COSMETIC ORTHODONTICS
INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
What is Aesthetics? Aesthetics is purely and simply the science of expression,expression being itself so defined as to be Identical with every form of Appreciation,Intuition or Imaginative Synthesis. “HENFREY� www.indiandentalacademy.com
How Far Have We Gone? In Aesthetics!! In Orthodontics!!! We have gone as far as developing materials which are tooth colored or (Invisible)in.. www.indiandentalacademy.com
1. Brackets 2. Wires 3. Rings or Chains 4. Auxiliaries TOGETHER IN A HARMONY BETWEEN
“ function and esthetics ” www.indiandentalacademy.com
HISTORICAL PRESPECTIVE
FIXED APPLIANCES INTRODUCED IN 1800’s
BANDING OF ANTERIOR &POSTERIOR TEETH
BONDING OF ANTERIOR ATTACHMENTS
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REDUCTION OF BRACKET SIZES
CERAMIC /COMPOSITE BRACKETS
COMPOSITE ARCHWIRES
LINGUAL ORTHODONTICS
INVISALIGN SYSTEM www.indiandentalacademy.com
ANTERIOR BAND1NG :
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TWIN BRACKETS
MINI-TWIN BRACKETS
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DESIGN VARIATIONS
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TOOTH COLOURED BRACKETS 1. PLASTIC BRACKETS introduced by NEUMAN (1969) Acrylic, nylon, epoxies, polysulphones, polycarbonates
USED IN a. Minimal torque situations b.Treatment of short duration STEEL SLOTED PLASTIC BRACKETS ----BEST SUITED www.indiandentalacademy.com
ADVANTAGES 1.Nontoxic 2.Easy fabrication 3.Good abrasion resistance 4.Good impact strength 5.No bad odour /distaste
DISADVANTAGES 1.Lack of strength 2.Wire - slot wear 3. Water absorption & degradation 3.Discoloration and staining 4.Poor dimensional stability www.indiandentalacademy.com
2.CERAMIC BRACKETS Introduced by MICHEAL SWARTZ (1987) FULL CERAMIC BRACKETS CERAMIC BRACKETS WITH METAL INSERTS
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Full ceramic brackets
With metal inserts
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MONOCRYSTALLINE /POLYCRYSTALLINE ALUMINA ( 2100`C ) ZIRCONIA (1000`C )
------Made of 3D inorganic molecules
Extremely high hardness and compressive strength.
Both are highly biocompatible www.indiandentalacademy.com
BONDING OF CERAMIC BRACKETS TO ENAMEL:
1. Mechanical retention via indentation / undercuts in base. 2. Chemical bonding with silane coupling agents.
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DISADVANTAGES 1. BRACKET FAILURE * Fracture of brackets * Friction within bracket slots * Tooth wear on bracket contact
2. BULK OF THE BRACKETS 3. SURFACE ROUGHNESS 4. INHIBITION OF POLYMERISATION 5. DEBONDING DIFFICULTIES * ENAMEL DAMAGE * Pulpal damage www.indiandentalacademy.com
CASE SELECTION CRITERIA Ceramic brackets are contraindicated in 1.Deep bite cases 2.Bruxism patients 3.Large restorations 4.Need for significant torque 5.Children www.indiandentalacademy.com
3.COMPOSITE BRACKETS A Composite is a multiphase material brought about by combining materials that differ in composition /form to obtain specific characteristics and properties. The constituents retain their identities and properties. Can be simplified as ‘dispersion of fillers(particles /fibres /whiskers ) in a binder or matrix (metals /ceramics /resins)’. Reinforcement of polymer with ceramic\ metals –most common combination in ORTHODONTICS www.indiandentalacademy.com
COMPOSITION Manufactured by ‘INJECTION MOLDING TECHNIQUE’. COMPOSITE PRECURSOR -Plasma treated high strength Polyethylene fibers REINFORCED WITH 1.Glass 2.Mineral filler 3.Metal 4.Ceramic liner 5.Metal liner www.indiandentalacademy.com
ADVANTAGES 1.SUPERIOR IMPACT RESISTANCE 2.INCREASED COMPRESSIVE STRENGTH 3.FATIGUE RESISTANCE 4.RESISTANCE TO DISCOLORATION
DISADVANTAGES 1.CREVICE CORROSION 2.DISINFECTION PROBLEMS 3.DIFFICULTY TO DETECT CRACKS
4.EXPENSIVE & CANNOT BE RECYCLED www.indiandentalacademy.com
ARCH WIRES-COSMETIC ADVANCES 1. Arch wires with plastic tubing \coating 2. Marsenol 3. Lee-white 4. Composite archwires 5. Optiflex archwires 6. Fibre reinforced composite www.indiandentalacademy.com
ARCH WIRES WITH PLASTIC TUBING \COATING : Earliest to be introduced
Stainless steel arch wires were coated with plastics DISADVANTAGES 1. Easy peeling off of the coating 2. Loss of friction control
