Tip edge /certified fixed orthodontic courses by Indian dental academy

Tip-edge
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


Tip-edge


• It is difficult to imagine that there was a
period in orthodontics before the invention
of the brackets. Yet this was the situation
when Angle developed and perfected
treatment procedures with his ‘E’arch
which expanded the dental arches but
provided no axial tooth control.


• The pin and tube
appliance
introduced by Angle
in 1910,overcame
the weak point in
his E arch---lack of
axial control but
permitted only
limited mesio distal
crown displacement
and difficulty in arch
wire placement.

• These two
shortcomings
were overcame
by development
of the Ribbon
arch appliance
by ingenious
removal of
portion of the
tube and
separation of the
pin from the
arch wire.

• However these appliance also required
frequent soldering to prevent the
mesiodistal tipping.


• A solution to all these
problems was offered
by Angle(1925) in his
latest and best
orthodontic
mechanism which
were referred initially
as ‘‘open face or tie
brackets’’ and
presently referred to
as edgewise
appliance or bracket.

• The high degree of control afforded by the
edgewise bracket provides a sense of
security and each tooth is always under
complete mesio-distal tip control.
• However due to increased control, teeth
are restricted by the brackets ,not only
from tipping independently in undesired
directions, but also from tipping in desired
directions.

• In comparison ,the ribbon arch type brackets
presently used in the Begg technique permit
mesiodistal tipping but are relatively demanding
on the operator. Gingivally facing slots
complicate arch wire placement and the range of
mesiodistal tipping is so great that it must be
continually monitored.
• It seems obvious that an ideal appliance might
combine the best of both while eliminating or at
least minimizing the disadvantages of each.


• Combination brackets were developed
but were not accepted readily by those
familiar with either technique as it was
neither an “Edgewise” nor a “Begg”
bracket. So a solution may lie in a
modification of either the ribbon arch or
edgewise bracket.


• Alexander Sved
in 1937 removed
all mesiodistal
angular control
from the arch
wire slot but the
bracket never
became
popular ,because
it had completely
lost its “edge”.

MODIFICATION OF THE
EDGEWISE MECHANISM

• Expanding the arch wire slot
• Elastomeric ligature for mesiodistal control
• Torquing flaps

• On the basis of desirability of mesial or
distal crown tipping for each tooth and the
apparent advantage of Begg tooth
movement KESLING have developed an
edgewise type bracket with a unique arch
wire slot .(Am.J.Orthod.1988)


• The slot has
diagonally opposed
surfaces that permit
initial crown tipping
which is controlled in
both direction and
degree. Since this
bracket permits
tipping yet also
provides edgewise
control, it was
referred as the Tipedge bracket.

Expanding the arch wire slot
Tip-edge bracket for
maxillary right canine.
Internal components of
the "propellor" slot
include: A and A, crown
tipping control surfaces;
B and B, root uprighting
control surfaces; C,
vertical and torque
control ridges or pivots;
D, rotational control
surface.

Elastomeric ligature for mesiodistal
control
• An unique
elastomeric ligature
was developed for
the tip-edge bracket
that can provide
mesiodistal angular
control and was
referred as tip-edge
ring.

• Stretching the
resilient ring into
place around the
bracket and arch
wire generates the
forces that
continuously act to
tip or to upright the
tooth
mesiodistally.

• These forces are partially
created by lingually facing
projections (B) on the
lingual surface of the ring
that are wedged between
the arch wire and the
bracket.
• A crossbar (A) in the center
of the ring affords additional
power and prevents it from
twisting during the
placement.

• It also facilitates orientation during
placement to ensure desired results and
is possible to influence or maintain either
crown tipping or root uprighting according
to ring’s orientation to the bracket and
arch wire.


Torquing flaps

• To facilitate the
retraction of anterior
teeth or mesial
movement of the
anchor molars
depending on needs
of each case, it is
necessary to permit
the free sliding of the
arch wire through
relatively larger molar
tubes (safety valves)
but buccolingual
torque control is lost.


• So Kesling developed
torquing flaps that can
be bent 90 degree to
cover the mesial ends
of 0.036 inch round
molar tubes.
• These flaps eliminates
the need for double
tubes and permit the
use of straight arch
wire (round or
rectangular) and
automatically provide
predetermined
buccolingual torque
control.

The generous sized vertical slots in Tip –
Edge brackets make possible the use of
many auxiliaries throughout treatment.

