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The Straight Wire The Straight Wire ConceptConcept
INDIAN DENTAL ACADEMY
Leader in continuing dental education www.indiandentalacademy.com
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The straight wire conceptThe straight wire concept
““The birth of a new concept is never an all or none phenomenon. It The birth of a new concept is never an all or none phenomenon. It is a slow evolution with contributions from many. A new principle is is a slow evolution with contributions from many. A new principle is an inexhaustible source of new views”an inexhaustible source of new views”
““Nothing in education is more astonishing than the amount of Nothing in education is more astonishing than the amount of ignorance it accumulates in the form of inert facts.. However , it is ignorance it accumulates in the form of inert facts.. However , it is the amalgamation of these inert facts, put forward by the genius’ of the amalgamation of these inert facts, put forward by the genius’ of our profession, that has led to the high standard of the Preadjusted our profession, that has led to the high standard of the Preadjusted Appliance system which it has acquired today”Appliance system which it has acquired today”
““The beauty of this concept is that a more consistent, more ideal The beauty of this concept is that a more consistent, more ideal result can be obtained with less physical and mental drain on the result can be obtained with less physical and mental drain on the operator in less overall time and minimal discomfort to the patient.”operator in less overall time and minimal discomfort to the patient.”
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The Straight Wire ConceptThe Straight Wire Concept
““The straight wire concept is not a product of serendipity, The straight wire concept is not a product of serendipity, but is a poetry in design. It is an appliance fully but is a poetry in design. It is an appliance fully programmed to combine simplicity and effectiveness programmed to combine simplicity and effectiveness required for the road to success”required for the road to success”
The genesis of the straight wire appliance was not a The genesis of the straight wire appliance was not a result of a single stray discovery, but rather the result of result of a single stray discovery, but rather the result of numerous experiments. Many individual innovations numerous experiments. Many individual innovations were distilled and combined to form this intricate design.were distilled and combined to form this intricate design.
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
E- ARCH (1900)E- ARCH (1900) PIN AND TUBE PIN AND TUBE
APPLIANCE (1910)APPLIANCE (1910) RIBBON ARCH RIBBON ARCH
BRACKET (1915)BRACKET (1915) EDGEWISE EDGEWISE
BRACKET(1925)BRACKET(1925)# SINGLE WIDTH BRACKET# SINGLE WIDTH BRACKET# 2 SINGLE WIDTH BRACKETS# 2 SINGLE WIDTH BRACKETS# TWIN BRACKETS# TWIN BRACKETS# LEWIS BRACKET# LEWIS BRACKET# VERTICAL SLOT LEWIS BRACKET# VERTICAL SLOT LEWIS BRACKET# LANG BRACKET# LANG BRACKET# TIP EDGE BRACKET# TIP EDGE BRACKET# CONVERTIBLE BRACKET# CONVERTIBLE BRACKET# EDGELOCK / SELF LIGATING # EDGELOCK / SELF LIGATING BRACKET BRACKET
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
THE E- ARCHTHE E- ARCH
THE FIRST FIXED APPLIANCETHE FIRST FIXED APPLIANCE DESIGNED BY ANGLE IN 1900DESIGNED BY ANGLE IN 1900
USED STATIONARY USED STATIONARY ANCHOAGEANCHOAGE
TIPPED TEETH INTO NEW TIPPED TEETH INTO NEW POSITIONPOSITION
EXCPANDED THE ARCHEXCPANDED THE ARCH
X MESIO DISTAL TOOTH X MESIO DISTAL TOOTH MOVEMENTSMOVEMENTS
X INDIVIDUAL TOOTH X INDIVIDUAL TOOTH MOVEMENTSMOVEMENTS
X ROOT MOVEMENTSX ROOT MOVEMENTS www.indiandentalacademy.comwww.indiandentalacademy.com
EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
THE PIN AND TUBE THE PIN AND TUBE APPLIANCEAPPLIANCE
