EVOLUTION OF ORTHODONTIC BRACKETS
INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
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Contents
Brief summary Idea for introducing horizontal slot Single width bracket Twin bracket Tripple bracket Jarabak bracket Lewis bracket Lang bracket Steiner bracket Broussard bracket Bioefficient bracket Dual env bracket Unitwin bracket Transition from 022 to 018 slot Andrews straight wire app. www.indiandentalacademy.com
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E.H ANGLE
E arch appliance
Pin and tube appliance
Ribbon arch appliance
Open face or tie bracket
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Evolution of edgewise appliance ď Ž
1907 – angle discontinued the use of jack screws
E Arch
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Evolution of edgewise appliance
Basic E arch www.indiandentalacademy.com
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Evolution of edgewise appliance
Ribbed E arch www.indiandentalacademy.com
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Evolution of edgewise appliance
E arch without threaded ends www.indiandentalacademy.com
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Evolution of edgewise appliance
E arch with hooks
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Evolution of edgewise appliance Pin and tube-1910
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Evolution of edgewise appliance
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Evolution of edgewise appliance The Ribbon Arch-1915
Brackets
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Evolution of edgewise appliance
Open face bracket www.indiandentalacademy.com
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Evolution of edgewise appliance
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Single width bracket
050’’ or 1.25 mm www.indiandentalacademy.com
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Siamese twin bracket
Swain Interbracket span 050’’
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Curved base twin bracket
Mechanism of action ďƒ deflection www.indiandentalacademy.com
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Posterior brackets
Twice the width of single width bracket 010’’or 2.5mm
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Tripple bracket
Better rotational and tipping adjustments Control over rotation ďƒ selective tying www.indiandentalacademy.com
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Long edgewise bracket
Horizontal and vertical slotted bracket Jarabak
Horizontal slot .017’’ wide .038’’ deep Vertical slot .017’’ wide .045’’ deep www.indiandentalacademy.com
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Long edgewise bracket
Available in 3 lengths .160’’ .120’’ distal .140’’
mesial Vertical slot on the base On distal end www.indiandentalacademy.com .016×.016
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Long edgewise bracket
Horizontal slot offcentred by .046’’ from the incisal edge
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Long edgewise bracket
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Lewis bracket
Soldered auxiliary rotation arms Single width feature- retained www.indiandentalacademy.com
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Lewis bracket ď Ž
Types:
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Curved base lewis bracket
Increase contact with band . Reduces trapping of the food.
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Vertical slot Lewis bracket
020 x020 vertical slot www.indiandentalacademy.com
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Steiner bracket ď Ž
Flexible rotation arms - did not rely entirely on the resiliency of archwire for tooth rotation.
ď Ž
Single width edgewise bracket
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Lang brackets
Howard Lang Single width bracket Flat rotational control wing
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Lang brackets
Wedge shape in profile Allows ease in lagation Prevents food lodgments
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Lang brackets Flattening of archwire curvature Incomplete seating of the wire.
Curvature maintained
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Broussard bracket
Grayford broussard Modified edgewise bracket in which there is addition of 0.0185 x 0.046 slot –to accept doubled 0.018 auxiliary wire www.indiandentalacademy.com
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Unitwin bracket (1989)
Thomas Creekmore Centered slot concept Single bracket Without tie wings Slot placed in the center of a .045’’twin bracket
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Unitwin bracket (1989)
Utilizes the feature of both single and twin bracket Maximum inter bracket span single width Rotational control twin tie wings
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The Dual Enviroment Bracket
George F. Schudy(1990) Design based on computer remodeling Large outer slot –.040’’for twin brackets and.030’’for single brackets. Smaller inner slot-.018/.016’’
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The Dual Enviroment Bracket
Outer slot allows the use of full size . 016×.022 initial arch wire
Same wire seated in inner slot
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The Dual Enviroment Bracket ď Ž
Clinical advantage
1.
Faster leveling of the arches with fewer wire changes
2.
Easier torquing of the teeth
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Bioefficient brackets (1995) ď Ž
Anthony D.Viazis ďƒ deltoid bracket Wide horizontal member but has a single width slot. Multifunctional bracket for bioefficient therapy
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Bioefficient brackets (1995) ď Ž
Maximum potential of any archwire is achieved when the largest possible wire is used.
1. Conformity to the crown anatomy and gingival outline.
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Bioefficient brackets (1995) 2. Ease in positioning due to the bracket design.
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Bioefficient brackets (1995)
Improper placement ďƒ easily recognized www.indiandentalacademy.com
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Bioefficient brackets (1995) 3. Minimum friction - Slot is elevated from the horizontal member. Area of contact bw the wire and the bracket is reduced
Better esthetics
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Bioefficient brackets (1995) 4. Tip control -horizontal
member has a twin bracket like effect.
