Fixed Appliance
Xiaorong, Wang
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.
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
Independent on patient compliance
disadvantage
Inconvenient for food processing and keeping oral
healthy
Increase the chair time
Cause inflammation and soreness if operated
inappropriatly
Influence on esthetic
The development of fixed appliance
1907s，The E-Arch
1911s，Pin and Tube
1916s，Ribbon Arch
1928s，Edgewise
First phase
E~arch
• 1900s
• Heavy labial arch
• Arch perimeter
increased
• Tipping teeth
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 .
Third phase
Ribbon arch
• 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
It provided poor
control of root position
Forth stage
Edgewise
• 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
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
Angle’s progression to the
edgewise appliance
• Edward Angle’s 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.
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
• The Begg concluded that extraction
of teeth was often necessary and set
out to adapt the ribbon arch
appliance
• 1950s Begg appliance was born
Straight wire appliance
• Improving the efficiency of the
edgewise appliance
• Used quicker and easier
The development of fixed
appliance
• Multibanded——direct bonding
• single bracket——twin brackets——
straightwire appliance
The development of fixed appliance
Ribbon Arch
Angle 1912
Edgewise
Angle 1928
Begg
Appliance
Tip-Edg
Kesling 1987
Begg 1954
Tweed
Appliance
Tweed 1941
Tip-Edge
Straightwire
Prescritions
light wire technic,Jarabak1963
segmental arch
technic,Burston1966
bioprogrssive
therapy,Ricketts1974
MEAW,Kim 1974
two by four arch,Mulligan 1982
B . Edgewise appliance
• At 1925,Angle created new edgewise
appliance
• The edgewise appliance became widely
popular in the 1950s
• In the middle 1980s,professor xiangyu,ye
brought the edgewise appliance into our
country
a. Components of appliance
• band
• bracket
• wire
• accessories
Band
• Diy：steel、weld；buccal tube ；hook
• Preformed bands
Buccal
rectangular tube
0.022
0.018
round tube 1.2mm
hook
Bracket
• Functional
Horizontal slot :the arch
vertical slot：bracket
wing : tie-ligature
bracket base: mesh base、
adhesive to enamel
Bracket Position
Height
U 1456
4.5 mm
U 2
3
L 1 2
4 mm
5 mm
4 mm
Position
Distal and mesial
Center bracket consistent
with the dental center
Axis inclination
Angle between the long
axis of the bracket and
the long axis of tooth
Angle of the crown teeth
Brackets
single bracket、twin brackets、
straight-wire brackets
Stainless Steel brackets 、plastic
brackets、ceramic brackets
Brackets
Orthodontic Arch wire Materials
• Ni~Ti wire：Superelasticity、pre-
formed arch、Shape memory
• round wire :strength and
springiness，Can be bend to any
desired shape
• rectangular wire：Strong strength
Ligating material
• Elastic o-ring
• Stainless steel wire ligature
• Self-ligating
accessories
• Sliding hook
• Lingual button
b. Characteristics and principles
• characteristic
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
principal
• a) Bending deformation of the wire
reset makes tooth movement
b）Retention of fixed wire
c. Basic treatment steps
a） Alignment and leveling
b） The closure of extraction space
c） Adjustment of the tooth relationship
d） Retainer ：fixed、removable
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
• inset、offset.
• purpose：curvature of the natural arch
form
second order 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
third order bend
• torque
lingual root torque/labial crown
torque；labial root torque/lingual
crown torque
• purpose：bucco-palatal or buccolingual position of the roots in respect
to the crowns of the teeth
Retainer
• Retainer ：removable fixed
• Time
C.
Straight wire appliance
Preadjusted appliance
Develop from the edgewise appliande，
which is basically an appliance with builtin 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
a.The development of the SWA
• 1972，Dr.Andrews : straight-wire
appliance(SWA)
• 1976，Secondly，Dr.Roth : Roth set-up
• 1997，thirdly，Dr.McLaughlin ,Dr.Bennett
Dr.Trevisi: MBTTM
b. characteristic
Improve the design of bracket
Precisely position the average tooth
Minimize the second- and third-order
bends
Shorten the course of treatment
Torque and axial inclination
c position：
Center of clinical crown
• Bracket Identification: Brackets’
distal-gingival wing is marked
d procedures：
first stage ：
alignment
——laceback ;
——cinch back
closure of extraction space
Second stage ： close of
extraction space
——sliding mechanics
D. Lingual appliance
E. Operation
1. separation
• Separation material
• Operating points
2. bonding
Cementation requirements
• Fitting around the tooth
• No stimulation of gingival tissue
• Good retention
• No interference with normal occlusion
Bonding bracket
• Direct bonding
• In-direct bonding
3. ligature
4. debonding
• Removing the bracket
• Removing the band
• Grinding the bonding material
• Polishing the tooth surface
Summary
•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