BANDS ON ALL TEETHBANDS ON ALL TEETH TUBES SOLDERED TO TUBES SOLDERED TO
BANDSBANDS ARCH WIRE SOLDERED TOARCH WIRE SOLDERED TO TUBE WITH PINSTUBE WITH PINS
COULD BRING ROOTS INTOCOULD BRING ROOTS INTO AXIAL ALIGNMENTAXIAL ALIGNMENT VERY DIFFICULT TO VERY DIFFICULT TO
PARALLEL PARALLEL TUBE AND PINSTUBE AND PINS
SOLDERING AND SOLDERING AND UNSOLDERING PINSUNSOLDERING PINS
ROTATIONAL ROTATIONAL ADJUSTMENTSADJUSTMENTS www.indiandentalacademy.comwww.indiandentalacademy.com
EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
THE RIBBON ARCH THE RIBBON ARCH BRACKETBRACKET
THE FIRST BRACKETTHE FIRST BRACKET DEVISED IN 1915 BY ANGLEDEVISED IN 1915 BY ANGLE BIG STEP IN EVOLUTION OF BIG STEP IN EVOLUTION OF
BRACKETSBRACKETS
ROTATIONAL MOVEMENTSROTATIONAL MOVEMENTS BUCCO-LINGUAL AND INCISO-BUCCO-LINGUAL AND INCISO-
GINGIVALGINGIVAL MOVEMENTSMOVEMENTS X DISTAL TIPPING OF BUCCAL X DISTAL TIPPING OF BUCCAL
SEGMENTSEGMENT X MESIODISTAL AXIAL MOVEMENTX MESIODISTAL AXIAL MOVEMENT X ARCH WIRE DID’NT PROVIDE X ARCH WIRE DID’NT PROVIDE
STABILIZATIONSTABILIZATION
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
THE EDGEWISE THE EDGEWISE BRACKETBRACKET
FINAL BRACKET DESIGN BY ANGLE FINAL BRACKET DESIGN BY ANGLE (1925)(1925)
BASED ON HIS “LINE OF OCCLUSION” BASED ON HIS “LINE OF OCCLUSION” CONCEPTCONCEPT
BRACKET WITH RECTANGULAR SLOTBRACKET WITH RECTANGULAR SLOT
0.022”X0.028”0.022”X0.028” ORIENTATION OF WIRE AT 90* ALONG ORIENTATION OF WIRE AT 90* ALONG
THE EDGETHE EDGE
OF THE RECTANGULAR WIREOF THE RECTANGULAR WIRE
MOVEMENT IN ALL 3 PLANES OF SPACEMOVEMENT IN ALL 3 PLANES OF SPACE TWIST AND TORQUE POSSIBLETWIST AND TORQUE POSSIBLE
GOLD BRACKET AND WIRE DEFORMEDGOLD BRACKET AND WIRE DEFORMED
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
SINGLE WIDTH BRACKETSSINGLE WIDTH BRACKETS THESE WERE ANGLES ORIGINAL EDGEWISE BRACKET DESIGNTHESE WERE ANGLES ORIGINAL EDGEWISE BRACKET DESIGN BRACKET WIDTH WAS 0.050”BRACKET WIDTH WAS 0.050”
ROTATIONAL MOVEMENTS WERE DIFFICULTROTATIONAL MOVEMENTS WERE DIFFICULT
TO OVERCOME THIS LIMITATION ANGLE SOLDERED EYELETS ONTO TO OVERCOME THIS LIMITATION ANGLE SOLDERED EYELETS ONTO BANDSBANDS
THESE EYELETS WERE TIED WITH LGATURES TO ALLOW ROTATIONTHESE EYELETS WERE TIED WITH LGATURES TO ALLOW ROTATION
REPEATED ADJUSTMENT OF LIGATURESREPEATED ADJUSTMENT OF LIGATURES RELAPSE IF TIES NOT CONTINUEDRELAPSE IF TIES NOT CONTINUED
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
TWO SINGLE WIDTH BRACKETSTWO SINGLE WIDTH BRACKETS
GREAT ROTATIONAL CONTROLGREAT ROTATIONAL CONTROL
ALIGNMENT OF BOTH BRACKETSALIGNMENT OF BOTH BRACKETS
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
TWIN BRACKETSTWIN BRACKETS ““SIAMESE TWIN BRACKETS”- SIAMESE TWIN BRACKETS”-
SWAINSWAIN 2 BRACKETS ON A COMMON BASE2 BRACKETS ON A COMMON BASE DISTANCE BETWEEN THE 2 DISTANCE BETWEEN THE 2
BRACKETS -0.050”BRACKETS -0.050”
EXCELLENT ROTATIONAL EXCELLENT ROTATIONAL CONTROLCONTROL
POSITIVE CONTROL ON THE POSITIVE CONTROL ON THE TOOTHTOOTH
4 SIZES- EXTRAWIDE,STANDARD, 4 SIZES- EXTRAWIDE,STANDARD, INTERMEDIATE,JUNIORINTERMEDIATE,JUNIOR
DECREASED INTERBRACKET SPANDECREASED INTERBRACKET SPAN THUS DECREASE RESILIENCY OF THUS DECREASE RESILIENCY OF
THE WIRETHE WIRE DIFFICULTY IN CLOSING LOOPS DIFFICULTY IN CLOSING LOOPS
AND 2AND 2NDND ORDER BENDS ORDER BENDS
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EVOLUTION OF THE BRACKETEVOLUTION OF THE BRACKET
LEWIS’ BRACKETLEWIS’ BRACKETSINGLE WIDTH BRACKETS WITH AUX UPSWEPT ROTATION WINGS FOR SINGLE WIDTH BRACKETS WITH AUX UPSWEPT ROTATION WINGS FOR
ROTATIONAL CONTROLROTATIONAL CONTROL
MISCELLANEOUSMISCELLANEOUSLANG’S BRACKETLANG’S BRACKET
VERTICAL SLOTSVERTICAL SLOTS
BROUSSARD’S BRACKETBROUSSARD’S BRACKET
TIP EDGE BRACKETTIP EDGE BRACKET
SELF LIGATING BRACKETSELF LIGATING BRACKET
CONVERTIBLE BRACKETSCONVERTIBLE BRACKETS
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Straight wired!Straight wired!
