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Brackets part 1/endodontic courses



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Brackets part 1/endodontic courses

  1. 1. BRACKETS PART 1 www.indiandentalacademy.com
  2. 2. CONTENTS  Introduction  Evolution of brackets  Ribbon Arch bracket  Edgewise brackets  Twin Brackets  Curved base twin brackets  Labio LingualAppliance  Modified Ribbon Arch Brackets (Begg)  Brackets used in  Parts of bracket  Materials used in Orthodontic brackets  Gold  Stainless steel  Plastic  Composite  Ceramic  Cobalt chromium alloy  Titanium  Zirconia www.indiandentalacademy.com
  3. 3.  Bracket width and size  Bracket and Type of rotation control wings  Lang brackets  Lewis bracket and its modifications  Steiner bracket  Broussard bracket   Mode of ligation  Conventional method  Self ligating brackets  Edgelok  Mobilok  Activa  SPEED  www.indiandentalacademy.com
  4. 4.  Brackets systems and Philosophy  Straight wire brackets  ROTH brackets  Ricketts Bioprogressive brackets  MBT brackets  Tip edge brackets  Lingual brackets  Conclusion  References www.indiandentalacademy.com
  5. 5. INTRODUCTION  In Orthodontics all the devices which projects horizontally to support the archwire and are open on one end usually vertical or horizontal plane are called brackets.  Raymond C. Thurow has defined bracket as an orthodontic attachment secured to a tooth for the purpose of engaging on arch wire www.indiandentalacademy.com
  6. 6. RIBBON ARCH APPLIANCE BY ANGLE (1916)1,2,3 www.indiandentalacademy.com
  7. 7. Pin and tube-1910 www.indiandentalacademy.com
  8. 8. Edgewise brackets.2,13  "latest and best orthodontic mechanism," (Dental Cosmos) which he introduced in 1925 "open face" or "tie brackets." 22x28 mils www.indiandentalacademy.com
  9. 9. Repeated tying was necessary to rotate the tooth to its final position. Tying was continued throughout the treatment plan to prevent any relapse. www.indiandentalacademy.com
  10. 10. Twin Brackets(Dual, double or Siamese brackets)13 www.indiandentalacademy.com
  11. 11. www.indiandentalacademy.com
  12. 12. Twin Brackets Extra wide www.indiandentalacademy.com
  13. 13. Curved Base Twin Bracket www.indiandentalacademy.com
  14. 14. Labio Lingual Appliance2  John Mershon developed this system in 1926 www.indiandentalacademy.com
  15. 15. Universal appliance brackets 2 Spencer Atkinson in 1935 www.indiandentalacademy.com
  16. 16. Twin wire brackets2 Joseph Johnson 1934 www.indiandentalacademy.com
  17. 17. Modified Ribbon Arch Brackets (Begg)2,13  1928, P. R. Begg of Adelaide, South Australia, a former student at the Angle School of Orthodontia  Observed that many of the patients he had treated with expansion using edgewise appliance experienced collapse of their occlusions at the end of retention and/or had unacceptable soft-tissue profiles  Begg’s appliance developed by Dr P.R.Begg 1956 www.indiandentalacademy.com
  18. 18. Begg’s adaptation took 3 forms  Replacement of precious metal ribbon arch with high strength 16 mil SS wire which became available in 1930s  Retained the original bracket but turned it upside down.  Added auxiliary springs for control of root positions. www.indiandentalacademy.com
  19. 19. www.indiandentalacademy.com
  20. 20. www.indiandentalacademy.com
  21. 21. PARTS OF BRACKETS www.indiandentalacademy.com
  22. 22. Base of the bracket  Welding tab ,solder or a bonding mesh  Curved to conform tooth structure  Mode of retention of bracket bases may be:  Mechanical retention  Micromechanical retention  Chemical adhesion  Mechanical and chemical retention www.indiandentalacademy.com
  23. 23. Bracket base types  Mesh type  The sizes of the wire mesh used in the manufacturing of the various single mesh type bases were 40, 60, 80, and 100 meshes (Dickinson 1980).  Non mesh type www.indiandentalacademy.com
  24. 24. PARTS OF A DIRECT-BONDING METAL BRACKET12 www.indiandentalacademy.com
  25. 25. MESH TYPE BASES FOIL MESH BASE (DENTAURUM) DYNA BOND MESH BASE (3M UNITEK) SUPER MESH BASE (GAC)ORMESH BASE (100 gauge foil mesh) (ORMCO) www.indiandentalacademy.com
  26. 26.  Nominal area of bracket base is measured by a method called Planimetry where enlarged photographs of bracket base are examined and mesh size is also calculated by counting wires per linear inch (Dickinson 1980). www.indiandentalacademy.com
  27. 27. NON-MESH TYPE BASES MICRO-LOC BASES (GAC) MICRO ETCH BASE (3M UNITEK) DYNA-LOCK INTEGRAL BASE 3M UNITEK LASER STRUCTURED BASE (DENTAURUM) www.indiandentalacademy.com