•
•
•
•

These auxiliaries are
Power pins
Rotating springs
Side winder springs

• Power pins are
means to accept
elastomerics or
rotating springs for
rapid, physiological
rotation.
• These can be
inserted into the
vertical slot from the
incisal or gingival on
any bracket at any
time.


Rotating springs
• Rotations are
corrected using
rotating springs
inserted through
the vertical slots of
the brackets.
• These are over
corrected
whenever possible
and held in these
positions
throughout
treatment

Mesio –distal uprighting springs
• They are available in
both standard and side
winder versions and are
made of .014 inch
Australian wire

• Side winder
Uprighting springs

are mesial or distal
uprighting springs with
power coils that are
concentric with the
desired axis of root
uprighting.

• With the Side-Winder, the
center of the power coil is
concentric with the center
of the bracket (the
desired axis of uprighting)
and the resulting force
vectors are vertical at the
contact points with
adjacent teeth.
• This would seem to
maximize the desired
distal root positioning and
minimize mesial
displacement of the
crown.

• However, when the
center of the power
coil is gingival to the
desired axis (standard
uprighting spring), the
vectors of force at the
level of the arch wire
would tend to move
the crown mesially to
open space distally
and/or apply undue
pressure to the lateral
incisor

• Side winder springs have several
advantages over standard springs
• Improve both esthetics and hygiene.
• Offer a choice of insertion from either
the occlusal or gingival aspect
• Appear to be more efficient than
standard springs.

Concept and function of tip-edge
• The tip-edge concept is to provide an edgewise
type bracket that is familiar to all orthodontists
can be used to treat all the malocclusions
through differential tooth movement.
• This is accomplished by maintaining everything
that is positively associated with an edgewise
bracket ,especially the labially facing arch wire
slot and tie wings, while removing the one thing
that prevents mesiodistal crown tipping—
diagonally opposed corners of the slot itself.

Inter-bracket distance
• The forces delivered to the teeth from arch wire
is inversely proportional to the distance between
the brackets –inter bracket distance. in other
words , wider the brackets shorter the distance,
greater the force.
• To eliminate this problem the orthodontists have
recently elected to use undersize or super
elastic NiTi wire which makes the tip and torque
control impractical for use.

• The tip edge arch wire slot completely
eliminates problems caused by
interbracket distances.
• Initially when using round arch wires the
cut corners of the slot prevent binding
from tipped teeth. as treatment progresses
and crown are tipped toward their final
position in the dental arch slot size have
increased. which permits passive
engagement of full size rectangular wire
with zero flexing

• each tooth will have
either one point or no
contact with the arch
wire. therefore
interbracket distance
is in effect from molar
tube to molar tube—
100%
• Because of 100%
inter tube distance the
molars are the only
teeth that feel the
corrective torque
forces which are
extremely light and
more than
appropriate.

Bite-opening
• Most malocclusions require bite
opening ,which involves the intrusion of
incisor teeth. If each tooth is free to intrude
along its own path of least resistance,
desired bite opening can accomplished
relatively rapidly and with the lightest of
the force—approx. 5 gram per tooth.


• Conventional edgewise slots prevents this
free root movement and when teeth are
tipped mesially or distally , can even
cause lateral movements of the roots to
further complicate the intrusion.


• Tip-edge arch wire slot with their one point
contacts with the arch wire prevent the
creation of such lateral pressure on the
root surface and permit the root to intrude
in unhindered fashion.


• Because of one point contact it is possible
to open the deepest of anterior bites
without the need of extra oral forces.
• The principles of differential forces and
mechanics are applied through high
tensile ,steel arch wire, light inter maxillary
elastics and to some extent, the force of
mastication.
• Intrusive forces are generated from
properly bent 0.016 inch high tensile
stainless steel arch wire.

•The amount of force
applied to the anterior
teeth is directly related
to the passive
distance (25mm)
between the arch wire
and the anterior
bracket slots which is
determined by the
degree of bite opening
bends in the arch wire
mesial to anchor molar
tubes and mesial
inclination of the
molars themselves.

• Bicuspids are never engaged until the bite
is open, so that all intrusive forces will be
concentrated on cuspids and incisors.
• The key to desired bite opening lies in the
continual use of light (2oz) elastics and the
highest tensile,0.016 inch arch wire with
proper bite opening bends.


