Introduction and history of orthodontics 2nd oct 2011

Presented by:
Dr. Jamal Giri
Resident (1st Year)
Introduction and
History of Orthodontics

 Orthodontics (Greek word)-
Orthos - to correct
Odontos - teeth
Dept. of dentistry-PG section, IOM (2011) 2

 The term “Orthodontics” – coined by
Jacques Lefoulon (france) in 1839.
 The term “Orthopedics” was first used by
Bunon in the year 1743 with regards to
correction of teeth .
 A.F. Talma used the terms “Orthodontics
and Dental Orthopedics” together.
 1985- Orthodontics and dentofacial
orthopedics.
3Dept. of dentistry-PG section, IOM (2011)

 British Society of Orthodontics (1922)
 “Orthodontics includes the study of growth and
development of the jaws and face particularly
and the body generally, as influencing the
position of the teeth; the study of action and
reaction of internal and external influences on
the development, and the prevention and
correction of arrested and perverted
development.”

 American Board of Orthodontics (ABO) :
 “Orthodontics is that specific area of the dental
profession that has its responsibility the study
and supervision of the growth and
development of dentition and its related
anatomical structures from birth to dental
maturity, including all preventive and
corrective procedures of dental irregularities
requiring the repositioning of teeth by
functional and mechanical means to establish
normal occlusion and pleasing facial contours.”

Branches of Orthodontics :
 Preventive Orthodontics
 Interceptive Orthodontics
 Corrective Orthodontics
 Surgical Orthodontics

(Summarized as Jackson’s Triad)
Functional Structural Esthetic
Efficiency Balance Harmony
Aims of orthodontics

Scopes of Orthodontic Treatment:
 Alteration in tooth position
 Alteration in skeletal pattern
 Alteration in soft tissue envelope

 Orthodontics is the
oldest speciality of
dentistry.
 Dentistry in turn had
it origins as a part
of medicine.
Medicine
Dentistry
Orthodontics

Orthodontic ages
 Ancient civilizations.
 Middle ages (476-1450 AD).
 Renaissance period (14th-16th century).
 Eighteenth century.
 Nineteenth century onwards.
 Orthodontics in United states.
 Orthodontics in Europe.
 The merger and then after…

 Specimens dating back to VIII century
B.C. indicate Etruscans may have been
the first people to employ orthodontics to
improve tooth alignment

 Crude appliances to regulate teeth –
recovered among the archaeological
remnants in Egypt, Greece and Mexico
(Mayans)

 First dental healers were physicians.
 Learned by trial & error & observation.

Hippocrates (460BC-377BC)
 The Greek
physician
Hippocrates (460
to 377 BC) is
considered as a
pioneer in medical
science.
 Corpus
Hippocraticum

 First teeth are formed by the nourishment
of the fetus in the womb.
 The shedding of the first teeth generally
takes place about seven years of age.
 Children who cut their teeth in winter time
get over the teeth period best.

 “Among those individuals with long-
shaped heads, some have thick necks,
strong parts & bones. Others have
strongly arched palates, their teeth are
irregularly arrayed, crowding one another
& they are bothered by headaches &
otorrhea.

Aristotle (384 to 322 BC)
 First comparative dental
anatomist.
 De Partibus Animalium (On the
Parts of Animals).
 Noted marked differences
between the dentition among
different animals and also
among the species of same
animal.

 Pitfall
 Males have more teeth than females in the
case of men, sheep, goats, and swine.
 “Aristotle maintained that women have
fewer teeth than men; although he was
twice married, it never occurred to him to
verify this statement by examining his
wives' mouths”. – Bertrand Russell

Aulius Cornelius Celsus(25BC-50AD)
 “If a second tooth
should happen to
grow in children
before the first has
fallen out, that which
ought to be shed is to
be drawn out & the
new one daily pushed
towards its place by
means of the finger
until it arrives at its
proper position”.

Claudius Galenus ( 130-200 AD)
 Described dental anatomy
and embryology by
specifically identifying the
origin, growth, and
development of the teeth
and enumerating the
functions of each.
 Pitfall
 He believed the teeth to be
true bones.

Paulus Aegineta (625-690 AD)
 When supernumerary
teeth cause an
irregularity of dental
arches, they may be
corrected by resection of
such teeth or by
extraction.
 Irregular teeth were
“displeasing in women.”