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BUILDING TREATMENT INTO BUILDING TREATMENT INTO EDGEWISE BRACKETSEDGEWISE BRACKETS
ANGLE (1929)ANGLE (1929) ANGULATED BRACKETS TO PRODUCE ANGULATED BRACKETS TO PRODUCE
TIPPINGTIPPING ANGULATED POSTERIOR BRACKETSANGULATED POSTERIOR BRACKETS
FOR ROOT MOVEMENTSFOR ROOT MOVEMENTS
TWEED (1941)TWEED (1941) ““ARTISTIC POSITIONING BENDS” IN ARTISTIC POSITIONING BENDS” IN
WIRESWIRES
FOR CORRECT AXIAL RELATIONSHIPSFOR CORRECT AXIAL RELATIONSHIPS
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BUILDING TREATMENT INTO BUILDING TREATMENT INTO EDGEWISE BRACKETSEDGEWISE BRACKETS
HOLDAWAY (1952)HOLDAWAY (1952)PUBLISHED A LANDMARK ARTICLE IN 1952 DESCRIBED 3 PUBLISHED A LANDMARK ARTICLE IN 1952 DESCRIBED 3 USES OF BRACKET ANGULATIONUSES OF BRACKET ANGULATION
AIDS IN PARALLELING ROOTS ADJACENT TO EXTRACTION AIDS IN PARALLELING ROOTS ADJACENT TO EXTRACTION SITESSITES
METHOD OF SETTING UP POSTERIOR ANCHORAGEMETHOD OF SETTING UP POSTERIOR ANCHORAGE
TO OBTAIN CORRECT AXIAL INLINATIONS.TO OBTAIN CORRECT AXIAL INLINATIONS.
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HOLDAWAYHOLDAWAY
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BUILDING TREATMENT INTO BUILDING TREATMENT INTO EDGEWISE BRACKETSEDGEWISE BRACKETS
JOHN STIFTER JOHN STIFTER (1958)(1958)BRACKETS WITH MALE AND BRACKETS WITH MALE AND FEMALE ATTACHMENTFEMALE ATTACHMENT
IVAN LEE(1960)IVAN LEE(1960)BRACKETS OF UPPER BRACKETS OF UPPER ANTERIORS AND LOWER ANTERIORS AND LOWER POSTERIORS HAD TORQUED POSTERIORS HAD TORQUED SLOTSSLOTS
JARABACK (1962)JARABACK (1962)SUGGESTED THAT UPPER SUGGESTED THAT UPPER ANTERIORS BE TORQUED AND ANTERIORS BE TORQUED AND ANGULATEDANGULATED
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BUILDING TREATMENT INTO BUILDING TREATMENT INTO EDGEWISE BRACKETSEDGEWISE BRACKETS
IN 1960’S IN 1960’S MANUFACTURERS-MANUFACTURERS-
RAISED THE BASE RAISED THE BASE OF UPPER LATERAL OF UPPER LATERAL INCISORS TO INCISORS TO ELIMINATE ELIMINATE LATERAL OFFSETLATERAL OFFSET
MOLAR TUBES MOLAR TUBES WITH 10* OFFSET WITH 10* OFFSET AND TORQUE FOR AND TORQUE FOR ROTATIONAL ROTATIONAL CONTROLCONTROL
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MANUFACTURER’SMANUFACTURER’S
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BUILDING TREATMENT INTO BUILDING TREATMENT INTO EDGEWISE BRACKETSEDGEWISE BRACKETS
LAWRENCE F. ANDREWS’ STRAIGHT LAWRENCE F. ANDREWS’ STRAIGHT WIRE APPLIANCE (1976)WIRE APPLIANCE (1976)
2 PRESCRIPTIONS2 PRESCRIPTIONS STANDARD (NON EXTRACTION)STANDARD (NON EXTRACTION) TRANSLATION (EXTRACTION)TRANSLATION (EXTRACTION)
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CONCEPT OF THE PEA CONCEPT OF THE PEA APPLIANCEAPPLIANCE
THE CONCEPT OF THE PEA APPLIANCE EVOLVED THE CONCEPT OF THE PEA APPLIANCE EVOLVED FROM A SERIES OF 5 STUDIES CONDUCTED BY L.F. FROM A SERIES OF 5 STUDIES CONDUCTED BY L.F. ANDREWSANDREWS..
EXAMINATION OF POST TREATMENT OCCLUSIONEXAMINATION OF POST TREATMENT OCCLUSION STUDY OF NATURALLY OCCURING OPTIMAL STUDY OF NATURALLY OCCURING OPTIMAL
OCCLUSIONOCCLUSION THE SIX KEYS TO OPTIMAL OCCLUSIONTHE SIX KEYS TO OPTIMAL OCCLUSION CROWN MEASUREMENTSCROWN MEASUREMENTS COMPARISON OF TREATED AND NATURAL COMPARISON OF TREATED AND NATURAL
OCCLUSIONOCCLUSION
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EXAMINATION OF POST TREATMENT EXAMINATION OF POST TREATMENT OCCLUSIONOCCLUSION
The first experiment was conducted in The first experiment was conducted in 19601960
Study models of hundreds of treated Study models of hundreds of treated cases submitted to the ABO, E. H. Angle cases submitted to the ABO, E. H. Angle Soc and Tweed Foundation considered to Soc and Tweed Foundation considered to be the state of the art in static occlusion in be the state of the art in static occlusion in the US.the US.
