J.

Adv Dental Research
All Right Res

REVIEW ARTICLE

Orthodontics in the past millenium
Vijayalakshmi PS* Veereshi AS **
*M.D.S, Reader, **M.D.S, Associate Professor,Department of Periodontics and Implantology,Departmant of
Orthodontics, Rungta College of Dental sciences, Bhilai,India. Email: dr.veereshi@gmail.com
Abstract:
Pearl Buck said “if you want understand today,
you have to search yesterday”. This article traces the
history of Orthodontics, which evolved as first speciality
of dentistry. It describes the journey in the quest of an
ideal Orthodontic appliance and about various
legendary orthodontists whose contribution in different
areas of orthodontics has led to the development of
orthodontics to the state of art, it is today.

The first mechanical treatment for correcting
irregularities was suggested by Gaius PlinusSecundus
(Pliny) (23-79 A.D.). 1 He advocated the filing of elongated
teeth to produce proper alignment. However, orthodontics,
as we think of it today has its roots in France in 18th century
when French physician, Pierre Fauchard (1728) considered
as Father of Dentistry, described an orthodontic appliance
known as ‘Bandlette’, later known as the expansion arch.1
Evolution of orthodontics as the first dental specialty:

Keywords:Orthodontics, Evolution, Present
Introduction:
“The heritages of the past are the seeds that bring
forth the harvest of the future”. Awareness of our historical
antecedents has acquired more importance today, since
changes are occurring so rapidly, that only by keeping our
eyes steady on what went before can we progress with
intelligence and confidence.
History of dentistry:
The first dental healers were physicians, but by
the middle ages the barber-surgeons of Europe had
specialized in the care of teeth. These practitioners not only
learned by trial and error but also by observation.
Baltimore College of Dental Surgery was the
first dental college in the world which opened its doors to a
class of five students on November 3rd, 1840.
Orthodontics- the beginning:
Hippocrates 1 (460-377 B.C.) was among the first
to comment about craniofacial deformity.Aurelius
Cornelius Celsus1 in 25 B.C. advocated that persistent
deciduous teeth should be extracted and that permanent
teeth which erupt in the wrong direction ought to be
corrected by finger pressure.Specimens dating back to VIII
century B.C. indicate Etruscans may have been the first to
employ orthodontic bands to improve tooth alignment.2

Serial Listing: Print-ISSN (2229-4112)
Online-ISSN (2229-4120)
Bibliographic Listing: Index Copernicus.
EBSCO Publishing Database.

The term orthodontia derived from two Greek
words- ‘orthos’ meaning right or correct and ‘dons’
meaning tooth, was first used by the Frenchman LeFoulon
in 1839. 1In 1880 Norman Kingsley (1829-1913) widely
considered as ‘Father of Orthodontics’ published his book‘Treatise on Oral Deformities as a Branch of Mechanical
Surgery’, where he offers many practical procedures of his
own like occipital anchorage and attempts for the first time
, the systematization of the treatment of occlusal
abnormalities.1, 2
However the emergence of orthodontics as a
true specialty is largely the result of the dominant, dynamic
and influential leadership of Edward Hartley Angle (18551930),
regarded
as
the
‘Father
of
Modern
Orthodontics.2Angle felt that orthodontics was as important
as other departments in dentistry and not a part of
prosthetics as it had been traditionally considered. In 1901
Angle and his followers organized the American Society of
Orthodontists (later known as American Association of
Orthodontists)
Development of fixed appliances:
18th Century (1700-1799):The first scientific attempt at
tooth movement was done by Pierre Fauchard through his
appliance known as the ‘Bandlette’. It consisted of a flat
strip of metal formed into an arch with suitably placed
holes, through which threads were passed to secure the
teeth, applying force to them.1
19th Century (1800-1899):Schange, a Frenchman invented
the adjustable clamp band with the introduction of a lingual
screw in 1841. The regulating jackscrew which delivered a
pushing force on the teeth was invented by Dwinelle in
New York in 1849.In 1861 Kingsley introduced the
headgear to apply extra-oral force and provide occipital
anchorage.
Norman Williams Kingsley (1829-1913) 2 was
regarded as “Orthodontic’s greatest genius” by even the

