Orthodontic appliances

OrthodonticOrthodontic
appliancesappliances
Mahmoud Saleh Mahmoud Fayed

Presented By:
Mahmoud Saleh Fayed

• Any Answer of the following questions should
include the classification of the appliance and
the answer of the question.

Types of appliances according to the
function:

Types of appliances

Advantages of Removable
appliance
1. Small in size.
2. Simple design.
3. Light in weight.
4. Easy to clean.
5. Low cost.
6. More esthetic.
7. No need for special equipment.

disadvantages of Removable
appliance
1. Not effective with uncooperative patient.
2. Treat the minor cases of malocclusion.
3. Allow the simple movements.

Advantages of Fixed
appliance
1. Don’t need to Patient cooperation.
2. Use to treat the complicated cases of
malocclusion.
3. Allow greater range of movement more than
the removable appliance.

Disadvantages of Fixed
appliance
1. More expansive than Removable appliance.
2. Allow accumulation of food around the
appliance.
3. Less esthetic.
4. Need for special equipment.
5. More complicated.
6. Difficult to clean.

The retentive components of any
Removable appliance :
1. Adam’s Clasp.
2. Acrylic Resin framework.
3. Labial Arch.
 they serve in retaining the
appliance in the patient mouth.

Removable appliances
Treatment
appliance
Adam’s Clasp
Labial Arch
Palatal Spring
Acrylic Resin
framework Posterior Bite PlaneMahmoud Saleh Mahmoud Fayed

Identify the appliance and mention its
components and function.
Name : Removable appliances with palatal spring.
Function: treatment of lateral incisor cross bite.
Classification: Active Removable Treatment
appliance.
Components:
1. Adam’s Clasp : use to retention
2. Palatal Spring : active component.
3. Acrylic Resin framework : use to retention
4. Labial Arch : use to retention
5. Posterior Bite Plane : use to separate the teeth from occlusion to
allow the movement of the lateral incisor and we use it asMahmoud Saleh Mahmoud Fayed

• Name: Adam’s Clasp .
• Function: serve in retaining the appliance in
the patient mouth.
• It is only located on the Molars and premolars.
Identify the appliance and its function.

Identify the appliance and mention its
components and function.
• Name: Removable Retainer.
• Function: retaining the teeth in its position.
• Classification: Passive removable Retainer.
• Component: Adam’s Clasp & Labial Arch (loop).
N.B ; Adam’s Clasp: It is only located on the
Molars and premolars. While the Labial Arch on
the anterior teeth.

Q1: Identify the appliance and mention its components
and function.
Q2: mention the type of malocclusion that treated by this
appliance.
• Name: Tongue Guard.
• Classification: removable treatment appliance.
• Components:
1. Adam’s Clasp.
3. Labial Arch.
4. Loops >>> the active component
• Function: it use to prevent the thumb sucking and tongue
thrusting in YoungYoung Patient.

Type of malocclusion:
1. Anterior Open bite.
2. Posterior cross bite.
3. Posterior collapse of maxilla.
4. Flaring of the upper incisors.
5. Retroclination of lower incisors.
6. High palatal vault.
7. Narrow V-shaped Palate.

• Name: Bilateral Expansion screw,
• Function: use to push the posterior teeth away
from each others to treat the collapsed Maxilla
(posterior cross bilateral).
• Component:
1. Adam’s Clasp. “ Passive or retentive component”
2. Acrylic Resin framework. “ Passive or retentive component”
3. Labial Arch. “ Passive or retentive component”
4. Expansion screw. “active component”
• Advantages
1. Small in size.
2. Simple design.
3. Light in weight.
4. Easy to clean.

5. Low cost.
6. More esthetic.
7. No need for special equipment.
 Disadvantages:
1. Not effective with uncooperative patient.
2. Treat the minor cases of malocclusion.
3. Allow the simple movements.
 Classification: Active Removable Treatment
Appliance

Name: Tongue Guard with bilateral
Expansion screw
• Classification: Active Removable treatment
Appliance.
• Component:Component:
 Retentive component:
1. Adam’s Clasp.
3. Labial Arch.
 Active components:
1. Loops.
2. Expansion screw.

• Function: Treatment of malocclusion Related to patient with
Thumb sucking or tongue thrusting which includeinclude:
1. Anterior Open bite.
2. Posterior cross bite.
3. Posterior collapse of maxilla.
4. Flaring of the upper incisors.
5. Retroclination of lower incisors.
6. High palatal vault.
7. Narrow V-shaped Palate.

Lower acrylicLower acrylic cap
Posterior Acrylic Plate.

