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EDGEWISE
APPLIANCE
www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

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CONTENTS
►

INTRODUCTION

►

ANGLE’S PHILOSOPHY

►

STANDARD EDGEWISE APPLIANCE

►

EVOLUTION

►

ATTATCHMENTS
BRACKETS
BUCCAL TUBES
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►

BRACKET PLACEMENT

►

BUCCAL TUBE PLACEMENT

►

BRACKET ANGULATION

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DR.EDWARD HARTLEY ANGLE
►

The edgewise arch
mechanism was the brain
child of this master
technician.

►

By the time of
Dr.Tweed,1930,with the
introduction of milled
brackets, S.S ligature
wires it had evolved into a
precision appliance, that
demanded accurate fitting
and placement of bands
and attachments on teeth.

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INTRODUCTION
► The edgewise arch mechanism/appliance was

Dr Angle’s last and greatest contribution to
orthodontics ,after almost a lifetime devoted to
improvement of orthodontic appliances.

► Edgewise mechanism was designed to place

teeth into Angle’s concept of line of occlusion:
“the line with which in form and position
according to type, the teeth must be in harmony
if in normal occlusion.”
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ANGLE’S PHILOSOPHY OF
TREATMENT
►

Based on the then prevalent assumption that, if cuspal
interdigitation of teeth were made normal, stimulation by
function would result in growth of basal bone structures.

►

Little or no thought was given to the inclination of the
mandibular incisor teeth or to normal mesiodistal relation of
teeth and their respective jaw bases and head structures.

►

It was assumed that function would take care of such
matters.

►

Extraction of teeth for orthodontic therapy wasn’t even an
option .
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►

E.H. Angle – Graduation 1878, experienced many
technical problems and frustrations in treatment which
irritated, motivated and inspired him to develop a
standard appliance. His obsession for order motivated
him to create the Angle System (1887)

►

This ultimately resulted in the multi banded edgewise
appliance 5yrs before his death.

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EVOLUTION OF EDGEWISE
APPLIANCE

►
►
►
►

ANGLE E-ARCH
PIN & TUBE (1911)
RIBBON ARCH APPLICANCE (1915)
EDGEWISE APPLIANCE (1925)
EVOLUTION OF EDGEWISE BRACKETS:
1)
2)
3)
4)
5)

SINGLE WIDTH BRACKET
SIAMESE BRACKET
LEWIS BRACKET
STIENER BRACKET
BROUSSARD BRACKET

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EDGEWISE APPLIANCE (1925)

To overcome the deficiencies of his previous appliances,
Angle changed the form of the bracket in the ribbon arch
appliance - He placed the slot in the centre and oriented
the slot from vertical to horizontal and inserted a
rectangular wire rotated 900 to the orientation the wire had
with the ribbon arch bracket
(hence the name edgewise)
► Bracket wide mesio-distally
► Rectangular slot for rectangular archwire
► .022x.028 inch slot size, same size wire
► Archwire inserted in narrowest dimension -EDGEWISE
► brackets were referred to initially as "open face" or "tie
brackets.“
►

►

Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Julwww.indiandentalacademy.com
(26 - 37): Expanding horizons of
edgewise arch wire slot - Kesling
Edgewise appliance

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►

►

►

The high degree of control afforded by the edgewise
bracket provides a sense of security. Each tooth is always
under complete mesiodistal tip control.
Teeth are restricted by the brackets, not only from tipping
independently in undesired directions, but also from tipping
in desired directions.

Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Jul (26 - 37): Expanding horizons of
edgewise arch wire slot - Keslin

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THE STANDARD APPLIANCE
USED BY ANGLE
►

Basic components of
the standard
appliance used by
Angle:

Traction screw,
jack screw,
attachment tubes,
band material
ligature wire,
arch wire,

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► Bands
► Obsolete wingless

bracket
► Washers
► Staples
► Ligature wire

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► Unique feature  rectangular wire

in
rectangular slot  twisting / torquing forces
could be imparted to control the axial inclination
of teeth

► So possible to move teeth in all 3 planes of

space with a single arch wire.

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►

For rectangular wire to move teeth into the “line of occlusion”,
it had to be shaped into normal arch form and given proper
twist or torque for individual teeth.

►

Angle recommended use of smaller diameter round archwires
in the early stages of treatment.