  28. 28. STAINLESS STEEL BRACKETS WITH DIFFERENT BASE TYPES  James Lopez (1980) studied retentive shear strength of sixteen commercially available stainless steel bracket bases.  The solid bases with perforations around the periphery had lowest mean shear strengths and are probably due to the lack of mechanical retention in the center of the base.  The solid base with perforations throughout the base slightly increased the mean shear strength values.  Solid base with circular indents that serve for retention was generally ranked in the intermediate bond strengths.  The foil mesh designs proved to range from the most inferior to the most superior shear strengths.  Smaller foil mesh bases could be used without sacrificing www.indiandentalacademy.com
  29. 29. CLASSIFICATION OF BRACKETS  Brackets can be grouped into various types based on :  Bracket material  Their width and size  Type of rotation control wings  Mode of ligation (ligation capabilities) www.indiandentalacademy.com
  30. 30. Materials used in Orthodontic brackets  GOLD BRACKETS  The original brackets as designed by Angle were made of gold. www.indiandentalacademy.com
  31. 31. Gold alloys  Gold at least 75%  Platinum, iridium and silver alloys  Lacked flexibility and tensile strength. German silver (a brass)  Copper 65 %, Nickel 14 %, and zinc 21%  1887 Angle  J.N.Farrar condemned the use of the new alloy, showing that it discolored in the mouth www.indiandentalacademy.com
  32. 32. www.indiandentalacademy.com
  33. 33. STAINLESS STEEL BRACKETS  Stainless steel entered dentistry in 1919 introduced at Krupp’s Dental Polyclinic in Germany by the company’s dentist F Hauptmeyer. He first used it to make a prosthesis and called it WIPLA ( like platinum in German), the designation which is still used in Europe.12  Brackets made of stainless steel are alloys formulated according to the American Iron and Steel Institute (AISI) www.indiandentalacademy.com
  34. 34. Composition 303 304 L 316 L SAF 2205 has 22% Cr, 5.5% Ni, 3% Mn, and 0.03% C The 2205 stainless steel alloy has a duplex microstructure consisting of austenitic and delta-ferritic phases and is harder and demonstrated less crevice corrosion than 316L alloy. (Oshida & Moore) www.indiandentalacademy.com
  35. 35.  Excess of carbon + Cr depleted Austenitic phase  Film of chromium carbide interferes with grain coherence and leads to intergranular corrosion. www.indiandentalacademy.com
  36. 36. Other additives are, Silicon (Si)  if kept at lower concentration, improves resistance to oxidation at & to corrosion Sulfur (S)  sulfur content allows easy machining of wrought parts Phosphorus (P)  allows use of a lower temperature for sintering Manganese (Mn)  used as a replacement for nickel to stabilize austenite www.indiandentalacademy.com
  37. 37. CLASSIFICATION OF STAINLESS STEELS Stainless steels are classified according to the American Iron and Steel Institute (AISI) system. 1) Austenitic steels (300 series) 2) Martensitic steels (400 series) 3) Ferritic steels 4) Duplex steels 5) Precipitation-hardenable (PH) steels 6) Cobalt containing alloys 7) Manganese containing steels www.indiandentalacademy.com
  38. 38. MANUFACTURING METHODS FOR METAL BRACKETS5  From thin metal strip that is stamped to shape  Milling one-piece attachment is milled on the lathe  Casting where one-piece brackets are made by casting  Sintering the partial welding together of metal particles below their melting point  Metal injection molding (MIM) This technique requires the use of computer-aided design, along with computer- numerical controlled machines tools. www.indiandentalacademy.com
  39. 39. PLASTIC BRACKETS  Morton Cohen and Silverman introduced the first commercially available plastic brackets (IPB brackets), manufactured by GAC in 1963.  They are made of acrylics, nylons, expoxy polysulfones, polycarbonates. www.indiandentalacademy.com
  40. 40. Advantages:  Clarity  Heat resistance  Less irritation to soft tissues  Resilient  Flexibility  no odor or bad taste (Newman, 1969)  Non toxic www.indiandentalacademy.com
  41. 41. Disadvantages  Staining and discoloration, (particularly in patients who smoke or drink coffee)  Poor dimensional stability (lack strength to resist distortion and breakage)  Wire slot wear (which leads to loss of tooth control)  Undue friction between the surface of the plastic bracket and metal arch wires that makes it very difficult to slide teeth into a new position.  Uptake of water (Newman 1973). www.indiandentalacademy.com