• A 25 mm
displacement
results in a
approx.1.5oz(42g
m) of depressive
force on the six
anterior teeth
when the wire is
engaged into the
brackets.

•Two class II elastics
(2oz each) pull the
max. arch wire
halfway toward the
anterior the brackets.
the 12-13 mm of
travel remaining to
the bracket slots
generates approx.1
oz(28gm) of
depression.


Variable arch wire slot
• tip-edge bracket slots are designed to permit
crown tipping in one direction but they also, in
effect, become larger as the teeth tip.
• Of course, the slot do not physically change, but
their interior geometry is such that, relative to
the plane of the straight wire, the vertical
dimension within the slot continuously increases
with each degree of distal crown tipping


• The effective vertical
dimension of the tipedge bracket slot
increases as the
tooth tips. this
eliminates binding
and facilitates
placement of arch
wires with larger
cross sections and
/or third order
(torque) discrepancy.

advantages
• No binding
• Ease of stepping up in arch wire size
• No unwanted mesial or distal root
movement
• No need to use nickel titanium or memory
wires to avoid discomfort and /or
accidental debonding in case of edgewise
brackets.

Retraction and space closure
without loss of vertical control


• With the conventional
edgewise brackets
retraction of anterior
teeth especially canines
results in binding and
friction with only a few
degree of distal crown
tipping
• Continued retraction and
tipping can result in
incisal deflection of the
arch wire itself which
may extrude the lateral
and central incisors and
lead to deepening of the
bite and more gingival
display..

• Retraction with
dynamic tipedge brackets
slots result in
zero binding at
the same
degree of
tipping and
continued
retraction and
tipping occurs
without any
flexing of the
wire.

Differential anchorage
• The problem of anchorage preservation remains
universal regardless of the orthodontic technique
used.
• Simple anchorage is provided by the teeth that
are free to tip in response to force application;
stationary anchorage occurs with teeth that can
move only bodily.
• Differential anchorage is the strategic application
of stationary anchorage units against simple
anchorage units.

• Although the lack of
mesiodistal control with
Angle’s ribbon arch
bracket was considered
a drawback by many
including Angle himself,
the freedom of the tooth
to tip actually improved
anchorage control by
pitting simple against the
stationary anchorage.
Unfortunately, there were
no efficient means to
upright the tipped teeth
at that time.


• The edgewise bracket
eliminated the simple
anchorage potential of
the anterior teeth.
• Tweed and others
applied differential
anchorage concept with
the edgewise appliance
by using a series of arch
wire with tip-back bends
in buccal segments there
by enhancing anterior
retraction as well as
anchorage preservation.

Straight wire mechanics
“TOE HOLD” EFFECT


• In preangulated appliance
,the anterior segment
shows reverse anchorage
effect due to decrease in
efficiency of bodily tooth
repositioning.
• It happens because the
tooth has to move in their
final axial inclinations which
is determined by tip and
torque already incorporated
in the brackets.
• This effect increases the
anchorage potential of the
anterior segment.-- “toe
hold effect”

• Regardless of the
bracket used , the
natural tendency of the
teeth in response to
horizontal forces is to
tip.
• With edgewise
brackets , this tipping
creates couples that
deflect the anterior
portion of the archwire
incisally. The
deflection is even
greater with
straightwire appliances
because of their
preangulated cuspid
and pretorqued incisor
bracket slots (toe hold
effect).

• In extraction treatment, this
arch wire deflection results in
a reverse curve of spee in
the upper arch and an
accentuated curve of spee
in the lower arch, which
restricts the ability to open a
deep anterior overbite
without extra-oral forces.
• The same adverse vertical
deflection occurs, although to
a lesser extent , during non
extraction treatment
whenever an attempt is
made to retract either arch.


• Attempting to control the vertical deflection
of the arch wire can make treatment overly
complex, requiring functional appliance,
multiple arch wires, headgears, and /or
orthognathic surgery.


• The differential straight arch technique (DSAT)
(Kesling Am.J.Orthod.1988) eliminates the complex
mechanics of conventional techniques and offer
these advantages:• Uses only 4 straight round wire or 6 if rectangular
arch wires are used in finishing stages.
• Less need for functional appliances, extra-oral
forces, or orthognathic surgery.
• Shorter treatment time
• Maximum inter-bracket distance

• This is made possible by the tip-edge
bracket’s arch-wire slot, which allows
crown tipping only in one predetermined
direction.
• The system uses differential anchorage
for major tooth movements, reserving the
straightwire concept for final finishing only.