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Bioefficient brackets (1995)
5. Better rotational control
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Transition from .022 .018 slot
022’’ or 0.55 mm wide 028’’ deep Gold archwires Late 1920s stainless steel Difference in the properties
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Transition from .022 .018 slot
Reduce the size of the wire Reduce the slot width to .018’’ Smaller archwires were used 018×025’’ Force delivered was acceptable Introduction of TMA and NiTi Limitation of original 022 slot have been overcome
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Andrews straight wire appliance
BRACKETS stand in between tooth and the orthodontist 1960 – concept of fully programmed appliance Advantage of FPA ELIMINATES WIRE BENDING
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Andrews ď Ž
Driving force for FPA
1.
Analysis of orthodontically treated final occlusion Analysis of naturally occurring optimal occlusion Six keys to normal occlusion
2. 3.
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Andrews
Andrews plane www.indiandentalacademy.com
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Andrews
FACC FA point Angulation
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Andrews
Inclination
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Interarch relationship
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Crown angulation
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Crown inclination
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Crown inclination of posteriors
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Absence of rotations
Curve of spee
Tight contacts
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Andrews classification 1.
Non programmed appliance-a set of brackets designed the same for all tooth types ,relying totally on wire bending.
2.
Partly programmed appliance- a set of brackets designed with some in built features ,but always require some wire bending
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Fully programmed appliance- a set of brackets designed to guide teeth directly to their goal positions with unbent wires. www.indiandentalacademy.com
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Features of Edgewise Bracket
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Non programmed bracket ď Ž
Angle’s edgewise app
FA point on FACC
All crowns will have equal facial prominences Extensive Wire bending www.indiandentalacademy.com
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Non programmed bracket ď Ž
Design shortcomings
1. Bracket base perpendicular to bracket stem. 2. Bracket bases are not contoured. 3. Slots are not angulated 4. Bracket stem are of equal faciolingual thickness. 5. Maxillary molar offset is not built in. 6. Bracket siting techniques are unsatisfactory.
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Non programmed bracket 1.
Bracket base perpendicular to bracket stem.
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Non programmed bracket
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Non programmed bracket
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Non programmed bracket ď Ž
Bracket bases are not contoured occlusogingivally.
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Non programmed bracket
Greater than 2째 Greater than 0.5 mm
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Non programmed bracket
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Non programmed bracket
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Non programmed bracket
Mesio-distal base contour www.indiandentalacademy.com
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Non programmed bracket ď Ž
Slots not angulated
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Non programmed bracket
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Non programmed bracket ď Ž
Bracket stem are of equal faciolingual thickness
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Non programmed bracket
Maxillary molar offset is not built in. www.indiandentalacademy.com
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Non programmed bracket Bracket siting techniques are unsatisfactory. ď Ž
Wire bending Primary wire bends (1st, 2nd, 3rd order ) Secondary wire bends tertiary wire bends www.indiandentalacademy.com
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Wire bending
angulation
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Wire bending
Occlusogingival slot positioning www.indiandentalacademy.com
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Wire bending
Inclination www.indiandentalacademy.com
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Wire bending
Prominence differences www.indiandentalacademy.com
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Wire bending
Prominence differences www.indiandentalacademy.com
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Wire bending
Total 76 bends
Fully programmed appliance www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Simplest version of FPA Standard brackets
One bracket for each tooth except for incisors and Maxillary molars Partly programmed app ďƒ 3 slot siting features www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature Feature 1Mid transverse planes of the slot, stem and crown must be the same.
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Fully programmed appliance ď Ž
Slot siting feature
Feature 2- Base of the bracket for each tooth type must have same inclination as the facial plane of the crown. www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature
Feature 3- Each bracket inclined base must be contoured occluso gingivally www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature
Feature 4- Mid sagittal plane of the slot, stem and crown must be same. www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature
Feature 5 -The plane of the bracket base at its base point must be identical to the facial plane of the crown at the FA point www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature
Feature 6 - Mesio distal curvature of base should match tooth.
the m-d contour of the www.indiandentalacademy.com
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Fully programmed appliance ď Ž
Slot siting feature
Feature 7 - The vertical components should be parallel to one another The horizontal components should be equidistant from the gingiva and the cusp tips.
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Fully programmed appliance ď Ž
Slot siting feature
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Fully programmed appliance ď Ž
Slot siting feature
Feature 8 – All slots point must have same distance between them and the crown embrasure line.
