preadjusted edgewise appliance

PRE ADJUSTED PRE ADJUSTED EDGEWISE APPLIANCEEDGEWISE APPLIANCE

Guided by:Dr. Suresh KanganeDr. Anand AmbekarDr. Pravinkumar Marure Dr. Yatishkumar JoshiDr. Chaitanya Khanapure

Presented by:Khushbu Agrawal

CONTENT

• History and evolution of fixed appliances• Straight wire concept and evolution

– Evolution of SWA– Concept of SWA– Need for a new appliance

• Design features of fully programmed brackets • Transition of standard edgewise to pre-adjusted

edgewise

HISTORY AND EVOLUTION OF FIXED APPLIANCES

EDWARD ANGLE (1855-1930)

• E-Arch (1907)

Contemporary orthodontics by William Profitt, 5th edi.

• Pin and Tube appliance (1912)

• Ribbon arch appliance (1915)

• Edgewise appliance (1926)

OTHER EARLY FIXED APPLIANCES:

•Labiolingual appliance

•Twin wire appliance

•Begg’s appliance

STRAIGHT WIRE

CONCEPT AND

EVOLUTION

6STRAIGHT WIRE: The concept and appliance by Lawrence F Andrews. 1989

EVOLUTION OF SWA

• Torqued slots for upper and lower incisors

• Angulated brackets and tubes to effect tipping movements

• Importance of bracket placement parallel to LACC• Angulated brackets on teeth adjacent to extraction

sites to aid root paralleling

• Raised brackets base of lateral incisor by 0.016 inch

STRAIGHT WIRE: The concept and appliance by Lawrence F Andrews. 1989

Evolution of SWA…

• Increased tip and torque for overcorrection

• Tip and Torqued brackets • Building treatment into appliance

• Straight wire appliance

• Vari-Simplex Discipline

Evolution of SWA…

• Introduced Slot machine

• Introduced Elan and Orthos system

Evolution of SWA…

CONCEPT OF SWA

Study 1 : Examination of post-treatment occlusion

• Began in 1960

• Asses static occlusion

• American Board of Orthodontics, EH Angles

Society, Tweed Foundation

• Post-treatment casts

Examination of post-treatment occlusion…

• Consistent features:

1. Incisors were not rotated

2. No crossbite / overjet

3. Class I molar relationship

Examination of post-treatment occlusion…

• Variations in result:1. Articulations of occlusal surface not proper2. Long axis of teeth on either site of extraction site

not parallel3. Inclinations and angulations varied among

patients treated with different orthodontists 4. Second molar not included in treatment5. Interdental spaces existed frequently6. No intraoral models or oral photographs 7. No standardization as to whether dental casts

were registered in centric occlusion or centric relation

Study 2:Naturally occurring optimal occlusion

Lawrence F. Andrews noted that too many post treated models had

obvious inadequacies, despite the acceptable molar relationships as

described by Angle.

17*Lawrence Andrews, The six keys to optimal occlusion. AJODO 1972(296-309)

• 120 non-orthodontic normal models were collected between 1960-1964.

• Models selected were of teeth which –– Had never had orthodontic treatment – Were straight and pleasing in appearance – Had a bite which looked generally correct – According to author would not benefit from

orthodontic treatment

Study 3:The six keys to optimal

occlusion

*Lawrence Andrews, The six keys to optimal occlusion. AJODO 1972(296-309)

SOME IMPORTANT TERMINOLOGIES

1] ANDREW’S PLANE The surface or plane on which the mid transverse plane of every crown in an arch will fall when teeth are optimally positioned.

Six keys to optimal occlusion…

2] CLINICAL CROWNThe amount of crown that can be seen intraorally or with a study cast

3] FACIAL AXIS OF CLINICAL CROWN (FACC)For all the teeth except molars, the most prominent portion of the central lobe on the facial surface of each crown For molars, buccal groove that separates the 2 large facial cusps.

