts called the upper second bicuspid the "key to
occlusion” because of its importance in the seating of the
upper buccal segments.
with the maxillary first molar, buccal root torque assures
that the roots can be slightly to the lingual and supported
by the dense cortical bone of the palate— particularly when
expansion is part of the treatment mechanics. A mesial root
tip of -5° in extraction cases facilitates root paralleling.

Maxillary cuspidsMaxillary cuspids
Inter canine angle – 134, the upper
cuspid should be torqued slightly
Lingual.
From esthetic point , the labial inclination
Of the upper cuspids is important in
supporting the corners of the mouth and
the caninus complex.
7° 10° Thin

Maxillary incisorsMaxillary incisors
Lateral 14° 8° Standard
Central 22° 5° Standard
Palatal root torque is necessary to achieve an interincisal angle
of 126. Not all cases should be torqued to such an angle,
but this built-in torque permits it when a full-size edgewise
archwire is engaged.
Torque depends on the facial type.
Both have standard thickness

Tip edge bracket systemTip edge bracket system
- 1986- 1986
(( Tip-edge orthodontics Richard ParkhouseTip-edge orthodontics Richard Parkhouse))
Introduced by Peter Kesling based on his experiences withIntroduced by Peter Kesling based on his experiences with
differential tooth movement and thesis written in 1968differential tooth movement and thesis written in 1968
Based on the rationale that each tooth has to tip freelyBased on the rationale that each tooth has to tip freely
either mesially or distally –not in both directions .either mesially or distally –not in both directions .
Keeping this in mind the appliance was designed toKeeping this in mind the appliance was designed to
provide all the benefits of differential tooth movement plusprovide all the benefits of differential tooth movement plus
pre determined degree of final crown tip and torquepre determined degree of final crown tip and torque

Basic design consist of-Basic design consist of-
-removal of diagonally opposed corners of a-removal of diagonally opposed corners of a
conventional edgewise slotconventional edgewise slot
-slot size is .022 x.028-slot size is .022 x.028
-lateral extensions or wings-lateral extensions or wings
-vertical slot .020 x.020-vertical slot .020 x.020
- deep grooves- deep grooves
The Rx- 1 bracket

BRACKET DESIGNBRACKET DESIGN
Vertical slot
– 0.020” square

Cut out surfaces – tip limiting surfaces
Intact surfaces – finishing surfaces
Central ridge - vertical control
A Dynamic slot ;-

Molar tube are designed –Molar tube are designed –
.036 round gingival tube.036 round gingival tube
.022 x .028 occlusal tube.022 x .028 occlusal tube
Use of round tubes – bite openingUse of round tubes – bite opening
in the initial stagesin the initial stages
Rectangular tube – space closure,Rectangular tube – space closure,
root uprightingroot uprighting

Maxillary Maximum crown tip
During translation
Final crown tip Final root torque
U1 20 distal 5 12
U2 20 distal 9 8
U3 25 distal 11 -4
U4 20 distal or mesial 0 -7
U5 20 distal or mesial 0 -7
Mandibular
L1 20 distal 2 -1
L2 20 distal 2 -1
L3 25 distal 5 -11
L4 20 distal 0 -20
L5 20 distal 0 -20

Advantage over original edgewise –Advantage over original edgewise –
Adversely tipped teethAdversely tipped teeth
Anchorage controlAnchorage control
Advantage over ribbon arch-Advantage over ribbon arch-
Inout compensation.Inout compensation.
Prevent distal crown tipping of cuspidPrevent distal crown tipping of cuspid

Outrigger appliance

Evolution of straightEvolution of straight
wire appliancewire appliance
By –
Dr. I. Rohiniwww.indiandentalacademy.com

Combination anchorage techniqueCombination anchorage technique
- four stage light wire appliance- four stage light wire appliance
- 1988- 1988
(( combination anchorage technique – Thompson vol 1988 Ajo-do may 363-79combination anchorage technique – Thompson vol 1988 Ajo-do may 363-79))
CAT in its early structure was principally a four stage
Begg light wire system, the fourth stage being the straight
wire finally.
The concept was to use a light wire appliance system to
establish the early organization of the malocclusion and
to finish the treatment with more rigid and precise
straight wire appliances.
What was originally believed to be modernized Begg wasWhat was originally believed to be modernized Begg was
actually a true combination anchorage technique.actually a true combination anchorage technique.

