REVIEW ARTICLE

Evolution of Orthodontic Brackets

Dr. Tamizharasi1, Dr. Senthil Kumar2

ABSTRACT:
Orthodontics distinguishes and differs itself from the other
1& 2
Professors branches of medicine by its widespread use of an array of devices
made of almost all the biomaterials known. From metals to plastic and
Department of Orthodontics from ceramics to composites, these materials bring beauty and health.
KSR Institute of Dental Science & Research, Brackets evolutions from the introduction of pin and tube to lingual,
Tiruchengode, Tamil Nadu. magnetic and self ligating brackets are rapid in pace and play a
significant role in advancement of Orthodontic field. Though, we all
are using recent brackets which are currently available in the markets,
it is important to know the past history of brackets which was used
earlier. Thus, this article reviews the history of various orthodontic
brackets and it's advantages and disadvantages. We suggest that
many more review studies should come aiming at the biocompatibility,
aesthetics and treatment results of each bracket. Such studies will
help the practitioner to decide the bracket selection for his treatment
plan.

Introduction edgewise bracket with a horizontal slot (0.022” x 0.028”).

One of the most important passive components of Ever since many modifications had come in bracket design
fixed appliances is brackets. They are merely handles for and in bracket material.
attachment of the force producing agents. Brackets can
affect the directions of the force vectors when torque, Classification
angulations, and in/out are built into the brackets. Brackets can be classified according to:-
Orthodontic treatment is based upon specific force 1. Width of bracket
applications to the dentition, the maxilla and the mandible. a. Mesiodistally narrow ex., Ribbon arch bracket,
In order to obtain these forces, orthodontic brackets are Begg bracket
attached to the teeth. Previously, brackets were banded to b. Mesiodistally wide ex., Edgewise bracket, Straight
the teeth. But, after, the introductions of bonding resin, wire bracket
brackets are rarely banded to the teeth. 2. Slot of bracket
a. Horizontal slot ex., Edgewise bracket
History b. Vertical slot ex., Begg bracket
It is difficult to imagine that there was a period in 3. Materials
Orthodontics before the invention of brackets. Yet this was a. Metal – Stainless steel, Gold, Titanium, Nickel
the situation when Angle developed and perfected b. Plastics
treatment procedures with his “E” arch which provided no c. Ceramics
axial tooth control. During this time he also advocated the d. Combination – Metal reinforced plastics, metal
pre-treatment extraction of teeth and devised methods to reinforced ceramics
close extraction spaces "sans" brackets. 4. Movement of tooth
The pin and tube appliance1 overcame the weak a. Tipping movement – Begg bracket
point in his “E” arch. Thus the prototype of bracket was b. Bodily movement - Straight wire bracket
conceived. The problems of pin and tube appliance were c. Tipping & Bodily movement – Combination
overcome in ribbon arch appliance by Angle with the bracket, Tip-Edge bracket
introduction of first orthodontic bracket – “the ribbon arch 5. Ligation of bracket
bracket”1. It had a vertical slot facing occlusally and was a. Conventional ligation – Edgewise bracket, Begg
made in gold. The next major advancement in bracket bracket
design that had withstood the test of time was the first b. Self-ligation- Edgelok bracket, SPEED bracket

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Evolution of Orthodontic Brackets
Description of Brackets
Ribbon Arch Bracket
The ribbon arch appliance introduced in 1915,
was the next step in the evolution of tooth alignment
devices. It was actually the first bracket, as such, to be used
in an orthodontic appliance. In the ribbon arch appliance,
the tube principle was abandoned for the bracket principle.
The mesial and distal walls of the tube were removed. Thus
these brackets had a vertical slot facing occlusally in
contrast to the Begg bracket which faces gingivally.
Universal Bracket
The name “universal”2 only connotes that the
bracket is effective to move and control tooth movement in
all planes. It is truly a light wire bracket, designed to be
used with light wires, but for stability purposes, heavy wires
are also accepted. This in itself makes the bracket
“universal” in its implementation. It has two separate slots
to receive single or multiple wires for the various tooth
movements. The bracket also has wings that enhance the
wire action.