4] FACIAL AXIS POINT (FA POINT) The point on the facial axis that separates the gingival half of the clinical crown from the occlusal half

• TOOTH CLASS – A group of teeth having similar shape and

function– E.g. incisors, canines, premolars, molars

• TOOTH TYPE– Subordinate category within a class of teeth– E.g. first mandibular premolars, second

mandibular premolars

Key I: Interarch Relationships1) As explained by Angle, the mesiobuccal cusp of permanent maxillary first molar occludes in the groove between mesial and middle buccal cusps of the permanent mandibular first molar

2) The distal marginal ridge of the maxillary first molar occludes with the mesial marginal ridge of the mandibular second molar

3) The mesiolingual cusp of maxillary first molar occludes in the central fossa of the mandibular first molar

4) The buccal cusps of the premolars have a cusp embrasure relationship with the mandibular premolars

5) The lingual cusps of maxillary premolars have a cusp-fossa relationship with the mandibular premolars

6)The maxillary canine has a cusp-embrasure relationship with the mandibular canine and first premolar. The tip of its cusp is slightly mesial to the embrasure

7) The maxillary incisors overlap the mandibular incisors, and the midlines of the arches match

Key II: Crown Angulation

• All crowns in the sample essentially have a ‘positive angulations’ that is, gingival portion is distal to incisal portion of crown

• All crowns of each tooth type are similar in amount of angulations

Key III: Crown Inclination

• Labiolingual or Buccolingual inclination

• Maxillary incisors – positive• Progressively negative from

maxillary canines to second molars

• Progressive negative inclination for mandibular incisors to second molars

Clinical implication of Key II and III :

• The wagon wheel effect:– For every 4 degrees of

lingual crown torque there is 1 degree of mesial convergence of the gingival portion of central and lateral crowns, that makes a ratio of 4:1

• The teeth should be free of undesirable rotations

• Example of problem: rotated molars would occupy more space

Key IV: Rotations

• The contact points should be tight (no spaces)• Exceptions: genuine toot-size discrepancies

Key V: Tight Contacts

• The planes of occlusion ranged from flat to slight curve of Spee (concave)

• Andrew believed that a flat plane should be the treatment goal as a form of overtreatment since there is a natural tendency for the curve of Spee to deepen with time.

Key VI: Occlusal Plane

Study 4:Crown measurement in 120 samples by Andrews

• After determining the 6 keys of occlusions Andrew made certain measurements in the non orthodontic models which helped in the development of the first fully programmed appliance

• The measurements made were: – Bracket area– Vertical contour– Angulation– Inclination– Maxillary molar offset– Horizontal contour– Facial prominence– Curve of spee

Measurements by Andrews…

The average findings for the maxillary teeth are:

1) Angulation:

2) Inclination:

3) Maxillary molar offset:

4) Crown prominence:

The average findings for the mandibular teeth are:

1) Angulation:

2) Inclination:

3) Crown prominence:

4) No offset was needed for mandibular molar because the middle & mesiobuccal cusps are equal in prominence.

5) The curve of Spee ranged from flat to 2.5 mm deep

• This study revealed consistencies in the position, morphology & relative facial prominence for the crown of each tooth type with an arch except for incisor inclination.

• The differences in the incisor inclination were attributed to interjaw disharmony.

• Thus special considerations must be given in the bracket design to correlate the inclination of incisors with interjaw relationship.

Study 5:Comparison between study models and treated casts

• After making the measurements, Andrew compared the 120 non-orthodontic models with the treated 1150 models.– That is best in nature vs best in treatment

• Comparison were made particularly in relation to the 6 keys of optimal occlusion:

Comparison between study models and treated casts…

KEY I - Inter-arch relationship:

• In 80% of the treated models, distal marginal ridge of maxillary I molar did not occlude with mesial marginal ridge of mandibular II molar.

• Premolars and canines did not have cusp-embrasure relationship.