BRACKETS DESIGN IN CAT
Two slots
1. Vertical slot
Gingival slot
True begg ribbon arch type.
2.Edge wise slot : Horizontal slot
Uses of two slots.
• Simple and efficient
• Movement
-Tipping
-Bodily
• Technique
-Light wire
-Straight wire

IMPROVEMENTS IN BRACKET DESIGN
The original combination brackets was
Bulky
Weak
esthetically unattractive
Problems with pinning, rotations, slot closure and occlusal
interferences
These problems were eliminated in new bracket design
Improvement in bracket design course from ideas and
suggestions from experience with several brackets designed
for combination treatment

CAT BRACKET DESIGN
•Clinically excellent for both light wire and straight wire
treatment.
•Comfortable.
•Esthetically pleasing to the patient.
•0.22 x 0.35” gingival or ribbon arch slot.
•0.018 x 0.025” or 0.022 x 0.028” straight wire slot.
•Vertical slot is also incorporated into the bracket for
use with up righting and rotating springs, elastic, hooks,
double arch wires.
Color coding dots are used to identify the brackets.
Maxillary brackets are – Red in colour
Mandibular brackets are – blue.
Color coding dots are placed distogingival aspect.www.indiandentalacademy.com

MODIFICATION IN BRACKETS DESIGNS
Maxillary incisor brackets – varying degrees of torque
Maxillary canine torque has been reduced to 0 to reduce the
prominence of the canine roots on the labial plate.
The torque in the lower 1st premolar was 17° and for lower
2nd premolar was 20°.It has been changed to standard 19° for
both.
Molar attachment have convertible double tubes
It facilitates extending the straight wire into round molar
tubes.
Redesigned 2nd molar tubes have reduced occlusal
interference on short crowned 2nd molars.

Molar tube offset 7° to facilitate proper rotation –
when straight continuous arch wire are used.
Redesigned pin slot and bracket pad have simplified
placement and retention of pins.
So that phase I & II can now be completed with the
same type of pin.

MODIFICATION OF PINS IN CAT
Lock in used in the technique are
Phase I & II retention pin
Phase III retention pin
Tandem,, hook pin
By pass clamp
Special pins – Reduce friction during tipping movement of an
arch wire in the gingival slot.
New auxiliary extension pins have been contoured for lip
comfort and modified to hold an elastomeric ring or an elastic.
Stainless steel extension pins are recommended for use with
surgical fixation ligatures. They are strong and with stand the
tension of these ligatures.www.indiandentalacademy.com

1.Phase III retention pin1.Phase III retention pin
2.Phase I and II retention2.Phase I and II retention
pinpin
3.Tandem, hook pin3.Tandem, hook pin
4.Bypass clamp4.Bypass clamp

BRACKET AND TUBE PLACEMENT
similar to that of straight wire appliances like edge wise slot parallel and at
the same level as the interproximal contact point of the teeth in normal
occlusion.
Molar tube can be banded or bonded.
Remaining brackets are bonded on the anterior and premolars keeping the
molar tube as guide line.
Molar tube placement
rectangular tube 3.5 mm from the molar cusp tip.
Other teeth are at the same level except canine and lateral incisor
If maxillary molars are interfering in static of functional occlusion,
-position have to be altered.
Canines edge wise slot should be 4mm
Maxillary lateral incisors 3 mm from the incisal edge.
Non extraction case – mandibular I premolar – 4mmwww.indiandentalacademy.com

BRACKET AND TUBE PLACEMENT

ADVANTAGES OR FAVORABLE FINDINGS IN
COMBINATION SYSTEMS
Time factor
Stage III can be altered because of the shortening of the
usual uprighting periods by finishing and uprighting and
torque in the rectangular slot.
In class I extraction cases – those stages II closure may be
minimal and uprighting of canines, stage III may be
completely eliminated and only rectangular finishing may be
needed.
It is often possible to enter the rectangular slot with the
main wire very early in the non extraction cases and to
control most of the uprighting and torque with only the
straight wire type and angulated and torqued slot.