  42. 42.  Various reinforced polycarbonate brackets were, 1) Fiberglass reinforced polycarbonate brackets 2) Ceramic reinforced polycarbonate brackets 3) Metal slot reinforced polycarbonate brackets 4) Metal slot and ceramic reinforced polycarbonate brackets (composite brackets) www.indiandentalacademy.com
  43. 43. PLASTIC WITH STAINLESS STEEL BRACKETS Available in .018 x .022, .022 x .028 slots by Dentaurum Advantages  Have unbreakable and distortion free slot  Wide tie wings for easy ligation  Rounded edges for patient comfort  Rough surface of bracket pad to facilitate retention of bonding adhesive  Suitable for all bonding systems But added bulk is required to provide adequate strength of the tie wings www.indiandentalacademy.com
  44. 44.  Commercially available :  Extra wide for maxillary incisors  Medium width for maxillary laterals  Narrow width for mandibular centrals and laterals  Medium width for all canines and bicuspids www.indiandentalacademy.com
  45. 45. POLYCARBONATES WITH FIBERGLASS REINFORCED BRACKETS  Currently available include (American orthodontics) as the name SILKON and SILKOMAN  Available in .018 x .022, .022 x .028 slots  Poor dimensional stability and reduced resistance to fracture. (Newman 1969) www.indiandentalacademy.com
  46. 46. PLASTIC WITH CERAMIC BRACKETS5  Advantages:  Enhanced strength without steel  Esthetic  Super smooth surface  Mechanical lock base  Available in .018 and .022 slot sizes in Roth prescription, Standard Edgewise appliance. VogueTM (GAC) www.indiandentalacademy.com
  47. 47. Composite brackets12 www.indiandentalacademy.com
  48. 48. Spirit®MB (ORMCO Classic (American Orthodontics) www.indiandentalacademy.com
  49. 49. Ceramic brackets  Ceramic orthodontic brackets were introduced in late 1980s  Ceramics used for the manufacturing of ceramic brackets were Alumina and Zirconia Various ceramic brackets available on the market www.indiandentalacademy.com
  50. 50.  Four different types of ceramic brackets currently available are Material Manufacturer, name Polycrystalline alumina American, dentarum, rockey mountain, unitek, transund and many others. Poly crystalline alumina with metal slot Unitek, clarity. Monocrystalline alumina A co, starfire. Polycrystalline zirconia Yumaura, toray. www.indiandentalacademy.com
  51. 51. INTERATOMIC BONDING OF CERAMICS combination of covalent and ionic bonding  This strong interatomic bonding accounts for the advantageous chemical inertness of dental ceramics. Al3+ Al3+ Al3+ Al3+ Al3+ Al3+ O2- O2- O2- O2- O2- O2- b2" b1 b' b" 3 2 1 www.indiandentalacademy.com
  52. 52. MANUFACTURING METHODS FOR CERAMIC BRACKETS MONOCRYSTALLINE (SAPPHIRE) BRACKETS molten high- purity aluminiu m oxide temperat ures above 2100C slow coolin g bulk single crystal alumina rod or bar form milled into brackets using diamond cutting,lasers, or ultrasonic cutting. subsequently heat treated to remove surface imperfections and stresses created by the milling process. www.indiandentalacademy.com
  53. 53. www.indiandentalacademy.com
  54. 54. POLYCRYSTALLINE ALUMINA BRACKETS aluminium oxide particles + binder 1800C to burn out the binder and achieve sintering of the particles milled into brackets using diamond cutting,lasers, or ultrasonic cutting. subsequently heat treated to remove surface imperfections and stresses created by the milling process. www.indiandentalacademy.com
  55. 55. www.indiandentalacademy.com
  56. 56. MXi (TP ORTHODONTICS) POLYCRYSTALLINE ALUMINA CERAMIC BRACKETS MONOCRYSTALLINE CERAMIC BRACKET Inspire Starfire www.indiandentalacademy.com
  57. 57. POLYCRYSTALLINE ALUMINA CERAMIC BRACKETS Allure (GAC) CLARITY (3M UNITEK) Micro-crystalline bonding surface 20/40 (American Orthodontics) www.indiandentalacademy.com
  58. 58. Bonding of ceramic brackets  Ceramic brackets bond to enamel by different methods.  Mechanical retention via indentations and / or under cuts in the base.  Chemical bonding by means of silane coupling agents. (both chemically and light cured adhesives are available).  Micromechanical retention through the utilization of a number of configurations, including protruding crystals, grooves, a porous surface, and spherical glass particles. www.indiandentalacademy.com
  59. 59.  The coupling agent:  -methacryloxypropyltrimethoxysilane (- MPTS) has been used for promoting chemical adhesion between surfaces. www.indiandentalacademy.com