Begg Bracket
These are modified ribbon arch brackets, which
are narrow mesio-distally and carry a vertical slot usually of
0.022” size. The ribbon arch brackets designed by Angle
were placed inverted by Begg3 with the slot facing
gingivally. The round arch wire is loosely fitted and held in
place by a lock pin or ligature tie wires. This is responsible
for the free tipping and sliding of teeth during the initial
stages of treatment. But, because of the narrow bracket
and round wire, apical movements are not possible without
the use of auxiliary springs.
Modern Begg Bracket
Dr. William J. Thompson introduced the Modern
Begg4 Technique in the year 1981. It comprises of the
advantages of the Begg light wire technique and Straight
Wire technique. The gingival, or ribbon-arch slot is
designed to permit maximum crown and root tipping
movements and the edgewise slot is designed for precise
final detailing. These bracket types provide adequate
mesiodistal width for optimal rotations, tipping and torque.
The base of the four-stage bracket is bevelled to reduce the
possibility of friction or binding with the arch wire. The
specifications for torque, tip, and in-out placement vary for
each tooth.
Tip Edge Bracket
Dr. Peter C. Kesling designed the Tip Edge
bracket5. From his experiences with differential tooth
movement for 30 years and a thesis written in 1968, he
determined that is necessary for each tooth to tip freely
either mesially or distally-not in both directions. The face of
Tamizharasi & Senthil Kumar
the edgewise bracket has been changed to permit free
crown tipping followed by controlled root uprighting.
Lateral extensions of the bracket behind the arch
wire provide maximum rotational control even when the
tooth is tipped. The wings are lingual to the archwire and
therefore not visible. Each bracket has a vertical slot to
accept rotating or uprighting springs, power pins and jigs
for accurate direct bonding. The slot is rectangular (0.020”
x 0.020”) with both the gingival and incisal ends chamfered
to facilitate the insertion of auxiliaries from either direction.
Ceramaflex II – 256 Begg Brackets
The most exciting addition to the Begg appliance
component list, are the ceramic brackets. TP Orthodontics
Inc markets it as “Ceramaflex II – 256 Begg” brackets. This
bracket is polycrystalline alumina and is manufactured by
injection moulding. The bonding surface has a
polycarbonate base with a slot to enable easy debonding
and to avoid enamel fracture that occurs with ceramic
brackets2.
Edgewise Bracket
Angle's final achievement, the edgewise
appliance, was the culmination of many years of effort and
many different appliance designs attempting to place the
teeth according to his “line of occlusion”. The original
edgewise bracket as designed by Angle1 was a soft gold
bracket with a 0.022” x 0.028” slot which was readily
deformed by the forces of occlusion and by tying ligature
wires to the bracket.
Various modification of edgewise brackets are:
Single Width Bracket
It was designed to overcome the problem of tooth
rotation. He devised soldered gold eyelets to be placed in
the bands.
Twin Bracket
The next development was the joining together of
two edgewise brackets on a common base. It was named
after the originator of the idea Swain1. The Siamese bracket
quickly gained popularity for use on upper central incisors
and on molar teeth. Its main advantage was its ability to
effect most of the tooth rotation without the use of auxiliary
eyelet ties. After many years another evolutionary step was
the curving of the base of the twin bracket to confirm to the
curvatures of the canines and premolar.
Lewis Bracket
Lewis developed another approach to the problem
of efficient tooth rotation. He soldered auxiliary rotation
arms that abutted against the bracket itself and thus offered
a lever arm to deflect the archwire and rotate the tooth. It
does not interfere with occlusogingival deflections of the
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Evolution of Orthodontic Brackets
archwire. The next development in the Lewis rotation
bracket was the curving of the base and wings of the
bracket to conform to the canine and premolar teeth.
Vertical Slot Lewis Bracket
A refinement in the Lewis bracket has been the
incorporation of a 0.020” x 0.020” vertical slot, making
possible the use of uprighting springs to correct axial
inclinations if needed.
Steiner Bracket
This bracket incorporated flexible rotation arms
which afforded a rotational effect. It works satisfactorily as
long as the flexible arms do not take on a permanent
deformation.
Broussard Bracket
It was developed by Garford Broussard1. It is a
conventional bracket with a closed, rectangular, vertical slot
0.018” by 0.046” which is formed when the bracket is
welded onto the band material.