Journal of Advanced Dental Research VolI : Issue I: October, 2010

11

Basic E arch. he had discontinued using jack screws and was exclusively using E – arch. It was in 1928 that Angle made his greatest contribution of all. which was published in the ‘Dental Cosmos’ in 1899.3 The most dominant. Ribbed E Arch . dynamic and influential figure in the specialty of orthodontics was Edward Hartley Angle (1855-1930) who is regarded as the ‘Father of Modern Orthodontics’. in form and position according to the type. Few among them are. orthodontic practice would not be possible as we know it today. In 1915 with the help of Dr. Through his great skill. 2 was the chief proponent and pioneer of removable appliances in US. By the use of a few simple soldering techniques. Creation of "tie bracket" by minor alteration of ribbon arch bracket and rotation of ribbon arch to "edgewise" position. He was the editor for 17 years and also the President of ADA in 1931. Angle’s various inventions before his edgewise appliance are as follows. H. It was the introduction of the Edgewise appliance in 1928 2. uprighting teeth over basal bone. extractions made more acceptable. He developed the diagnostic facial triangle. He organized the first school of Orthodontia – The Angle School of Orthodontia in 1900. Ketcham – (1870-1935) 1 Albert.Spencer Atkinson introduced the Universal appliance which was a combination of ribbon arch appliance & edgewise appliance. Tweed’s list of contribution to the field is quite long.The original Angle bracket was made up of soft gold with 0. George Crozat2 in 1928 developed the Crozat appliance – a removable appliance fabricated entirely of precious metal with effective clasps for I molars modified from Jackson’s designs from which Class II elastics were employed to treat Class II malocclusions. Kingsley was able to restore normal speech and to improve facial appearance with prosthetic restoration for his cleft palate patients. Other developments taking place around the world that influenced American orthodontic history are recounted in the following pages.‘Practical orthodontics’. brilliantly simplified normal occlusion. Pennsylvania. Holly Broadbent4 published in the first issue of Angle Orthodontist – ‘A New X-ray Technique & Its Application to Orthodontia’. Oren A. V. the practice of orthodontics altered forever in 1870 with an invention that most orthodontists have not associated seriously with treatment. He pioneered the use of retainers to stabilize orthodontic results Martin Dewey (1881-1933): 1 Martin Dewey published his textbook on orthodontic philosophy and mechanical procedures in 1914 .In May 1900 ‘The American Society of Orthodontists’ was formed and Angle was elected its president. He believed that an orthodontic appliance must have 5 propertiesSimple. serial extraction.1930: Serious study of tissue changes during orthodontic tooth movement was carried out by AlbinOppenheim in 1911. light. 2010 12 . 1900-1910:3 The first decade of 21st century was an era of manufacture of standardized appliances. Victor Hugo Jackson (1850-1929)1. Transformation of pin and tube into ribbon arch appliance by ingenious removal of portions of tube and separation of pin from arch wire in 1916.Clavin Case was a contemporary of Angle. which 100 years of experience has proved to be correct except when there are aberrations in the size of teeth.028” slot. Albert H. E Arch without threaded ends. Joseph Johnson 1. He was one of the first to stress on root movement (1892). Calvin Case-(1847-1923): 1 Dr.Case was a pioneer in orthodontic mechanotherapy. By 1907. E Arch with hooks. 1911. KetchamMemorial.the Albert H. 1925. In 1948 William Journal of Advanced Dental Research VolI : Issue I: October. This statement.J. dentists could make a required ‘fitting’ as it was called. Angle’s postulate was that the upper first molars were the key to occlusion and that the upper and lower molars should be related so that the mesiobuccal cusp of the upper molar occludes in the buccal groove of the lower molar. Pin and tube appliance. C. He made one of his greatest contributions in the field of cleft palate when in 1859 he made his first obturator. Stable. In recognition of his services to orthodontics and in his honor the ABO established what is now considered as the specialty’s most coveted prize . using a flat wire & round wire in combination. In 1880 he invented his “first real appliance”the jack and traction screw which marked the beginning of his life work. In 1940. the teeth must be in harmony if in normal occlusion. Dewey founded and became editor of the International Journal of Orthodontia (now AJO-DO). He emphasized the 4 objectives of orthodontic treatment with emphasis and concern for facial esthetics. 1931-1940: In 1931. 2 introduced the twin arch appliance in 1938 in which the resiliency of the double wires provided the gentle force for tooth movement. resilient wires for tooth alignment (1919). 2 introduced the labiolingual appliance. to the specialty and dentistry. 1910. Mosby. He devised a specially designed appliance known as the Jackson's crib.for expansion. Use rubber elastics in treatment (1892) and to use small gauge. Oliver 1. Angle defined ‘line of occlusion’ as – the line with which. Delicate and Inconspicuous. Without adhesives. cephalometric tracing & evaluation. Efficient. Adv Dental Research All Right Res REVIEW ARTICLE eccentric genius – E. He gave the world what he called as the ‘latest and the best’.050” wide and was soldered to gold band material. Angle.Charles Hawley introduced the Hawley’s retainer in 1908.ketcham worked diligently in the American Society of Orthodontics and served as its President in 1929. Dr. It was the invention of dental cement by Magill of Erie. 1941-1950: In 1941 Charles Tweed introduced an ‘edgewise’ appliance. It was the introduction of cephalometric roentgenography.022 x 0. However.2 Angle’s classification has 4 classes. It was .H. Dental supply companies sold appliances made as sets of various kinds mounted on cards. Angle developed a classification of malocclusion.

