INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
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Brackets in Orthodontics www.indiandentalacademy.com
Combination Brackets
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The Universal Bracket ► Developed
Atkinson
► Central
shallow
by Dr. Spencer R. --1928
shaft too narrow and
► Appliance
has undergone periodic refinements without losing its essential features. www.indiandentalacademy.com
The Universal Bracket ► ►
1. 2.
Modified design called the 3-D Universal Bracket Design-vertical hollow shaft with two lateral welding tabs -central shaft has two slot openings Horizontal – opening labially at gingival third Vertical –opens incisally and extends gingivally one third of the bracket height www.indiandentalacademy.com
The Universal Bracket ► Gingival
slot can only hold round wire (.008 - .016) ► Incisal slot can hold single round, double round, twisted bundle of round, single ribbon flat wire (.008x.020 up to .016x.028) ► Wider mesiodistally and deeper buccolingually www.indiandentalacademy.com
Six basic movements
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Six basic movements
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Five Archwire Combinations Available
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The Universal Bracket ► Combination
provides the appliance with full control in three planes of space ► Incisal wire: Rotations Levelling Torque Guiding rail when coil springs are used at gingival level www.indiandentalacademy.com
The Universal Bracket ► Gingival
wire: M-D axial inclinations Guide when teeth are moved bodily Fulcrum for labio-lingual movements Levelling
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Conventional Light Wire Bracket and 3-D Universal Bracket ► Moves
teeth with full 3D control ► Canine retraction is simple due to railroad principle ► Very light wires used ► Improved rotational control ► Space inside shaft greater
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Begg /Chun-Hoon “Original” Combination Brackets ► Interchangeability
of techniques,for transfer cases or for use of labial rectangular archwire after 3rd stage of lightwire treatment.
► Available
in regular and curved bases. www.indiandentalacademy.com
Begg /Chun-Hoon “Full Flanged” Combination Brackets ► Modified
version which offered gingivally extended welding flanges to provide more welding area ► Also allow archwire to rest completely within the bracket.
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Modular Self Locking Appliance ► Introduced
by –FOGEL AND MAGILL -1976
► It
is a light wire system using a single pivotal bracket or twin self locking low frictional attachments
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Modular Self Locking Appliance â–ş An
adaptable receptacle makes possible use of the combination technique â–ş Horizontal slot
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Modular Self Locking Appliance Insert bracket – Made of special soft stainless steel ► Archwire chamber ► Beaks ► Insert slot ► Slot apex ► Seat ► Stem www.indiandentalacademy.com
Modular Self Locking Appliance
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Modular Self Locking Appliance â–ş Placement
of the insert bracket- fits into the vertical slot of the receptacle
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Modular Self Locking Appliance ► Receptacle
– available in three sizes - Small (.150”) - Medium (.180”) - Wide (.200”) ► Three vertical slots are present which accommodate insert brackets and the auxiliaries www.indiandentalacademy.com
Modular Self Locking Appliance
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Modular Self Locking Appliance â–ş Single
slot is used in the early stages; both mesial and distal slots used in the finishing stages â–ş Receptacle is placed towards the incisal edge of the band
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Modular Self Locking Appliance â–ş Insertion
of wire into the insert bracket
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Modular Self Locking Appliance â–ş Removal
of archwire using an insert spreader
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Modernized Begg –Combination Technique ► William
J. Thompson AJO –JUNE 1981
► The
rationale was to develop treatment mechanics that uses the advantages of both BEGG and STRAIGHT WIRE at the same time minimizing the disadvantageous. www.indiandentalacademy.com
Modernized Begg â–ş 1. 2. 3. 4. 5. 6.
Favourable characteristics of BeggRapid bite opening. Rapid ant. Alignment. En mass anterior retraction. Good anchor control. Ant. Root torque is unlimited. Predictable molar and incisor positions. www.indiandentalacademy.com
Modernized Begg â–ş 1. 2. 3. 4. 5.
Unfavourable characteristicsPost. root torque is difficult. Three dimensional arch coordination is difficult. Maintaining rotations is difficult Maintaining uprighting and torque is difficult. Finishing intricacies are difficult. www.indiandentalacademy.com
Modernized Begg â–ş 1. 2. 3. 4. 5.
