Professional Documents
Culture Documents
APPLIANCES
Prepared and Presented By:
Musab A.rahman
DEFINITION:
Are attachments that are fixed to the tooth
surface, the forces are exerted via the
attachments using arch wires and/or other
auxiliaries thus are capable of greater range of
movements than that of the removable ones.
It cannot be adjusted neither removed by the
patients
ADVANTAGES:
Precise tooth control
Is possible because its possible to move the
teeth in 3 planes of space so
achieving
perfect alignment of teeth both inter and intra
arch
DISADVANTAGES
Oral hygiene requirements:
It becomes difficult as the food debris tends to
accumulate around the attachments
Esthetics:
Fixed appliances are generally made out of
metals so not esthetically accepted by most
patients. The advent of lingual technique and
tooth colored brackets have helped to
overcome this advantage so far.
CONTRAINDICATIONS
:
Poorly motivated patient:
As the patients responsibility os not limited to
maintaing a good oral hygiene but will also
involve elastic and headgear wearing and
keeping appointments at regular intervals
COMPONENTS:
Active
passive
ACTIVE
These include components which are capable
of generating tooth moving forces. These
include:
a. Separators
b. Archwires
c. Elastics
d. Elastomerics
e. Springs
f. Magnets
BRASS WIRE
Initial soft brass wire 0.5 to 0.6mm passed
interdentally and twisted
They were painful, caused lacerations due to
the uncontrolled forced
Brass separators in
place medial and
distal to the maxillary
left first molar
Laceration injury
caused because of
loosening of
the twisted end of the
brass separator
KESSLYING
SEPERATOR
are made of 0.016 special plus Australian
wire with helices at the closed end. The open
straight arm passes below the contact
sufficient space is created within 4 hours of
application
RING SEPERATORS
Are small elastic rings that are stretched and
passed through the interdental contacts using
separators placing plier
Elastic
separators. The
lose ones have
a rectangular
cut section
whereas the
ones on the
stick are round
Placement of elastomeric
separators using dental
floss. Two pieces of floss are
placed through the hole in the
center of the separator and are
held one in each hand
ARCH WIRES
Are available in various dimentions and
materials
Physical properties:
Springback: ability to return to its original
shape after an applied force
Biocompatibility
Joint ability: whether the material can be
welded or soldiered
Frictional characteristics
CaCr
TMA
NiTi
ss
Low
Medium
High
Low
Springba
ck
High
Medium
low
High
Stiffness
Good
Good
poor
Good
Formabil
ity
Low
Medium
High
Low
Resilienc
e
SS, stainless steel; NiTi, nickel titanium; TMA, ?
Good
Good
Good
.Biocomp
titanium; CoCr, cobalt chromium.
medium
high
medium
low
Friction
*CoCr
TYPES
Stainless steel
Stainless steel is an alloy consisting of iron, chromium and
nickel, which has a large modulus of elasticity. As such, stainless
steel archwires are generally stiff and resist deformation, which
makes them ideal as working archwires, flexibility of stainless
steel archwires can be increased by winding several smaller
wires together to form large multistrand or twistflex wires; or
wrapping smaller wires around a larger central wire to produce a
coaxial wire
Cobalt chromium
Commercially marketed as Elgiloy, cobalt chromium
has a greater formability than stainless steel and
similar stiffness, but with greater friction. It can be
hardened by heat-treating in the laboratory and is
used for the construction of auxiliaries, such as an
intrusion arch or quadhelix.
Beta titanium
Introduced in the 1980s, beta titanium wires have
good formability, with a stiffness of around one-third
that of stainless steel; but they are also associated
with higher
friction. These archwires are used in the fi nal stages
of treatment, when finishing bends may be required
to detail individual tooth position and achieve
settling of the occlusion.
