HISTORY OF
ORTHODONTICS
rd
BDS 3 year
Dr. Gyan P. Singh,
Deptt. Of Orthodontics&Dentofacial Orthopaedics
25/08/2014 ( 12-1 PM),C.P. Govila Auditorium
ORTHODONTICS IN GREECE & ROME
HIPPOCRATES (460-377 B.C.)
-Greek physician
-Reference to both teeth & jaw were
found in his writings.
-Gave earliest description of irregularities
of teeth.
-All information collection in text—
Corpus
hippocraticum.
Hippocrates , in his Epidemics found that;
‘Among those individuals with long shaped
head some have thick necks, strong bones;
others have strongly arched palate, their
teeth are disposed irregularly arranged,
crowding one on the other.
3
-Aristotle (384 to 322 BC)
- the Greek philosopher , studied the teeth in a broad
manner
-Marked difference between human teeth and those of
animals and, in fact differences between the different
species of animals
• AULIUS
CORNELENIUS
CELSUS (25 BC-AD
50 )
“If a second tooth should
happen to grow in
children before the first
has fallen out, that which
ought to be shed is to be
drawn out & the new one
daily pushed towards its
place by means of the
finger until it arrives at
its proper position”.
5
MIDDLE AGES (476 -1450)
-Paul of Aegina (Paulus Aeginata (625 – 690)
- wrote, ‘When supernumerary teeth
causes an irregularity of of dental
arches, they may be corrected by
resection of such teeth or by extraction.
-Stated that ‘irregular teeth were
‘displeasing in women’
RENAISSANCE PERIOD
(14TH – 16TH CENTURY)
LEONARDO DA VINCI
(1452-1519)
-Painted a smile on the lips of
MONA LISA.
-1st to recognize tooth form
-1st to realize that each tooth was
related to another tooth & to the
opposing jaw.
SIXTEENTH TO
SEVENTEENTH
CENTURY
The first mention of practicing dentistry was exclusively
made by Pierre Dionis(1658-1718).
He called dentists ‘Operator for the teeth’
and stated that they could also open or widen the teeth
when they are set too close together’
EIGHTEENTH CENTURY
-Beginning in the 18th century,
leading country
in the field of dentistry was
FRANCE.
-Efforts of one man:
PIERRE FAUCHARD (16781761)
He is referred to as the ‘Founder
of Modern Dentistry
In 1728 ,he published the general work on
dentistry, 2 volumes entitled
‘THE SURGEON DENTIST ,A TREATISE ON
THE TEETH’
Fauchard, described first orthodontic appliance
Bandelette.
10
- Consists of horse shoe
shaped strip of precious
metal to which teeth are
ligated.
11
JOHN HUNTER (1728-1793)
-An English anatomist and surgeon, took keen
interest in anatomy of teeth and jaws.
12
His book-‘THE NATURAL HISTORY OF HUMAN
TEETH’ in 1771
• First to describe nomenclature to classify the
teeth(incisors , bicuspids and molars)
• First to describe growth of jaws
13
EUROPEAN PIONEERS OF EARLY
19TH CENTURY
JOSEPH FOX(1776-1816)
- ‘The Natural history and Diseases of Human
Teeth’(1814) to the budding science of
orthodontics.
-First to classify malocclusion (1803) First to observe
that mandible grows mainly by
distal extension beyond the molars,
with little or no increase in the anterior region.
14
AMERICAN PIONEERS OF EARLY 19th
CENTURY
- J. S. Gunnel (1840)
Invented occipital anchorage for mandibular protrusion
William Lintott (1941)
- Introduced the use of screws
15
ORTHODONTICS PIONEER OF LATE 19TH
CENTURY
.
In the early 1900s ,groundbreaking
scientists ,built the orthodontic
edifice brick by brick.
NORMAN W.KINGSLEY(1825-1896):
Edward H. Angle referred to
Kingsley as;
‘’Orthodontia’s greatest genius”
• Born on 2nd Oct 1825
• Joined Dr. A.W. Kingsley,
Pennsylvania.
