Tip edge technique /certified fixed orthodontic courses by Indian dental academy

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


Contents
• Introduction &Tip-Edge concept - Neelima
• Differential Straight Arch Technique –
Sameer
• s
• Stages of treatment
• Final Finishing
• Conclusion
• References

Introduction
Since the 1900 Angle introduced various
appliances :
• Angle’s E-arch
• Pin and Tube appliance(1910)
• Ribbon arch appliance (1915)
• Edgewise appliance(1925)


Edgewise appliance
•
•
•
•
•
•

Labially facing horizontal slot
3-dimensional control over tooth
Very high forces were used
Anchorage depends on extra oral forces
No provision for closure of posterior spaces
Arch wire slot restricts the anteroposterior
correction of dental arches


Begg appliance
During the early 1930s, P.R Begg reverted to the use
of ribbon arch brackets• Permitted free tipping followed by controlled
uprighting
• Use of round wires
• Use of differential forces(2 oz)
• Demands on anchorage units was reduced
However the vertically facing slot had the following
limitations:
– Hindrance in manipulation
– Reduced mesio-distal control

Straight wire appliance
• 1970s Dr Lawrence Andrews introduced
the Straight Wire “bracket system”
• Concept of Preadjusted applianceTip, torque, in-out compensations for each
tooth was available.


Introduction of the concept of Tip-Edge

• Limitations of conventional Straight Wire
bracket
– Moving teeth apex first generates maximum
anchorage resistance
– Torque control - unwanted reciprocal torque
reaction in adjacent teeth
– Full expression of torque not achieved- “torque
slop” due to play between bracket and arch wire


Tip edge concept
• Peter C Kesling decided to
combine both the techniques
• Modified a straight wire bracket
,to create Tip Edge bracket
• Technique was first introduced
at the Kesling-Rocke
Orthodontic
Centre,Westville,Indiana,USA
in 1986.


• Differential force technique: initial crown
tipping followed by controlled root
uprighting with straight arch wires
(differential tooth movement with straight
arch wires). Therefore it is known as the
“Differential straight arch technique”
Arch wire slot permits initial crown tipping
mesially or distally and faces
horizontally, the slot and bracket are
termed “TipEdge”

Features of tip edge appliance
• Labially facing arch wire slots –improved
manipulation with elastomeric ties
• Light forces(2 oz)
• Reduced strain on anchorage
• With a rectangular slot ,a 3-D control was
afforded
• Slots open and close during treatment for
maximum ease of arch wire change and minimal
discomfort
• Facilitated intrusion of teeth.

Tip edge brackets
Kesling determined that :
• It is necessary for each tooth to tip
either mesially or distally –not both
directions
• All teeth tip distally except those
distal to the extraction sites-which tip
mesially
• Anchor molars should remain upright
throughout Rx.


• Diagonally opposite corner were removed
• Permits desired distal crown
tipping
• Preadjusted in 3 dimensionstip,torque,in & out built in
• Slot size-0.022”x0.028”


Central ridge
Lateral extensions
Uprighting surface

Tipping surface

Profile view

Occlusal view

Design features
• Slot size: 0.022”X0.028”
• Vertical slot: 0.020”x0.020”- to accept
rotating or up righting springs, power pins ,jigs
etc. Both the gingival and incisal ends are
chamfered to facilitate the insertion of
auxiliaries from either direction.
• Lateral extensions- for rotational control
hidden behind the arch wire –which is
esthetic.
• In and out compensation-eliminates the
need for lateral, bicuspid or molar offset
• Torque built in base
• Tip built in face

• Slot permits initial M-D tipping ,this prevents
bowing of arch wire during retraction/space
closure and automatically enhances anchorage.
• Uprighting surfaces of the slot determine the
final tip angulations reached with an uprighting
spring. These surfaces can also control torque
if an edgewise arch wire is used.


Dynamic arch wire slot
Tip edge slots become larger as the teeth tip. The
vertical dimension within the slot continuously
increases with each degree of distal tipping,
eliminating binding &facilitates placement of A/W’s of
larger cross sections.


Advantages
• No binding or archwire deflection during
retraction
• Ease of stepping up of archwire size
• No inadvertent mesial or distal root
movement
• Ease of placing rectangular archwires when
third order discrepancies exist between
archwire and slot.
• No need to use NiTi archwires to avoid
discomfort and accidental debonding

Advantages of Tip Edge brackets
• Over conventional edgewise brackets
– Eliminates undesired force couples to promote
rapid bite opening and prevent midline
discrepancies
– Anchorage problems are eliminated as space can
be closed with light forces and minimum wire
deflection. This results in diminished anchorage
demands and increased vertical control.
– Permits free crown tipping followed by controlled
uprighting
– Can reposition teeth and jaws with light forces
and still maintain total control over their final
positions. www.indiandentalacademy.com

Edgewise bracket

Tip-Edge bracket


• Over Begg brackets
– Horizontally facing archwire slots facilitate initial
archwire engagement especially on rotated teeth.
Elastomeric ties provide a cushion or flexibility that
enhances patient comfort and reduces the chances for
bond failure
– In –out compensation eliminate the need for molar (or
other) offsets.
– Slot designs causes automotive shift from tipping to
bodily movement at the predetermined angle and
increase anterior anchorage to encourage mesial
movement of posteriors –
“Programmed Differential Mechanics”
– Labio-lingual root torque from rectangular wires
possible.


• References
• Tip Edge guide and the Differential Straight Arch
Technique. Peter C Kesling
• Orthodontics by Graber Vanarsdall.
• Tip Edge Othodontics.Parkhouse
• Dynamics of the Tip-Edge
bracket.PeterCKesling.AJODO1989;96:16-25
• Treatment with Tip-Edge brackets and Differential
tooth movement.KeslingPC,Rocke
TR,KeslingCK.AJODO1991;99:387-401
• The Tip –Edge Concept:Eliminating Unnecessary
Anchorage Strain.Kesling CK.JCO1992;26:165-178.


Thank you
For more details please visit


Tip edge technique /certified fixed orthodontic courses by Indian dental academy

Recommended

Recommended

More Related Content

Viewers also liked

Viewers also liked (18)

More from Indian dental academy

More from Indian dental academy (20)

Tip edge technique /certified fixed orthodontic courses by Indian dental academy