HISTORY OF ORTHODONTICS

BDS 3rd yearDr. Gyan P. Singh,

Deptt. Of Orthodontics&Dentofacial Orthopaedics25/08/2014 ( 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.

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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.

-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

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• 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”.

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 (1678-

1761)He is referred to as the ‘Founder

of Modern Dentistry

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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.

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- Consists of horse shoe shaped strip of precious metal to which teeth are ligated.

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JOHN HUNTER (1728-1793)

-An English anatomist and surgeon, took keen interest in anatomy of teeth and jaws.

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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

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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.

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AMERICAN PIONEERS OF EARLY 19th CENTURY

William Lintott (1941)

- Introduced the use of screws

- J. S. Gunnel (1840)Invented occipital anchorage for mandibular protrusion

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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.

ORTHODONTICS PIONEER OF LATE 19TH

CENTURY

.

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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.

Over 100 articles on Cleft palate rehabilitation.Inadequacies of cleft palate

surgery.Obturators.Orthodontic diagnosis. Orthodontic appliances.Introduced occipital anchorage

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- 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

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• EMERSON C. ANGELL : open mid palatal suture

with a split plate(1860)

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• WILLIAM E. MAGILL ; first to cement (platinum)

bands (1871)

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1871 C.R.COFFIN :

Kingsley student reported an expansion appliance which bears his name

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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.

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- 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

- In 1893, Henry A. Baker, introduced intermaxillary rubber bands to

correct protrusion, known as ‘Baker anchorage”.

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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.

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- 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.

• 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)

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“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”

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- Maxillary first permanent molar - stable landmark in craniofacial anatomy

- Angle developed classification of malocclusions

,published in – ‘Dental Cosmos’ in 1899.

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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.

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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.

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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.

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- 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.

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- The heavy archwire was supplied in 4 designs, depending on treatment plan -

1. Basic E arch - used in mandible with Baker anchorage

1900-E -Arch Appliance

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- Incredible degree of craftsmanship.

- Impractical in clinical use.

- Poor spring qualities.

1901 Pin and Tube Appliance

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-Vertically positioned rectangular slot with ribbon arch of 10

x 20 gold wire.

- Good spring qualities.

- Allowed versatile movements.

1910-Ribbon Arch Appliance

-First bracket was introduced by Angle in 1916 for use with his ribbon arch mechanism

1925 EDGE WISE

-Most accepted-Allows tooth movement in the three plane- Angle gave edgewise bracket,,later on C. Tweed gave edgewise appliance

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• 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’.

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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.

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• 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

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• Case used headgears for cleft patients and other

• His greatest contributions to be prosthetic correction of cleft palate.

- First to use light wires (.016-.018) Advocated extraction to correct facial deformities

Case’s 1911 paper provoked acrimonious debate that came to be known as “Great Extraction v/s non extraction debate”

The Great Extraction Controversy

:recommended extraction

:opposed it on the ground that it

inhibits growth

: It warned against undesirable

sequelae

P.FAUCHARD & CELSUS

HUNTER

DELABARRE

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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.

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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.

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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-

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- 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…

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Charles A. Hawley (1861 – 1929)

- 1908 - introduced ‘Hawley’s retainer appliance’

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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.

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• 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

1910 -1920

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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

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•1928- George Crozat

•Originally called “Invisible brace”, later became Crozat appliance

- 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.

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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

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1940 - 1950

Charles H Tweed (1895-1970)

–1941; introduced edgewise appliance based on basal bone concept.

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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

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5. Tweed’s diagnostic facial triangle.

6. Introduced anchorage preparation.

6. Serial extraction of primary & permanent teeth. (preorthodontic guidance)

• Tweed philosophy.

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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

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Thomas .M. Graber (1917-2007)

• Born in St.Louis on May 17th 1917.

• Graduation – Washington University, St.Louis.

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• 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.

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Lawrence F. Andrews(1929-)

• Father of pre-adjusted bracket system.

• Nature’s best-120 non-orthodontic normal cases.

• 6 keys of occlusion – 1972.

• Orthodontia’s best – 1150 treated cases.

• Straight wire appliance(1970)

Functional appliances to midcentury

• The history of the functional appliance can be traced back to 1879, when Norman Kingsley introduced the“bite-jumping” appliance

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• 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.

• 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)

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Herbst appliance.-was introduced in 1905 by Emil Herbst (1842-1917), 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.

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• 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.

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• 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.

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• 1977 – Clark’s Twin Block.

• Rapid functional correction of malocclusion.

• Materials • Metals• Gold• SS• CoCr• Titanium• Magnet• Plastics• Ceramic• Ceramic with metal slot• Zirconia

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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

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

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- E.H. Angle 1889 Classification of malocclusion

- E.H. Angle 1907 E –arch

- Charles Hawley 1908 Retainer

- Andresen 1908 Activator

- E.H. Angle 1912 Pin & tube appliance

- Newell 1912 Vestibular screen

• E.H. Angle 1912 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.