Favourable characteristics of SWAPrecision arch coordination is routine. Precision intercuspation is routine. Buccolingual root torque is routine. Simplified finishing wires are routine . Minimal wire adjustments in finishing.
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Modernized Begg â–ş 1. 2. 3. 4. 5. 6.
Unfavourable characteristics – Rigid appliance due to interbracket distance. More friction with sliding mechanics. Additional supportive anchorage recommended. Segmental retraction of anterior teeth. Forward tipping of incisors in continuous wire leveling. Prolonged bite opening mechanics. www.indiandentalacademy.com
Four Stage Bracket ► Appliance
Design: ► Combination bracket design.. each constructed to perform its function at a specific stage ► Lower
third of the bracket is a type 256 Begg bracket ► Upper two thirds is a .018 x .025 straight wire slot www.indiandentalacademy.com
Four Stage Bracket
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Four Stage Bracket ► Begg
slot heights are dictated by the edgewise slot…are 1 to 1.5mm more gingival ► Brackets are indexed for easy identification.. Identification marks are toward the distoocclusal
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Four Stage Bracket â–ş Free
tipping is possible because of specially tapered bracket slot
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Four Stage Bracket ► Begg
procedures should be carried out throughout Stage I and II and at least partly through Stage III ► The combination bracket is not a substitute for Stage III ► Second molars should not be incorporated initially. In late Stage III or Stage IV, sectional wires to level the second molars can be placed www.indiandentalacademy.com
Four Stage Bracket
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THE BEDDTIOT APPLIANCE â–ş Begg
Edgewise Diagnosis-Determined Totally Individualized Orthodontic Technique. - RICHARD HOCEVAR-1985
The appliance offered the capacity to employ the principles and features of the Begg and edgewise mechanism in specific situation in which they are most advantageous. www.indiandentalacademy.com
BRACKET DESIGN ► Narrow
,single width -0.050” or 1.3mm Edgewise Bracket ► 2 slotsHorizontal-.022(height)x.028(depth) Vertical- .020 x .020 ► Archwire slot are torqued with indicator Gingival groove –lingual root torque Occlusal groove-lingual crown torque www.indiandentalacademy.com
THE BEDDTIOT APPLIANCE
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THE BEDDTIOT APPLIANCE
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► Except
for the torque the brackets are identical and interchangeable .
► There
are a total of five brackets which differ only in the torque-0˚,5˚,10˚,15˚, 20˚ ► Buccal tubes -4.5 mm - .022 x .028 25˚ - lingual crown torque for lower molars 10˚ - for the upper molars www.indiandentalacademy.com
Characteristic featureIn cases of deep bite or severe anchorage cases – additional rectangular tube is is placed diagonally at an angle of 15˚,with its mesial end pointing gingivally. ► Advantage – 1. Increase the anchorage. 2. Built in anchor bend. ►
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THE BEDDTIOT APPLIANCE
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Tip Edge â–ş Introduced
by Peter Kesling based on his experiences with differential tooth movement â–ş Brackets designed to promote distal crown tipping on all teeth except those distal to the extraction site
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Tip Edge Basic design consist of-removal of diagonally opposed corners of a conventional edgewise slot -slot size is .022 x.028 -lateral extensions or wings -vertical slot .020 x.020 - deep grooves www.indiandentalacademy.com
Tip Edge
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Tip Edge ► Advantages
of Tip-Edge Brackets over Ribbon Arch Type Brackets In/out compensations built in Horizontally facing slot Can stop free distal tipping of canines
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Tip Edge â–ş Tipping
surfaces limit degree of initial crown tipping; uprighting surfaces control final tip and torque
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Tip Edge ►
► 1. 2. 3. 4. 5.