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ATTATCHMENTS
► BRACKETS
► BUCCAL TUBES
► LIGATURE TIE WIRE

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EVOLUTION OF EDGEWISE
BRACKETS
Original bracket –
► soft gold ,
► .022 x .028 inch slot
► Slot was readily deformed by the forces of
occlusion.

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1)Single width brackets :► original bracket .050 inch wide & soldered to the gold band
material
► archwire rests on bottom of bracket slot instead of the band
► ineffective for tooth rotation because of the narrow width
► Angle devised gold eyelets for rotation to be soldered on
bands

►

Source: AJO-DO on CD-ROM (Copyright © 1998 AJO-DO),
Volume 1981 Sep (237 - 255): Why edgewise? - Hocevar
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DISADVANTAGE
►

Repeated tying of the eyelets for rotation.

►

Necessary to continue tying eyelets throughout treatment
to prevent relapse.

►

Tying rotation eyelets is time consuming.

►

Ineffective.

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2)Twin brackets:- two brackets on one base
-“Siamese twin brackets” by
Swain
- space between two brackets
was .050 inch (equal to width
of one bracket )
- Available in different widths:►
Extra wide
►
Standard
►
Intermediate
►
Junior
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Twin brackets

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ADVANTAGE
► ability

to effect tooth rotations without using
auxiliary rotation ties.

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3)Curved base twin bracket:►

curved bases to confirm to the curvatures of the canines &
premolars

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ADVANTAGE
► Offers

a positive control (greater axial
inclination control)

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DISADVANTAGE
► increased

width decreases the inter bracket span
(i.e. length of archwire between brackets), thus
decreasing the resiliency.

► Source:

AJO-DO on CD-ROM (Copyright © 1998
AJO-DO), Volume 1981 Sep (237 - 255): Why
edgewise? - Hoceva
www.indiandentalacademy.com
4)Lewis bracket:► Developed by Lewis in
1950.
► To overcome the problem
of efficient tooth rotation.
► He soldered auxillary
rotation arms that
abutted against the
bracket itself, thus, offered
a lever arm to deflect the
archwire & rotate the tooth.
► One piece bracket with
integral rotation wings

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ADVANTAGE
► These

wings do not interfere with
occlusogingival deflections of archwire & do
not decrease the interbracket span
► 100% of the desired tooth rotation is
possible.

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5)Curved base Lewis bracket:► Curved base confirms to the canine, premolar surface
► Types:- Long
Short

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ADVANTAGE
► Wings

lie close to the tooth throughout their
length ,so less trapping of food
► Increases the surface area

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6)Vertical slot Lewis bracket :►
►

Incorporation of .020 x .020 inch vertical slot
Possible to use uprighting spring to correct axial
inclinations if needed

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ADVANTAGE
1) complete rotational control
2) do not reduce the interbracket span

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7) Steiner bracket :►
►
►

Given by Cecil C Steiner in 1931
Incorporated flexible rotation arms & so did not rely
on the resiliency of the archwire for tooth rotation
Introduced tie wings for ease of ligation

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ADVANTAGE
► Easy to tie
► Quite efficient for tooth rotation

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DISADVANTAGE
► Once permanent deformation of the arms has

occurred, complete rotation will not be effective
unless the arms are adjusted to their original
positions.

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8)Broussard bracket:►
►

Designed by Garford Broussard for use in the Broussard
technique
Addition of a 0.0185 x 0.046 inch vertical slot to accept a
doubled 0.018 inch auxillary wire

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EVOLUTION OF EDGEWISE
BUCCAL TUBE
►
►
►
►

1)Original buccal tube was a piece of .022x .028 inch
gold or nickel silver tubing soldered to the molar band
Length –3/16 or ¼ inch
Buccal tube is for the insertion and stabilisation of the
archwire.
Notched distal ends - to facilitate a tie back ligature

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Hook – gingival to buccal tubes, soldered on the
bands for placement of elastics

Inconel tube - gold buccal tubes were discarded
- is preattatched to the curved and
contoured welding flange.
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2)Combination buccal tubes
► Incorporates a round tube for insertion of a face bow
► Posses sufficient rigidity to resist deformation from the
forces of occlusion.
► Fairly close tolerances must be maintained between
archwire & tube for effective transmission of torque to the
tooth

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3)Triple buccal tube
► additional rectangular tube for auxillary sectional & base
archwire

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LIGATURE TIE WIRE
► Used to attatch archwire to the bracket.
► Dead soft .009 or .010 inch stainless steel ligature

wire is used.