• In non-extraction
class II treatment, the
tip-edge bracket’s
unidirectional
limitation of tooth
movement inhibits
mesial movement of
the mandibular
dentition.
• However the crowns
of the max. teeth can
simultaneously tip
distally toward a class
I occlusion.

Stages in differential straight arch
technique


• Treatment is divided into 3 stages

STAGE I

STAGE II

STAGE III

Each stage features a distinct set of treatment goals that
must be achieved before moving on to the next .
Specific arch wires and auxiliaries are employed during each
stage.
Mixing the goals or the use of improper arch wire or
auxiliaries can lead to excessive anchorage loss, and
compromised control of the vertical dimension

Stage I
• In contrast to conventional edgewise
techniques, which tend to approach
correction of each aspect of a
malocclusion sequentially, Stage One of
the DSAT initiates treatment by addressing
the correction of all major aspects
simultaneously.
• The goals for stage I each listed in order of
importance are:www.indiandentalacademy.com

• (1)-Open or close the bite to an edge to edge
incisal relationship while correcting any anteroposterior discrepancy.

• (2)-correct anterior crowding, rotations or
spacing.
• (3)-correct posterior cross bite
• Duration of stage 1-- -6 weeks to six months,
depending upon the malocclusion.

Correcting Anterior Overbite:
Correction of anterior deep bite allows full expression
of any potential mandibular growth in correction of a
Class II malocclusion.
 Stage one arch wires are formed from 0.016” high
tensile stainless steel wire.
 In extraction treatment, arch wires are generally
straight ( no vertical loops) with bite opening bends
placed several millimeters mesial to the molar tube.
This allows distal sliding of the arch wire as retraction of
anterior teeth occurs.



• During non extraction treatment some means
must be provided to preserve space for the
premolars, which are not engaged until after
anterior overbite correction.
• This can be accomplished by placing the plastic
tubings over the arch wires between the canine
bracket and the molar tubes or stop bends
mesial to the molar tube.


• When anterior open bite or edge to edge
incisal relationship exists at the start of
treatment, the maxillary arch wire is kept
straight.
• Very mild bite opening bends are placed
in mandibular arch (5-10°), serving only to
prevent the molars from tipping mesially in
response to application of Class II elastics
(if overjet correction is required.)

Proper use of Class II elastics (1-2 oz. On
each side) in conjunction with properly
modified high tensile stainless steel wires
will correct severe anterior overbites within
4-6 months of treatment.
precaution: Use of excessive elastic force ,
or use of overly resilient wires may worsen
the deep bite rather than improve it.


• Vertical control is one of the problems
occasionally encountered in Straight wire
treatment.
• Two cases, Helen Taylor (AO 2003 Feb )one
with deep overbite and one with anterior openbite, demonstrate the use of a Tip-Edge stage-1
wire to enhance vertical control in conjunction
with Straight wire brackets and super elastic
main arch wires.``


• With tip edge brackets using a super elastic wire
as the main wire throughout the majority of
treatment, forces are kept light and canine teeth
are able to translate bodily distally with minimum
anchorage loss.
• With the additional control afforded by the
auxiliary wire, no tipping into extraction sites is
seen despite the flexibility of the main arch wire.


Over jet / under jet correction
• Accomplished simultaneously along with anterior vertical
discrepancies through use of either Class II or III elastics
depending on incisor relationships.
• Over jet or under jet in absence of anterior overbite
can be corrected with horizontal (Class I) elastics if
space is available in the arch for retraction.
• Advantages:• Eliminates possibility of molar extrusion.
• Particularly important in high angle or anterior open bite
cases.


• If patient incompliance
is encountered with the
use of class II or class
III elastics, an Outrigger
appliance is placed to
encourage elastic wear.
• This appliance provides
an effective means of
ensuring elastic wear. If
elastics are not worn the
hooks extend labially
into uncomfortable
positions, when elastics
are engaged the hooks
swing incisally into
much comfortable
position.

Force vector of intrusion and
retraction mechanics


• The force vectors
involved in bite
opening and anterior
retraction during
differential tooth
movement in class II
div I malocclusion
have been described
by Hocevar.
• The independent force
vectors produced by
the arch wire and class
II elastics were shown
to combine into a
single resultant vector
that intrudes and
retracts the max.
anterior teeth.