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EXAMINATION OF POST TREATMENT EXAMINATION OF POST TREATMENT OCCLUSIONOCCLUSION
All models showed some common trends-All models showed some common trends- Molars were in Class I relationshipMolars were in Class I relationship Incisors were not rotatedIncisors were not rotated No overjet/ crossbiteNo overjet/ crossbite
But there were several inconsistencies like-But there were several inconsistencies like- Articulation?Articulation? Long axes of teeth adjacent to extraction sitesLong axes of teeth adjacent to extraction sites Inclinations and angulations variedInclinations and angulations varied 22ndnd molar not included molar not included Interdental spacing due to incomplete treatmentInterdental spacing due to incomplete treatment Rotation of teeth requiring translationRotation of teeth requiring translation No mounting to check functional occlusionNo mounting to check functional occlusion Co-Cr coordinationCo-Cr coordination
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STUDY OF NATURALLY STUDY OF NATURALLY OCCURING OPTIMAL OCCURING OPTIMAL
OCCLUSIONOCCLUSION 22ndnd experiment, 1964, Help of experiment, 1964, Help of
A.G.Brodie (Univ of Illinois)A.G.Brodie (Univ of Illinois) With the presumption that With the presumption that
naturally occuring optimal naturally occuring optimal occlusion is worth emulating.occlusion is worth emulating.
120 casts of patients with 120 casts of patients with following features-following features-
Never had undergone Never had undergone orthodontic treatmentorthodontic treatment
Well aligned teeth, pleasing Well aligned teeth, pleasing appearanceappearance
Excellent occlusionExcellent occlusion Would not benefit from Would not benefit from
orthodontic treatmentorthodontic treatment
The facial axis and mid point of The facial axis and mid point of clinical crown of each tooth clinical crown of each tooth was markedwas marked www.indiandentalacademy.comwww.indiandentalacademy.com
THE SIX KEYS TO OPTIMAL THE SIX KEYS TO OPTIMAL OCCLUSIONOCCLUSION
The third and most important experiment in the The third and most important experiment in the development of the preadjusted appliancedevelopment of the preadjusted appliance
The 6 keys individually were not new but put together The 6 keys individually were not new but put together were of special value as-were of special value as-
Complete set of indicators of optim al occlusion.Complete set of indicators of optim al occlusion. Judged by tangible landmarksJudged by tangible landmarks Judged from facial/ occlusal viewJudged from facial/ occlusal view
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TERMINOLOGYTERMINOLOGY
Andrews PlaneAndrews Plane
Clinical CrownClinical Crown
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TERMINOLOGYTERMINOLOGY
Crown AngulationCrown Angulation
Crown InclinationCrown Inclination
FACCFACC
FA PointFA Point ClassClass TypeType
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Six KeysSix Keys
Key 1Key 1Molar Interarach Molar Interarach relationshiprelationship
Mesiobuccal cusp of the permanent Mesiobuccal cusp of the permanent maxillary molar occludes in the buccal maxillary molar occludes in the buccal groove of the perm mand molargroove of the perm mand molar
Distal marginal ridge of the upper 1Distal marginal ridge of the upper 1 stst molar molar occludes with the mesial marginal ridge of occludes with the mesial marginal ridge of the lower 2the lower 2ndnd molar molar
Mesiopalatal cusp of the upper 1Mesiopalatal cusp of the upper 1stst molar molar occludes in the central fossa of the lower ist occludes in the central fossa of the lower ist molarmolar
Buccal cusps of upper premolars in the Buccal cusps of upper premolars in the embrasures of the lower premolarsembrasures of the lower premolars
Palatal cusps of upper premolars in a cusp-Palatal cusps of upper premolars in a cusp-fossa relationship with lower pmsfossa relationship with lower pms
Upper canines in cusp embrasure with lower Upper canines in cusp embrasure with lower caninescanines
Upper anteriors overlap the lower anteriors Upper anteriors overlap the lower anteriors
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Six KeysSix Keys
Key 2Key 2
Crown AngulationsCrown Angulations Essentially all crowns have Essentially all crowns have
positive angulationpositive angulation Gingival potion of FACC distal Gingival potion of FACC distal
to occlusal portionto occlusal portion All crowns of tooth type have All crowns of tooth type have
similar angulationssimilar angulations Tip pattern is consistent for all Tip pattern is consistent for all
individualsindividuals Important esp anteriorlyImportant esp anteriorly
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Six KeysSix Keys
Key 3-Key 3-Crown InclinationCrown Inclination
Maxillary incisors have positive Maxillary incisors have positive inclinationinclination
Mandibular incisors have slight Mandibular incisors have slight negative inclinationnegative inclination
Interincisal angle<180*Interincisal angle<180* Max incisor +ve inclination > Max incisor +ve inclination >
mand incisor –ve inclmand incisor –ve incl Upper Central> LateralUpper Central> Lateral Upper 345 –veUpper 345 –ve Upper 67 more –veUpper 67 more –ve Mand= progresively -ve Mand= progresively -ve
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Six KeysSix Keys
Key 4-Key 4-Absence of rotationsAbsence of rotations
Key 5-Key 5-Tight contactsTight contacts
Key 6-Key 6-slight to flat curve of slight to flat curve of speespee
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CROWN MEASUREMENTSCROWN MEASUREMENTS
44thth study involved the study involved the measurement of crowns measurement of crowns in the sample for-in the sample for-
• Bracket area of tooth typeBracket area of tooth type• Vertical crown contourVertical crown contour• Crown angulationCrown angulation• Crown inclinationCrown inclination• Maxillary molar offsetMaxillary molar offset• Horizontal crown contour Horizontal crown contour • Facial prominenceFacial prominence• Depth of Curve of SpeeDepth of Curve of Spee
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CROWN MEASUREMENTSCROWN MEASUREMENTS
UpperUpper 11 22 33 4,54,5 66
AngulationAngulation 55 99 1111 22 55
InclinationInclination 77 33 -7-7 -7-7 -9-9
ProminenceProminence 2.12.1 1.651.65 2.52.5 2.42.4 2.92.9
Molar OffsetMolar Offset 10*10*
LowerLower 11 22 33 4,54,5 66
Angulation Angulation 22 22 55 22 22
InclinationInclination -1-1 -1-1 -11-11 -17,-22-17,-22 -30-30
ProminenceProminence 1.21.2 1.21.2 1.91.9 2.352.35 2.52.5Curve of SpeeCurve of Spee 0-2.50-2.5
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COMPARISON OF TREATED AND COMPARISON OF TREATED AND NATURAL OCCLUSIONNATURAL OCCLUSION
The 5The 5 thth study compared 1150 treated study compared 1150 treated cases with the measurements and the six cases with the measurements and the six keys.keys.