  60. 60. Advantages  The optical esthetic properties of ceramics provide the only main advantage over stainless steel brackets  A very important physical property of ceramic brackets is the extremely high hardness of aluminium oxide, so that both monocrystalline and polycrystalline alumina have a significant advantage over stainless steel (Birnie 1990).  Swartz (1988) stated that ceramic brackets are nine times harder than stainless steel brackets and enamel www.indiandentalacademy.com
  61. 61.  Reported bond strengths for ceramic brackets are in the range of 123 to 288 kg/cm2 compared with 50 to 170 kg/cm2 for stainless steel brackets www.indiandentalacademy.com
  62. 62. Drawbacks of ceramic brackets 1. The frictional resistance between orthodontic wire and ceramic brackets is greater and less predictable than it is with steel brackets.  This makes determining optimal force levels and anchorage control difficult. www.indiandentalacademy.com
  63. 63.  Pratten, Popli & Germane (1990) studied frictional resistance between ceramic and stainless steel brackets using Nitinol and stainless steel wires.  Ceramic brackets provide significantly greater frictional resistance than stainless steel brackets when they are used in combination with either stainless steel or nitinol arch wires.  Under all conditions, the stainless steel brackets had lower coefficients of friction than the ceramic brackets. www.indiandentalacademy.com
  64. 64.  Omana and Moore (1992) compared static frictional properties of metal and ceramic brackets and concluded that,  Smoother, injection-molded ceramic brackets appear to create less friction than other ceramic brackets.  Wider metal or ceramic brackets create less friction than narrower brackets of the same material. www.indiandentalacademy.com
  65. 65. CERAMIC BRACKETS WITH METAL SLOTS VIRAGE (American Orthodontics) CLARITY (3M UNITEK) www.indiandentalacademy.com
  66. 66. 2. The surface is rougher or more porous than that of steel brackets and hence can lead to oral hygiene problems. 3. The added bulk required to provide adequate strength makes oral hygiene still more difficult www.indiandentalacademy.com
  67. 67. 4. They are less durable and are brittle in nature.  The limiting physical property of ceramic brackets is fracture toughness.  An alumina ceramic bracket has a fracture toughness of 3.0 to 5.3 Mpa  Stainless steel bracket has a fracture toughness of 80 to 90 MPa www.indiandentalacademy.com
  68. 68. 5. They can induce wearing of enamel of opposing tooth 6. Difficult to debond than steel brackets and wing fracture may easily occur during debracketing www.indiandentalacademy.com
  69. 69. www.indiandentalacademy.com
  70. 70. A Example of fracture of the Starfire bracket. B Example of fracture of the Allure bracket. C Example of fracture of the Transcend bracket. Bishara and Trulove1990 AJO-DO www.indiandentalacademy.com
  71. 71. bond failure at the bracket-adhesive interface bond failure at the enamel- adhesive interface combination bond failure. Part of the adhesive remains on the tooth surface and part is removed with the bracket.www.indiandentalacademy.com
  72. 72. TIE-WING STRENGTH  Photoelastic studies and finite-element analyses have shown that tie-wings are generally the locations of concentrated stresses when forces are applied to the ceramic brackets.  Tie-wing fractures have been much more common for the single-crystal alumina brackets because of their lower resistance to crack propagation. www.indiandentalacademy.com
  73. 73. Clinical precautions when using mechanical debonding techniques11 The blades of the pliers should be placed at the enamel-bracket interface to www.indiandentalacademy.com
  74. 74. www.indiandentalacademy.com
  75. 75. www.indiandentalacademy.com
  76. 76. Electrothermic debracketing (ETD)  Sheridan, Brawley and Hastings (1986) introduced an alternative to conventional bracket removal. The technique is called Electrothermic debrackAJeting (ETD). ETD is the technique of removing bonded brackets from enamel surfaces with a cordless battery device that generates heat. www.indiandentalacademy.com
  77. 77.  Dentaurum thermodebonding unit inserted into bracket slot. www.indiandentalacademy.com
  78. 78.  Scheu-Dental ceramic thermodebonding plier with ceramic bracket inserted. www.indiandentalacademy.com