• 1852 – first office in Oswego, New
York.
16
After 1850, appeared: the most notable was
Kingsley’s book
“A Treatise on “Oral Deformities(1880)”
- Cleft palate prostheses.
Artificial replacement of missing parts.
External immobilization.
17
Over 100 articles on
Cleft palate rehabilitation.
Inadequacies of cleft palate
surgery.
Obturators.
Orthodontic diagnosis.
Orthodontic appliances.
Introduced occipital anchorage
- Described “Jump the bite”(1880)
-Main objective was not to protrude lower teeth, but
to change or jump the bite in case of excessively
retreating lower jaw
19
• EMERSON C. ANGELL : open mid palatal suture
with a split plate(1860)
20
• WILLIAM E. MAGILL ; first to cement (platinum)
bands (1871)
21
1871 C.R.COFFIN :
Kingsley student
reported an expansion
appliance which bears
his name
22
JOHN NUTTING FARRAR:
( 1839-1913)-Father of American
Orthodontics
- Began the era of biologic tooth
movements.
First to use occipital anchorage to
retract anterior teeth (1850) - His
treatise on “irregularites of teeth
and their correction” (1888) is
considered a great work devoted
exclusively to orthodontics.
23
- He recommended bodily movements of teeth (1888)
- He originated the theory of intermittent forces and
developed a screw to deliver this force in controlled
increments
24
- In 1893, Henry A. Baker,
introduced intermaxillary rubber bands to
correct protrusion, known as ‘Baker
anchorage”.
EDWARD H. ANGLE
(1855 – 1930)
- Born in a farm in
Pennsylvania on June 1st,
1855 .
- Marked ability to improve &
create mechanical
equipment on the farm.
- Developed a passion for
simplicity in design.
26
- 1878- Graduated from Pennsylvania College of
Dentistry.
-1887 – Appointed to Chair of Orthodontia in dental
department of University of Minnesota.
Conveyed through his paper, ‘Notes on Orthodontia
with a New System of Regulation & Retention’ at
9th International Medical Congress.
1887 – Ohio Journal of Dental Science.
27
• 1888 – Lecture to Iowa State Dental Society –
demonstrated expansion arch & its auxiliaries.
• 1894 – Professor of Orthodontia at Marian Sims
College, receiving MD degree the following year.
- In 1900, founded the first postgraduate school
of orthodontics (Angle school of Orthodontia)
- In 1907, founded, first orthodontic journal,
(The American Orthodontist)
“The
best balance, the best harmony, the best
proportions of the mouth in its relation to the
other features require that there shall be a full
complement of teeth & that each tooth shall be
made to occupy its normal position - i.e. normal
occlusion”
30
- Angle developed classification of malocclusions
,published in – ‘Dental Cosmos’ in 1899.
- Maxillary first permanent molar - stable landmark in
craniofacial anatomy
31
32
Angle stated “The idea of a postgraduate school was forced upon me
because I wished to see those who had a desire to study
orthodontia better receive the opportunity to do so”.
Angle had commenced informal instructions in
orthodontia in his office in 1900.
33
In May 1900 at a banquet in Dr. Angle’s office, the
students & teachers decided that the time was ripe for
an Orthodontic Society.
The American Society of ‘Orthodontists ’.
On June 11, 1901, 10 members elected Angle as
president.
34
1907 – moved his school to New York.
1908 – moved his school to New London, Conn.,
Decided to give up practice of orthodontia & devote
himself to study, teaching & development of better
appliances.
35
- James Angle – first student of Edward H. Angle
College of Orthodontia in California.
- 1922 – Graduates of Pasadena, St. Louis & New
London formed The Edward H. Angle Society.
- Angle attended the last society meeting on June
1928 in New London, Connecticut.
- The society ceased to exist after his passing
away in 1930.
-17 Nov,1930 – society reorganized & restarted
from former members.