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BRACKET & TUBE
PLACEMENT
►

Angle - “goal of correct bracket & tube placement is
to produce an ideal occlusion at the end of treatment
with flat, straight, ideal archwires

►

Brackets were soldered to band strips with the slot
parallel to the band strip.

►

General rule was to place band strip with the
brackets parallel to the long axis of the teeth.

www.indiandentalacademy.com
►

Posterior brackets were angulated to produce desired
tooth movements

www.indiandentalacademy.com
►

Holdaway (1952) described three uses for bracket angulation
a) as an aid in paralleling roots adjacent to extraction spaces
b) as a method of setting up posterior anchorage units into tipped back
or anchorage prepared positions
c) as a means of obtaining correct axial inclinations or artistic
positioning

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REFERENCES


Orthodontics Current Principles and Techniques
- Thomas Graber , Robert Vanarsdall



Contemporary Orthodontics - William R. Proffit



Orthodontics Principles and Practice T.M.Graber

www.indiandentalacademy.com
REFERENCES
►

Orthodontics Current Principles and Techniques –
Thomas Graber , Brainerd F. Swain.

►

AJO-DO on CD-ROM (Copyright © 1998 AJO-DO),
Volume 1981 Sep (237 - 255): Why edgewise? - Hoceva

►

AJO-DO on CD-ROM (Copyright © 1998 AJO-DO),
Volume 1988 Jul (26 - 37): Expanding horizons of
edgewise arch wire slot - Keslin

www.indiandentalacademy.com
www.indiandentalacademy.com
Leader in continuing dental education

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Edge wise appliance /certified fixed orthodontic courses by Indian dental academy