  79. 79. The disadvantages of electrothermal bonding :  A potential for pulpal damage that still needs to be definitively assessed.  An increase in the temperature of the cone part of the handpiece, which has the potential to cause patient discomfort or mucosal irritation if carelessly used.  The still-bulky handpiece design, which makes its intraoral use difficult in the premolar region. www.indiandentalacademy.com
  80. 80. CO-CR ALLOY BRACKETS 5  Increased surface hardness  Cast surface is smoother than machined surface providing lower friction forces between wire and bracket.  It also undergoes less corrosion as compared to stainless steel. www.indiandentalacademy.com
  81. 81. TITANIUM BRACKETS 8,5 • Pure titanium bracket (DENTAURUM) in 1995. • Its one-piece construction requires no brazing layer, and thus it is a solder- and nickel-free bracket. • Titanium brackets were grayer in color and rougher in texture than the stainless steel brackets • Imparts none of the metallic taste as seen in stainless steel brackets • Titanium also has low thermal conductivity www.indiandentalacademy.com
  82. 82. Composition  The chemical composition is 99+% Ti  less than 0.30% iron  0.35% oxygen  0.35% nitrogen  0.05% carbon  0.06% hydrogen.  The marking and the structuring of the retentive base pads were done by a computer-aided laser (CAL) cutting process, which generates micro- and macro-undercuts. www.indiandentalacademy.com
  83. 83. Role of TiO2  Inhibits adsorption or absorption of foreign metal ions or additional oxygen atoms.  Its passivity over a broad pH range  No corrosion  Ti exhibits the minimum tissue response of all commonly used metals. www.indiandentalacademy.com
  84. 84. ZIRCONIA BRACKETS9  Researchers have suggested that brackets constructed from zirconia have low friction in clinical use. (Springate 1991).  Low frictional coefficients, good wear resistance, high fracture toughness, and biocompatibility [Keith, Kusy, and Whitley(1994 AJO DO)]  Commercially available as:  Harmony – Hudson ltd. Sheffield U.K.  Toray – Yamura corp. Tokyo Japan www.indiandentalacademy.com
  85. 85. BRACKETS PART II By Dr. Neha Chowdhry www.indiandentalacademy.com
  86. 86. CONTENTS  Introduction  Evolution of brackets  Ribbon Arch bracket  Edgewise brackets  Twin Brackets  Curved base twin brackets  Labio LingualAppliance  Modified Ribbon Arch Brackets (Begg)  Brackets used in  Parts of bracket  Materials used in Orthodontic brackets  Gold  Stainless steel  Plastic  Composite  Ceramic  Cobalt chromium alloy  Titanium  Zirconia www.indiandentalacademy.com
  87. 87.  Bracket and Type of rotation control wings  Lang brackets  Lewis bracket and its modifications  Steiner bracket  Broussard bracket   Mode of ligation  Conventional method  Self ligating brackets  Edgelok  Mobilok  Activa  SPEED www.indiandentalacademy.com
  88. 88.  Brackets systems  Straight wire brackets  ROTH brackets  MBT brackets  Tip edge brackets  Lingual brackets  Conclusion  References www.indiandentalacademy.com
  89. 89. BASED ON ROTATION CONTROL WINGS2,13  Disadvantages:  Inter bracket distance is decreased.  Resiliency in the arch wire is decreased.  Difficulty in employing closing loop arch wires and second order bends.  Interferes with the amount of closing action that can be obtained by activating closing loops. But the narrower bracket allowed more activation of these arch wires. www.indiandentalacademy.com
  90. 90. Lang bracket  Dr. Howard Lang  The single bracket allows for easy ligation and increased interbracket width  The wing can easily be activated for rotational control. www.indiandentalacademy.com
  91. 91. Advantages 1. 100% desired tooth rotation . 2. Overcorrection 3. They do not interfere with activation of closing loops. 4. Second order bends and other archwire bends slide freely past the rotation wings www.indiandentalacademy.com
  92. 92. Lewis bracket by Dr. Paul D Lewis, (1950) www.indiandentalacademy.com
  93. 93. Curved Lewis bracket www.indiandentalacademy.com
  94. 94. Vertical slot lewis bracket  further refinement was done by incorporating a .020 x.020 vertical slot  Advantage- uprighting spring to correct axial inclination. www.indiandentalacademy.com
  95. 95. Steiner bracket by Cecil Steiner www.indiandentalacademy.com
  96. 96. PREADJUSTED EDGEWISE BRACKETS Andrew’s Straight Wire Appliance (SWA) www.indiandentalacademy.com
  97. 97.  The original SWA was introduced by Andrews in 1972  He recommended a wide range of brackets. - For extraction cases, anti-tip,anti-rotation, and power arms for control space closure. -Three sets of incisor brackets with varying degrees of torque for different clinical situation. www.indiandentalacademy.com