KEY II - Angulation: • In 91 % of the treated models, crowns had one or

more teeth whose angulation differed from those of optimal sample.

KEY III - Inclination:

Inter incisal FACC – • In optimal- more than 180 degrees in 78%• In treated - Less than 180 degrees in 81.5%

KEY IV - Rotation: Rotations were evident in 67% of post treated cases.

KEY V - Tight contacts: Spaces were seen in 43% of post treatment casts.

KEY VI - Curve of Spee: More than 2.5 mm in 56% of post treatment casts.

• These evidence showed that only few post treatment results met the six key standards.

• So a quarter century of research done by Andrew, devoted to naturally optimal & treated occlusions has yielded not only the six keys, but also several principles fundamental to the concept of fully programmed appliance.

Summary of principles• Each normal tooth type is similar in shape from one

individual to another.

• The size of normal crowns within a dentition has no effect on their optimal angulation, inclination or prominence of their facial surface.

• Most individuals have normal teeth regardless of whether their occlusion is flawed or optimal.

• Jaws must be normal & correctly related to permit the teeth to be correctly positioned & related.

• Dentitions with normal teeth and in jaws that are or can be correctly related can be brought to optimal occlusal standards.

NEED FOR A NEW APPLIANCE

• The edgewise appliance designed by Angle is "Non programmed" because of the bilaterally symmetric design.

• If located on the FA point & the FACC & used with unbent archwire, the brackets would cause the Inclination of the facial plane of each crown to be at 90 degrees to occlusal plane,

• The occlusogingival positions of each crown to be irregular,

• All crowns to have equal facial prominence & angulation of the FACC of each crown to be at 90 degree to the occlusal plane.

Need for a new appliance…

The major shortcomings of edgewise appliance are:

1. Bracket bases are perpendicular to bracket stem2. Bracket bases are not contoured occlusogingivally3. Slots are not angulated4. Bracket stems are of equal faciolingual thickness 5. Maxillary molar offset not built in6. Bracket siting techniques are unsatisfactory

1] Bracket bases are perpendicular to bracket stem

• Can cause problems for the slot inclination and occlusogingival position.

• The effect when the brackets are aligned with unbent arch wire.

2] Bases not contoured occlusogingivally:

• Can unintentionally cause rocking of bracket occlusally or gingivally.

• There will be irregular slot siting in each arch caused by vertically flat based brackets.

• This diagram shows the effect of the irregularly placed brackets.

3] Slots are not angulated:

• The bracket slots of the edgewise brackets are non angulated.

• When the vertical components of the brackets are sited parallel to FACC & base point sited at FA point, the angle of the slot vary to many different angulation

• This diagram shows the effects when the brackets are placed without slot angulation

4.Stems of equal prominence:

• Distance between bracket base & center of slot is same in each brackets.

• Therefore when the brackets are placed they become as irregular in the facial prominence as the crown

• With the unbent archwire the facial surface of each crown becomes equidistant from the embrasure line, which is undesirable.

5.Maxillary molar offset not built in:

• The midsagittal plane of the slot is angular to the mid sagittal plane of the crown.

• Rotational effect of the molars

6. Unsatisfactory bracket sitting techniques:

• Most of the authors & practitioners seldom agree about which landmarks are best for bracket siting

• Each requires a different wire bending

• Tweed – specified number of mm from cusp tip or

incisal edge

• Saltzman – middle third of clinical crown

• Holdsway – altered according to malocclusion,

open bite or deepbite

• Jaraback – determined by the shape of crown

• Lindquist – relative to height of marginal ridges

for posterior teeth 73

DESIGN FEATURES OF

FULLY PROGRAMMED

BRACKETS

DESIGN FEATURES OF FULLY PROGRAMMED BRACKETS…

1] Slot sitting features

• Midtransverse plane: Feature 1: Midtransverse plane of slot, stem, crown must be same