36
1900-E -Arch Appliance
- The heavy archwire was
supplied in 4 designs,
depending on treatment
plan 1. Basic E arch - used in
mandible with Baker
anchorage
37
1901 Pin and Tube Appliance
- Incredible degree of craftsmanship.
- Impractical in clinical use.
- Poor spring qualities.
38
1910-Ribbon Arch Appliance
-First bracket was introduced
by Angle in 1916 for use with
his ribbon arch mechanism
-Vertically positioned rectangular slot with ribbon arch of 10
x 20 gold wire.
- Good spring qualities.
- Allowed versatile movements.
39
1925 EDGE WISE
-Most accepted
-Allows tooth movement in
the three plane
- Angle gave edgewise
bracket,,later on C. Tweed gave
edgewise appliance
• All said and done, Angle possessed
extraordinary technical skills, a very inventive
mind and an unbending, uncompromising nature
which truly makes him a mechanical, technical
and clinical genius, the repercussions of whose
inventions and contributions are strongly felt
even today.
Very aptly and deservingly he is called the
“Father of Modern Orthodontics’.
41
CALVIN S. CASE (1847-192
• 1871-Graduated from Ohio
college of dental surgery.
- Wrote a practical treatise on
“Technics and principles of
Dental Orthopedia” (1908)
and wrote 123 articles
• First to use along with Henry
Baker Class II elastics and was
the first to attempt bodily
movement.
42
• CONTRARY to Angle ,Case used different type of
appliance for each patient and stressed facial
esthetics in contrast to Angle’s reliance on occlusion
• He advocated changing the name of speciality to
‘Facial Orthopedia’
• 1892-First to stress on root movement & used
rubber elastics in treatment.
• Rehabilitation of cleft palate deformities-Case type
of obturator still in use
43
- First to use light wires (.016-.018)
Advocated extraction to correct facial deformities
• Case used headgears for cleft patients and
other
• His greatest contributions to be prosthetic
correction of cleft palate.
Case’s 1911 paper provoked acrimonious
debate that came to be known as “Great
Extraction v/s non extraction debate”
44
The Great Extraction Controversy
P.FAUCHARD
& CELSUS
:recommended extraction
HUNTER
:opposed it on the ground that it
inhibits growth
DELABARRE
: It warned against undesirable
sequelae
CASE :
Appeared in Chicago before National Dental
Association’s annual meeting in July (1911) with his
paper
“The question of extraction in Orthodontia”
Discussion erupted into full scale debate..
He was supported by impressive argument
Matthew Cryer ,a renowned anatomist.
46
Martin Dewey (1881-1933)
.
• Born in 1881, Kansas.
• 1902-attended one of the first
classes of Angle school of
orthodontics.
• 1914- ‘Practical orthodontics’ orthodontic philosophy and
mechanical procedures.
• 1911-Dewey school of
orthodontia.
47
MARTIN DEWEY :
- Advocated non extraction and challenged Case.
- ortho thought ,including Early regulation,Heredity, Bone
growing and Evolution.
- But Angle’s follower won the day and for next 30 yrs extraction
disappeared-
48
- Orthodontist such as John Mershon, Joseph Johnson ,George
Crozat ,whose appliances relied on non-extraction
philosophy,helped perpetuate this philosophy.
- But by 1930’s dentist were beginning to notice relapse…
49
Charles A. Hawley
(1861 – 1929)
- 1908 - introduced
‘Hawley’s retainer
appliance’
50
Benno E. Lischer (1876-1959)
He wrote;
-1909; Elements of Orthodontia
-1912 ; ‘Principles & methods of Orthodontia’.
Coined terms – mesioocclusion
- distoocclusion
- neutroocclusion
- Stressed ,the relationship between muscles, malformation &
malocclusion.
51
1910 -1920
• John. V. Mershon
(1867-1953)
Introduced Removable
Lingual Arch (1909)
based on the principle
that teeth must be free
& unrestricted (if
otherwise rigidly
connected) for
adaptation to normal
growth i.e
- First invisible Appliance
52
Albert. H. Ketcham - (1870-1935)
-1902 - Graduate of Angle School of
Orthodontics.
