4.1Review of Clinical Procedures 2014

8/11/2019 4.1Review of Clinical Procedures 2014

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FIXED ORTHODONTIC

APPLIANCES

DENT 657


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Removable vs. Fixed Appliances

REMOVABLE

Tipping only

No control over rootmovement

Pts co-operation

Hygienic

FIXED

Bodily translation

Control of rootmovement

Less dependent on

pts co-op

Less hygienic


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DEVELOPMENT OF FIXED

ORTHODONTIC APPLIANCES


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Development of Fixed appliances

Early fixed appliances

Late 1800sEdward Angle


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EARLY FIXED APPLIANCES


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Standard Edgewise appliance

Early 1900s


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Pre-adjusted edgewise appliance

1970sRefined manufacturing process with built-

inadjustments specific for each tooth

Advances in material sciences madeattachment much smaller


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BANDED APPLIANCES


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Bonding to Enamel


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Bonding Surface - Bracket Base


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BONDED APPLIANCES


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Lingual Appliance


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Self Ligating Appliance


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PASSIVE FIXED APPLIANCES


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Components of the Fixed

Appliance

Bands

Molar Tubes

BracketsBuccal Tubes

Arch Wires

Auxiliaries: Elastomeric products, Coil

springs, Lingual arches, Extra-oral

appliances


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Posterior attachments

MOLAR TUBES


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Appliance

Bands

Molar Tubes

BracketsArch Wires


springs, Lingual arches, Extra-oralappliances


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Appliance

Bands

Molar Tubes

BracketsArch Wires


springs, Lingual arches, Extra-oralappliances


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ARCH WIRES

Maxillary and mandibular

Arch form described as parabolic shaped

Size and cross-section of wires varyMaterial varies eg. Nickel Titanium alloy

(NiTi), Titanium Molybdenum Alloy

(TMA), Stainless Steel


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Elastics


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EXTRA ORAL FORCES - HEAD GEAR


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Coil Spring

Closed or open coil springs

Pre Adjusted Edgewise


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Pre-Adjusted Edgewise

Appliance or The Straight Wire

Appliance

Larry Andrews - studied normal occlusion

and individual tooth positionsDeveloped prescriptions for individual tooth

position

Elements of

idealtooth position are built

into the appliance

Minimizing active wire manipulation-

The Straight Wire Concept


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First order / in-out - Horizontal plane

Second order / tip - Mesio-distal angulation

Third order / torque - Labio-lingualangulation

3 - Dimensional control of tooth position


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First order or In-out


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Second order or Tip

4


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Third order or Torque

4

To Torqueis the least efficient

tooth movement using orthodontic

appliances


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Significance of accurate bracket/band

positioning

Precise tooth positioning

Optimal effect of pre-adjustment

OcclusionEsthetics

Stability


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POSITIONING BRACKETS -

GENERAL INSTRUCTIONS

Rhomboidal shape

Disto-lingual wing mark

Central scribe line (long axis)


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Maxillary Central Incisors

4

Distance from the slot to theincisal edge = 4mm

From the occlusal, the bracket

is centered mesio-distally.

As a guide, approximate theincisal edge of the incisor with

the base of the bracket

perpendicular to the clinical

crown long axis.

4


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Maxillary Lateral Incisor

3.5

Distance from the slot to the incisal edge= 3.5mm

3.5


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Maxillary Cuspids

4.5

4.5 mm

Distance from cusp tip to bracket slot =4.5 mm

The severe angulation and prominent

anatomy of cuspids (10o) can make

placement difficultFrom the occlusal view, the bracket is

centered mesio-distally on the prominent

buccal developmental ridge. This also

corresponds to the clinical crown long

axis. This will usually be mesial to thecenter of the contacts


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Mandibular Incisors


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Mandibular Cuspid


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Maxillary first molar bands


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Mandibular first molar bands


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Bracket Heights from Cusp tip or Incisal Edge


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Right 2nd

M

1st

M

2nd

B

1st

B

Cu LI CI CI LI Cu 1st

B

2nd

B

1st

M

2nd

MLeft

Upper 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Upper

Bracket

height

3.5

4 4 4

4.5

3.5

4 4

3.5

4.54 4 4

3.5

In mm

Occ

plane

Bracket

height

3.5

4 4 4

4.5

4 4 4 4

4.5

4 4 4

3.5 In mm

Lower 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Lower

Documents

4.1Review of Clinical Procedures 2014