Name: Mono-Block
• Classification:Classification: Lower Removable functional
Treatment Appliance.
• Function:Function: It use for treatment of Skeletal Class II
due to mandibular deficiency ( SNB ).
• Mode of Action:Mode of Action: Forward Positioning of the
mandible which will stretch the muscles and
accelerate the mandibular Growth.
1.Labial Arch.
2.Acrylic Framework

3. Lower acrylic cap: it is the component that is
responsible for Forward Positioning of the
mandible and it should cover all the labial
surface of the lower anterior teeth to allow
proper distribution of the forces on the teeth
and this prevent the Proclination of Lower
teeth.
4. Posterior Acrylic Plate : in case of Deep biteDeep bite
this acrylic Plate should be relieved to allow
the over-eruption of the posterior teeth, which
will lead to teeth movement elimination of
the anterior Deep bite.

Head
strap
Cervical or Occipital strap
Hook
Outer Bow
Inner
Bow

Name:Name: Head Gear
• ClassificationClassification: Fixed-Removable Active treatment
Appliance.
• Function:Function: It use for treatment of Skeletal Class II
due to maxillary excess ( SNA ), Anchorage and
also treat the anterior bite (deep or Open).
• Types:Types:
High pull:High pull: it allows the intrusion and distalization
of upper 1st
molar so it will treat the anterior
Open bite.

low pull:low pull: it allows the extrusion and distalization of
upper 1st
molar so it will treat the anterior deep bite.
Straight:Straight: used when there is no Open or deep bite to
treat.
• Mode of Action:Mode of Action: It restrict the maxillary growth
in the Young patients ( Orthopedic) or move
the teeth in Older Patient ( Orthodontic).
1. Head strap (high pull) , Cervical or Occipital strap ( low pull).
2. Inner Bow: attached to the orthodontic Band.
3. Outer Bow: attached with hook to the head strap and also
attached to the inner bow.
4. Hook.

Name :Name : Chin Cup
• ClassificationClassification: Removable Active treatment
Appliance.
• Function:Function: It is used for treatment of Skeletal
Class III due to mandibular excess ( SNB).
• Mode of Action:Mode of Action: It restrict the mandibular
growth in the Young patients (Orthopedic).

Name:Name: Face Mask
• ClassificationClassification: Removable Active treatment
Appliance.
• Function:Function: It use for treatment of Skeletal Class III
due to maxillary deficiency ( SNA ).
• Mode of Action:Mode of Action: It accelerate the maxillary
growth in the Young patients (Orthopedic).

Fixed appliancesFixed appliances

Name:Name: Elastic separators
• Classification:Classification: Fixed treatment appliance.
• Function:Function: use to create mesial and distal spaces
between the teeth to allow the proper sitting of
Orthodontic Bands.
• Mode of application:Mode of application: the Separators are stretched
and then pushed gently in the proximal spaces,
then leave it for one weekone week till the space is
created , after that is should be removed to avoid
its depression within the gingival pocket or to be
swallowed by the patient.

Special Pre-cautionSpecial Pre-caution
In case of missing separators , Preiapical
Radiograph should by taken to locate the
missing Separator.

UL 30 Means : Upper Left Size 30
Orthodontic tubes for different sizes of theOrthodontic tubes for different sizes of the
orthodontic wiresorthodontic wires

Name:Name: Orthodontic Bands
• N.B:N.B:
1.It should be precisely fit with the molar which
can be tested by slight resistance on removal.
2.Band usually cemented to the tooth structure by
glass ionomer due to :
 fluoride releasing capacity which will provide
anti-cariogenic effect.
Can easily set in wet condition.

• Disadvantages:
 Low Bonding capacity.
Water soluble
3.The orthodontic band composed of hook which
is directed Disto-gingivalDisto-gingival to allow the proper
application and removal of Orthodontic wires.

Name:Name: Orthodontic Tube
• Cementation:Cementation: flowable resin composite due:
 High Bonding capacity.
Water Insoluble .
• Disadvantages:
NoNo fluoride releasing capacity So provide NoNo
Can’tCan’t be easily bonded in wet condition.

• The orthodontic Tube composed of hook
which is directed Disto-gingivalDisto-gingival to allow the
proper application and removal of
Orthodontic wires.

MeshworkMeshworkColor Code

Name:Name: Orthodontic Bracket
• Cementation:Cementation: flowable resin composite due:
 High Bonding capacity.
Water Insoluble .
• Disadvantages:
NoNo fluoride releasing capacity So provide NoNo
Can’tCan’t be easily bonded in wet condition.

1.1. Color Code:Color Code: use to identify which bracket use with
specific type of teeth & the direction of bracket
application.
2.2. Meshwork :Meshwork : to Increase the surface area of
attachment to the tooth structure and to provide
mechanical interlocking between the composite
attached to the tooth surface and the bracket.
3. Hook: use to identify the direction of bracket
application & to allow the proper application and
removal of Orthodontic wires.

