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FIXED ORTHODONTIC APPLIANCES. DENT 657. REMOVABLE Tipping only No control over root movement Pt’s co-operation Hygienic. FIXED Bodily translation Control of root movement Less dependent on pt’s co-op Less hygienic. Removable vs. Fixed Appliances.
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FIXED ORTHODONTIC APPLIANCES DENT 657
REMOVABLE Tipping only No control over root movement Pt’s co-operation Hygienic FIXED Bodily translation Control of root movement Less dependent on pt’s co-op Less hygienic Removable vs. Fixed Appliances
Development of Fixed appliances • Early fixed appliances • Late 1800s • Edward Angle
Development of Fixed appliances • Standard Edgewise appliance • Early 1900s
Development of Fixed appliances • Pre-adjusted edgewise appliance • 1970s • Refined manufacturing process with “built-in” adjustments specific for each tooth • Advances in material sciences made attachment much smaller
Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Buccal Tubes • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances
Posterior attachments • MOLAR TUBES
Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances
Anterior Attachments • Brackets
Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances
ARCH WIRES • Maxillary and mandibular • Arch form described as “parabolic shaped” • Size and cross-section of wires vary • Material varies eg. Nickel Titanium alloy (NiTi), Titanium Molybdenum Alloy (TMA), Stainless Steel
Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances
Coil Spring Closed or open coil springs
Pre-Adjusted Edgewise Appliance or The Straight Wire Appliance • Larry Andrews - studied normal occlusion and individual tooth positions • Developed prescriptions for individual tooth position • Elements of “ideal” tooth position are built into the appliance • Minimizing active “wire manipulation” - The Straight Wire Concept
Pre-adjusted edgewise appliance • First order / in-out - Horizontal plane • Second order / tip - Mesio-distal angulation • Third order / torque - Labio-lingual angulation 3 - Dimensional control of tooth position
Pre-adjusted edgewise appliance • First order / in-out - Horizontal plane • Second order / tip - Mesio-distal angulation • Third order / torque - Labio-lingual angulation
4 Second order or Tip
Pre-adjusted edgewise appliance • First order / in-out - Horizontal plane • Second order / tip - Mesio-distal angulation • Third order / torque - Labio-lingual angulation
4 Third order or Torque To “Torque” is the least efficient tooth movement using orthodontic appliances
Significance of accurate bracket/band positioning • Precise tooth positioning • Optimal effect of “pre-adjustment” • Occlusion • Esthetics • Stability
POSITIONING BRACKETS - GENERAL INSTRUCTIONS Rhomboidal shape Disto-lingual wing mark Central scribe line (long axis)
4 Maxillary Central Incisors 4
3.5 Maxillary Lateral Incisor 3.5
4.5 Maxillary Cuspids 4.5 mm