• Midtransverse plane: Feature 2: Base must have same inclination as of facial plane of crown

• Midtransverse plane: Feature 3: Contoured occlusogingivally

• Midsaggital plane: Feature 4: Midsaggital plane of slot, stem, crown must be same

• Midsaggital plane: Feature 5: Vertical components designed to be parallel to each other

• Midsaggital plane: Feature 6: Base contoured mesiodistally

• Midsagittal plane: Feature 7: The vertical components of the bracket should be parallel to one another

• Midfrontal plane: Feature 8: All slot points within an arch must have same distance between them and crown embrasure lines

• Gingival tie wings on posterior brackets extend further laterally

2] Convenience features

• Facial surfaces of incisor and canine brackets parallel their bases

• This feature is incorporated for Lip comfort

• Power arms

• Hooks

• Facebow tubes

• Utility tubes

• Rotation wings

3] Auxiliary features

ADVANTAGES AND

DISADVANTAGES OF SWA

ADVANTAGES

1.Ease of archwire construction

2.No need for interbracket span

3.Less round tripping

4.Better control of tooth positions

5.Consistent result in shorter treatment time

6.Patient comfort

7. Complete space closure with one set of archwires

8. Ease of ligation

9. Ease of bracket identification

10. Easier more accurate bracket placement

11. Precise control on premolar and molar torque

13. Precise finishing control in all 3 planes

DISADVANTAGES

1.Individual variations in facial surface curvature

2.Consistent LA point is questionable

3.Different skeletal types have different inclines of

occlusal planes

4.No specification regarding placement of bracket

from manufacturers

TRANSITION FROM

STANDARD EDGEWISE TO

PREADJUSTED EDGEWISE

APPLIANCE

• The mechanical treatment of most orthodontic cases can be divided into six stages:

1. Anchorage control

2. Leveling and aligning

3. Overbite control

4. Overjet reduction

5. Space closure

6. Finishing 92

TRANSITION FROM STANDARD EDGEWISE TO PEA…

1] Anchorage Control • Increased tendency for incisors and cuspids to tip

forward• To manage:

– Omega loop stops and molar ties– Palatal bars and headgears – Lingual arches class III elastics – Archwire bend behind distally banded molar

2] Leveling and aligningFactor 1: •To prevent anterior teeth forward tipping•Need to prevent mesial tipping as well as retracting cuspid into extraction sitesFactor 2: •Need for overcorrection at the end of treatment

• To avoid this problems:1. Lacebacks

• To avoid this problems:2. Bendbacks

3] Overbite and overjet reduction

• Distally tipped cuspids

• Caused mesial aspect of bracket to be more incisal

causing extrusive effect on incisors

• Causing bite deepening

To manage:

•Do not bond incisors

•Upright cuspid root first by lacebacks and then

engage incisors •Also, lower second molar banding as early as possible

4] Space closure

• Standard edgewise: Closing loop arches

• PEA: Hooks placed in anterior section of straight

arches and elastics or spring forces tied from

molar brackets

5] Finishing

• More accurate the appliance, less time and effort

required during finishing

• Necessary to place archwire bends to compensate

for tooth shape and size, improper bracket

positioning

CLASSIFICATION OF

PREADJUSTED EDGEWISE

APPLIANCE

TORQUE IN BASE

LA pointLA pointSlot pointSlot point

Base pointBase point

VARIOUS APPLIANCE

PRESCRIPTIONS

Bracket prescription: Incisors through premolars

106Contemporary orthodontics by William Profitt, 5th edi.