Nickel titanium
Nickel titanium or NiTi archwires are
characterized by high fl exibility and the delivery of
low force over long range. They also exhibit the
phenomenon of shape memory; when deformed they
will tend to return to their original shape; and
superelasticity, the wire delivering the same force
over a large range of deformation
ELASTICS
Can be made of latex or latex free
Are available inn various strengths which
depends upon the diameter and thickness, are
chosen according to purpose and colour coded
by strength
classI:
Are intra arch mainly placed between the
molars and incisors in the same arch to close
the extraction spaces by retracting anterior
teeth or protracting the posterior
classII:
Are intermaxillary placed between mandibular
molars and maxillary anteriors, can be used to
produce intrusion of max. anterior (Begg
therapy stage1) or decrease the overjet by
retraction of the max. anterior
Class III:
Are intermaxillary placed between maxillary
molars and mandibular incisors, generally in
the TTT of angle class III malocclusions
Diagonal elastics:
Worn for midline deviation correction
Cross-bite elastics
Are intermaxillary and used to correct cross
bite in the buccal segment and placed
according to the tooth in cross bite, generally
from the palatal surface of the maxillary molars
or premolars to the buccal of the lower molars
or premolars
Box elastic
Extra-oral elastics
ELASTOMERS
Are generally made of polyurethane
materials, found in various forms:
Elastic chains ( aka E-chains ):
Used for space closure and are available in 3
different strengths based on the distance
between the rings (continous,closed,long )
Elastic ligature:
Used to secure the arch wires in edgewise or
pre adjusted edgewise brackets.
SPRINGS
Various types of springs are used as auxiliaries
to generate tooth moving forces, are mainly
used for tooth up-righting and torqueing in
beggs appliance therapy, tip edge appliances.
Spring maybe used to open spaces ( open coil
spring) or close spaces (closed coil spring)
Has the following types:
Up righting springs:
Made of 0.012 or 0.014 Australian wire,
they move the tooth root in a mesial or distal
direction
Mesiodistal
uprighting
springs
Rotating
springs
Torquing spring:
Capable of moving the root labial/lingual or palatal
in direction, the force is generated when the spring
is deformed and engaged along the arch wire
PASSIVE
Are those components which are not capable of
generating tooth movement forces but help in
providing attachments for other auxillaries to the
tooth or retaining other active components
A-Bands
B-Brackets
C-Buccal tubes
BANDS
Are either costume fabricated or commercially
made sizes
Are metal attacments (encircles the tooth) that are
cemented and provides a place for attachments of
other auxillaries which can be either welded or
solidered to the band
Indications:
1-teeth that will receive heavy intermittent forces
against the attachments (primary indication) e.g
upper 1st molar against extraoral forces will be
placed via a head gear
Steps of banding:
-Step I Separation of adjacent teeth:
can be achieved using separators for a duration of 2
to 7 days depending upon the separator used.
BRACKETS
defined as a device that projects horizontally to
support auxiliaries and is open on one side usually in
the vertical or horizontal
Edgewise brackets
Edgewise brackets have rectangular slots, which are deeper in the
horizontal as opposed to vertical plane. Slot and archwire dimensions have
traditionally been described empirically, with the original dimensions
being 0.022 inches vertically and 0.028 inches horizontally to
accommodate gold archwires, which were quite soft. Once stiffer stainless
steel archwires were introduced, slot size was reduced to 0.018 inches
vertically and 0.025 inches horizontally. However, with greater uptake of
pre-adjusted edgewise systems, there has been a move back to the
original slot dimension.
Edgewise brackets
Edgewise appliance
Begg bracket
Self-ligating brackets
In an attempt to reduce friction and appointment
times, a range of brackets whose slot is closed by the
use of a metal gate or clip are now available . This
technique is referred to as self-ligation, as the
ligation system is built into the bracket
Rectangular tube
(pre-adjusted edgewise)
Lingual Attachments
are accessory attachments other than brackets and tubes
which are placed on the lingual aspect of teeth (bonded) or
bands (welded).
These include:
Easy-threading eyelets
Lingual sheaths
Lock Pins
are either made of brass or soft steel. These are
used to hold the wire in bracket slots in the Begg
technique or accessories in the tip edge technique.
Ligature Wires:
Ligature wires are soft stainless steel wires of
0.008 to 0.010 inch in diameter. These may be used
to hold / ligate the archwire in brackets (Fig. 39.44A)
or to tie segments of teeth together
THANK YOU
f. Magnets