KEY 1-KEY 1-- - Most cases showed Angle’s Class I molar relationship. Most cases showed Angle’s Class I molar relationship.
However,However, The distal marg ridge of upper 6 x mmr of lower 7The distal marg ridge of upper 6 x mmr of lower 7 Pm’s and canines didn’t show a cusp- embrasure Pm’s and canines didn’t show a cusp- embrasure
relationship relationship
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COMPARISON OF TREATED AND COMPARISON OF TREATED AND NATURAL OCCLUSIONNATURAL OCCLUSION
KEY 2-KEY 2-Values= +/- 2 was considered incorrectValues= +/- 2 was considered incorrect91% of cases had 1 or more teeth with incorrect angulation91% of cases had 1 or more teeth with incorrect angulationUpper laterals and canines showed –ve angUpper laterals and canines showed –ve angUpper 6 ranged from -ve in non ext to +ve in ext casesUpper 6 ranged from -ve in non ext to +ve in ext cases
KEY 3-KEY 3-Values +/- 2 was considered incorrectValues +/- 2 was considered incorrectInterincisal angle on FACC > 180* in 78% casesInterincisal angle on FACC > 180* in 78% casesUpper 456 not always -veUpper 456 not always -ve
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COMPARISON OF TREATED AND COMPARISON OF TREATED AND NATURAL OCCLUSIONNATURAL OCCLUSION
KEY 4-KEY 4-Rotational errors were measured using angle between Rotational errors were measured using angle between
contact points and arch form. contact points and arch form.
Values= +/- 2 was considered incorrectValues= +/- 2 was considered incorrect
67% of cases had rotations esp. teeth that were translated67% of cases had rotations esp. teeth that were translated
KEY 5-KEY 5-47% showed spacing due to incorrect angulation47% showed spacing due to incorrect angulation
KEY 6-KEY 6-56% showed excessive curve of spee56% showed excessive curve of spee
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CONCLUSIONSCONCLUSIONS
FEW TREATED CASES FOLLOWED FEW TREATED CASES FOLLOWED THE 6 KEYSTHE 6 KEYS
INTER ORTHODONTIST TREATMENT INTER ORTHODONTIST TREATMENT PRIORITIED VARIEDPRIORITIED VARIED
NO CHANGE IN 10 YEARSNO CHANGE IN 10 YEARS
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PRINCIPLESPRINCIPLES
ALL TEETH OF SAME TYPE WERE SIMILAR IN SIZE ALL TEETH OF SAME TYPE WERE SIMILAR IN SIZE AND SHAPEAND SHAPE
SIZE OF CROWN HAS NO EFFECT ON ANGULATION, SIZE OF CROWN HAS NO EFFECT ON ANGULATION, INCLINATION OR PROMINENCEINCLINATION OR PROMINENCE
MOST PEOPLE HAVE NORMAL TEETH MOST PEOPLE HAVE NORMAL TEETH REGARDLESS OF OCCLUSIONREGARDLESS OF OCCLUSION
JAWS MUST BE CORRECTLY RELATED FOR JAWS MUST BE CORRECTLY RELATED FOR OPTIMAL OCCLUSIONOPTIMAL OCCLUSION
DENTITIONS WITH NORMAL TEETH IN JAWS THAR DENTITIONS WITH NORMAL TEETH IN JAWS THAR ARE/ CAN BE CORRECTLY RELATED CAN BE ARE/ CAN BE CORRECTLY RELATED CAN BE BROUGHT TO OPTIMAL OCCLUSIONBROUGHT TO OPTIMAL OCCLUSION
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE
1.1. BRACKET BASES BRACKET BASES PERPENDICULAR PERPENDICULAR TO THE STEMTO THE STEM
PROBLEMS IN SLOT PROBLEMS IN SLOT INCLINATIONINCLINATION
PROBLEMS IN PROBLEMS IN OCCLUSO-GINGIVAL OCCLUSO-GINGIVAL POSITIONPOSITION
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE2. BRACKETS NOT 2. BRACKETS NOT
CONTOURED CONTOURED OCCLUSO-OCCLUSO-GINGIVALLYGINGIVALLY
PROBLEMS IN SLOT PROBLEMS IN SLOT INCLINATIONINCLINATION
PROBLEMS IN PROBLEMS IN OCCLUSO-GINGIVAL OCCLUSO-GINGIVAL POSITIONPOSITION
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE
3. BRACKETS NOT 3. BRACKETS NOT CONTOURED CONTOURED MESIO DISTALLYMESIO DISTALLY
PROBLEMS IN SLOT PROBLEMS IN SLOT SITINGSITING
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE
4. SLOTS NOT 4. SLOTS NOT ANGULATEDANGULATED
EACH CROWN HAS EACH CROWN HAS ANGULATION.ANGULATION.
