Fixed Appliences

Evaluation of Fixed Appliances in Brief

Dr.Edward Angel - 1926.

- Father of Modern Orthodontics

- School of Orthodontics

- Edgewise Appliance

- 1st bracket, Band

- Classification of mal-occlusion

- Proponent of non extraction treatment.

Edgewise

Slot

Bracket

Rectangular slot

Rectangular wire insertion for 3 dimensional control

Followers of Dr.Edward Angel

- Dr. Tweed

- Dr.Begg

Dr.Tweed popularized edgewise technique and extraction therapy.

Dr.Begg popularized Beggs technique and extraction therapy.

Begg Technique

Light wire technique, Round Wire technique. Tooth movement is sequential and divided in to three stages.

1st stage- Alignment, decrowding correction of deep bite bite and over jet.

2nd Stage- Retraction of teeth and closure of all the spaces.3rd Stage- Root uprighting and torquing.4th Stage- Finishing and detailing

Features of Begg technique

-1st and 2nd stages mainly include tipping of teeth

- In the 3rd stage tooth uprighting is done and torque is done.

- Connection of root inclination in Labio lingual direction is called as torquing of roots.

Uncontrolled tipping Control Tipping

Edgewise system

Bodily Movement of teeth can be achieved In 1971 Andrews introduced Preadjusted Edgewise system-Built in Tip and Torque in Brackets-Reduction of number of stages-Esthetically pleasing bracket system-Excellent finishing and detailing.

Recent Advances in PEA

• Esthetic Brackets

• Composite Brackets, Plastic Brackets,

Ceramic Brackets

• Titanic Brackets (Nickel Free)

• Segmental Approach to reduce the

treatment time and more comfortable to

patient.

Begg Technique Advances

Tip Edge - - Concept of both Beggs and Edgewise technique

- Concept of light wire technique continued

- Rectangular wire finish

- Bracket design more pleasant and comfortable than Beggs Brackets.

Orthodontic Treatment Planning

Class I MalocclusionSkeletal Class I

-Proclination

-Bimaxillary protrusion

-Crowding

-Spacing

-High labial positioned canines.

Proclination:-With space- Without spacing

Pre treatment profile, Age:15yrs

Crowding-Mild - 2-3mm

-Moderate - 3-6mm

-Severe - 6 and above

Class II cases:

Every growing period

1. Maxillary prognathismMandibular Normal

2. Maxillary NormalMandibular deficient

Vertical growing

Horizontal growing

Treatment plan: to hold maxillary growth in

anterior and posterior plane and vertical

plane. Head gear can be given.

Following to orthopaedic treatment,

fixed treatment can be started in permanent

dentition.

Vertical maxillary excess long face, incompetent lips, proclined incisors, infantile swallowing pattern

Skeletal open bite with long face syndrome

Maxillary intrusion splint, with habit breaker, with headgear.

Post orthopedic appliance

• Maxillary Normal

• Mandibular deficient

Treatment plan: Functional Appliance

Therapy to advance the mandible:

-Activator

-Twin block

-Bionator

This is followed by fixed appliance therapy.

• Prognathic Maxillary

• Retrognathic mandible

Treatment Plan:

Head and gear and Functional appliance

Class II Combination

Class II non growing:

1. Maxillary forward

2. Mandibular back.

Orthodontics

- Caumafluege1. Upper extraction only 4 4

4 4 2. 4 4

4 43. 4 4 5 54. Non Extraction

Late growing years

• Fixed functional appliances

1. EVA Appliance

2. Jasper Jumper

3. S.U.S. Device

4. Fixed Twin Block

5. Herbst Appliance

6. Class II Corrector

Class II Div.

Feature :

a. Usually Mandible / Chin Prominent

b. ‘U’ Shape arches

c. Cetrals retroclined

d. Deep bite.

Treatment Plan:

1. Alignment of incisors

2. Intrusion of incisors and correction of deep bite

3. Some times mandibular relocation takes place in to class I

4. Growth Modulation through functional appliance if no relocation.

Class III Growing

• Retraguathic Maxilla

• Normal Mandible 6-9 years:

Face mask, reverse pull head gear

9-13 years:

Facemask with rapid palatal expander

RPE to split the sutures and facilitates the translation of maxilla forward.

After 16 years

Orthognathic Surgery

Growing mandible:

- Chin Cup

- Observe the mandible thought the growth

period.

- May require surgery at end of growth

period.