Other Modifications:
SVED MODIFICATION1
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT AND
NARROW LIGATURE SLOT
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT AND
WIDE LIGATURE SLOT
LEE-FISHER EDGEWISE BRACKET
MODIFIED LEE-FISHER EDGEWISE BRACKET
Preadjusted Edgewise Bracket
In this bracket system the need for the first, second
and third order bends has been reduced by producing a
custom bracket for each tooth, in which a combination of
varying thickness of bracket base, inclinations of slot and
torque of the slot are used to minimize the wire bending for
ideal archwire. These characteristics for each tooth are
called the “appliance prescription” or “building treatment
into the appliance”.
1. Andrews Prescription
Dr. Lawrence F. Andrews6 introduced the Straight Wire
Appliance to Orthodontic profession in 1970. His
appliance was based on six keys to normal occlusion.
He divided the appliance as nonprogrammed,
partially programmed and fully programmed
appliances. Non programmed brackets are without
slot or base inclination. Partly programmed bracket
contains 220 slot inclinations. Fully programmed
brackets have 220 base inclination.
2. The Roth Set-up
The Roth Set-up7 was introduced in the year 1976. The
purpose of the Roth setup was to provide idealized
Tamizharasi & Senthil Kumar
tooth positions prior to appliance removal that would
allow the teeth in most instances to settle in
nonorthodontic normal's studied by Andrews. He
altered the prescription of the Andrews appliance to
allow the teeth to be placed in a slightly overcorrected
position in all three planes.
3. Swain Modification of The Roth Set-up
Swain altered the prescription of the Andrews
appliance to what he thought would allow the teeth to
be placed in a slightly overcorrected position in all three
planes of space but not so far overcorrected that the
teeth would not “settle” into an idealized position1.
4. Vari-simplex Brackets
The Vari-Simplex Discipline includes a specific bracket
system used in case treatment. Dr. Wick Alexander8
described it in the year 1978. The Vari-Simplex system
is designed for 0.018” bracket slots and 0.017” wire.
Though 0.022” brackets can also be used, he feels
patient comfort is improved, treatment time is
decreased, and the teeth are more easily moved into
their proper positions with the 0.018” slot.
5. Bennett & Mclaughlin Technique
The authors Richard P. McLaughlin & John C. Bennett9
introduced this technique, in the year 1995. They
produced a “Theoretical Bracket Placement Chart” by
measuring the distance from the incisal or occlusal
edge to the centre of the clinical crown. Values at
+0.5mm and +1.0mm were added for larger teeth,
and values at -0.5mm and -1.0mm for smaller teeth.
6. Segmental Arch Technique
Dr. Charles J. Burstone introduced this technique which
uses the Medium Diamond Twin brackets of the Orthos
prescription. His Vertical Tube Cuspid Bracket10 is very
popular featuring an horizontal auxiliary tube.
7. Bioprogressive Technique
Dr. Robert Murray Ricketts 1 1 introduced the
Bioprogressive therapy in the year 1976. There are 3
combinations - standard progressive setup where
torque is built into upper incisor and all 4 canines, full-
torque setup where torque built in lower molars and
premolars, triple-control setup with rotational control.
8. Linear Dynamic System
The linear dynamic System is a simplified version of the
Bioprogressive11 therapy given by Dr. James J. Hilgers
in the year 1987. According to him, if double or triple
buccal tubes on upper or lower molars are used ideal
orthodontic occlusion can be achieved.
9. The Level Anchorage System
It consists of a banded or bonded edgewise appliance
with built-in tip, torque, and offset and an analysis and
treatment-planning chart with a step-by-step treatment
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Evolution of Orthodontic Brackets
procedure for seven different extraction and non
extraction choices.
10. The “ORTHOS” System
Dr. Craig Andreiko12, applied computer-aided
engineering technology to orthodontic appliance
design in developing the Orthos System, truly incited a
worldwide movement away from pre-adjusted
appliances based on 1960s metrology.
11. The Bios System
“Bios” is a light-wire, higher-torque version of the
Orthos appliance system. Dr. Jim Hilgers designed the
Bios system13 to allow for earlier torque control with
lighter wires. It differs from the Orthos prescription by
virtue of its increased torque in upper incisors and in the
mandibular posterior segment, as well as lingual root
torque in upper and lower cuspids.