• The precise manner in which these occurs
is dependent on the path of the resultant
vector in relation to the center of
resistance of each tooth


• However while using differential straight
arch technique, there is no need to
predetermine the force vectors or the
individual center of rotation for anterior
teeth.
• Any tendency for max. or mand.flaring is
automatically checked because of bent
given distal to the molar tubes. So any
tendency for incisors crown to flare labially
will be checked by the anchor molar
themselves.

Anterior
Alignment
• When space is
available distal to
the canines, anterior
alignment is
achieved by using
elastomeric ties to
the arch wire
through the vertical
slots of the Tip Edge
brackets.
• The Tip Edge
archwire slot allows
adjacent teeth to
simply tip out of the
way as lingually
displaced teeth are
brought into
position.

• When moderate to severe crowding is
present at start of non extraction
treatment, vertical loops are placed in the
anterior segments of .016 inch arch wires.


Stage II


• Primary goal is the closing of posterior
spaces.
• It is the shortest of the three stages of Tip
Edge treatment, usually completed in 2 to
3 appointments.
• Patient is instructed to wear light (1.5-2
oz) Class II or Class III elastics as needed
to maintain desired anterior tooth
relationships.

• Goals of Stage Two:
1. Close remaining posterior spaces.
2. Correct or maintain dental midlines.
3. Correct posterior cross bites.
4. Achieve Class I molar relation
5. Over rotate severely rotated premolars.
6. Level anchor molars.
7. Maintain all corrections achieved in Stage One.

• Far less arch wire manipulation is required
during stage II because the arch wire
serve only to maintain the vertical and
lateral corrections achieved during stage I.
• To provide maximum control, round arch
wires(o.022inch)high tensile stainless
steel are placed in both max. and mand.
arches.


• In mild to moderate
anchorage cases,
the arch wires are
engaged through
the occlusal
rectangular molar
tubes during Stage
II.
• This levels the
premolars and
molars early ,
easing the transition
to Stage III

•In maximum
anchorage
cases, where
friction within
the molar tube
is of concern,
it is preferred
to insert the
arch wires
through larger
diameter
gingival round
tubes.

Automatic Canine Rotational Control
During Retraction.


• With the Differential
Straight Arch
Technique, no canine
rotation problem
occurs during space
closure.
• This is because
forces are applied not
to the labial surfaces,
but at the contact
point with lateral
incisors, which are
moved distally along
with centrals by the
arch wire.

Stage II breaking mechanics
• Some time abundant space is present in
the mandibular arch, due to cogenital
missing teeth, microdontia or extraction in
border line cases .
• In such cases over retraction of the
anteriors is not desired.


• Application of
mechanical brakes,
(Sidewinder
springs) on
premolars, canines
and incisors, in
conjunction with .
022” round wire or
0.0215x0.028 inch
rectangular wire
turn them into a
larger anchor unit
that can drag the
posterior teeth
forward using
strong horizontal
force(6-8 oz).

Stage III
• Goal:• Upright the roots of all the teeth to ideal
mesio-distal and labiolingual inclinations.
• Maintain all the corrections achieved in the
first two stages.
• It is the longest stage of the treatment.
• Non-extraction case -6 months and
extraction cases-9-12 months

• The same 0.022 inch arch wire used
during stage II or full size 0.0215-0.028
inch rectangular wire are used during this
stage.
• Stage III auxiliaries:--all individual tooth
movement are accomplished using these
auxiliaries.
Side winder
uprighting spring

Torquing auxiliaries

Clock wise
Counterclock
wise

• Torquing of maxillary
incisor roots are done
by nickel titanium
torque bars. These are
curved ribbon arch
sections of 0.022 -0.018
inch dimensions with 30
degree of torque.
• These auxiliaries are
virtually invisible when
in place because they
are present directly
behind the arch wire.

• For use of Torque Bars, special Deep Groove
Brackets are used on the maxillary central
incisors.
• These feature conventional preadjusted
Edgewise arch wire slots cast into the bottom of
Tip Edge arch wire slots.
• A cap fills the Deep Groove in Stages One and
Two. This is removed at beginning of Stage
Three , and a Torque bar ligated tightly lingual to
the round base arch wire

A. Standard Tip-Edge bracket. B. "Deep Groove" version
for maxillary incisors, featuring conventional edgewise
slot that is filled with special cap to keep arch wire in
outer slot during Stages I and II. C. Cap is removed for
Stage III and deep groove used to engage nickel
titanium torquing auxiliary under main arch wire.


