FIXED ORTHODONTIC APPLIANCES

1. FIXED ORTHODONTIC APPLIANCES DENT 657

2. 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

3. DEVELOPMENT OF FIXED ORTHODONTIC APPLIANCES

4. Development of Fixed appliances • Early fixed appliances • Late 1800s • Edward Angle

5. EARLY FIXED APPLIANCES

6. Development of Fixed appliances • Standard Edgewise appliance • Early 1900s

7. 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

8. BANDED APPLIANCES

9. Bonding to Enamel

10. Bonding Surface - Bracket Base

11. BONDED APPLIANCES

12. Lingual Appliance

13. CERAMIC APPLIANCES

14. Self Ligating Appliance

15. PASSIVE FIXED APPLIANCES

16. Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Buccal Tubes • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances

17. Posterior attachments • MOLAR TUBES

18. Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances

19. Anterior Attachments • Brackets

20. Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances

21. 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

22. Components of the Fixed Appliance • Bands • Molar Tubes • Brackets • Arch Wires • Auxiliaries: Elastomeric products, Coil springs, Lingual arches, Extra-oral appliances

23. Elastics

24. EXTRA ORAL FORCES - HEAD GEAR

25. Coil Spring Closed or open coil springs

26. 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

27. 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

28. First order or In-out

29. Pre-adjusted edgewise appliance • First order / in-out - Horizontal plane • Second order / tip - Mesio-distal angulation • Third order / torque - Labio-lingual angulation

30. 4 Second order or Tip

31. Pre-adjusted edgewise appliance • First order / in-out - Horizontal plane • Second order / tip - Mesio-distal angulation • Third order / torque - Labio-lingual angulation

32. 4 Third order or Torque To “Torque” is the least efficient tooth movement using orthodontic appliances

33. Significance of accurate bracket/band positioning • Precise tooth positioning • Optimal effect of “pre-adjustment” • Occlusion • Esthetics • Stability

34. POSITIONING BRACKETS - GENERAL INSTRUCTIONS Rhomboidal shape Disto-lingual wing mark Central scribe line (long axis)

35. 4 Maxillary Central Incisors 4

36. 3.5 Maxillary Lateral Incisor 3.5

37. 4.5 Maxillary Cuspids 4.5 mm

38. Maxillary Bicuspids

39. Mandibular Incisors

40. Mandibular Cuspid

41. Mandibular Bicuspids

42. Maxillary first molar bands

43. Mandibular first molar bands