  98. 98. Maxilla www.indiandentalacademy.com
  99. 99. Mandible www.indiandentalacademy.com
  100. 100. Roth Bracket system www.indiandentalacademy.com
  101. 101.  To avoid inventory difficulties or multiple bracket system, ROTH recommended a single appliance system to manage both extraction and non-extraction cases. www.indiandentalacademy.com
  102. 102. Purpose of the ‘Roth setup’  To provide idealized tooth position prior to appliance removal  Allow the teeth to settle to Andrews non Orthodontic normals www.indiandentalacademy.com
  103. 103. Overcorrection Single prescription with overcorrection in all planes of space "Six Keys to Normal Occlusion" www.indiandentalacademy.com
  104. 104. Bracket type  0.018 and 0.022 slot brackets available  0.018 – too restrictive in wire size selection  0.022 slot preferred – in terms of :  Wire size selection  Stabilizing arches as anchor units  Control of torque in buccal segment www.indiandentalacademy.com
  105. 105. Single wing bracket with rotation arms versus twin bracket www.indiandentalacademy.com
  106. 106. Bracket height www.indiandentalacademy.com
  107. 107. Upper 1’s 2’s 3’s 4’s 5’s 6’s 7’s Tip 50 90 130 00 00 00 00 Andrews 5 9 11 2 2 5 5 Lower 1’s 2’s 3’s 4’s 5’s 6’s 7’s Tip 20 20 70 -10 -10 -10 -10 Andrews 2 2 5 2 2 2 2 Tip www.indiandentalacademy.com
  108. 108. Upper 1’s 2’s 3’s 4’s 5’s 6’s 7’s Torque 120 80 -20 -70 -70 -140 -140 Andrews 7 30 -7 -70 -70 -9 -90 Lower 1’s 2’s 3’s 4’s 5’s 6’s 7’s Torque -10 -10 -110 -170 -220 -300 -300 Andrews -10 -10 -110 -170 -220 -300 -300 www.indiandentalacademy.com
  109. 109. Upper torque considerations There was a tendency for upper first molar palatal cusps to extrude. A bracket with – 140 of buccal torque gives extra control. www.indiandentalacademy.com
  110. 110. www.indiandentalacademy.com
  111. 111. Wick Alexander 1983 The Vari Simplex Discipline www.indiandentalacademy.com
  112. 112. VARI SIMPLEX DISCIPLINE Bracket selection Bracket height Bracket angulation Bracket torque Bracket in-out. www.indiandentalacademy.com
  113. 113. Bracket selection Twin brackets (Diamond brackets)www.indiandentalacademy.com
  114. 114. www.indiandentalacademy.com
  115. 115. Lang Bracket www.indiandentalacademy.com
  116. 116. www.indiandentalacademy.com
  117. 117. Lewis Bracket www.indiandentalacademy.com
  118. 118. www.indiandentalacademy.com
  119. 119. Twin brackets with convertible sheath www.indiandentalacademy.com
  120. 120. www.indiandentalacademy.com
  121. 121. Bracket height Maxillary Arch  Centrals X  Laterals X – 0.5mm  Cuspids X + 0.5mm  Bicuspids X  1st MolarsX – 0.5mm  2nd Molars X – 1.0mm  Mandibular Arch  Centrals X – 0.5mm  Laterals X – 0.5mm  Cuspids X + 0.5mm  Bicuspids X  1st MolarsX – 0.5mmwww.indiandentalacademy.com
  122. 122. Bracket tip Andrews 20 www.indiandentalacademy.com
  123. 123. Vari simplex bracket torques Andrews -7 -1 www.indiandentalacademy.com
  124. 124. Bracket in/out www.indiandentalacademy.com
  125. 125. The MBT system www.indiandentalacademy.com
  126. 126. Bracket type  Range of brackets - Standard size metal brackets. - Mid-size metal brackets. -Esthetic brackets.  Improved i.d system Laser numbering of standard size metal brackets.  Rhomboidal shape Reduces bulk and assists accuracy of bracket placement. www.indiandentalacademy.com
  127. 127.  Drawing of original SWA bracket.  Dots (upper) and dashes (lower) were used for i.d purposes. www.indiandentalacademy.com
  128. 128.  Drawing of MBT brackets.  Standard size brackets have a rhomboidal form and numerical i.d.system. www.indiandentalacademy.com
  129. 129.  Lower premolar bracket may be offset on specially designed bases,to increase bond strength and reduce the risk of bond failure. www.indiandentalacademy.com
  130. 130.  Tapered bracket bases on lower incisors can help in plaque control in this difficult area. www.indiandentalacademy.com
  131. 131. The MBT prescription Disadvantages of additional anterior tip  Significant drain on A/P anchorage.  Increased the tendency to bite deepening during alignment stage.  Brought upper canine root apex too close to the first premolar root in some cases. www.indiandentalacademy.com
  132. 132. TIP SPECIFICATION ANTERIOR TIP Reduced anterior tip was incorporated into the appliance to conform to Andrews original research, and to dramatically reduce the anchorage needs of each case. www.indiandentalacademy.com