• For torquing of individual teeth, an Individual Root
Torquing Auxiliary is used.
• These are often used with Ceramic Tip Edge
brackets, which do not have the Deep groove feature.


• Significant anchorage strain only occurs
during uprighting and torquing.
• However at this point in treatment the
occlusion is class I with no spacing and
ideal overjet and overbite relationships.
• This allows for excellent control of
anchorage with no need for extra oral
reinforcement.


finishing

Rectangular arch wire
approach

Round wire
approach


• Round Wire Approach:
• Reserved for severe A-P skeletal discrepancies,
as they permit maxillary and/or mandibular teeth
to assume compensating labiolingual
inclinations.
• Also used when patient does not need molar
torque or selective labiolingual root positioning
of canines or mandibular incisors.
• In such cases, torque to maxillary incisors could
be provided by Torque bars.

• The relatively heavy forces from uprighting
springs and torquing auxiliaries are applied to
the teeth only after all teeth are in proximal
contact, or contiguous.
When the crowns of teeth are inclined distally,
these reciprocal forces will reinforce anchorage
as the teeth are initially urged distally against the
anchor molars during the early phase of
uprighting.
• Kesling refers to this as Contiguously Reciprocal
Uprighting.

Rectangular arch wire approach
• Their practicality in Stage Three was demonstrated by
Richard Parkhouse.
• Strongest indications are: Generalized and individual
torquing requirements, such as for molars, canines,
mandibular incisors.
• Molar torque is nearly impossible to achieve with round
wire.
• Placement of Sidewinder springs on all other teeth in
conjunction with rectangular wire, automatically torques
them.
• For full torque expression, full size rectangular wires, .
0215 x. 028 ” are used.

Recent advances— tip-edge PLUS
bracket (JCO Feb 2006)
• The traditional procedure for treating class
I crowded cases requires the application
of force to create spaces before a flexible
wire can be inserted for alignment.
• Conventional appliances need extra
ligatures to be used over the main arch
wire however which adds chair time.


• Tip edge PLUS brackets
offers a way to use overlay
mechanics with reduced
friction by combining two
slots -standard tip –edge
slot which can
accommodate a wire as
large as .022 -.028 inch
and a hidden deep tunnel
which accepts wire as
large as .018 inch.
• The space opening and
alignment can be
performed simultaneously
thus reducing the
treatment time.

Use of tip edge PLUS bracket in
class II and class III nonextraction
treatment (JCO July 2006)
• In conventional non extraction treatment, using
elastics for anchorage, it is difficult to maintain
the incisor position. the most common solution in
edgewise mechanics has been to place a full
size arch wire as early in the treatment as
possible which makes the leveling and
alignment difficult.
• Overlay mechanics can efficiently resolve this
problem but it is often unaesthetic.

EFFICIENCY IN BONE DEFECT
CASES (JCO, 1998 Feb )


• Patients with repaired alveolar clefts can
be difficult to treat orthodontically.
• In cleft lip and palate cases with
inadequate grafting, the average 2nd- and
3rd-order bracket prescriptions in
Preadjusted appliances may be
particularly inappropriate.


The Tip-Edge appliance has
several advantages in these
situations
• Selective 2nd-order tipping is possible, and
further control can be gained by “power-tipping”
with auxiliary springs.
• Although a range of tipping movements are
possible, extreme tipping is prevented by the
“self-limiting” bracket prescription.
• The bracket torque prescription can be
circumvented by the use of round wires, or
applied progressively using rectangular wires
and auxiliary springs.

Mesial tipping of maxillary left canine,
with limited alveolar bone mesial to
canine root.

After controlled mesial root uprighting with
Tip-Edge bracket and Side-Winder spring.


conclusion
• By addressing the limitations of edgewise
appliance from a fresh perspective—identifying
the bracket slot as the source of anchorage
problems-the Tip-edge concept produced the
first edgewise appliance to allow the use of
differential tooth movement, without sacrificing
the precise finishing of edgewise therapy.
• Major tooth repositioning and apical base
correction can be accomplished with simplified
mechanics and very light intra oral forces.

