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Fixed Appliance Xiaorong, Wang A.The development of fixed appliance Definition ： Commonly refers to orthodontic brackets which are attached to teeth and exhibit the properties that dentists desire . The appliance is removed until the therapy finished. advantage Brackets attached to teeth Provid enough anchorage for tooth movement 3-D control of tooth movement (translation、controlled movement） Tooth movement occur effciently Effective treatment for comprehensive malocclusion Independent on patient compliance disadvantage Inconvenient for food processing and keeping oral healthy Increase the chair time Cause inflammation and soreness if operated inappropriatly Influence on esthetic The development of fixed appliance 1907s，The E-Arch 1911s，Pin and Tube 1916s，Ribbon Arch 1928s，Edgewise First phase E~arch • 1900s • Heavy labial arch • Arch perimeter increased • Tipping teeth Second phase Pin and tube • The E-Arch was capable only of tipping teeth to a new position. It was not able to precisely position any individual tooth. Angle began placing bands on other teeth and used a vertical tube on each tooth , with this appliance , tooth movement was accomplished by repositioning the individual pins at each appointment . Third phase Ribbon arch • Modified the tube on • • each tooth to provide a vertically positioned rectangular slot behind the tube The wire was placed into the slot and held with pins It provided poor control of root position Forth stage Edgewise • To overcome the deficiencies of the ribbon arch • In the year of 1928， arch wire was inserted an • • a 90-degree angle to the plane of insertion of the ribbon arch Multibanded appliance、single bracket,the rectangular wire was tied into a slot with ligatures This appliance did allow excellent control of crown and root position in all three planes of space Angle’s progression to the edgewise appliance • Edward Angle’s position an the “father of modern orthodontics” is based not only on his contribution to classification and diagnosis buy also on his creativity in developing new orthodontic appliances. Begg appliance • Raymond Begg had been taught use of the ribbon arch appliance at the Angle school before his return to Australia in the 1920s • The Begg concluded that extraction of teeth was often necessary and set out to adapt the ribbon arch appliance • 1950s Begg appliance was born Straight wire appliance • Improving the efficiency of the edgewise appliance • Used quicker and easier The development of fixed appliance • Multibanded——direct bonding • single bracket——twin brackets—— straightwire appliance The development of fixed appliance Ribbon Arch Angle 1912 Edgewise Angle 1928 Begg Appliance Tip-Edg Kesling 1987 Begg 1954 Tweed Appliance Tweed 1941 Tip-Edge Straightwire Prescritions light wire technic,Jarabak1963 segmental arch technic,Burston1966 bioprogrssive therapy,Ricketts1974 MEAW,Kim 1974 two by four arch,Mulligan 1982 B . Edgewise appliance • At 1925,Angle created new edgewise appliance • The edgewise appliance became widely popular in the 1950s • In the middle 1980s,professor xiangyu,ye brought the edgewise appliance into our country a. Components of appliance • band • bracket • wire • accessories Band • Diy：steel、weld；buccal tube ；hook • Preformed bands Buccal rectangular tube 0.022 0.018 round tube 1.2mm hook Bracket • Functional Horizontal slot :the arch vertical slot：bracket wing : tie-ligature bracket base: mesh base、 adhesive to enamel Bracket Position Height U 1456 4.5 mm U 2 3 L 1 2 4 mm 5 mm 4 mm Position Distal and mesial Center bracket consistent with the dental center Axis inclination Angle between the long axis of the bracket and the long axis of tooth Angle of the crown teeth Brackets single bracket、twin brackets、 straight-wire brackets Stainless Steel brackets 、plastic brackets、ceramic brackets Brackets Orthodontic Arch wire Materials • Ni~Ti wire：Superelasticity、pre- formed arch、Shape memory • round wire :strength and springiness，Can be bend to any desired shape • rectangular wire：Strong strength Ligating material • Elastic o-ring • Stainless steel wire ligature • Self-ligating accessories • Sliding hook • Lingual button b. Characteristics and principles • characteristic a） Can effectively control the movements of teeth in all directions b） Dental arch through the wire as a whole could give a good anchorage principal • a) Bending deformation of the wire reset makes tooth movement b）Retention of fixed wire c. Basic treatment steps a） Alignment and leveling b） The closure of extraction space c） Adjustment of the tooth relationship d） Retainer ：fixed、removable Three order bend first order bend • so-called in-out bends, which are represented by the distance of the brackets slot to the tooth serface and is a horizontal adjustment • inset、offset. • purpose：curvature of the natural arch form second order bend vertical bend tip back bend、terminal tip back bend、tip forward bend、axial positional bend Purpose：up and down or tip bends, to provide correct axial inclination and tooth-root alignment in a mesil-distal demention third order bend • torque lingual root torque/labial crown torque；labial root torque/lingual crown torque • purpose：bucco-palatal or buccolingual position of the roots in respect to the crowns of the teeth Retainer • Retainer ：removable fixed • Time C. Straight wire appliance Preadjusted appliance Develop from the edgewise appliande， which is basically an appliance with builtin 3D prescription to represent ideal tooth positions, without the three order bend into the arch wire Theoretic： Andrews published his classic article “the six keys of ideal occlusion a.The development of the SWA • 1972，Dr.Andrews : straight-wire appliance(SWA) • 1976，Secondly，Dr.Roth : Roth set-up • 1997，thirdly，Dr.McLaughlin ,Dr.Bennett Dr.Trevisi: MBTTM b. characteristic Improve the design of bracket Precisely position the average tooth Minimize the second- and third-order bends Shorten the course of treatment Torque and axial inclination c position： Center of clinical crown • Bracket Identification: Brackets’ distal-gingival wing is marked d procedures： first stage ： alignment ——laceback ; ——cinch back closure of extraction space Second stage ： close of extraction space ——sliding mechanics D. Lingual appliance E. Operation 1. separation • Separation material • Operating points 2. bonding Cementation requirements • Fitting around the tooth • No stimulation of gingival tissue • Good retention • No interference with normal occlusion Bonding bracket • Direct bonding • In-direct bonding 3. ligature 4. debonding • Removing the bracket • Removing the band • Grinding the bonding material • Polishing the tooth surface Summary •Familiar with the characteristics and the principle of fixed appliance •Familiar with the composition of appliance treatment and basic steps Composition：band、bracket、arch wire、appliance Procedure ：alignment 、close space、adjustment、 retainer