Variable anchorage straight wire technique
EJO – 27 2005(180-185)
The combination of begg and straight wire technique
was improved by 2nd
generation of combination brackets
developed by Thompson(1995) and the idea was to improve
the possibilities to adopt and vary intra-arch anchorage need
of individual patient.
a study was done to compare the results of combination
anchorage technique and SW technique.

Both VAST and SW technique seemed to produce same
treatment results.
In the hands of experienced orthodontist, the VAST
required no extra oral traction and fewer scheduled
appointments than the SW technique.

CONCLUSIONS
CAT Approach with modified brackets has been
efficient, effective, and esthetically pleasing, satisfactory to
the patient.
CAT has provided optimum anchorage control and
tooth movement in any given situation.
Finally: What we think we know today shatters the
errors and blunders of yesterday and is tomorrow
discarded as worthless.

BEDDTIOT
Begg's - edgewise diagnosis determined totally
individualized orthodontic technique
Richard.A.Hocevar
“ The intent was to incorporate the important
advantages, features, and capabilities of many fixed
appliances and minimize deficiencies, making the most
of current understanding of orthodontic biomechanics
and technology ”.
-Hocevar (July 1985, AJO-DO)

Begg principles are employed in some cases; various
edgewise techniques in others. A wide variety of
combinations may be employed easily.
Beddtiot Philosophy

Brackets are narrow, single-width edgewise brackets
with 0.022 inch (height) ´ 0.028 inch (faciolingual
depth) horizontal arch wire slots. On the lingual side of
the bracket is a 0.020 ´ 0.020 inch vertical slot.
BRACKETS

The arch wire slots are ''torqued" (cut at such angles to
the brackets that they will be oriented parallel to the
plane of the arch when the teeth are positioned
properly)

Except for torque, the brackets are all identical.
Therefore, they are interchangeable; any bracket
may be used on any tooth.
Placed with its torque-indicator groove gingival, a
bracket provides lingual root torque; with the
groove occlusal, it provides lingual crown torque.

Buccal Tubes
- 4.5 mm long, 0.022 ´ 0.028 inch "edgewise“ tubes
- 25° lingual crown torque for lower
- 10° for upper first molars
- Distal end of the maxillary tube is angulated
outward 10° from the welding flanges to maintain
the proper rotation ("toe-in")

Deepbite or moderate-to-severe anchorage requirement
cases –
An additional rectangular tube is carried diagonally
across the buccal surface of the basic tube, its mesial end
pointing gingivally

Outer tube-
It carries the main (working) arch wires during the bite-
opening and retraction phases of treatment
Inner tube – carry heavy rectangular sectional wires to
lock molar and premolar teeth together( prevents tipping,
anchorage control)

Correction of Rotations
Mild corrections - offset the bracket slightly toward
the side of the tooth that is displaced lingually. Simple
engagement of the bracket on the arch wire with a
small elastomeric ligature will correct the rotation.
Moderate to Severe corrections
-gentle ligature or elastomeric thread may be
used to tie the bracket to the arch wire.
- Bayonet bends may also be used

Original Uprighting spring
Helix is farther from the
arch wire,
- Hook arm is slightly
longer
Modified Uprighting spring
- Less bulk.
- More hygienic,
- Less likely to impinge
upon or irritate the gingiva,
-www.indiandentalacademy.com

“ BEDDTIOT was designed to facilitate application of
the best modality in every situation, to handle any case,
whether it would be treated best with Begg-like
biomechanics or one of the many Edgewise approaches ”
- Hocevar

Level anchorage systemLevel anchorage system
ROOT began using the angulated appliances of Holdaway in
1954 and since that time, he included the anchorage needed to
reduce ANB angle, correct class II molar relationships, close
extraction space, and level curve of Spee.
In 1975 Root began using a completely preadjusted appliance,
varying the amount of angulation in the buccal segment by
severity of the malocclusion

He uses more accurate timing of each step in therapy
and more treatment control by means of periodic self-
checks.
This is what he called “level anchorage system”