Lingual Brackets
Dr. Kinya Fujita14 introduced the Mushroom arch wire
appliance in the year 1979. In the lingual bracket, the
opening of the slot was set on the occlusal surface of the
teeth in order to facilitate the fitting of the wire. The groove
for lockpin insertion was set mesiodistally in the slot and an
auxiliary groove was set in the occlusogingival direction to
facilitate correction of the mesiodistal tipping of the teeth.
Self Ligating Brackets
Self ligating brackets were introduced in the
seventies with the Edgelok bracket. These brackets have
the advantage of aesthetics and comfort. The possibility of
puncture wounds from ligature ties is nil. The most
common used brackets are “Mobil-Lok brackets”, “Insert
bracket”, “SPEED brackets15”, “ Activa Brackets”, “Damon
SL Brackets” , “Time Bracket” etc., Shortened chair time and
slightly less incisor proclination appear to be the significant
advantages of self-ligating system16. Recently, the
introduction of active and passive self-ligating brackets has
presented a challenge to the speciality because of the novel
ligation mode and the potential alterations in load and
moment expression during mechanotherapy.
Bioefficient Brackets
Dr. Anthony D. Viazis designed the Bioefficient
brackets17 in the year 1995. These triangular brackets are
twin brackets with a single-slot type. It was designed to
provide the first differential stiffness bracket to
accommodate the new, differential-force superelastic wire.
Adhesive Precoated Brackets
The orthodontic resources of United and the adhesive
expertise of 3M have combined to create the first Adhesive
Precoated metal brackets. It does not set until it's light cured.
Bracket Materials
The first orthodontic attachments were made of
gold. Since the introduction of Stainless steel it has
Tamizharasi & Senthil Kumar
remained the most widely used material in the manufacture
of orthodontic attachments. Plastics were introduced in the
late sixties and ceramics have been introduced in the mid
eighties. Titanium bracket have solved the problems of
nickel sensitivity, corrosion, and inadequate retention. It's
one-piece construction requires no brazing layer, and thus
it is solder and nickel-free. TP orthodontics has introduced
the Nu-Edge bracket in the year 1997. It uses cobalt
chromium alloy that is essentially nickel free.
Polycarbonate brackets were described and tested
by Newman in 1969. Later,polyurethane, fiber-reinforced,
and filler-reinforced brackets became available18. They
have limited popularity because of clinical problems of
staining – rendering them unaesthetic, distortion and
tearing of the bracket –particularly from torsional forces.
More efforts are directed improving the strength of
polycarbonate/ polymeric brackets by reinforcing the weak
plastic matrix. These types of brackets are reinforced with
ceramic, glass or even with metal inserts.
Ceramic brackets were first introduced in 1987
and it has found wide acceptance and still holds more
promise. The number of problems such as excessive bond
strength, enamel fracture on debonding, brittleness of the
bracket and surface finish has been largely addressed in
the second generation of ceramic brackets.
Magnetic brackets were introduced by Kawata et
al19., in 1987. The magnetic material that first employed
clinically was a cast alloy consisting of 25% to 30%
chromium, 15% to 25% cobalt, and 45% to 60% iron.
Recently, a new material that contains a rare earth metal
–samarium has been included in the magnet. The magnet
has at the present time the highest available coercivity and
maximum energy product.
Bracket Width
The wider the bracket, all other things being equal,
the easier it will be to generate the moments needed to
bring roots together at extraction sites or to control
mesiodistal position of roots in general. The wider bracket
reduced both the force needed to generate the moment
and the contact angle, and is thus advantageous for space
closure by sliding.
Despite their advantage, wider brackets also have
disadvantage. The wider the bracket on a tooth, the
smaller the interbracket span between adjacent teeth, and
therefore the shorter the effective length of the archwire
segments between supports. The maximum practical width
of a wide bracket is about half the width of a tooth, and
even narrower brackets have an advantage when teeth are
malaligned, because the greater interbracket span gives
more springiness.
Bracket Slot
Good torque is possible with steel wires and 18mil
edgewise brackets. The original 22-slot would have some
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Evolution of Orthodontic Brackets
advantage during space closure but would be a definite
disadvantage when torque was later added. If only steel
wires are to be used, the 18-mil slot system has advantage
over the larger bracket size. NiTi alloys with springback
and resistance to permanent deformation have overcome
some of the alignment limitations of steel wires in 22 mil slot
brackets, while rectangular NiTi and Beta-Ti wires offer
advantages over steel for the finishing phases of treatment
and torque control17.