Bracket prescription: Incisors through premolars

Molar bracket/tube prescription

• Variable appliance prescriptions1. SWA2. Roth 3. MBT4. Ricketts: Bioprogressive therapy5. Alexander’s principles6. Viasis Bioefficient brackets7. Bidimensional systems8. The Butterfly system 9. SEBA/ Protorque system10. Self-ligating system

• Conclusion• References

CONTENT

Straight wire appliance

• Lawrence Andrew, Father of Preadjusted bracket system (1972)

SWA tip

2º 2º 5º 2º 2º

2º 2º 11º 9º 5º

Tip values STRAIGHT WIRE: The concept and appliance by Lawrence F Andrews. 1989

Torque values 111

Lateralincisors

Centralincisors

3º 7º

-1º -1ºOriginal SWA

Lateralincisors

Centralincisors

10º 17º

-6º -6ºRecommended torqueOriginal SWA

SWA…

Roth precription

• 1976, the second generation brackets• Need to place compensating curves and reverse

curves• Overcorrect malocclusion• Full size archwires • Hooks were added

112Roth, R.H.: Treatment Mechanics for SWA in Orthodontics: Current principles and techniques. JCO 1985

Roth tip

0º 0º 7º 0º 0º

0º 0º 9º 9º 5º

Tip values

Roth, R.H.: Treatment Mechanics for SWA in Orthodontics: Current principles and techniques. JCO 1985

ROTH Prescription…

Molars Premolars Canines Lateralincisors

Centralincisors

0º0º

-30º-30º

-14º-14º

-7º -7º

-2º 8º 12º

Torque values

Roth, R.H.: Treatment Mechanics for SWA in Orthodontics: Current principles and techniques. JCO 1985

ROTH Prescription…

MBT PRESCRIPTION

• McLaughlin, Benett and Trevisi (1997)• The third generation brackets• Versatility• Light archwire forces• Lacebacks and Bendbacks for early anchorage

control

115Systemized orthodontic treatment mechanics by McLaughlin, Bennett and Trevisi 2001

5º 5º 0º 0º 8º 8º 4º

2º 2º 2º

2º 3º 0º 0º

Tip values

Systemized orthodontic treatment mechanics by McLaughlin, Bennett and Trevisi 2001

MBT Prescription…

Centralincisors

+6º 0º -6º

-6º-6º

-17º-12º

-14º-14º

-7º -7º

+7º 0º -7º 10º(-10º) 17º

Torque values

Systemized orthodontic treatment mechanics by McLaughlin, Bennett and Trevisi 2001

MBT Prescription…

Ricketts: bioprogressive therapy

• Robert Murray Ricketts (1976)• “Bio” – technology with biology• “Progressive” – treatment sequence

118The textbook of The Bioprogressive therapy by Robert Ricketts

• In 1970’s, two principle bracket designs available were:1. Rotation arms2. Twin – Siamese type – or dual bracket

• Ricketts experimentally moved from rectangular slot to 016 square box

• Return to 019 x 025 slot• Standardize 018 x 025 slot• Ricketts went to 0185 x 030 slot

Ricketts Bioprogressive therapy…

RICKETTS BRACKET DESIGN

1] Deep slot– Permits two light arches to be employed at once – Chamfer or bevel at the box entrance to

facilitate wire seating– More accurate distance for torque grooves to be

placed

2] Wide incisal-gingival wing– Easy access for tie wires– Even a single wing of once bracket can be used

as eyelet– Auxiliary wire can be placed underneath the

wing– Rubber elastic traction– Accessibility for cement removal under the

3] Softer material– Permits closing of bracket for rotation with

later reopening for finishing– Doesn’t fracture or chip teeth easily during

interferences– Can be pinched close around narrow wires for

absolute wire engagement

0º 0º 0º 0º 5º 8º 0º

0º 0º 0º

0º 15º 0º 0º

Tip values

The textbook of The Bioprogressive therapy by Robert Ricketts

Centralincisors

0º0º

22º0º

0º0º

0º 0º

7º 14º 22º

Torque values

The textbook of The Bioprogressive therapy by Robert Ricketts

• 1980’s Ricketts and Gugnio: 3 sets of brackets 1. Proversion – Class II div 2, deep bites2. Neutroversion – Class I openbite or deepbite 3. Retroversion – Class II div 1 and uprighting

upper incisors

• Now-a-days – “Utility arch” from Bioprogressive technique

• Made from 016 x 016 blue elgiloy• Vertical discrepancies treated prior to horizontal

The ALEXANDER’S discipline

• Vari-simplex discipline (1978)– Variety of brackets– KISS principle– Knowledgeable orthodontist

• Esthetically pleasant face with stability of treatment and a balanced occlusion.