WHEN A FULL SIZE WHEN A FULL SIZE WIRE IS INSERTED WIRE IS INSERTED RESULTANT RESULTANT ANGULATION ANGULATION INCORRECT.INCORRECT.
IF BRACKET IF BRACKET ANGULATED ONLY 2 ANGULATED ONLY 2 POINT CONTACT.POINT CONTACT. www.indiandentalacademy.comwww.indiandentalacademy.com
SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE
5.5. BRACKETS STEMS BRACKETS STEMS OF EQUAL OF EQUAL PROMINENCEPROMINENCE
6.6. MAXILLARY MAXILLARY MOLAR OFFSET MOLAR OFFSET NOT BUILT INNOT BUILT IN
IST ORDER BENDS IST ORDER BENDS REQUIRED.REQUIRED.
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE7. 7. ANGULAGTION ANGULAGTION
LANDMARKS DIFFEREDLANDMARKS DIFFERED LONG AXIS OF CROWN –LONG AXIS OF CROWN –
NOT VISIBLENOT VISIBLE LONG AXIS OF TOOTH- LONG AXIS OF TOOTH-
NOT VISIBLENOT VISIBLE INCISAL EDGE- INCISAL EDGE- TOO FAR AWAY,TOO FAR AWAY,
MAY BE CHIPPED MAY BE CHIPPED LATERAL CURVEDLATERAL CURVEDCUSP TIPS?CUSP TIPS?
MARGINAL RIDGES – TOO MARGINAL RIDGES – TOO FAR AWAYFAR AWAY
CONTACT POINTS– NOT CONTACT POINTS– NOT VISIBLEVISIBLE
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE8. 8. INCLINATION INCLINATION
LANDMARKS LANDMARKS DIFFEREDDIFFERED
LONG AXIS OF LONG AXIS OF CROWN –NOT VISIBLECROWN –NOT VISIBLE
BRACKET HEIGHT BRACKET HEIGHT FRON CUSP TIPFRON CUSP TIP
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE8. 8. EXCESSIVE WIRE BENDING REQUIREDEXCESSIVE WIRE BENDING REQUIRED TO INITIATE/ MAINTAIN TOOTH MOVEMENTTO INITIATE/ MAINTAIN TOOTH MOVEMENT TO COMPENSATE FOR SLOT SITING TO COMPENSATE FOR SLOT SITING
ERRORSERRORS TO COMPENSATE FOR ERRORS IN WIRE TO COMPENSATE FOR ERRORS IN WIRE
BENDINGBENDING TO COMPENSATE FOR SIDE EFFECTS TO COMPENSATE FOR SIDE EFFECTS
OFWIRE BENDINGOFWIRE BENDING
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SHORTCOMINGS OF THE SHORTCOMINGS OF THE STANDARD EDGEWISE STANDARD EDGEWISE
APPLIANCEAPPLIANCE PRIMARY BENDSPRIMARY BENDS
11STST ORDER -46 BENDS ORDER -46 BENDS22NDND ORDER- ORDER- 33RDRD ORDER- ORDER-ERRORS- 30 BENDSERRORS- 30 BENDS
SECONDARY BENDSSECONDARY BENDSFOR ERRORS INFOR ERRORS INSLOT SITINGSLOT SITINGWIRE BENDINGWIRE BENDINGJUDGEMENTJUDGEMENT
TERTIARY BENDSTERTIARY BENDSLOOPS, STOPS ETCLOOPS, STOPS ETC
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DESIGN FEATURES OF THE DESIGN FEATURES OF THE NEW APPLIANCENEW APPLIANCE
SLOT SITING FEATURES SLOT SITING FEATURES
CONVENIENCE FEATURESCONVENIENCE FEATURES
AUXILLIARY FEATURESAUXILLIARY FEATURES
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SLOT SITING FEATURESSLOT SITING FEATURES
MID TRANSVERSE PLANE MID TRANSVERSE PLANE THE MID TRANSVERSE PLANE OF THE SLOT, STEM THE MID TRANSVERSE PLANE OF THE SLOT, STEM
AND CROWN MUST COINCIDEAND CROWN MUST COINCIDE BASE SHOULD HAVE SAME INCLINATION AS THE BASE SHOULD HAVE SAME INCLINATION AS THE
FACIAL PLANEFACIAL PLANE BASE CONTOURED OCCLUSO GINGIVALLY TO BASE CONTOURED OCCLUSO GINGIVALLY TO
MATCH CROWN CURVATUREMATCH CROWN CURVATURETHESE FEATURES ELIMINATED-THESE FEATURES ELIMINATED-
X 2X 2NDND ORDER BENDS FOR OCC-GIN DISHARMONY ORDER BENDS FOR OCC-GIN DISHARMONYXX 33RDRD ORDER BENDS FOR INCLINATION ORDER BENDS FOR INCLINATIONXX OTHER BENDS FOR SIDE EFFECTSOTHER BENDS FOR SIDE EFFECTS
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SLOT SITING FEATURESSLOT SITING FEATURES
MID SAGGITAL PLANE MID SAGGITAL PLANE THE MID SAGGITAL PLANE OF THE SLOT, STEM AND CROWN THE MID SAGGITAL PLANE OF THE SLOT, STEM AND CROWN
MUST COINCIDEMUST COINCIDE THE PLANE OF BASE AT BASE POINT SHOULD BE IDENTICAL THE PLANE OF BASE AT BASE POINT SHOULD BE IDENTICAL
TO FACIAL PLANE AT FA POINT TO FACIAL PLANE AT FA POINT BASE CONTOURED MESIODISTALLY TO FIT EACH TOOTHBASE CONTOURED MESIODISTALLY TO FIT EACH TOOTH VERTCAL COMPONENTS PARALLELTO EACH OTHERVERTCAL COMPONENTS PARALLELTO EACH OTHER