• The tip-edge appliance may not be the
most popular appliance today but it has
certainly provided an opportunity to both
Begg and Edgewise practitioners to come
closer, to a common more versatile
appliance system.


• References:---1.Kesling P.C.-:Dynamics of the Tip-Edge
bracket, Am.J.Orthod.
1989.vol.96,page:16-28,
2.Kesling CK. -The Tip Edge concept:
eliminating unnecessary anchorage
strain.J Clin Orthod1992
March;vol.XXXVI.NO.3:Page.165-178.
3.Kaku J, Arimoto H, Sinohara N, Greenfield
R.-- Use of Tip Edge Brackets to reduce
posterior anchorage requirements after
molar distalization.-- J Clin Orthod
2004;38; 320-324.

4.Kesling CK.------A simplified means of
engaging the outrigger appliance-JCO2006
March.vol;XL.NO.3.page.150-151
5.Kim YH.-- Anterior openbite malocclusion:
nature, diagnosis and treatment by means of
multiloop edgewise archwire technique.
Angle Orthod. 1987;vol. 57:page,290–321.
6.Kesling PC, Rocke RT, Kesling CK.-Treatment with Tip-Edge brackets and
differential tooth movement. --Am J Orthod
Dentofacial Orthop. 1991; 99: page.387–
402.

7. Begg PR, Kesling PC. --The differential
force method of orthodontic treatment.
--Am J Orthod. 1977;vol. 71:page.1–39.
8.Greenfield R.--- Simultaneous torquing
and intrusion auxiliary.- J Clin Orthod.
1993; vol.27, page:305–318.
9.TM Graber, RL Vanarsdall Jr--Orthodontics:Current Principles and
techniques.-- 3rd edn, Mosby, 2000.
Page.721-748.

10.Galicia-Ramos, Killiany D, Kesling PC.
--A Comparison of Standard Edgewise,
Preadjusted Edgewise,and Tip-Edge in
Class II Extraction Treatment.-- J Clin
Orthod 2001;35:page.145-53.
11.Helen Taylor ---- Use of a Tip-Edge
Stage-1 Wire to Enhance Vertical
Control During Straight Wire
Treatment: Two Case Reports--The
Angle Orthodontist: 2003 Feb -Vol. 73,
No. 1, page. 93–99.

12.Kesling CK—Differential anchorage and the
edgewise appliance—JCO 1989 June. vol—
XXIII,No.6,page;402-409.
13.ROBBIE LAWSON, --Use of Tip-Edge Brackets
in Patients with Repaired Alveolar Clefts-- JCO,
1998 Feb vol .XXXII ,no.2 page (84 - 88):
14.Praveen Mishra, Ashima Valiathan—Fixed
orthodontic techniques-J Nep Med Assoc.1995
Oct-Dec,VOL.33,PAGE.391-397.


15.John K. Kaku ----Overlay mechanics with
the tip edge PLUS bracket—JCO 2006
Feb ,Vol. page-81-82.
16.Kesling,P.C.:Expanding the horizons of
the edgewise arch wire slot, Am.J.Orthod
1988 July; vol.94;page:26-37
17.Jayne E. Harrison---Early experience
with the tip-edge appliance.—BJO1998
Feb Vol.25,no-1,page-1-9.

18.Lawrence P, Fine H, Cisneros G.-- Canine
retraction: A comparison of two preadjusted
bracket systems. --AJODO
1996August,vol;110,no-2,page: 191-196.
19.Shelton C, Cisneros G, Nelson S.
--Decreased treatment time due to changes in
technique and practice philosophy. --AJO-DO
1994,Dec; vol106,page:654-57.
20.Parkhouse R, Parkhouse P. --The Tip Edge
torquing mechanism: a mathematical
validation.-AJO DO
2001june,vol;119:page.632-639.

21.Rocke RT. Employing Tip-Edge brackets on
canines to simplify straight-wire mechanics.
AJO DO 1994;106:341-50.
22.Jiuxiang Lin et al-- Lower Second Molar
Extraction in Correction of Severe
Skeletal Class III Malocclusion --The Angle
Orthodontist: 2006 Feb ,Vol .76, No. 2,
page. 217–225.
23. John K. Kaku ----Overlay mechanics with
the tip edge PLUS bracket part-2 —JCO
2006 JULY.vol.XL,no.7 page.436-444.

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