Name:Name: Metallic Orthodontic Bracket
• Advantages:
 High strength.
Low Cost.
High durability.
• Disadvantages:
Poor esthatics.

Name:Name: Esthetic Orthodontic
Bracket• Classification:Classification: Fixed treatment appliance.
• According of the material of construction:According of the material of construction:
1.Plastic.
2.Ceramic..
Plastic:
• Advantages:
More esthetic than metal Brackets.
Low cost relative to ceramic brackets.
Disadvantages: Early Discoloration.

Ceramic:
• Advantages:
1.More esthetic than metal and plastic Brackets.
2.High resistance to Discoloration.
• Disadvantages:
High cost.
Brittle and easy to fracture.
Causing wearing in the opposing teeth.
Difficult to remove without fracture of the
bracket itself.

Name: O-Tie
• Function:Function: it is use to provide attachment of
the orthodontic wire to the brackets.

Trans-palatal Arch
Orthodontic
Band

Name :Name : Trans-Palatal Arch (TPA)
• Classification:Classification: Upper Passive (active if with a loop)
Fixed treatment appliance.
• Function:Function: Anchorage.
1.Orthodontic bands “retentiveretentive “ : glass ionomer
due to :
 fluoride releasing capacity which will provide
Can easily set in wet condition.
2.2.TPA “TPA “ activeactive “:“: it is the component responsible
for Anchorage.

Trans-palatal Arch
Orthodontic Band
Acrylic Button or Plate

Name: Nance Holding Arch
• Classification:Classification: Upper Passive Fixed treatment
appliance.
1. Orthodontic bands : Retentive.Retentive.
2. Acrylic Button or Plate
3. Trans-palatal Arch
Complication Of Acrylic Button :Complication Of Acrylic Button :
Food Accumulation.
Inflammation.
Ulceration. Mahmoud Saleh Mahmoud Fayed

Mini Screw

Name:Name: Mini Screw.
• Classification:Classification: Passive Fixed treatment appliance.
• Site Of Action :Site Of Action : it may be used for both Upper
and lower anchorage.
• Application:Application: the surface of the attached Gingiva
is Anesthetized , then the Appliance Screwed
into the periostium.

Orthodontic Band
Lingual Arch

Lingual Arch
Orthodontic Band
Loop

Name:Name: Lingual Arch
• Classification:Classification: Passive (active if with a loop) Fixed
treatment appliance.
1.Orthodontic bands : Retentive.Retentive.
2.Lingual Arch.
• Site Of Action :Site Of Action : it may be use for lower
anchorage

Orthodontic Band
Loop

Name:Name: Space Maintainer
• Classification:Classification: Passive Fixed Retention
appliance.
• Function:Function: MaintainMaintain the space between the
teeth and prevent the crowding to allow the
Eruption of the permanent tooth.
1.Orthodontic Band.
2.Loop.

Orthodontic BandLoop
Spring

Name:Name: Space Regainer.
• Classification:Classification: Active Fixed Treatment
appliance.
• Function:Function: RegainRegain the space between the
drifted teeth to allow the Eruption of the
permanent successor of the early lost
deciduous tooth.
1.Orthodontic Band.
2.Loop.
3.Spring. Mahmoud Saleh Mahmoud Fayed

Name: Orthodontic Wire
• Classification: according to the metal :Classification: according to the metal :
 NiTi Wire :NiTi Wire :
1.1. HasHas a property called “shape Memory”
2. when it binds it tend to regainregain its Normal form
again.
3.It is usually used in the beginningbeginning of the
Treatment to Move the teeth in predetermined
direction.
So it is considered as Active Fixed Treatment
Appliance .

 Stain less Steel Wire :Stain less Steel Wire :
1.1. Doesn’tDoesn’t have the property of “shape Memory”.
2.when it binds it doesn’tdoesn’t tend to regain its Normal
form again.
3.It is usually used at the endend of the Treatment to
Keep the teeth in predetermined Position .
 So it is considered as Passive Fixed Retainer
Appliance
Heat Treated NiTi : it is the same as Stain lessStain less
Steel Wire.Steel Wire.

Name : Lingual Brackets
• Advantage:Advantage:
 Esthetically acceptable.
• Disadvantage:Disadvantage:
Highly Expensive .
Need High experience.
Uncomfortable for the patient.
• Shape :Shape : Mushroom shaped.