Barber surgeons (chirurgeons)
 Earliest known organization of barbers
was formed in 1096 AD.
 Began to thrive all over Europe.
 Up to the year 1416, the barbers were not
interfered with in the practice of surgery
and dentistry. But it was soon evident
that they were attempting too much.

Leonardo da vinci (1452-1519 AD)
 The first artist to dissect
the human body and draw
accurate pictures of these
dissections.
 The first to recognize
tooth form.
 The first to perceive the
concept of articulation.

 Described the maxillary and frontal
sinuses and established their relationship
to facial height.
 Determined and made drawings of the
number of teeth and their root formations.
 He noted that “those teeth that are the
farthest away from the line of the
temporomandibular articulation are at a
mechanical disadvantage as compared
with those that are nearer.”

Andreas Vesalius (1514-1564 AD)
 Set a precedent in the study
of human anatomy when he
personally performed a
dissection.
 The Fubric of the Human Body
 Described the minute
anatomy of the teeth,
particularly the dental follicle
and subsequent pattern of
tooth eruption.
 Proved Galen wrong!! 28Dept. of dentistry-PG section, IOM (2011)

Ambrose Paré (1517?-1590 AD)
 A french surgeon
 Paid specific attention to
dentofacial deformities,
especially to the cleft
palate.
 He was the first surgeon
to devise an obturator for
treatment of cleft.

Gabriele Fallopio (1523 to 1562),
 An Italian anatomist.
 Observationes Anatomica.
 A detailed description of
the dental follicle.
 Also gave us the terms
hard and soft palate.

Bartholomaeus Eustachio (1520- 1574)
 Also an Italian anatomist.
 Libellus de Dentibus (Book on
the Teeth).
 Collected the writings of
various authors from
Hippocrates to Vesalius,added
the results of his own
researches.

 Gave the first accurate account of the
phenomenon of the sequential
development of the first and second
dentitions ( Disagreed with Vesalius).
 The first clear description of dental pulp
and root canal.
 Described the periodontal membrane for
the first time and thought of it as a
gomphosis type of joint.

Arzei Buchlein
 A book of surgical art published in 1530 AD
(Author unknown).
 “When teeth begin to drop out ... push the
new one every day toward the place where
the first one was until it sits there and fits
among the others, for if you neglect to
attend to this, the old teeth (deciduous)
will remain and the young ones
(permanent) will be impeded from growing
straight.” 33Dept. of dentistry-PG section, IOM (2011)

 France became the leader in dentistry
throughout the world in the eighteenth
century.
 This was primarily attributed to one man,
Pierre Fauchard.
 He created order out of chaos, developed
a profession out of a craft.

Pierre Fauchard (1678-1761 AD)
 Father of modern dentistry.
 The Surgeon Dentist, A
Treatise on the Teeth (1728).
 His book is said to be the first
complete scientific description
of dentistry.

 He developed the first
orthodontic appliance:
bandolet, designed for arch
expansion.
 Fauchard described 12 cases
of orthodontic treatment in
patients whose ages ranged
from 12 to 22 years, with
apparently good results.

Etienne Bourdet (1722-1789 AD)
 The dentist to the King of
France.
 Advocated the Fauchard
method but went a step
further by recommending
only gold strips on the
labial surface for the
upper arch and on the
lingual surface for the
lower arch.

Robert Bunon (1702-1788 AD)
 French dental surgeon.
 Essay on the Teeth.
 “I claim that a good formation of the teeth
can be procured if care is given them from
the earliest age. I even go further and I
say that the tooth germs and the tooth
materials are favorably disposed by the
regimen of the prospective mother.”

John Hunter (1728-1793 AD)
 A great teacher of
anatomy.
 Natural History of the
Human Teeth.
 Demonstrated the growth,
development, and
articulation of the maxilla
and mandible with the
attached musculature.

 Outlined the internal structure of the
teeth: enamel and dentin and their
separate functions.
 Experimentally established the difference
between bone and teeth for the first time.
(But he concluded tooth to be non
vascular).
 Nomenclature of teeth: incisor, bicuspid
and molar.

Robert Blake (1772-1822 AD)
 A disciple of Hunter.
 “On the Structure and Formation of the
Teeth in Man and Various Animals.”
(thesis presented to the University of
Edinburgh).
 “I feel myself justified that the alveolar
arches continue to increase during the
entire progress of the formation of the
teeth.”