126The 20 Principles of the Alexander Discipline by R.G. Wick Alexander. 2008

127The 20 Principles of the Alexander Discipline by R.G. Wick Alexander. 2008

The Alexander’s Discipline…

VIASIS bioefficient brackets

• Bioefficient therapy (1995)• By Anthony Viasis• New superelastic A-NiTi wires• Multifunctional single brackets

129Anthony Viasis. Bioefficient therapy. JCO 1995 Sept.:552-68

1] Conformity to crown anatomy and crown outline

Viasis brackets…

2] Ease of use

Viasis brackets…

3] Minimum friction

Viasis brackets…

4] Tip control

Viasis brackets…

5] Rotation control

Viasis brackets…

6] Vertical slot

Viasis brackets…

7] High anterior torque

Viasis brackets…

BIDIMENSIONAL SYSTEMs

1] BIMETRIC SYSTEM

•Schudy and Schudy (1975)•016 slots on anteriors•022 slots on posteriors•022 x 016 SS wire with a 900 twist distal to canines

137Vipul K S, Bidimensional Technique: A Topical Review. Int J Dentistry Oral Sci. 2015 2(6), 94-

2] BIDIMENSIONAL EDGEWISE SYSTEM

•Dr. Gianelly (1985)•Non-preadjusted 022 x 028 slot brackets for all the teeth•0.016”x0.022” archwire is used with a 900 twist distal to the lateral incisors•‘‘Bidimensional-wire’’ technique

3] BIDIMENSIONAL SLOT SYSTEM

•Dr. Gianelly (2000)•018 slot on centrals and laterals •022 slot on canines and posteriors•Anteriors – “tight fit” – three dimensional control•Posteriors – “loose fit” – sliding mechanics

THE BUTTERFLY YSTEM

• S. Jay Bowman in 2003• Features:

– new low profile brackets, – miniature twin-wing design, – rounded tie wings, and – elimination of standard hooks

140S. Jay Bowman. The Butterfly System. JCO 2004: 274-87

• Feature 1: Versatile vertical slot

Removable T-Pins or hook pins can be placed through vertical slots of any brackets when needed, eliminating integral bracket hooks

The Butterfly system…

Vertical or “sling” tie: stainless steel ligature placed through

vertical slot and around archwire for severely displaced teeth

Compliance Spring used with round stainless steel archwire and intermaxillary elastics to provide

labial root torque

U-Turn square-wire rotating spring

Power Arm limits tipping when used with elastics, chains, or nickel

titanium coil springs

Traditional Begg’s uprighting spring

• Feature 2: Progressive posterior torque

Inappropriate posterior torque causes excessive curve of Wilson Increased maxillary posterior torque

(–14°) and reduced mandibular posterior torque (–10°) to improve

intercuspation and posterior overjet, flatten curve of Wilson, and reduce

interferences

• Feature 3: Reversible second premolar brackets

Zero or negative angulation in second premolar bracket

promotes improper intercuspation in

nonextraction cases

Butterfly System second premolar brackets (+3° tip) improve posterior marginal

ridge adaptation in nonextraction treatment

Zero or positive angulation in second premolar brackets promotes improper root

angulation during space closure

Butterfly System’s reversible second premolar brackets.

Butterfly System second premolar brackets placed on first premolars to improve root paralleling during space

closure after extraction of second premolars

• Feature 4: Progressive mandibular anterior tip

• Feature 5: Angulated first molar attachments

Prominent distobuccal cusps result when first molar bands are fitted to marginal ridges

instead of placing molar attachments parallel to

buccal cusps.