1515 00 00 00 66 77 44 tiptip
1010 1010 -7-7 -7-7 00 77 1515 torquetorque
1010 66 44 44 66 22 22 TipTip
2525 2222 1111
LowLow
fit =fit =
1717
1111 00 00 00 torquetorque

BRACKET PLACEMENT

There are two choices of distal crown tip for the
mandibular buccal teeth
Regular:- mandibular 2nd
premolars – 4 distal crown tip
mandibular 1st
molars – 6
mandibular 2nd
molars – 10
Major:- mandibular 2nd
premolars – 6
1st
molar – 10
2nd
molar – 15
Choice depends on the severity of malocclusion

The unique quality of LAS is predictability.
If this system of orthodontic care has value , it lies in five
primary areas.
To fully state a problem is more than half way to its solution.
A precise and repeatable treatment plan is mandated by
defining the problem
 As treatment progresses the practitioner can periodically run
a self-check.
 Predictability
 Applicability of special brackets and bands automatically
coordinated with a straight arch wire.

Bioefficient bracket systemBioefficient bracket system
It is a modification of preadjusted systemIt is a modification of preadjusted system
introduced byintroduced by Viazis.Viazis.
The bracket prescriptions were designed toThe bracket prescriptions were designed to
overcorrect malocclusion and to make it possibleovercorrect malocclusion and to make it possible
to work with the largest possible wires from theto work with the largest possible wires from the
start of the treatment .start of the treatment .
(Atlas of advanced orthodontics: a guide to clinical efficiency - Anthony D. Viazis)

Rationale behind the bracket design is-Rationale behind the bracket design is-
 maximum potential of any archwire ismaximum potential of any archwire is
achieved when the largest possible wire is used.achieved when the largest possible wire is used.
The archwire between a narrow single bracketThe archwire between a narrow single bracket
will have less stiffness and greater flexibilitywill have less stiffness and greater flexibility

BRACKET DESIGNBRACKET DESIGN

The bracket is designed to fulfill followingThe bracket is designed to fulfill following
requirements-requirements-
1. Conformity to the crown anatomy and gingival1. Conformity to the crown anatomy and gingival
outlineoutline

2.2. Ease of use-Ease of use-
if the ball indicator is towards the centre of curvatureif the ball indicator is towards the centre of curvature
of the gingiva, the vertical member automaticallyof the gingiva, the vertical member automatically
lines up along the long axis of the tooth.lines up along the long axis of the tooth.

3. Minimum friction;-
the single slot contact produces the least amount of
wire –bracket contact and thus the lowest possible friction.

4. Tip control:-
In this bracket design, as soon as a tooth begins to tip
(as in space closure), the archwire contacts the side elbows,
and the single slot momentarily becomes a wide twin slot
that produces root movement before any further crown
movement. Thus, the tooth "walks" back in a zigzag fashion.

5.5. Rotational control-narrow ,elongated configuration ofRotational control-narrow ,elongated configuration of
the bracket ,with the wings moved towards thethe bracket ,with the wings moved towards the
mesiodistal surface of the teeth provide maximummesiodistal surface of the teeth provide maximum
rotational controlrotational control

6. Vertical slot :- uprighting springs can be used.
7. High torque in anterior brackets:

The Next Generation :Straight WireThe Next Generation :Straight Wire
ApplianceAppliance
 This concept was introduced by Creekmore andThis concept was introduced by Creekmore and
Randy in 1993 AJORandy in 1993 AJO
 Frequently anticipated results are not achievedFrequently anticipated results are not achieved
by using a preadjusted appliance and straightby using a preadjusted appliance and straight
wire .wire .

 There are atleast five reasons –There are atleast five reasons –
1.1. Inaccurate bracket placementsInaccurate bracket placements –a mean of .34–a mean of .34
mm error in vertical plane and 5.54mm error in vertical plane and 5.54˚ for˚ for
angular placement is observedangular placement is observed
- Balut et.al- Balut et.al
2.2. Variations in tooth structureVariations in tooth structure
3.3. Variations in ant –post and vertical jaw relationsVariations in ant –post and vertical jaw relations
require variations in the position of the max andrequire variations in the position of the max and
mand incisors.mand incisors.