IN Germany...
 Gottfried Janke
 attributed the shedding of deciduous teeth to
the obliteration of their vessels by the
compression of the erupting permanent teeth.
 Adam A. Brunner
 advised that “milk teeth should never be
extracted unless there be manifest signs of the
presence of the corresponding permanent
teeth, or when it is painful or decayed.”

Orthodontics in United states.

 In Colonial America, primitive conditions
for dental care existed until European-
trained “operators for the teeth” came to
this country seeking fresh opportunities.
 One of the most important native
practitioners was John Greenwood (1760
to 1819).

 Benjamin James (1814)
 Noted that he was “often called upon to cure
irregularity, than to prevent it.”
 Levi S. Parmly (1819)
 “where irregularities are allowed to proceed
and become fixed, it is often a matter of
difficulty, and sometimes of impossibility to
rectify them.”

 Robert Augustine (1854)
 The correction of irregularities, however, easy
in theory, will be found most difficult and
delicate in practice; not only will much skill be
found requisite, but, in equal degree, patience.
 By the mid-nineteenth century basic
concepts of diagnosis and treatment had
begun.

 Baltimore College of
Dental Surgery – first
dental college in the
world – opened its
doors to a class of 5
students on Nov 3rd,
1840.

 E.G. Tucker (1846) was the first American
to use rubber bands for tooth movement.
 Emerson C. Angell (1860) used a jack
screw type of device between the
maxillary premolars in 14 yrs old girl and
achieved and increase in arch width by
1/4th inch in 14 days.
(Father of Rapid Maxillary Expansion.)

Chapin. A. Harris (1806-1860 AD)
 Orthodontic tooth
movement is a result of
bone resorption on one
side & bone deposition
on the other side of the
root.
 Pressure –tension theory
 Schwarz (1932)

Norman W. Kingsley (1829-1913 AD)
 “Orthodontia’s greatest
genius” – E.H. Angle.
 Experimented with
appliances.
 Fabricated obturator for
cleft patients.
 “Jumping the bite.”
 forerunner of modern
functional appliances.

 A Treatise on Oral Deformities.
 Over 100 articles on:
 Cleft palate rehabilitation.
 Orthodontic diagnosis.
 Introduced the headgear to apply
extraoral force & provide occipital
anchorage (1861).

 Emphasized the importance of the
relationship between mechanics and
biology as the principle on which
orthodontics should be based.
 Claimed that bending of alveolar bone
would take place during orthodontic tooth
movement (1877 AD).
 The first to recommend that etiology,
diagnosis, and treatment planning were
the acceptable bases of practice.

John Nutting Farrar (1839-1913 AD)
 The Father of American
Orthodontics.
 Investigated the
physiologic and pathologic
changes occurring in
animals as the result of
orthodontically induced
tooth movement.
 Published a series of
articles in Dental cosmos.

 Supported Kingsley’s concept of alveolar
bone bending during orthodontic tooth
movement (1888 AD).
 The originator of the theory of intermittent
force.
 The first person to recommend root or
bodily movement of the teeth.
 Treatise on Irregularities of the Teeth and
Their Correction (1888).

Edward Hartley Angle (1855-1930)
 Father of Modern
Orthodontics.
 Never an outstanding student
in “book-learning”
 Marked ability to improve &
create mechanical equipment
on the farm.
 Apprenticed himself to a
dentist at his mother’s
request.

 Received his DDS degree from the
Pennsylvania College of Dental Surgery-
1878.
 Being at heart an inventor, the field of
general dentistry offered little interest.
 Angle became keenly interested in
orthodontics.

 Experienced many technical problems &
frustrations in treatment which irritated,
motivated & inspired him to develop a
standard appliance.

 5 properties of an ideal orthodontic
appliance-
1. SIMPLE – Push, Pull & Rotate
2. STABLE – Fixed to teeth.
3. EFFICIENT – Based on Newton’s 3rd law
of anchorage.
4. DELICATE – Accepted by tissues.
5. INCONSPICUOUS – Esthetically
acceptable.

Angle’s postulates
 Upper first molars are the key to occlusion
and the most stable landmark in
craniofacial anatomy.
 Upper & lower molars should be related so
that the mesiobuccal cusp of the upper
molar occludes in the buccal groove of the
lower molar.
 The teeth must be in harmony in normal
occlusion.