  • 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 3. CONTENTS ► INTRODUCTION ► ANGLE’S PHILOSOPHY ► STANDARD EDGEWISE APPLIANCE ► EVOLUTION ► ATTATCHMENTS BRACKETS BUCCAL TUBES www.indiandentalacademy.com
  • 4. ► BRACKET PLACEMENT ► BUCCAL TUBE PLACEMENT ► BRACKET ANGULATION www.indiandentalacademy.com
  • 5. DR.EDWARD HARTLEY ANGLE ► The edgewise arch mechanism was the brain child of this master technician. ► By the time of Dr.Tweed,1930,with the introduction of milled brackets, S.S ligature wires it had evolved into a precision appliance, that demanded accurate fitting and placement of bands and attachments on teeth. www.indiandentalacademy.com
  • 6. INTRODUCTION ► The edgewise arch mechanism/appliance was Dr Angle’s last and greatest contribution to orthodontics ,after almost a lifetime devoted to improvement of orthodontic appliances. ► Edgewise mechanism was designed to place teeth into Angle’s concept of line of occlusion: “the line with which in form and position according to type, the teeth must be in harmony if in normal occlusion.” www.indiandentalacademy.com
  • 7. ANGLE’S PHILOSOPHY OF TREATMENT ► Based on the then prevalent assumption that, if cuspal interdigitation of teeth were made normal, stimulation by function would result in growth of basal bone structures. ► Little or no thought was given to the inclination of the mandibular incisor teeth or to normal mesiodistal relation of teeth and their respective jaw bases and head structures. ► It was assumed that function would take care of such matters. ► Extraction of teeth for orthodontic therapy wasn’t even an option . www.indiandentalacademy.com
  • 8. ► E.H. Angle – Graduation 1878, experienced many technical problems and frustrations in treatment which irritated, motivated and inspired him to develop a standard appliance. His obsession for order motivated him to create the Angle System (1887) ► This ultimately resulted in the multi banded edgewise appliance 5yrs before his death. www.indiandentalacademy.com
  • 9. EVOLUTION OF EDGEWISE APPLIANCE  ► ► ► ► ANGLE E-ARCH PIN & TUBE (1911) RIBBON ARCH APPLICANCE (1915) EDGEWISE APPLIANCE (1925) EVOLUTION OF EDGEWISE BRACKETS: 1) 2) 3) 4) 5) SINGLE WIDTH BRACKET SIAMESE BRACKET LEWIS BRACKET STIENER BRACKET BROUSSARD BRACKET www.indiandentalacademy.com
  • 10. EDGEWISE APPLIANCE (1925) To overcome the deficiencies of his previous appliances, Angle changed the form of the bracket in the ribbon arch appliance - He placed the slot in the centre and oriented the slot from vertical to horizontal and inserted a rectangular wire rotated 900 to the orientation the wire had with the ribbon arch bracket (hence the name edgewise) ► Bracket wide mesio-distally ► Rectangular slot for rectangular archwire ► .022x.028 inch slot size, same size wire ► Archwire inserted in narrowest dimension -EDGEWISE ► brackets were referred to initially as "open face" or "tie brackets.“ ► ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Julwww.indiandentalacademy.com (26 - 37): Expanding horizons of edgewise arch wire slot - Kesling
  • 12. ► ► ► The high degree of control afforded by the edgewise bracket provides a sense of security. Each tooth is always under complete mesiodistal tip control. Teeth are restricted by the brackets, not only from tipping independently in undesired directions, but also from tipping in desired directions. Source: AJO-DO on CD-ROM (Copyright © 1998 AJODO), Volume 1988 Jul (26 - 37): Expanding horizons of edgewise arch wire slot - Keslin www.indiandentalacademy.com
  • 13. THE STANDARD APPLIANCE USED BY ANGLE ► Basic components of the standard appliance used by Angle: Traction screw, jack screw, attachment tubes, band material ligature wire, arch wire, www.indiandentalacademy.com
  • 14. ► Bands ► Obsolete wingless bracket ► Washers ► Staples ► Ligature wire www.indiandentalacademy.com
  • 15. ► Unique feature  rectangular wire in rectangular slot  twisting / torquing forces could be imparted to control the axial inclination of teeth ► So possible to move teeth in all 3 planes of space with a single arch wire. www.indiandentalacademy.com
  • 16. ► For rectangular wire to move teeth into the “line of occlusion”, it had to be shaped into normal arch form and given proper twist or torque for individual teeth. ► Angle recommended use of smaller diameter round archwires in the early stages of treatment. www.indiandentalacademy.com
  • 17. ATTATCHMENTS ► BRACKETS ► BUCCAL TUBES ► LIGATURE TIE WIRE www.indiandentalacademy.com
  • 18. EVOLUTION OF EDGEWISE BRACKETS Original bracket – ► soft gold , ► .022 x .028 inch slot ► Slot was readily deformed by the forces of occlusion. www.indiandentalacademy.com
  • 19. 1)Single width brackets :► original bracket .050 inch wide & soldered to the gold band material ► archwire rests on bottom of bracket slot instead of the band ► ineffective for tooth rotation because of the narrow width ► Angle devised gold eyelets for rotation to be soldered on bands ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hocevar www.indiandentalacademy.com
  • 20. DISADVANTAGE ► Repeated tying of the eyelets for rotation. ► Necessary to continue tying eyelets throughout treatment to prevent relapse. ► Tying rotation eyelets is time consuming. ► Ineffective. www.indiandentalacademy.com