THESE FEATURES ELIMINATED-THESE FEATURES ELIMINATED-XX 1ST ORDER BENDS FOR MOLAR OFFSETS AND M-D SLOT 1ST ORDER BENDS FOR MOLAR OFFSETS AND M-D SLOT
SITINGSITINGX 2X 2NDND ORDER BENDS FOR OCC-GIN DISHARMONY AND ORDER BENDS FOR OCC-GIN DISHARMONY AND
ANGULATIONANGULATIONXX SECONDARY BENDS FOR SIDE EFFECTSSECONDARY BENDS FOR SIDE EFFECTS
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SLOT SITING FEATURESSLOT SITING FEATURES
MID FRONTAL PLANE MID FRONTAL PLANE THE MID FRONTAL PLANE OF EACH THE MID FRONTAL PLANE OF EACH
SLOT MUST SUPERIMPOSE ON IT’S SLOT MUST SUPERIMPOSE ON IT’S CROWN’S PROMINENCE PLANECROWN’S PROMINENCE PLANE
ALL SLOTS SHOULD HAVE SAME ALL SLOTS SHOULD HAVE SAME DISTANCE FROM EMBRASURE LINE DISTANCE FROM EMBRASURE LINE
THESE FEATURES ELIMINATED-THESE FEATURES ELIMINATED-
XX 1ST ORDER BENDS1ST ORDER BENDSwww.indiandentalacademy.comwww.indiandentalacademy.com
CONVENIENCECONVENIENCE FEATURESFEATURES
o GINGIVAL TIE WINGS GINGIVAL TIE WINGS LATERAL TO SEALATERAL TO SEA
NO GINGIVAL IMPINGEMENTNO GINGIVAL IMPINGEMENT EASY LIGATIONEASY LIGATION
o STEMS OF LOWER 456 STEMS OF LOWER 456 GINGIVALGINGIVAL
• NO OCCLUSAL INTERFERENCESNO OCCLUSAL INTERFERENCES
o FACIAL SURFACES OF FACIAL SURFACES OF UPPER 123 PARALLEL UPPER 123 PARALLEL TO BASES IN TURN TO BASES IN TURN PARALLEL TO CROWN PARALLEL TO CROWN FACEFACE
o LIP COMFORTLIP COMFORT
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AUXILLIARYAUXILLIARY FEATURESFEATURES
COUNTER BUCCOLINGUAL TIP IN UPPER 6’SCOUNTER BUCCOLINGUAL TIP IN UPPER 6’S COUNTER MESIODISTAL TIP COUNTER MESIODISTAL TIP COUNTER ROTATIONCOUNTER ROTATION TRANSLATION BRACKETSTRANSLATION BRACKETS MAX TRANSLATION BRACKETSMAX TRANSLATION BRACKETS MEDIUM TRANSLATION BRACKETSMEDIUM TRANSLATION BRACKETS MIN TRANSLATION BRACKETSMIN TRANSLATION BRACKETS POWER ARMPOWER ARM
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STAGES OF TREATMENTSTAGES OF TREATMENT
ANCHORAGE CONTROLANCHORAGE CONTROLLEVELLING AND ALIGNINGLEVELLING AND ALIGNINGOVERBITE/ OVERJET CONTTROLOVERBITE/ OVERJET CONTTROLSPACE CLOSURESPACE CLOSUREFINISHINGFINISHING
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ANCHORAGE CONTROLANCHORAGE CONTROL
WITH THE INCREASE IN THE TIP THERE IS A WITH THE INCREASE IN THE TIP THERE IS A GREATER TENDENCY OF THE ANTERIORS GREATER TENDENCY OF THE ANTERIORS TO PROCLINETO PROCLINE
UPPER>LOWERUPPER>LOWERSOLUTIONSSOLUTIONS
OMEGA LOOP STOPSOMEGA LOOP STOPS MOLAR TIE BACKSMOLAR TIE BACKS TPA, LINGUAL ARCH, HGTPA, LINGUAL ARCH, HG CLASSIII ELASTICSCLASSIII ELASTICS ARCH WIRE BENT DISTALLY BEHIND MOLARARCH WIRE BENT DISTALLY BEHIND MOLAR
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LEVELLING AND ALIGNINGLEVELLING AND ALIGNING
TWO PROBLEMS TWO PROBLEMS ASSOCIATED WITH ASSOCIATED WITH THE PEATHE PEA
ROLLER COASTER ROLLER COASTER EFFECTEFFECT
NEED FOR NEED FOR OVERCOMPENSATIOVERCOMPENSATIONON
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OVERBITE CONTROLOVERBITE CONTROL
DEEP BITE DUE DEEP BITE DUE TO CANINE TIPTO CANINE TIP
A.A. WHEN CANINES WHEN CANINES WERE UPRIGHT / WERE UPRIGHT / DISTALLY TIPPEDDISTALLY TIPPED
B.B. ROLLER COASTER ROLLER COASTER EFFECTEFFECT
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SPACE CLOSURESPACE CLOSURE
MOST SIGNIFICANTMOST SIGNIFICANTSLIDING POSSIBLE BECAUSE OF THE SLIDING POSSIBLE BECAUSE OF THE
STRAIGHT WIRESTRAIGHT WIRE
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FINISHINGFINISHING
FINISHING REQUIRED MINIMAL WIRE BENDING TO FINISHING REQUIRED MINIMAL WIRE BENDING TO COMPENSATE FOR VARIATIONS IN TOOTH SHAPE, COMPENSATE FOR VARIATIONS IN TOOTH SHAPE, SIZE, ERRANEOUS BRACKET POSITIONING OR SIZE, ERRANEOUS BRACKET POSITIONING OR OVERCORRECTIONOVERCORRECTION
TIP CONTROL- ADJUSTMENT MAY BE NEEDEDTIP CONTROL- ADJUSTMENT MAY BE NEEDED TORQUE CONTROL-NEEDED IN UPPER AND LOWER TORQUE CONTROL-NEEDED IN UPPER AND LOWER
INCISORS.INCISORS.