 The line of
occlusion is smooth
(caternary) curve.

Angle’s classification has 4 classes:

Angle’s contribution to orthodontics
 Established orthodontics as a separate
branch of dentistry.
 Classified malocclusion-1899
 Established Angle School Of Orthodontics
in St. Louis ,Connecticut in 1900 and
Pasadena in 1920.
 Founded American Society Of Orthodontics
in 1901.
 Developed different orthodontic appliances

 1907 - E -Arch Appliance
 Simple design.
• Heavy interrupted forces.
• Tipping of teeth to new position.
• Not possible to precisely position any individual
teeth.

 1912- Pin and Tube Appliance
Move the teeth bodily.
Capable of great precision in tooth
movement.
• Incredible degree of craftsmanship.
• Impractical in clinical use.

 1915 - Ribbon Arch Appliance
 First bracket.
 Vertically positioned rectangular slot with
ribbon arch of 10 x 20 gold wire.
 Good spring qualities.
 Allowed versatile movements.
 Poor control of root position.

 1928 - Edgewise Appliance
 ‘Latest and the best’.
 Re-orientation of slot from
vertical to horizontal.
 Rectangular wire of 0.022 x
0.028 inch inserted in a
horizontal slot.
 Excellent control of crown &
root position in all three
planes of space.

Non-extraction paradigm
Rousseau
 Emphasized the
perfectability of man
Wolff
 the internal
architecture of bone
responds to stresses
placed on that part of
the skeleton.

 Angle consulted the
famous artist of the day
Professor Wuerpel for the
ideal facial form.
 Wuerpel ridiculed that it
is impossible to specify
any one facial form as
ideal.

 The best balance, the best harmony, the
best proportions of the mouth in its
relation to the other features require that
there shall be a full complement of teeth &
that each tooth shall be made to occupy
its normal position - i.e. normal occlusion.

Calvin S. Case (1847-1923)
 Graduate of Ohio College of
Dental Surgery.
 First to try bodily tooth
movement.
 Pioneered use of retainers.
 Fabrication of obturator for
rehabilitation of cleft lip
and palate.
 First to use small gauze,
light resilient wires for
tooth alignment. 71Dept. of dentistry-PG section, IOM (2011)

 Initially a genuine admirer of Angle.
 The discord:
 Angle attributed the origin of the use of
intermaxillary elastics to Baker.(1893)
 The bombshell:
 Concept of extraction for the treatment of
malocclusion.

 The climax of this conflict was a debate in
1911 at the annual meeting of the
National Dental Association (former name
of the ADA).
 Dewey(Angle’s Student) Vs. Case:
 one of the most sharpest and most heated
controversies.
 Angle & his followers won the day.
 Extraction of teeth for orthodontic purpose
essentially disappeared.

Martin Dewey (1881-1933)
 Known for his
modification of Angle’s
classification of
malocclusion.
 Product of Angle’s
school of orthodontics.
 1911-Dewey school of
orthodontia.

75
 1914- Book entitled ‘Practical orthodontics.’
 1915- Founded and became editor of the
International Journal of Orthodontia (now
AJO).
 1931- president of American dental
association (ADA)
Dept. of dentistry-PG section, IOM (2011)

Albert. H. Ketcham (1870-1935 AD)
 1902 - Graduate of
Angle School of
Orthodontics.
 First to introduce
Roentgenogram &
Photography
 Investigated the
problem of root
resorption.
 Founding president
of ABO. 76Dept. of dentistry-PG section, IOM (2011)

Milo Hellman (1873-1947 AD)
• Angle’s student.
• He demonstrated high
percentage of upper 1st
molar rotation and warned
in classifying malocclusion.
• He pioneered the use of
hand- wrist radiograph to
determine the growth age
and status of the patient.

 1929 -The American Board of Orthodontics
(ABO) was founded and is the oldest
specialty board in dentistry.
 1931 – Holly Broadbent introduced
cephalometric radiography and tracing.

Percy Raymond Begg(1898-1983 AD)
 Student of Angle.
 Returned to Australia
in 1925.
 Non-extraction +
Ribbon arch mechanics
 Poor post treatment
profiles and relapses.