• N.B :N.B : the wire should be bended at the
premolars area to by Pass the Palatal cusp.
• Type of the wire:Type of the wire: St.st wire or Heat treated NiTi

Name: Modified Lingual Arch with
bilateral expansion Screw

Metallic Spears
Orthodontic Band

Name: Spear Tongue Guard
• Classification:Classification: Passive Fixed Treatment
appliance.
• Function:Function: it use to prevent the thumb sucking
and tongue thrusting in UncooperativeUncooperative YoungYoung
Patient.
1.Metallic Spears “ Passive” :use to prevent the
thumb sucking .
2.Orthodontic Band : Retentive component

Name:Name: Herbest
• Classification:Classification: Functional Fixed Treatment
appliance.
• Function :Function : It use for treatment of Skeletal Class II
due to mandibular deficiency ( SNB ).
• Mode Of Action:Mode Of Action: This appliance is used to move
the lower jaw forward. It can be fixed or
removable. When it is fixed, it is cemented to
teeth in one or both arches using stainless steel
crowns. An expansion screw may be used
simultaneously to widen the upper jaw.

Name : Twin Block
• Classification:Classification: Functional Fixed Treatment
appliance.
• Function :Function : It is used for treatment of Skeletal
Class II due to mandibular deficiency ( SNB ).
• Mode Of Action:Mode Of Action: It is made up of two components :
an upper and a lower plate, which work together to
posture the lower jaw forward. This frees up the
“locked-in” lower jaw and encourages it to grow to its
fullest potential. The upper plate may also have an
expansion screw to widen the upper arch to avoid
developing a posterior crossbite when the lower jaw is
advanced. Mahmoud Saleh Mahmoud Fayed

Advantages of Twin blocks Over the
Mono block
Twin block allow the patient to talk and move
the mandible more freely than Mono block, and
that’s why it is considered more comfortable.

Inter arch Elastic to Treat Dental Class II

Name:Name: Inter arch Elastic
• Classification: active Removable treatment.
• Function : to Treat Dental Class II relationship.

Elastic Treat Skeletal Class III

Name:Name: Inter arch Elastic
• Classification: active Removable treatment.
• Function : to Treat Dental Class III relationship.

Name: Lip Bumper
• ClassificationClassification: Fixed-Removable Active treatment
Appliance.
• Function: Space Regainer.
• Mode Of Action: wire appliance used to move the lower
molars back and the lower front teeth forward, creating
room for crowded front teeth. The lip bumper is an internal wire
bow that attaches to the buccal tubes on the cheek side of the
lower molar bands inside the mouth. The front portion of the
bow has an acrylic pad or bumper that rests against the inside of
the lower lip. The lower lip muscles apply pressure to the
bumper creating a force that moves the molars back.

Retention
Removable
Essix Retainer

Hawley retainer

Fixed 3 To 3 Retainer
Indicated for the generalized spacing and it is adapted to the
lingual surface of the teeth and bonded by resin composite .

Fixed 1 To 1 Retainer
Indicated for Corrected midline Diastma . And it is adapted to
the lingual surface of the teeth and bonded by resin
composite .

Fixed 33R

Important NotesImportant Notes
• Treatment orthodontic appliances may be
considered as Orthodontic appliance (treat
malocclusion related to teeth) Or Orthopedic
(treat malocclusion related to bone)
• Skeletal Class II caused by : maxillary excess or
mandibular deficiency or a combination.
• Skeletal Class III caused by : maxillary
deficiency or mandibular excess or a
combination.

• Orthodontic appliances are not to be used with
Old patient who passed the growth spurt
( commonly older than 13-14 Y) >>>> they ‘d
rather be treated by orthognathic surgeries.
• The disto-gingival structures:
i. Hook of the Tube.
ii.Hook of the bracket.
iii.Hook of the band.
iv.Color code.
• Appliances Provide Anchorage:
i. Head gear. ( Upper )
ii.TPA. ( Upper )

iii. Nance holding Arch. (upper )
iv. Mini Screw. ( Upper & lower )
v. Lingual Arch ( lower )
vi. Lip bumper. ( lower )
• There are two Appliances that can be related to
radiographs :
i. Space Regainer.
ii. Elastic Separators.

Cases
• A 13 Years Old child , suffering from
decreased SNA Angle , which one of the
appliances is suitable for him? And why?
• A 20 years old man, suffering from increased
SNB Angle , which one of the appliances is
suitable for him? And why?
• A 9 years old Female with adenoid face &
Class II division 1 malocclusion , which one of
the appliances is suitable for her ? And why?

• A 15 Years Old child suffering from increased
SNA Angle , which one of the appliances is
suitable for him? And why?
• Radiographic Image show sever mesial tilting
of lower 1st
molar blocking the eruption of
lower 2nd
premolar , which one of the
appliances is suitable for this patient ?
• Radiographic Image show a radio-opaque
mass within the gingival pocket of patient
under orthodontic treatment , what is the
most liable appliance present in the Pocket ?

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