FIXED ORTHODONTIC
APPLIANCES
DENT 657
Removable vs. Fixed Appliances
REMOVABLE
Tipping only
No control over root
movement
Pts co-operation
Hygienic
FIXED
Bodily translation
Control of root
movement
Less dependent on pts
co-op
Less hygienic
DEVELOPMENT OF FIXED
ORTHODONTIC APPLIANCES
Development of Fixed appliances
Early fixed appliances
Late 1800s
Edward Angle
EARLY FIXED APPLIANCES
Development of Fixed appliances
Standard Edgewise appliance
Early 1900s
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
BANDED APPLIANCES
Bonding to Enamel
Bonding Surface - Bracket Base
BONDED APPLIANCES
Lingual Appliance
CERAMIC APPLIANCES
Self Ligating Appliance
PASSIVE FIXED APPLIANCES
Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Buccal Tubes
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances
Posterior attachments
MOLAR TUBES
Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances
Anterior Attachments
Brackets
Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances
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
Components of the Fixed
Appliance
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances
Elastics
EXTRA ORAL FORCES - HEAD GEAR
Coil Spring
Closed or open coil springs
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
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
First order or In-out
Pre-adjusted edgewise appliance
First order / in-out - Horizontal plane
Second order / tip - Mesio-distal angulation
Third order / torque - Labio-lingual
angulation
Second order or Tip
4
Pre-adjusted edgewise appliance
First order / in-out - Horizontal plane
Second order / tip - Mesio-distal angulation
Third order / torque - Labio-lingual
angulation
Third order or Torque
4
To Torque is the least efficient
tooth movement using orthodontic
appliances
Significance of accurate bracket/band
positioning
Precise tooth positioning
Optimal effect of pre-adjustment
Occlusion
Esthetics
Stability
POSITIONING BRACKETS -
GENERAL INSTRUCTIONS
Rhomboidal shape
Disto-lingual wing mark
Central scribe line (long axis)
Maxillary Central Incisors
4
Distance from the slot to the
incisal edge = 4mm
From the occlusal, the bracket
is centered mesio-distally.
As a guide, approximate the
incisal edge of the incisor with
the base of the bracket
perpendicular to the clinical
crown long axis.
4
Maxillary Lateral Incisor
3.5
Distance from the slot to the incisal edge
= 3.5mm
3.5
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 (10
o
) can make
placement difficult
From 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 the
center of the contacts
Maxillary Bicuspids
Distance from cusp tip to bracket slot =
4 mm
From the occlusal view, the bracket is
centered mesio-distally on the prominent
buccal developmental ridge. This also
corresponds to the clinical crown long
axis.
Mandibular Incisors
Mandibular Cuspid
Mandibular Bicuspids
Maxillary first molar bands
Mandibular first molar bands
Palmer notation used in Orthodontics
Right Left
Upper 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Upper
Tooth # 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Tooth # 31 30 29 28 27 26 25 24 23 22 21 20 19 18
Lower 7 6 5 4 3 2 1 1 2 3 4 5 6 7 Lower
The bracket height chart is written in Palmer Notation. This notation numbers the teeth starting
with the central incisors as 1. The laterals are then 2. The canines are 3. The 1
st
and 2
nd
premolars are 4 and 5 respectively, the 1
st
molars are 6 and the 2
nd
molars are 7.
Bracket Heights from Cusp tip or Incisal Edge
Right 2
nd
M
1
st
M
2
nd
B
1
st
B
Cu LI CI CI LI Cu 1
st
B
2
nd
B
1
st
M
2
nd
M
Left
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
4.5
4 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