 Feb. 1928- started extraction.
 Later started Ribbon arch brackets with
slots facing gingivally.
 Ribbon arch appliance + extraction
Begg technique

 Charactristics of Begg’s appliance
 Replacement of precious metal ribbon arch
with high strength 16mil stainless steel wire.
 Retained the original ribbon arch bracket but
turned it upside down so that the bracket slot
points gingivally.
 Added auxillary springs to the appliance for
control of root position.

 Begg revolution:
 Begg appliance became widely popular
(1960s).
 Removed the need for headgear.
 Allowed more efficient tooth movement with
less discomfort.
 Used stainless steel wire instead of gold or
platinum. (Arthur Wilcock)

Charles H. Tweed
 Charles H. Tweed applied
to the Angle school in
Pasadena in 1925 but was
refused admittance.
 Angle told him to study
and to become more
serious about
orthodontics.

 Angle and Tweed worked closely together
for the last two years of Angle's life.
 Tweed made progress records of his
patients every 4 months. He packed the
records in a suitcase and took them to
Pasadena, where Angle studied them and
outlined a treatment plan for the next 4
months.

 Angle was so pleased with Tweed's work,
that he was instrumental in making it
possible for Tweed to be invited to give
lectures at several orthodontic meetings.
 In 1932, Tweed published his first article
in The Angle Orthodontics. It was titled
"Reports of Cases Treated with the
Edgewise Arch Mechanism."

 Tweed held to Angle's firm conviction that
the practitioner must adhere to the line of
occlusion concept and never extract teeth.
 But little did he know...

 After 5 years of orthodontic practice,
Tweed became disheartened with his work
for two reasons:
 1) the protrusive faces that he was creating.
 2) the unstable dentition.
 He resolved to study his many failures and
his few successes.

 Tweed’s conclusion:
 1) The patients who had pleasing facial
balance and harmony also had mandibular
incisors that were upright over basal bone.
 2) The carefully planned extractions allowed to
improve appearance as well as stability

 By 1940 he had records of 100 patients,
treated first without extractions and then
retreated with extractions.
 He put these patient records on display at
an American Association of Orthodontists
(AAO) meeting.
 “Just put your plaster on the table."

 Angle gave orthodontics the edgewise
bracket, but Tweed gave orthodontists a
way to use it.
 He devoted all 42 years of his professional
life to the use and refinement of Angle's
invention, the edgewise appliance.

 Not a single person dominated.
 Development of removable and
myofunctional appliances.
 Angles dogmatic approach to occlusion – less
impact in Europe.
 Precious metal for fixed appliances less
available.
 2 types of devices :
 Active plates or removable appliances
 Activator or functional appliances

Development of active plate
 1839 – Charles Goodyear invented
vulcanite. ( late 1930s- vulcanite was
replaced by acrylic)
 1881 – Coffin plate by Coffin.

 1902- Pierre Robbin devised “Monobloc”
made of single block of vulcanite. It
is used to position the mandible
forward in patients with glossoptosis and
severe mandibular retrognathism.

 1908 – Hawley’s
retainer appliance
was developed.
(Charles. A. Hawley)
 1911 – J.H. Badcock
- expansion plate
with screw.

 A.M. Schwarz
 1938 – ‘Lehrgang der
Gebissregulung’ -
Orthodontic bible in Europe.
 “Removable Orthodontic
Appliances‟ (1966)
 “Schwarz double plate”
 combination of activator &
active plate. (class II div I)

 Philip Adams (1950s)
 modified arrowhead
clasp made by
Schwarz into the
Adam’s crib.
 Versatile clasp: Basis
for English removable
appliances.

Development of functional appliances
 Viggo Andresen in Denmark
(1908)- Activator
 Modified Hawley’s type
retainer.
 Forward positioning of
mandible-for saggital
correction.
 Used for the first time on his
own daughter.
 “Biomechanical working
retainer”

 Later Andersen teamed up with karl
Haupl- changes in the appliances.
 “Functional jaw orthopedics.”
 “Norwegian appliance.”
 Haupl coined the term Activator
 Ability to activate muscles

 Most frequently
used activator
modification –
Bionator by Balters.
(early 1950s)

 H.P. Bimler – myodynamic appliance.
 Expanding the maxillary arch by cross
wise transmission of transverse
mandibular movements.
 Stockfish Kinetor.