Bracket Bases
One of the most important factors in retention of
an Orthodontic bracket is type of bracket base. The most
common bracket bases are perforated bases, foil mesh
bases, photoetched bases and integrated cast type bases.
The use of small, less noticeable, metal bases helps avoid
gingival irritation. The wire size of the mesh as well as the
size and topography of spot welds are also considered in
bond strength.
Today's favourite bases are die cut from laminates
made of a fine mesh, pressed under heat to a foil that can
have various thickness. A still promising forward step is
the micromechanical retention, achieved by coating the
bases with porous metal powder.
Coating of bonding agents on bracket bases also
increases retention. The coating process increases
mechanical retention by creating undercuts on the top and
sides of the wire mesh. The brackets are also silanated as a
final step which creates higher additional bond strength
due to chemical bonding of the bracket with the adhesive.
Recycling
Though there are still concerns about the possible
increased risk of cross infection, yet recycled brackets are
still used to reduce the cost per case. Brackets can be
recycled either by application of heat to burn off the
adhesive or by using chemical solvents to strip off the
adhesive.
Discusssion
Although Orthodontia started to function without
the use of brackets, yet today it has become an integral
part of it. With the advent of aesthetic brackets and
aesthetic archwires the field is becoming more refined day
by day. But, still metal brackets have more advantages
than aesthetic brackets in reducing the friction during
retraction and also facilitates easy debonding procedures.
The invention of self ligating brackets has
shortened the treatment duration, reduces the patient visits
and enhances better patient co-operation. The recent
introduction of zirconia-based ceramics as a restorative
dental material has generated considerable interest in the
dental community. According to Koutayas SO et al20.,
zirconia based orthodontic brackets can be technologically
feasible. Heravi F21 states that in future, the reduction in the
Tamizharasi & Senthil Kumar
curing time and change in light direction may increase the
bond strength and reduce enamel fracture during
debonding. The bracketless invisible aligner technique has
been considered as a new developed orthodontic technique
since its appearance during the period of late 1990s.
According to Bai YX22 there have been many opportunities
for further development and clinical application for this
technique with the developments of material sciences,
computer software and hardware technology, rapid
prototyping techniques, et al.
Regarding bracket materials, Eliades T23 states that
manufacturing techniques might be modified to include laser-
welding methods and metal injection molding. Esthetic
bracket research will involve the synthesis of high-crystallinity
biomedical polymers with increased hardness and stiffness,
decreased water sorption, and improved resistance to
degradation. Further, he describes that new plastic brackets
might incorportate ceramic wings23.
Sims MR24 has viewed the future of brackets from a
technical point. According to him, in the next millennium,
the genome revolution and knowledge of protein
production and control could lead to the genetic correction
of dentofacial anomalies and pain-free, biomolecular
methods of malocclusion correction and long-term stability.
A fundamental change would be in the abolition of bracket
systems and their replacement with preprogrammed
microchips driven by computers, and the control of PDL
blood vessels and cells by pharmacological targeting.
Future survival of this profession will depend on a radically
different specialist who will be educated with a
postgraduate curriculum based on molecular biology and
computer engineering24.
Summary And Conclusion
Orthodontia has attained unmeasurable goals in
the past century. Today, we are surprised to know that there
was a period when Orthodontia was functioning without
brackets. The advancement of the size, shape, material
and technology of brackets of today is amazing. Hence, it is
necessary for the Orthodontist to keep in pace with rapid
changing technology of Orthodontic brackets and
materials to be a successful clinician.
Though various authors have predicted the future
of brackets in their own ways yet at present tooth
movements produced by bracket-archwire combination
will be the ultimate method for years to come. Periodic
reviews are necessary for the orthodontist to update his
knowledge as well as to decide a better treatment plan
and provide better comfort zone to the patient. This
article has only reviewed the evolution of brackets. We
suggest that many more review studies should come
aiming at the biocompatibility, aesthetics and treatment
results of each bracket. Such studies will help the
practitioner to decide the bracket selection for his
treatment plan.
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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

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