  133. 133. Incisor Tip Cuspid Tip Upper Central Upper Lateral Lower Central Lower Lateral Upper Lower MBT Versatile+ 4.0 8.0 0 0 8.0 3.0 Original SWA3 5.0 9.0 2.0 2.0 11.0 5.0 www.indiandentalacademy.com
  134. 134. Bicuspid Tip Molar Tip Upper First Upper Second Upper First Upper Second MBT Versatile+ 0 0 0 0 Original SWA 2.0 2.0 5.0 5.0 www.indiandentalacademy.com
  135. 135. Lower Bicuspid Tip Lower Molar Tip Lower First Lower Second Lower First Lower Second MBT Versatile+ 2.0 2.0 0 0 Original SWA 2.0 2.0 2.0 2.0 www.indiandentalacademy.com
  136. 136. TORQUE SPECIFICATION INCISOR TORQUE •Upper incisor brackets are provided with additional palatal root torque; while lower incisor brackets are provided with additional labial root torque. •This adjustment aids in the correction of the most common torque problems occurring in the incisor areas. www.indiandentalacademy.com
  137. 137. Upper central incisor torque  Increased palatal root torque for upper centrals. www.indiandentalacademy.com
  138. 138. Upper lateral incisor torque  Increased palatal root torque for upper lateral incisors. www.indiandentalacademy.com
  139. 139. Lower incisor torque  Increased labial root torque for lower incisors. www.indiandentalacademy.com
  140. 140. Incisor Torque Incisor Torque Upper Central Upper Lateral Lower Central Lower Lateral MBT Versatile+ 17.0 10.0 -6.0 -6.0 Original SWA 7.0 3.0 -1.0 -1.0 www.indiandentalacademy.com
  141. 141. UPPER CUSPID ,BICUSPID AND MOLAR TORQUE. •Upper cuspid and bicuspid brackets are provided with the normal -70 of torque. •Upper molar brackets are provided with an additional 50 of buccal root torque (-90 to -140 ) to reduce palatal cusp interferences with these teeth. www.indiandentalacademy.com
  142. 142.  Upper canine torque.  Available in –70 ,00 , +70 , torque.  The 00 and +70 options are for cases with narrow maxillary bone form andor prominent canine roots,and are often used with archwires in the tapered form. www.indiandentalacademy.com
  143. 143. Upper torque considerations There was a tendency for upper first molar palatal cusps to extrude. A bracket with – 140 of buccal torque gives extra control. www.indiandentalacademy.com
  144. 144. Upper Cuspid, Bicuspid and Molar Torque Upper Cuspids Upper 1st Bicuspid s Upper 2nd Bicuspids Upper 1st Molars Upper 2nd Molars MBT Versatile+ -7.0 -7.0 -7.0 -14.0 -14.0 Original SWA -7.0 -7.0 -7.0 -9.0 -9.0 www.indiandentalacademy.com
  145. 145. LOWER CUSPID,BICUSPID AND MOLAR TORQUE. •Progressive buccal crown torque is provided in the brackets of the lower posterior segments. •This allows for buccal uprighting of these teeth,which is beneficial in most cases. www.indiandentalacademy.com
  146. 146.  Lower canine torque available in –60 ,00 ,+60 ,  The 00 and +60 options are for cases with narrow mandibular bone form or prominent canine roots,or deep bites at start of treatment. www.indiandentalacademy.com
  147. 147. Lower Cuspid, Bicuspid and Molar Torque Lower Cuspids Lower 1st Bicuspid s Lower 2nd Bicuspid s Lower 1st Molars Lower 2nd Molars MBT Versatile+ -6.0 -12.0 -17.0 -20.0 -10.0 Original SWA -11.0 -17.0 -22.0 -30.0 -35.0 www.indiandentalacademy.com
  148. 148. TIP EDGE BRACKET SYSTEM by Dr. Peter C. Kesling (1988). t www.indiandentalacademy.com
  149. 149. www.indiandentalacademy.com
  150. 150. Tip edge bracket Diagonally opposite corner were removed Permits desired crown tipping TIP LIMITING SURFACE FINISHING SURFACE www.indiandentalacademy.com
  151. 151.  (A)Narrow metal tip edge bracket  (B)Twin metal tip edge bracket  (C)Narrow ceramic tip edge bracket www.indiandentalacademy.com
  152. 152. Lingual brackets2 Dr. Kraven Kurz of California in 1982 www.indiandentalacademy.com
  153. 153. Generation 1 * The first Kurz lingual appliance in 1976 has flat maxillary occlusal bite plane from canine to canine * Lower incisor brackets are ½ rounded and these had no hooks on any brackets. www.indiandentalacademy.com
  154. 154. Generation 2 in 1980 * Hooks were added to all canine bracket www.indiandentalacademy.com
  155. 155. Generation 3, 1981. • Hooks were added to premolars brackets. • The first molar had bracket with an internal hook. • Second molar had a terminal sheath without hook but had terminal recess for elastic traction. www.indiandentalacademy.com
  156. 156. Generation 4, 1982-84  Addition of low profile anterior inclined plane on the central and lateral incisor  Bracket hooks are optional based upon individual treatment needs. www.indiandentalacademy.com