4.4. Need for overcorrectionNeed for overcorrection
5.5. Mechanical deficiencies of the edgewiseMechanical deficiencies of the edgewise
appliance –force application away fromappliance –force application away from
CRes.CRes.
-play between arch wire and-play between arch wire and
slot.slot.
-force diminution.-force diminution.

The Next Generation :Straight WireThe Next Generation :Straight Wire
ApplianceAppliance
THE SLOT MACHINETHE SLOT MACHINE

Advanced Preadjusted ApplianceAdvanced Preadjusted Appliance
FabricationFabrication
 TorqueTorque –with the use of an incisor Torque–with the use of an incisor Torque
Template (Creekmore Enterprises ).Template (Creekmore Enterprises ).
 TipTip -can be adjusted taking in consideration the-can be adjusted taking in consideration the
anchorage requirement .anchorage requirement .
 Rotations-Rotations- rotations can be accurately measuredrotations can be accurately measured
by using rotational guidesby using rotational guides

 HeightHeight – more precise height– more precise height
measurements are possiblemeasurements are possible
All this requires proper planning ofAll this requires proper planning of
individual tooth movement so as toindividual tooth movement so as to determinedetermine
exact amount of torque ,tip ,exact amount of torque ,tip , rotation androtation and
height parameter for eachheight parameter for each
toothtooth

The Élan and Ortho's systemThe Élan and Ortho's system
This was introduced byThis was introduced by Craig Andreiko(1994)Craig Andreiko(1994)
These are two appliance system that represent the firstThese are two appliance system that represent the first
modern CAD/CAM technology for appliance design inmodern CAD/CAM technology for appliance design in
orthodontic field.orthodontic field.
(Jco interviews Craig Andreiko on the elan and ortho’s system Jco – 1994 aug 456-468)

Elan is first system to integrate treatment plan andElan is first system to integrate treatment plan and
appliance for a specific patient.appliance for a specific patient.
Elan system begins with digitizing the skeletal and dentalElan system begins with digitizing the skeletal and dental
entity of the patient .entity of the patient .
The system then proceeds to design an occlusion basedThe system then proceeds to design an occlusion based
on the practitioners treatment plan and on algorithmson the practitioners treatment plan and on algorithms
developed to mate the three dimensional positioning ofdeveloped to mate the three dimensional positioning of
the dentition to the skeletal framework.the dentition to the skeletal framework.

Based on all these the system designs and fabricateBased on all these the system designs and fabricate
brackets ,wires and bracket positioning devices that arebrackets ,wires and bracket positioning devices that are
essentially reversed engineered from the desired finalessentially reversed engineered from the desired final
results for that individual patient .results for that individual patient .
Begin with the end in mindBegin with the end in mind

•Mandibular brackets are placed as occlusally as possibleMandibular brackets are placed as occlusally as possible
for hygiene and assuring clearance from the buccal cuspfor hygiene and assuring clearance from the buccal cusp
•Maxillary bracket are placed fairly central due to absenceMaxillary bracket are placed fairly central due to absence
of interference .of interference .
•Currently the system is available only in the twin bracketCurrently the system is available only in the twin bracket
configuration with both 018 and 022 .configuration with both 018 and 022 .

Advantages –Advantages –
Highly individualized treatment .Highly individualized treatment .
More efficient.More efficient.
Fewer appointmentsFewer appointments
Allows the operator to spend more time onAllows the operator to spend more time on
designing treatment plans and less time bendingdesigning treatment plans and less time bending
wires .wires .

OrthosOrthos system is a new average prescription and appliancesystem is a new average prescription and appliance
design based on computer analysis of more than 100 casesdesign based on computer analysis of more than 100 cases
derived from the Elan technology.derived from the Elan technology.
It consist of a coordinated system of brackets ,buccal tubesIt consist of a coordinated system of brackets ,buccal tubes
and wires .and wires .

Prescriptions incorporated in the appliancePrescriptions incorporated in the appliance
design are meant for a particular race .design are meant for a particular race .
 Asian version of ortho’s will soon beAsian version of ortho’s will soon be
available .available .