• First to introduce Roentgenogram &
Photography.
• 1926 - Comprehensive data on root
resorption..
• A great teacher & guide- ‘Ketcham
Seminar’.
1929 : President of American Board of
Orthodontics
53
•1928- George Crozat
•Originally called “Invisible brace”,
later became Crozat appliance
54
- Paul Simon’s (1883 -1957) – studies of facial bones
that introduced the orbital canine rule
- American board of Orthodontics was created in 1929,
& incorporated in 1930.
1930 -1940
Justus A. W. von Loon (1915)- first to introduce
cephalometrics into orthodontics
- In 1922,Paccini, gave the term cephalometrics
1931 –B. Holly Broadbent published in the first issue
of Angle Orthodontist – ‘A New X-ray Technique &
Its Application to Orthodontia’
- Herbert Hofrath (1931) from Germany
- Introduced . cephalometric roentgenography,
cephalometric tracing & evaluation
56
1940 - 1950
Charles H Tweed
(1895-1970)
–1941; introduced
edgewise appliance
based on basal bone
concept.
57
Tweed’s contributions –
1.
4 objectives of orthodontic treatment with emphasis
for facial esthetics.
2.
Upright mandibular incisors over basal bone.
3.
Acceptance of judicious extraction of teeth.
4.
Clinical application of cephalometrics
58
5. Tweed’s diagnostic
facial triangle.
6. Introduced anchorage
preparation.
6. Serial extraction of
primary & permanent
teeth. (preorthodontic
guidance)
• Tweed philosophy.
59
1950 – 1960
-1948 – Cephalometric Analysis by William B Downs.
-it presented an objective method of portraying many
factors underlying
any malocclusion,
exclusive of the teeth
60
Thomas .M. Graber (1917-2007)
• Born in St.Louis on May
17th 1917.
• Graduation –
Washington University,
St.Louis.
61
• 20 textbooks, 22 chapters in other textbooks,
180 publications in journals & 930 book &
journal abstract reviews.
• 1964 – Kenilworth Dental Research
Foundation.
• Editor-in-chief of AJO for 15 years.
• Changed to AJO-DO.
62
Lawrence F. Andrews(1929-)
• Father of pre-adjusted
bracket system.
• Nature’s best-120 nonorthodontic normal cases.
• 6 keys of occlusion – 1972.
• Orthodontia’s best – 1150
treated cases.
• Straight wire
appliance(1970)
63
Functional appliances to midcentury
• The history of the functional appliance can be traced
back to 1879, when Norman Kingsley introduced
the“bite-jumping” appliance
• 1902 – ‘Monobloc’ by Pierre Robin.
– Single block of vulcanite.
– To prevent glossoptosis in micromandible
& Cleft lip & palate patients.
Myofunctional therapy
• Alfred P. Rogers (1873-1959; Angle School, 1903)
called the father of myofunctional therapy,
• recognized the importance of the whole orofacial
system.
65
• Rogers was the first to implicate the facial muscles
for the growth, development,and form of the
stomatognathic system
• The activator
In 1909, Viggo Andresen (1870-1950)
Herbst appliance
.
-was introduced in 1905
by Emil Herbst (18421917), but his findings
were not published until
1935
- suitable for slightly
older children whose
cooperation might not be
dependable, because it is a
fixed appliance worn 24
hours a day.
67
• Rolf Frankel(1908 -2001) – Frankel Function Regulator in 1957
• Appliance confined to oral vestibule – shields buccal and labial
musculature away from teeth & investing tissues.
• Exercise device – eliminates lip trap, hyperactive mentalis,
aberrant buccinator & orbicularis oris action.
68
• Most frequently used activator modification –
Bionator by Wilhelm Balters
- In 1952, Hans Mühlemann created the propulsor.
It was based on the activator, but it lacked the
metal elements.
