Fixed Appliance Xiaorong, Wang Xiaorong, Wang. A. The development of fixed appliance Definition ： Commonly refers to orthodontic brackets which are attached.

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Fixed Appliance Xiaorong, Wang Xiaorong, Wang Slide 2 A. The development of fixed appliance Definition Commonly refers to orthodontic brackets which are attached to teeth and exhibit the properties that dentists desire. The appliance is removed until the therapy finished. Slide 3 advantage Brackets attached to teeth Provid enough anchorage for tooth movement 3-D control of tooth movement (translation controlled movement Tooth movement occur effciently Effective treatment for comprehensive malocclusion Effective treatment for comprehensive malocclusion Independent on patient compliance Independent on patient compliance Slide 4 disadvantage Inconvenient for food processing and keeping oral healthy Inconvenient for food processing and keeping oral healthy Increase the chair time Increase the chair time Cause inflammation and soreness if operated inappropriatly Cause inflammation and soreness if operated inappropriatly Influence on esthetic Influence on esthetic Slide 5 The development of fixed appliance 1907s The E-Arch 1911s Pin and Tube 1916s Ribbon Arch 1928s Edgewise Slide 6 First phase E~arch E~arch 1900s 1900s Heavy labial arch Heavy labial arch Arch perimeter increased Arch perimeter increased Tipping teeth Tipping teeth Slide 7 Second phase Pin and tube The E-Arch was capable only of tipping teeth to a new position. It was not able to precisely position any individual tooth. Angle began placing bands on other teeth and used a vertical tube on each tooth, with this appliance, tooth movement was accomplished by repositioning the individual pins at each appointment. The E-Arch was capable only of tipping teeth to a new position. It was not able to precisely position any individual tooth. Angle began placing bands on other teeth and used a vertical tube on each tooth, with this appliance, tooth movement was accomplished by repositioning the individual pins at each appointment. Slide 8 Third phase Ribbon arch Modified the tube on each tooth to provide a vertically positioned rectangular slot behind the tube Modified the tube on each tooth to provide a vertically positioned rectangular slot behind the tube The wire was placed into the slot and held with pins The wire was placed into the slot and held with pins It provided poor control of root position It provided poor control of root position Slide 9 Forth stage Edgewise To overcome the deficiencies of the ribbon arch To overcome the deficiencies of the ribbon arch In the year of 1928 arch wire was inserted an a 90-degree angle to the plane of insertion of the ribbon arch In the year of 1928 arch wire was inserted an a 90-degree angle to the plane of insertion of the ribbon arch Multibanded appliance single bracket,the rectangular wire was tied into a slot with ligatures Multibanded appliance single bracket,the rectangular wire was tied into a slot with ligatures This appliance did allow excellent control of crown and root position in all three planes of space This appliance did allow excellent control of crown and root position in all three planes of space Slide 10 Angles progression to the edgewise appliance Edward Angles position an the father of modern orthodontics is based not only on his contribution to classification and diagnosis buy also on his creativity in developing new orthodontic appliances. Edward Angles position an the father of modern orthodontics is based not only on his contribution to classification and diagnosis buy also on his creativity in developing new orthodontic appliances. Slide 11 Begg appliance Raymond Begg had been taught use of the ribbon arch appliance at the Angle school before his return to Australia in the 1920s Raymond Begg had been taught use of the ribbon arch appliance at the Angle school before his return to Australia in the 1920s The Begg concluded that extraction of teeth was often necessary and set out to adapt the ribbon arch appliance The Begg concluded that extraction of teeth was often necessary and set out to adapt the ribbon arch appliance 1950s Begg appliance was born 1950s Begg appliance was born Slide 12 Straight wire appliance Straight wire appliance Improving the efficiency of the edgewise appliance Improving the efficiency of the edgewise appliance Used quicker and easier Used quicker and easier Slide 13 The development of fixed appliance Multibandeddirect bonding Multibandeddirect bonding single brackettwin brackets straightwire appliance single brackettwin brackets straightwire appliance Slide 14 The development of fixed appliance Ribbon Arch Angle 1912 Edgewise Angle 1928 Begg Appliance Begg 1954 Tip-Edg Kesling 1987 Tweed Appliance Tweed 1941 Tip-Edge light wire technic,Jarabak1963 segmental arch technic,Burston1966 bioprogrssive therapy,Ricketts1974 MEAW,Kim 1974 two by four arch,Mulligan 1982 Straight- wire Prescritions Slide 15 B. Edgewise appliance At 1925,Angle created new edgewise appliance At 1925,Angle created new edgewise appliance The edgewise appliance became widely popular in the 1950s The edgewise appliance became widely popular in the 1950s In the middle 1980s,professor xiangyu,ye brought the edgewise appliance into our country In the middle 1980s,professor xiangyu,ye brought the edgewise appliance into our country Slide 16 a. Components of appliance band band bracket bracket wire wire accessories accessories Slide 17 Band Diy steel weld buccal tube hook Diy steel weld buccal tube hook Preformed bands Preformed bands Slide 18 Buccal rectangular tube 0.022 rectangular tube 0.022 0.018 0.018 round tube 1.2mm round tube 1.2mm hook hook Slide 19 Bracket Functional Functional Horizontal slot :the arch vertical slot bracket vertical slot bracket wing : tie-ligature wing : tie-ligature bracket base: mesh base adhesive to enamel bracket base: mesh base adhesive to enamel Slide 20 Bracket Position Height Height U 1 4 5 6 4.5 mm U 1 4 5 6 4.5 mm U 2 4 mm U 2 4 mm 3 5 mm 3 5 mm L 1 2 4 mm L 1 2 4 mm Slide 21 Position Distal and mesial Center bracket consistent Center bracket consistent with the dental center with the dental center Axis inclination Axis inclination Angle between the long Angle between the long axis of the bracket and axis of the bracket and the long axis of tooth the long axis of tooth Slide 22 Angle of the crown teeth Slide 23 Brackets single bracket twin brackets straight-wire brackets single bracket twin brackets straight-wire brackets Steel brackets plastic brackets ceramic brackets Stainless Steel brackets plastic brackets ceramic brackets Slide 24 Brackets Slide 25 Orthodontic Arch wire Materials Ni~Ti wire Superelasticity pre- formed arch Shape memory Ni~Ti wire Superelasticity pre- formed arch Shape memory round wire :strength and springiness Can be bend to any desired shape round wire :strength and springiness Can be bend to any desired shape rectangular wire Strong strength rectangular wire Strong strength Slide 26 Ligating material Elastic o-ring Elastic o-ring Stainless steel wire ligature Stainless steel wire ligature Self-ligating Self-ligating Slide 27 accessories Sliding hook Sliding hook Lingual button Lingual button Slide 28 b. Characteristics and principles characteristic characteristic a Can effectively control the movements of teeth in all directions a Can effectively control the movements of teeth in all directions b Dental arch through the wire as a whole could give a good anchorage b Dental arch through the wire as a whole could give a good anchorage Slide 29 principal a) B ending deformation of the wire a) B ending deformation of the wire reset makes tooth movement b Retention of fixed wire reset makes tooth movement b Retention of fixed wire Slide 30 c. Basic treatment steps a Alignment and leveling b The closure of extraction space c Adjustment of the tooth relationship d Retainer fixed removable Slide 31 Three order bend first order bend so-called in-out bends, which are represented by the distance of the brackets slot to the tooth serface and is a horizontal adjustment so-called in-out bends, which are represented by the distance of the brackets slot to the tooth serface and is a horizontal adjustment inset offset. inset offset. purpose curvature of the natural arch form purpose curvature of the natural arch form Slide 32 second order bend vertical bend tip back bend terminal tip back bend tip forward bend axial positional bend vertical bend tip back bend terminal tip back bend tip forward bend axial positional bend Purpose up and down or tip bends, to provide correct axial inclination and tooth-root alignment in a mesil-distal demention Purpose up and down or tip bends, to provide correct axial inclination and tooth-root alignment in a mesil-distal demention Slide 33 third order bend torque lingual root torque/labial crown torque labial root torque/lingual crown torque torque lingual root torque/labial crown torque labial root torque/lingual crown torque purpose bucco-palatal or bucco- lingual position of the roots in respect to the crowns of the teeth purpose bucco-palatal or bucco- lingual position of the roots in respect to the crowns of the teeth Slide 34 Retainer Retainer removable fixed Retainer removable fixed Time Time Slide 35 C. Straight wire appliance Preadjusted appliance Develop from the edgewise appliande which is basically an appliance with built- in 3D prescription to represent ideal tooth positions, without the three order bend into the arch wire Theoretic Andrews published his classic article the six keys of ideal occlusion Andrews published his classic article the six keys of ideal occlusion Slide 36 a.The development of the SWA 1972 Dr.Andrews : straight-wire appliance(SWA) 1972 Dr.Andrews : straight-wire appliance(SWA) 1976 Secondly Dr.Roth : Roth set-up 1976 Secondly Dr.Roth : Roth set-up 1997 thirdly Dr.McLaughlin,Dr.Bennett Dr.Trevisi: MBT TM 1997 thirdly Dr.McLaughlin,Dr.Bennett Dr.Trevisi: MBT TM Slide 37 b. characteristic Improve the design of bracket Precisely position the average tooth Minimize the second- and third-order bends Shorten the course of treatment Improve the design of bracket Precisely position the average tooth Minimize the second- and third-order bends Shorten the course of treatment Slide 38 Torque and axial inclination Slide 39 c position Center of clinical crown Center of clinical crown Bracket Identification: Brackets distal-gingival wing is marked Bracket Identification: Brackets distal-gingival wing is marked Slide 40 d procedures first stage alignment first stage alignment laceback ; cinch back Slide 41 closure of extraction space Second stage close of extraction space sliding mechanics Slide 42 D. Lingual appliance Slide 43 E. Operation 1. separation Separation material Separation material Operating points Operating points Slide 44 2. bonding Slide 45 Cementation requirements Fitting around the tooth Fitting around the tooth No stimulation of gingival tissue No stimulation of gingival tissue Good retention Good retention No interference with normal occlusion No interference with normal occlusion Slide 46 Bonding bracket Direct bonding Direct bonding In-direct bonding In-direct bonding Slide 47 3. ligature Slide 48 4. debonding Removing the bracket Removing the bracket Removing the band Removing the band Grinding the bonding material Grinding the bonding material Polishing the tooth surface Polishing the tooth surface Slide 49 Familiar with the characteristics and the principle of fixed appliance Familiar with the composition of appliance treatment and basic steps Composition band bracket arch wire appliance Procedure alignment close space adjustment retainer Summary