  157. 157. Generation 5, 1985-86 • Anterior inclination plane became more pronounced • In the maxillary anterior region the canine also had an inclined plane. • Hooks are optional. www.indiandentalacademy.com
  158. 158. Generation 6, 1987-90 • Inclined plane on maxillary anterior becomes more square in shape. • Hooks of anterior and premolars were elongated hooks are available on all brackets. www.indiandentalacademy.com
  159. 159. Generation at 7, 1990 to present  Maxillary anterior inclined plane is now heart shaped with short hooks.  The lower anterior brackets have larger inclined plane with short hooks.  The premolar brackets were widened mesiodistally and the hooks shortened  The increased width of premolar bracket allows better angulation and rotation control  The molar brackets now came with either a huge cap or a terminal sheath. www.indiandentalacademy.com
  160. 160. Self ligating brackets12,14  Self ligating brackets it is defined as “a bracket which utilizes a permanently installed moveable component to entrap the arch wire”. www.indiandentalacademy.com
  161. 161.  The passive brackets use a rigid, movebale component to entrap the arch wire.  Tooth control is solely determined by the fit between the arch wire and the slot.  The slot becomes a tube and hence tooth control is often compromised when undersized arch wires are used.  Damon SL, EdgeLock www.indiandentalacademy.com
  162. 162. Active self ligating brackets www.indiandentalacademy.com
  163. 163. The first self-ligating bracket, the Russell attachment, was developed by a New York orthodontic pioneer, Dr. Jacob Stolzenberg, in the early 1930s www.indiandentalacademy.com
  164. 164. The Edgelok bracket by Dr. Jim Wildman of Eugene, Oregon(1971) www.indiandentalacademy.com
  165. 165. SPEED BRACKETS  Developed during the 1980s and introduced by Herbert Hanson.  The name is derived from the descriptive term spring-loaded, precision, edge-wise, energy and delivery. www.indiandentalacademy.com
  166. 166. Herbert Hanson (1986): Speed bracket. JCO, 20, No.3, 183-189www.indiandentalacademy.com
  167. 167. www.indiandentalacademy.com
  168. 168. ACTIVA BRACKET Erwin.C. Pletcher www.indiandentalacademy.com
  169. 169. Time bracket by Wolfgang Heiser of Innsbruck, Austria www.indiandentalacademy.com
  170. 170. References 1. William R.Proffit, ‘Contemporary Orthodontics’,Third Edition Year 2004 Elsevier , 2-4,386 – 392 2. T.M. Graber,’Orthodontics Principles and Practice,Third Edition year 1996 ,1 -5 3. Milton b.Asbell,A Brief History Of Orthodontics American Journal of Orthodontics & Dentofacial Orthopedics Year 1990: Volume 98 (2);176 – 189 4. Andrews L.F. (1990): JCO interviews, JCO 24, 493-508 5. Brantley Orthodontic materials scientific and clinical aspects. First edition 143-160 6. Andreas Karamouzos, DDS, Athanasios... Clinical characteristics and properties of ceramic brackets: A comprehensive review Source AJO-DO Volume 1997 Jul (34 - 40) 7. Bordeaux, Moore and Bagby Ceramic bracket base design AJO- DO Volume 1994 Jun (552 - 560) www.indiandentalacademy.com
  171. 171. 8. R. P. Kusy Evaluation of titanium brackets for orthodontic treatment: Part I The passive configuration . AJO-DO Volume 1998 Nov (558 - 572) 9. Keith, Kusy, and Whitley Evaluation of zirconia brackets -AJO- DO Volume 1994 Dec (605 - 614) 10. Bishara and Trulove Different debonding techniques for ceramic AJO-DO Volume 1990 Sep (263 - 273): brackets 11. Samir E. Bishara, Ceramic Brackets:A Clinical Perspective World J Orthod 2003;4:61–66. 12. Graber T, Vanarsdall L. Current Principles and Techniques Mosby publications third edition 314-350 13. Thomas Graber, Swain Orthodontics current principles and techniques Jaypee brothers 572-579 14. Herbert Hanson Speed bracket. JCO, 1986: 20, No.3, 183- 189 15. Tip Edge Othodontics.R Parkhousewww.indiandentalacademy.com
  172. 172. 16. Straight Wire,the Concept & Appliance, Lawrence F Andrews 17. The Alexander Discipline, Contemporary Concepts & Philosophies, R G Alexander. 18. Systemized Orthodontics Treatment Mechanics, Mclaughlin, benett,trevesi. 19. Roth R H The Straight Wire Appliance 17 Years Later, Jco 21,632-642. 20. Treatment Mechanics For The Straight Wire Appliance;Roth R H www.indiandentalacademy.com
  173. 173. www.indiandentalacademy.com
  174. 174. www.indiandentalacademy.com

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