- The propulsor was later perfected by Hotz.
69
• 1977 – Clark’s Twin Block.
• Rapid functional correction of malocclusion.
70
•
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Materials
Metals
Gold
SS
CoCr
Titanium
Magnet
Plastics
Ceramic
Ceramic with metal slot
Zirconia
The beginning of Selectivity (1975 to the present)
•
•
•
•
Self – ligating brackets.
Composite – ceramic+polymer advantages.
Bonding – adhesive pre-coated brackets.
Curing – Light emitting diodes, Plasma arc
lights (Xenon), Laser lights (Argon laser).
- The tip-edge bracket does just that. Developed by Dr. Peter
Kesling of Westville, Indiana, in 1986
72
Summary
- Pierre Fauchard
1728
Bandelette
-Charles Goodyear
1839
Vulcanite
-Tucker
1846
Rubber elastics
-D William Dwinelle
1849
Jack screw
-Emerson C. Angell
1860
Expansion of plates
-Coffin
1860
Coffin spring
-Kingsley
1861
Headgear
-
E.H. Angle
1889
Classification of malocclusion
-
E.H. Angle
1907
E –arch
-
Charles Hawley
1908
Retainer
-
Andresen
1908
Activator
-
E.H. Angle
1912
-
Newell
1912
•
E.H. Angle
1912
Pin & tube appliance
Vestibular screen
Ribbon arch appliance
Martin Schwarz
1938
Schwarz double plate
-William Downs
1948
Down’s analysis
-Balter
1950
Bionator
-P.R. Begg
1956
Begg technique
-Rolf Frankel
1957
Frankel appliance
-Ricketts
1958
Bioprogressive therapy
• Andrews
1970
Straight wire appliance
• KURZ
1976
LINGUAL ORTHODONTIC APPLIANCE
• Pancherz
1977
Herbst appliance
• Clark
1977
Twin block
• Alexander
1978
Vari-Simplex
MCQ:
1.Cephalometry was introduced by
(A) Margolis and William Wilson (1925)
(B) Tweed and Mills(1940)
(C) Bjork and Sassouni(1995)
(D) Broadbent and Hofrath(1931)
2. Father of modern orthodontics
(A) Dewey
(B) Angle
(C) Andrew
(D)Clark
3.Angle’s classification was modified by
(A) Dewey
(B) Calvin Case
(C) Andrew
(D) Clark
4. Use of finger pressure to align the irregular teeth was advocated
by
(A) Edward H.Angle
(B) Aulius C. Celsus
(C) Charls H. Tweed
(D) William C. Angell
5.Angle’s contribution in Orthodontics include the following
except
(A) Pin and Tube appliance
(B) Edgewise appliance
(C)E-Arch
(D)Straight wire appliance
6. Activator was introduced by
(A) Dewey
(B) Andresen
(C) Andrew
(D) clark
7.Straight wire appliance was introduced by
(A) Dewey
(B) Angle
(C) Andrew
(D) Clark
8. Edgewise appliance based on basal bone concept was introduced
by
(A) Edward H.Angle
(B) Aulius C. Celsus
(C) Charles H.Tweed
(D) William C.Angell
9. Six Keys of occlusion was given by
(A) Andrew
(B) Roberts Ricketts
(C) Charles H.Tweed
(D) Calvin case
10. Bionator was introduced by
(A) Anderson
(B) Balters
(C) Rolf Frankel
(D) Bjork
References:
1.Salzman JA: Practice of Orthodontics,JB Lippincott
company,1966
2.Graber TM:Principles and Practicce Orthodontics,WB
Saunders,1988
3.Proffit WR:Contemporary Orthodontics,Mosby,Inc,2000
4.Asbell M B,A brief history of orthodontics,American journal of
orthodontics,August 1990.volume 98. number 2, p. 176-183.
5.Asbell M B,A brief history of orthodontics,American journal of
orthodontics,August 1990.volume 98. number3, p. 206-213.