 Rolf Frankel of
Germany.
 Function Regulator in
1950s.
 Appliance confined to
oral vestibule –
shields buccal and
labial musculature
away from teeth &
investing tissues.

The Merger and then after…
 The 50s and 60s were the decades when
cross-continental barriers began
dissolving.
 Egil Harvold – faculty at University of
Toronto, introduced ‘Norwegian system’ in
U.S.
 In Europe fixed appliances started
replacing removable appliances for
comprehensive treatment.

 Dr. H. D. Kesling, an orthodontist, was so
impressed by Dr. Begg’s work that he was
instrumental in bringing Dr. Begg to USA.
 April, 1960- Dr. Begg presented his cases
treated with Begg Technique at the AAO
annual meeting.
 This was first introduction to Begg
Mechanics in USA.

Lawrence F. Andrews
 Father of pre-adjusted
bracket system.
 6 keys of occlusion –
1972.
(Research spanning ten
years led to The Six
Keys to Optimal
Occlusion)

106
Edward. H. Angle
Raymond Begg
(Conventional
Begg)
P.C Kesling
(Tip-edge & tip-
edge plus)
Messias Rodrigues
(simplified straight
wire tech.)
Charles Tweed
(edge-wise)
Lawrence Andrews
(straight wire)
1st generation
Ronald Roth
2nd generation
MBT (McLaughlin,
Bennett, Trevisi)
3rd generation
Dept. of dentistry-PG section, IOM (2011)
Modified Begg
(Begg principle without
ribbon arch bracket)
Refined Begg
(Dr. Jayade,
Sims)

 Vick Alexander
 1978: Vari-Simplex
Discipline.
 Charles Burstone
 Segmented arch
technique.
 COGS
 Introduced TMA, chinese
NiTi, fibre reinforced
composite.

T.M. Graber
 Wrote 20 textbooks, 22
chapters in other textbooks,
180 publications in journals &
930 book & journal abstract
reviews.
 1950 – First PhD to Dentist by
Northwestern University
Medical School.
 Editor-in-chief of AJO for 15yrs.

 William. J. clark
developed the Twin
Block Technique in
1977.
 The technique is now
the most widely used
functional technique
throughout the world.

 1977 – Pancherz resurrected Herbst
appliance.
 Developed by Emil Herbst in early 1900s.

 J.J.Jasper in 1980-
Jasper jumper.
 A flexible, fixed
tooth borne
functional
appliance

Robert Ricketts
 Bioprogressive therapy
(1950s).
 Concept of VTO (Visual
treatment objective) and
computerized cephalometry
(mid-1970s).

Visual treatment objective (VTO)

Cone beam computed tomography
(CBCT)

Skeletal anchorage
 Vitalium screws (Gainsforth and Higley,
1945).
 Conventional osseointegrated implants
(Roberts et al., 1989).
 Mini-plates (Jenner and Fitzpatrick, 1985)
 Onplants (Block and Hoffman, 1995)

 Palatal implants
(Wehrbein et al.,
1996)
 Mini-implants
(Kanomi, 1997)
 Miniscrews (Costa et
al., 1998).

Orthodontics in Nepal
 B.P.K.I.H.S is the first government
hospital to provide orthodontic treatment
where as in Kathmandu valley, IOM is the
first.
 Dr. Sambhu Man Singh(DORCS- England,
1974) is the first Orthodontist of Nepal.
 Dr. Praveen Mishra is the first orthodontist
with MDS degree(MAHE – 1995).

 Orthodontics and Dentofacial
Orthopaedics Association of Nepal
(ODOAN) has been established in 2009. It
is the first association among dental
postgraduate specialities.
 At present there are 14 orthodontists (as
registered ODOAN) in Nepal most of them
are centred in Kathmandu valley.

 ODOAN :affiliated to Asian Pacific
Orthodontic Society (APOS) in Feb 2010
and World Federation of orthodontics
(WFO) in June 2010 as 108th member.
 Post graduation in Orthodontics was started
in National Academy of Medical
Sciences(NAMS) in 2008 for the first time in
Nepal.
 2010- IOM and people’s dental college.
 2011- Universal college of medical sciences.

 “History is reading all that you can as
fast as you can and - remembering as
much as you can.”
Lynn Berleffi Darr

Introduction and history of orthodontics 2nd oct 2011

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