Molar tubes – .036 round gingival tube .022 x .028 occlusal tube They are available with – Extraction and non extraction kits Torque in base/ face Over rotation bracket Positing jigs Tip edge rings www.indiandentalacademy.com
Tip Edge
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Tip Edge
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Tip Edge
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Tip Edge Positioning Jigs
Overrotation Brackets
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Combination Anchorage Technique â–ş The -
original combination brackets proved to
beBulky Weak Aesthetically unattractive Problems with pinning, rotations, slot closure, occlusal interference www.indiandentalacademy.com
Combination Anchorage Technique â–ş CAT
-
bracket design is comfortable and esthetically pleasing It had a .022 x .035 gingival or ribbon arch slot. .018 x .025 /.022 x .028 edgewise slot. Enclosed vertical slot
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Combination Anchorage Technique
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Combination Anchorage Technique
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Combination Anchorage Technique Brackets are available with colour coding dots for easy identification . - maxillary –red mandibular-blue Molar attachments with convertible molar tubes. Bracket size and contour have been reduced Redesigned pin slot . ►
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Combination Anchorage Technique â–ş Use
of Tandem Arches
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Begg – Ribbon Arch Combination System ► Introduced
by Nikhil Vashi JIOS-Jan 1991
► Appliance
was designed to combine the advantages of the BEGG and the Edgewise and the Preadjusted Appliance www.indiandentalacademy.com
Begg – Ribbon Arch Combination System ► Design►A
gingival ribbon wise slot (.018” x .027”) ► An incisal or occlusal horizontal slot (.020” x .020”) ► Two vertical slots
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Begg – Ribbon Arch Combination System BRACS
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Begg – Ribbon Arch Combination System ► Molar
tube is rectangular ribbon wise for ribbon arch and has a 6˚ offset .
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Begg – Ribbon Arch Combination System ► Different
movements can be obtained just by tying or pinning the archwire differently.
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Begg – Ribbon Arch Combination System
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“J” bracket- Begg Combination
Bracket
►
Introduced by Dr Jayade –JIOS 1991
►
Requisites of a good combination bracket – It must be capable of delivering all the advantages of the Begg appliance and at the same time eliminate all its disadvantages . It must permit the incorporation of SW concept of finishing without its disadvantages. Should have more than one slot . Should be economical .
1.
2. 3. 4.
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“J” bracket- Begg Combination Bracket ► 1. 2. 3. 4.
Advantages of multiple slot brackets over single bracketDiametrically opposite treatment requirements. Possibility of applying forces to the teeth at different areas . Switching slots help in altering or reinforcing anchorage. Use of segmental /tandem wires. www.indiandentalacademy.com
“J” bracket- Begg Combination Bracket ► Rationale
-
of orientation of slots in the new designAll bracket slots are cuboidal.
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“J” bracket- Begg Combination Bracket ►
Movements which remain unaffected by this orientation of the slot –
Intrusion or extrusion . 2. Labio lingual crown tipping using round wire 3. Labio lingual root movement 1.
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“J” bracket- Begg Combination Bracket ►
Movements which are affected by changing the slot orientation –
1.
Mesiodistal crown tipping (slot height).
2.
Rotational control (slot depth) www.indiandentalacademy.com
“J” bracket- Begg Combination Bracket ►
Disadvantage of the twin slot arrangement-
►
Drastically reduce mesio-distal tipping.
►
Decrease in the inter bracket wire span.
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“J” bracket- Begg Combination Bracket ► 1. 2. 3. 4.
Net effect of changed orientation of the slotPermits optimum mesio distal crown tipping . Affords good rotational control. Allows to fully utilize torquing abilities of rectangular wire. Partly overcomes disadvantages of twin bracket configuration. www.indiandentalacademy.com
“J” bracket- Begg Combination Bracket ►
“J” bracket configuration –
1.
The single slot(.024” ht x 1 mm wide). This permits easy tipping to adequate extent in initial stages; faces horizontally
2.
The twin slots(.032” ht x .018” depth, placed 3mm apart) www.indiandentalacademy.com
“J� bracket- Begg Combination Bracket
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“J” bracket- Begg Combination Bracket ►
-
-
AdvantagesBetter rotational control. Possibility of using uprighting springs and auxiliaries along with .018” round base wire . Possibility of using full torquing potential of rectangular wire upto .018” x .025” www.indiandentalacademy.com
“J� bracket- Begg Combination Bracket
3.
Using both slots together when necessary, advantage of the combination bracket can be derived
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“J” bracket- Begg Combination Bracket ► Molar
attachment – When only first molars are available: gingival rectangular tube in ribbonwise orientation and a round tube occlusally . When both 1st and 2nd molars are utilized: 2nd molar will have such a combination tube and 1st molar has twin rectangular attachment gingivally, and an occlusal round tube. www.indiandentalacademy.com
www.indiandentalacademy.com Leader in continuing dental education
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