A. Butterfly System molar attachments have –6° angulation to account for differences in first molar marginal ridges.

B. When Butterfly System first molar bands are fitted to marginal ridges, tube angulation keeps buccal cusps parallel

to occlusal plane.

• Feature 6: Preventive mandibular anterior torque

• Feature 7: Conservative anterior torque

• Feature 8: Improvement in overjet

• Feature 9: Bonding pad attachments

SEBA/protorque SYSTEM

• Sugiyama Evidence Based Asian prescription • Dr. Raymond Sugiyama and Dr. Mauricio

Gonzalez• Todays PEA – derived from Caucasian norms• Dr. Sugiyama studied the significant differences in

the dental anatomy and cephalometric measurements between Caucasians and Asians

CEPHALOMETRIC COMPARISONS

Asians Caucasians Differences1.U1-SN = 107.5° 104.2° +3.3°2.U1-FH = 114.0° 109.6° +4.4°3.L1-MP = 95.2° 91.2° +4.0°4.L1-APo = 4.5mm 1.0mm +3.5mm5.L1-APo = 26.2° 22.0° +4.2°6.U1-L1 = 124.4° 134.0° -9.6°

7.Higher torque and lower angulation – keep the teeth in the middle of the basal bone during orthodontic movement – lessening the chance for root resorption

SEBA System…

• He concluded –1. Asian teeth are wider mesio-distally and have

less angulation 2. The upper and lower incisors of Asian teeth are

more proclined, in relation to basal bone3. The interincisal angle is significantly less for

Asians

• Higher torque and lower angulation – keep the teeth in the middle of the basal bone during orthodontic movement – lessening the chance for root resorption.

SEBA System…

0º 0º 9º

º 2º 2º

0º 0º 9º 6º 3º

2º 2º 5º 0º 0º

Tip values

SEBA System…

Centralincisors

3º3º

-6º -6º

8º 18º 24º

Torque values

SEBA System…

SELF-LIGATING BRACKETS

• Dr. Dwight Damon (1998)• Low friction brackets• Active and passive types

4º 4º 5º 4º 2º

2º 2º 5º 9º 5º

Tip values

Self-ligating brackets…

Centralincisors

-6º-6º

-28º-10º

-14º-18º

-11º -11º

7º 6º 15º

Torque values

Self-ligating brackets…

CONCLUSION

• A variety of PEA prescription are available in the market now-a-days.

• No single appliance however can be used to achieve ideal treatment results.

• The success of orthodontic treatment still depends on clinicians knowledge and willingness to do the wire bending as and when needed.

conclusion

REFERENCES• Contemporary orthodontics by William Profitt, 5th Edition• STRAIGHT WIRE: The concept and appliance by Lawrence F

Andrews. 1989• Roth, R.H.: Treatment Mechanics for SWA in orthodontics: Current

principles and techniques. JCO 1985• Anthony Viasis. Bioefficient therapy. JCO 1995 Sept.:552-68• Systemized orthodontic treatment mechanics by McLaughlin, Bennett

and Trevisi 2001• S. Jay Bowman. The Butterfly System. JCO 2004: 274-87• Vipul K S, Bidimensional Technique: A Topical Review. Int J Dentistry

Oral Sci. 2015 2(6), 94-96.• The Bioprogressive therapy by Robert Ricketts • Smartclip Self-ligating appliance system by Hugo Trevisi 2007

references

THANK YOU

preadjusted edgewise appliance

Health & Medicine

Transcript of preadjusted edgewise appliance

Edgewise mechanism

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EDGEWISE APPLIANCE STRAIGHTWIRE APPLIANCE ESTHETIC … · 3 Edgewise bracket Edgewise slot: 0.022 x 0.028 inch or Edgewise slot: 0.018 x 0.022 inch EDGEWISE APPLIANCE