  • 21. 2)Twin brackets:- two brackets on one base -“Siamese twin brackets” by Swain - space between two brackets was .050 inch (equal to width of one bracket ) - Available in different widths:► Extra wide ► Standard ► Intermediate ► Junior www.indiandentalacademy.com
  • 23. ADVANTAGE ► ability to effect tooth rotations without using auxiliary rotation ties. www.indiandentalacademy.com
  • 24. 3)Curved base twin bracket:► curved bases to confirm to the curvatures of the canines & premolars www.indiandentalacademy.com
  • 25. ADVANTAGE ► Offers a positive control (greater axial inclination control) www.indiandentalacademy.com
  • 26. DISADVANTAGE ► increased width decreases the inter bracket span (i.e. length of archwire between brackets), thus decreasing the resiliency. ► Source: AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hoceva www.indiandentalacademy.com
  • 27. 4)Lewis bracket:► Developed by Lewis in 1950. ► To overcome the problem of efficient tooth rotation. ► He soldered auxillary rotation arms that abutted against the bracket itself, thus, offered a lever arm to deflect the archwire & rotate the tooth. ► One piece bracket with integral rotation wings www.indiandentalacademy.com
  • 28. ADVANTAGE ► These wings do not interfere with occlusogingival deflections of archwire & do not decrease the interbracket span ► 100% of the desired tooth rotation is possible. www.indiandentalacademy.com
  • 29. 5)Curved base Lewis bracket:► Curved base confirms to the canine, premolar surface ► Types:- Long Short www.indiandentalacademy.com
  • 30. ADVANTAGE ► Wings lie close to the tooth throughout their length ,so less trapping of food ► Increases the surface area www.indiandentalacademy.com
  • 31. 6)Vertical slot Lewis bracket :► ► Incorporation of .020 x .020 inch vertical slot Possible to use uprighting spring to correct axial inclinations if needed www.indiandentalacademy.com
  • 32. ADVANTAGE 1) complete rotational control 2) do not reduce the interbracket span www.indiandentalacademy.com
  • 33. 7) Steiner bracket :► ► ► Given by Cecil C Steiner in 1931 Incorporated flexible rotation arms & so did not rely on the resiliency of the archwire for tooth rotation Introduced tie wings for ease of ligation www.indiandentalacademy.com
  • 34. ADVANTAGE ► Easy to tie ► Quite efficient for tooth rotation www.indiandentalacademy.com
  • 35. DISADVANTAGE ► Once permanent deformation of the arms has occurred, complete rotation will not be effective unless the arms are adjusted to their original positions. www.indiandentalacademy.com
  • 36. 8)Broussard bracket:► ► Designed by Garford Broussard for use in the Broussard technique Addition of a 0.0185 x 0.046 inch vertical slot to accept a doubled 0.018 inch auxillary wire www.indiandentalacademy.com
  • 37. EVOLUTION OF EDGEWISE BUCCAL TUBE ► ► ► ► 1)Original buccal tube was a piece of .022x .028 inch gold or nickel silver tubing soldered to the molar band Length –3/16 or ¼ inch Buccal tube is for the insertion and stabilisation of the archwire. Notched distal ends - to facilitate a tie back ligature www.indiandentalacademy.com
  • 38. Hook – gingival to buccal tubes, soldered on the bands for placement of elastics Inconel tube - gold buccal tubes were discarded - is preattatched to the curved and contoured welding flange. www.indiandentalacademy.com
  • 39. 2)Combination buccal tubes ► Incorporates a round tube for insertion of a face bow ► Posses sufficient rigidity to resist deformation from the forces of occlusion. ► Fairly close tolerances must be maintained between archwire & tube for effective transmission of torque to the tooth www.indiandentalacademy.com
  • 40. 3)Triple buccal tube ► additional rectangular tube for auxillary sectional & base archwire www.indiandentalacademy.com
  • 41. LIGATURE TIE WIRE ► Used to attatch archwire to the bracket. ► Dead soft .009 or .010 inch stainless steel ligature wire is used. www.indiandentalacademy.com
  • 42. BRACKET & TUBE PLACEMENT ► Angle - “goal of correct bracket & tube placement is to produce an ideal occlusion at the end of treatment with flat, straight, ideal archwires ► Brackets were soldered to band strips with the slot parallel to the band strip. ► General rule was to place band strip with the brackets parallel to the long axis of the teeth. www.indiandentalacademy.com
  • 43. ► Posterior brackets were angulated to produce desired tooth movements www.indiandentalacademy.com
  • 44. ► Holdaway (1952) described three uses for bracket angulation a) as an aid in paralleling roots adjacent to extraction spaces b) as a method of setting up posterior anchorage units into tipped back or anchorage prepared positions c) as a means of obtaining correct axial inclinations or artistic positioning www.indiandentalacademy.com
  • 45. REFERENCES  Orthodontics Current Principles and Techniques - Thomas Graber , Robert Vanarsdall  Contemporary Orthodontics - William R. Proffit  Orthodontics Principles and Practice T.M.Graber www.indiandentalacademy.com
  • 46. REFERENCES ► Orthodontics Current Principles and Techniques – Thomas Graber , Brainerd F. Swain. ► AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise? - Hoceva ► AJO-DO on CD-ROM (Copyright © 1998 AJO-DO), Volume 1988 Jul (26 - 37): Expanding horizons of edgewise arch wire slot - Keslin www.indiandentalacademy.com
  • 47. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com