LOWER MOLARS -VE TORQUE, UPPER MOLARS-LOWER MOLARS -VE TORQUE, UPPER MOLARS-+VE ROOT TORQUE+VE ROOT TORQUE
ARCH WIDTH ADJUSTMENTSARCH WIDTH ADJUSTMENTS ROTATIONAL CONTROLROTATIONAL CONTROL CURVE OF SPEE CORRECTIONCURVE OF SPEE CORRECTIONwww.indiandentalacademy.comwww.indiandentalacademy.com
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MM AA XX MM AA NN
TIPTIP TORQUETORQUE OFFSETOFFSET TIPTIP TORQUETORQUE OFFSETOFFSET
CENTRALCENTRAL 55 77 22 -1-1
LATERALLATERAL 99 33 22 -1-1
CUSPIDCUSPID 1111 -7-7 55 -11-11
11STST PM PM 22 -7-7 22 -17-17
22NDND PM PM 22 -7-7 22 -22-22
11STST MOLAR MOLAR 55 -9-9 1010 22 -30-30 00
22NDND MOLAR MOLAR 55 -9-9 1010 22 -33-33 00
ORIGINAL PRESCRIPTIONORIGINAL PRESCRIPTION
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TOOTHTOOTH TIPTIP TORQUETORQUE
CLASS ICLASS ITORQUE TORQUE CLASS IICLASS II
TORQUE TORQUE CLASS IIICLASS III
CENTRALCENTRAL 55 77 22 1212
LATERALLATERAL 55 33 -2-2 88
CUSPIDCUSPID 1111 -7-7 -7-7 -7-7
11STST PM PM 22 -7-7 -7-7 -7-7
22NDND PM PM 22 -7-7 -7-7 -7-7
11STST MOLAR MOLAR 5 CLASS I5 CLASS I
0 CLASS II0 CLASS II-9-9
-9-9
22NDND MOLAR MOLAR 5 CLASS I5 CLASS I
0 CLASS II0 CLASS II-9-9
-9-9
MAXILLARY STANDARDMAXILLARY STANDARD
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TOOTHTOOTH TIPTIP TORQUETORQUE
CLASS ICLASS ITORQUE TORQUE CLASS IICLASS II
TORQUE TORQUE CLASS IIICLASS III
CENTRALCENTRAL 22 -1-1 44 -6-6
LATERALLATERAL 22 -1-1 44 -6-6
CUSPIDCUSPID 55 -11-11 -11-11 -11-11
11STST PM PM 22 -17-17 -17-17 -17-17
22NDND PM PM 22 -22-22 -22-22 -22-22
11STST MOLAR MOLAR 22 -30-30 -30-30 -30-30
22NDND MOLAR MOLAR 22 -35-35 -35-35 -35-35
MANDIBULAR STANDARDMANDIBULAR STANDARD
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MAXILLARY TRANSLATIONMAXILLARY TRANSLATION
TOOTHTOOTH AA NN GG RR OO TT II NN CC
MINMIN MEDMED MAXMAX MINMIN MEDMED MAXMAX MINMIN MEDMED MAXMAX
33 1313 1414 1515 22 44 66 -7-7 -7-7 -7-7
44 66 55 44 22 44 66 -7-7 -7-7 -7-7
55 00 -1-1 -2-2 22 44 66 -7-7 -7-7 -7-7
66 33 22 11 1212 1414 1616 -13-13 -14-14 -15-15
77 33 22 11 1212 1414 1616 -13-13 -14-14 -15-15
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MANDIBULAR TRANSLATIONMANDIBULAR TRANSLATION
TOOTHTOOTH AA NN GG RR OO TT II NN CC
MINMIN MEDMED MAXMAX MINMIN MEDMED MAXMAX MINMIN MEDMED MAXMAX
33 77 88 99 22 44 66 -11-11 -11-11 -11-11
44 44 55 66 22 44 66 -17-17 -17-17 -17-17
55 00 -1-1 -2-2 22 44 66 -22-22 -22-22 -22-22
66 00 -1-1 -2-2 22 44 66 -30-30 -14-14 -15-15
77 00 -1-1 -2-2 22 44 66 -35-35 -14-14 -15-15
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Thank YouThank You
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