The Butterfly systemThe Butterfly system
- S. Jay Bowman- S. Jay Bowman
Aldo Carano- Jco may 2004Aldo Carano- Jco may 2004
The butterfly system has several unique features designed to
improve upon existing preadjusted appliance concepts.
It is based on a new low profile, twin –wing bracket.
The bracket’s reduced profile, its miniature twin-wing
design and rounded tie wings, and the elimination of standard
hooks results in an appliance that is more comfortable,
esthetic and hygienic.

Versatile vertical slot :-
 elimination of ball hooks
 a simple hook pin or T-pin can be inserted
 a stainless steel ligature or elastic thread can be placed to
engage teeth that are blocked out.

Butterfly system prescription
maxillarymaxillary 11 22 33 44 55
TorqueTorque +14+14 +8+8 00 -7-7 -8-8
AngulationAngulation +5+5 +9+9 +9+9 00 +3+3
RotationRotation 00 00 00 00 00

Conservative anterior torque:-
for class II div 2 cases which often have lingually
tipped incisors. Central incisor labial crown torque of
14 appears to be sufficient for a class II div 2, a class III
Patient or even an extraction case.
To prevent lingual displacement of the canines this
prescription has no torque in the maxillary canine brackets.
To match with the reduced progressive posterior torque
the mandibular canine features a moderate – 3 torque

Progressive posterior torque:-
many bracket prescriptions contain an extreme amount
of mandibular posterior lingual crown torque, intended to
obtain cortical anchorage.
compounding this problem there is popular use of over
expanded arch and bracket prescriptions having limited
maxillary posterior lingual crown torque.
This combination tends to tip the upper posterior teeth to
Buccal and “roll in” the lower posterior teeth to lingual,
resulting in - prominent maxillary palatal cusps,
- inappropriate interdigitation of the maxillary
buccal cusps,
- increased occlusal interferences
-accentuated curve of Wilson

Progressive posterior torque was designed into the
Butterfly system prescription
the maxillary posterior brackets have -14 of torque to help
Prevent buccal tipping of 1st
and 2nd
molars
Reduced mandibular posterior torque -10 to improve
Intercuspation and posterior overjet, flatten curve of
wilson, and reduce interferences.

Angulated first molar attachments
The butterfly system incorporates -6 tip of the attachments
welded to the first molar bands to compensate for the
difference in marginal ridge heights.
The bands are fitted evenly at the mesial and distal ridges,
Prominent disto buccal cusps result when 1st
molar bands
are fitted to marginal ridges instead of placing molar
attachments parallel to buccal cusps.

Mandibular:-
TorqueTorque AngulationAngulation RotationRotation
CentralCentral
incisorincisor
-5-5 +2+2 00
CentralCentral
incisorincisor
-10-10 +2+2 00
laterallateral -5-5 +5+5 00
LateralLateral -10-10 +5+5 00
caninecanine -3-3 +6+6 3D3D
11stst
premolarpremolar -7-7 00 00
22ndnd
premolarpremolar -9-9 +3+3 00www.indiandentalacademy.com

Preventive mandibular anterior torque:-
Al Qabandi and colleagues reported 6-7 of lower incisor
flaring simply from - leveling and aligning
- class II elastics
- clockwise rotation of mandibular plane
- extrusion of maxillary incisors
The lingual crown torque of -5 – is intended to resist
the incisor tipping inherent in leveling mechanics.
-10 preventive torque to counteract additional tipping from
class II elastics

Butterfly bracket system is mainly based on modifications
to the 2nd
generation preadjusted edge wise system
The intent was to take best from the past and to
avoid common problems, thus producing more efficient
treatment and more favorable results.

Cannon Ultra Bracket System
A
James .L. Cannon

Summarizing so far…
All the above prescriptions globally reflect the
treatment philosophy of their different authors.

Incisor torque
Andrews Roth Alex Root Bennett Hilgers

Canine position
Andrews Andrews Roth Alex Root Bennett Hilgers
Max

The real value of PEA becomes apparent in finishing,
the more accurate the appliance, the less time and
effort required in this stage. Even though not required
in initial stages ,in most cases some wire bending is
required in finishing stage to precisely position teeth.
conclusion

Evolution of straight wire appliance 1

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Evolution of straight wire appliance 1