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Fully programmed appliance Convenience feature-
1. The gingival tie wings of the posterior Brackets extend farther laterally . www.indiandentalacademy.com
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Fully programmed appliance Convenience feature-
2. Bases are inclined . www.indiandentalacademy.com
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Fully programmed appliance Convenience feature-
3. Facial surface of the incisor and canine brackets are designed to parallel their bases - lip comfort. www.indiandentalacademy.com
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Fully programmed appliance Convenience feature-
4. In mandibular incisor brackets, the tie wings are designed with least amount occlusofacial prominence 5.Bracket identification. www.indiandentalacademy.com
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Fully programmed appliance Auxiliary feature – - Power arms - Hooks - Face bow tubes - Utility tubes - Rotational wings
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Fully programmed appliance
Incisor bracket
3 brackets with different base inclinations
Post treatment interjaw relationship can be predicted
Unpublished study (1968) on hundred cephs
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Fully programmed appliance Incisor bracket
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Fully programmed appliance Incisor bracket
Cl II
Cl I
Cl III www.indiandentalacademy.com
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Fully programmed appliance Incisor bracket
Cl II
Cl I
Cl III www.indiandentalacademy.com
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Angulation for central and lateral incisorsTooth
Central
Lateral
Maxillary
5
9
Mandibular
2
2
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Fully programmed appliance ď Ž
Posterior bracket
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Tooth
II molar
I Molar
II PM
I PM
Canine
Maxillary
5/-9 (10o offset)
5/-9 (10o offset)
2/-7
2/-7
11/-7
Mandibul ar
2/-35
2/-30
2/-22
2/-17
5/-11
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Inclination and angulation for 6-7 to finish in class II Tip reduced and offset removed
Tooth
II Molar
I Molar
Maxillary
0/-9
0/-9
Mandibular
-
-
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Fully programmed Translation brackets
Bodily movement of the teeth is required What is translation??? Translation problems Need for over correction
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Fully programmed Translation brackets ďƒ˜
They have all the qualities of the standard brackets plus few other feature . Power arm Counter mesiodistal tip Counter rotation Counter buccolingual tip
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Fully programmed Translation brackets Minimum translation bracket – requiring a translation of 2 mm or less Medium translation brackets – requiring a translation of more than 2mm but less than 4 mm Maximum translation brackets -requiring a translation of more than 4 mm.
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Fully programmed Translation brackets ď Ž
Translation solutions-
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Fully programmed Translation brackets ď Ž
Concept regarding Levers
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Fully programmed Translation brackets ď Ž
Lever common to all edgewise brackets
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Fully programmed Translation brackets Counter rotation
The slot is rotated in the direction of translation Slot rotation plus mesiodistal slot length plus archwire flex equals counterrotation and rotation overcorrection. www.indiandentalacademy.com
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Fully programmed Translation brackets ď Ž
Countermesiodistal tip
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Fully programmed Translation brackets
Slot angulation plus mesiodistal slot length plus power arm length plus activated archwire equals Countermesiodistal tip and angulation overcorrection. www.indiandentalacademy.com
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Fully programmed Translation brackets Counterbuccolingual tip
Base inclination + faciolingual slot length + arch wire deflection = Counterbuccolingual tip www.indiandentalacademy.com
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Why different prescriptions??? ď Ž 1. 2. 3. 4. 5. 6. ď Ž
Valid reasons Natural variations Different growth patterns Different malocclusions (Cl II div II) Need for overcorrection (Roth) Arch wire play (Bioprogressive therapy) Ethnic differences Commercial reasons www.indiandentalacademy.com
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Why different prescriptions???
Andrews Roth MBT
022 slot
Bioprogressive – 018 slot Alexander ( vari- simplex) – 016 slot www.indiandentalacademy.com
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Vari-simplex discipline-Alexander
1. 2. 3.
Vari – variety of bracket used Simplex – KISS principle fewer archwire changes Treatment philosophy – Tweeds fundamentals Anchorage preparation Positioning Mb incisors over basal bone Orthopedic alteration using head gear
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Vari-simplex discipline-Alexander ď Ž
Key objective Non extraction therapy as far as possible Interproximal enamel reduction Control of Mb incisor position with –ve torque
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Vari-simplex discipline-Alexander ď Ž
Bracket selection Twin brackets Lang brackets Lewis brackets
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Vari-simplex discipline-Alexander
Wedge shape in profile Allows ease in lagation Prevents food lodgments
Lang brackets www.indiandentalacademy.com
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Vari-simplex discipline-Alexander
Why not use lewis bracket on canine ??? Arch wire placement Curvature maintained Mx cuspid attrition www.indiandentalacademy.com
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Vari-simplex discipline-Alexander
Bracket positioning
Key for placement – bicuspid height --X
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Vari-simplex discipline-Alexander
Angulation Measured from long axis of crown
Major change Tip of mand molars 2 ° to - 6° www.indiandentalacademy.com
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Vari-simplex discipline-Alexander
Reason for -6°tip Gain in the arch length Promotes leveling 0° angulation in Mb 2nd molar– Need not to be uprighted excessively
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