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MARSENOL: E.T.E COATED NICKEL TITANIUM It exhibits all the characteristics of NiTi . The coating is adherent and is flexible,fracture resistant, delivers force over long periods. LEE WHITE: STAINLESS STEEL \NiTi bonded to EPOXY COATING Coating is completely opaque, does not peel ,chip , stain or discolor www.indiandentalacademy.com
COMPOSITE ARCH WIRES: Made of S-2 glass fibres and acrylic resin. Manufactured by 1. Photopulstration 2. Electromagnetic radiation
ADVANTAGES Translucent Strong & Springy Variable Stiffness Dimensional Stability Minimal Staining www.indiandentalacademy.com
‘OPTIFLEX’ ARCH WIRES Designed by Dr. Taloss Composite of ceramic fiber-plastic-nylon. Made of 3 layers: 1. Silicon dioxide core –force production 2. Silicon resin middle layer - protection 3. Nylon outer layer –stain resistance www.indiandentalacademy.com
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ADVANTAGES Highly esthetic Stain resistant Light continuous force Greater flexibility and resiliency Low friction Corrosion resistance High biocompatibility
DISADVANTAGE
‘ No formability’ www.indiandentalacademy.com
FIBRE REINFORCED COMPOSITE Made of S GLASS FIBRES in a matrix of THERMOSET BIS-GMA Available as –1.Rope type 2.Woven strip 3.Unidirectional strip
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USES: 1.Retainers 2.After initial aligning can replace main arch wire 3. Any attachments can be directly bonded www.indiandentalacademy.com
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LINGUAL ORTHODONTICS “INVISIBLE BRACES”
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CASE SELECTION CRITERIA NON EXTRACTION CASES 1.Cl.I , Deep bite , mild crowding 2Cl..I , Deep bite , generalized spacing 3.Cl.II , Deep bite 4.Cl.II div.2 , mand. retrusion 5.Diastema closure EXTRACTION CASES 1.Cl.I, low FMA , severe crowding 2.Cl.II with minimal crowding www.indiandentalacademy.com
ADVANTAGES 1. Totally invisible
2. Facial surfaces are not damaged 3. Lip contour not distorted DISADVANTAGES
1. Decreased accessibility 2. Small interbracket span –freq. adjustments 3. Difficulty to perform complex movements 4. Speech distortion and tongue irritation www.indiandentalacademy.com
CASE REPORT
PRETREATMENT
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DURING TREATMENT
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POST TREATMENT
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INVISALIGN The invisible way to align teeth without braces, using a series of clear removable aligners
ADVANTAGES
Invisible,
Removable, Comfortable. Invisalign also allows a person to view his own virtual treatment plan, he can see how his teeth will look when the treatment is complete. www.indiandentalacademy.com
The Technology Behind Invisalign Invisalign is a high-volume, customized manufacturing process by advanced computer technology |
Using advanced imaging technology, Invisalign transforms the plaster models into a highly accurate 3-D digital image.
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A computerized movie - called ClinCheck- depicting the movement of the teeth from the beginning to the final position is created . From the approved ClinCheck file, Invisalign uses laser scanning to make a customised set of aligners , sent to the clinician .
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CASE REPORT BEFORE
AFTER
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RETAINERS QCM RETAINER
ESSIX RETAINER
FRC RETAINER
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AUXILIARIES Easy to tie ligatures
Elastomeric modules
Rotation wedges
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CONCLUSION “An orthodontic patient smile is no more a metallic smile” It’s in our hands to keep in pace with the recent advances in esthetic dentistry to meet the increasing esthetic concern of the patient . www.indiandentalacademy.com
Brackets
Auxiliaries Wires
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ACKNOWLEDGEMENT PRINCIPAL :
Dr. E . Munirathnam Naidu M.D.S VICE PRINCIPAL AND HEAD OF THE DEPARTMENT:
Dr. P. Jaya Kumar M.D.S. Staff Members And P.G. Students, Meenakshi Ammal Dental College, CHENNAI.
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www.indiandentalacademy.com Leader in continuing dental education
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