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DENT 656 – Orthodontics

DENT 656 – Orthodontics. Fixed Orthodontic Appliances. Sarandeep Huja huja.1@osu.edu. 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.

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DENT 656 – Orthodontics

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  1. DENT 656 – Orthodontics Fixed Orthodontic Appliances Sarandeep Huja huja.1@osu.edu

  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 • Early fixed appliances • Late 1800s • Edward Angle – E Arch, Pin and Tube, Ribbon and Edgewise • Only subtle modifications to the edgewise design have been made, it remains the mainstay in orthodontics (Begg appliance used in Asia to a limited extent)

  4. Early Fixed Appliances

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

  6. 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 • Increased efficiency with pre-adjusted appliances

  7. Banded Appliances

  8. Bonding to Enamel

  9. Bonding Surface - Bracket Base

  10. Bonded Appliances

  11. Indirect bonding

  12. Lingual orthodontics Edgewise slot Must do indirect bonding Decreased interbracket span

  13. Lingual Appliance

  14. Ceramic Appliances - Esthetics Adult treatment

  15. Self Ligating Appliance Brands: Damon, Speed

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

  17. Posterior attachments • MOLAR TUBES Triple vs. Double Tubes

  18. Anterior Attachments • Brackets

  19. Arch Wires • Maxillary and mandibular • Arch form described as “parabolic shaped” • Size and cross-section of wires vary • Material varies e.g. Nickel Titanium alloy (NiTi), Titanium Molybdenum Alloy (TMA), Stainless Steel

  20. Elastics Different si CL II Cl III Vertical Latex (allergy’s Different sizes (thickness and dimension)

  21. Elastics Midline elastics Variety of directions

  22. Extra Oral Forces - Head Gear

  23. Coil Spring Closed or open coil springs

  24. 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

  25. 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

  26. First order or In-out

  27. 4 Second order or Tip

  28. 4 Third order or Torque To “Torque” is the least efficient tooth movement using orthodontic appliances

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

  30. Questions

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