D. Dr. Other analyses were presented by -C. 1995 and the World Journal of Orthodontics in 2000.Sassouni (1969).R. R. loose-fitting appliance modification that transferred functioning muscle stimuli to the jaws. He rightly Journal of Advanced Dental Research VolI : Issue I: October. 5 In 1902 Pierre Robin introduced the ‘Monobloc’ named so since it was made of a single block of vulcanite. He introduced utility arch. Coben (1955).7 T. It was translated as the immensely successful ‘Removable Orthodontic Appliances’ by Graber and Neumann in 1966. Andrews ushered in the preadjusted era with the introduction of the Straight Wire Appliance (SWA) which was hailed as a revolutionary development with the dual advantage of less wire bending and improved quality of finished cases. Tweed (1953). The 50s and 60s were the decades when cross-continental barriers began dissolving and the dichotomy between European and American orthodontics started disappearing. based on its ability to activate muscle forces. This was accelerated by the replacement of orthodontic bands with bonded attachment which made placement of fixed appliances easier for both the dentist and the patient. Begg of Australia. It presented an objective method of portraying many factors underlying any malocclusion and that there could be a variety of causes of malocclusion exclusive of the teeth. Thomas Graber was born in St. Jarabak (1970). This appliance achieved rapid functional correction of malocclusion by transmitting favorable occlusal forces to the occlusal inclined planes covering the posterior teeth. where designs of different split plates with various screws were shown. Rolf Frankel6 believed that active perioral muscles and tissue mass have potential restraining effect on the outward development of dental arches particularly during the transitional period of development. Two years later A.40 blue elgiloywire and the use of preformed bands in orthodontics. Haupl collaborated with Andresen and together wrote about their appliance & the interpretations of its actions.5. S.C. In 1956 Begg introduced the concept of Differential force.In 1977.5As of now. It is known and practiced in its various forms as conventional / traditional begg.E.Another landmark contribution of Andrew’s is the 6 keys of occlusion which he gave in 1972. 2010 13 . Charles Hawley introduced the Hawley’s retainer appliance in 1908.6Schwarz also introduced the ‘Schwarz double plate’5 which attempted to combine the advantages of activator & active plate for treatment of class II div 1. Steiner (1953).Thus there was predominance of simple removable plates in Britain and of functional appliances in Central Europe. 22 chapters in other textbooks. He started the World Federation of Orthodontics in May 15. Andrews :1.6. The Bionator developed by Balters is the most frequently used activator modification today. Only the Hawley retainer came to stay. But in the next 3 decades these plates were eclipsed by Angle’s fixed appliances which dominated the orthodontic world.H.M. Jacobson (1975) Development of removable appliances: In 1881.Philip Adams2.3. to the ‘apparatus’ introduced by Andresen.5The development of the unique and complex myodynamic appliance was due to the ingenuity of H. Fixed appliances: At this point in time the world received another landmark contribution in the field of fixed appliance.M.6in Belfast modified the arrowhead clasp favored by Schwarz into Adams crib. Ricketts (1966). lightforce wire appliance by P. Ricketts 11: Dr. 10 Graber founded the Kenilworth Dental Research Foundation in 1964. Schwarz published a textbook entirely devoted to treatment with plates. Bimler5Stockfish originally a disciple of Bimler modified the appliance and produced the Kinetor 5. Lawrence F.1. Graber : (1917-2007) Dr. introduced by Emil Herbst. which became the basis for English removable appliances and is still the most effective clasp for orthodontic purposes.9Peter Kesling modified the edgewise bracket to create Tip-Edge bracket in 1988. J.5.6 developed the twin-block appliance as a two-piece appliance. In Europe fixed appliances started replacing removable appliances for comprehensive treatment. teeth and supporting tissues. Clark 5. Louis. modified begg.2. His ability to express complex concepts in an easy-to-read style has resulted in over 20 textbooks. refined begg. the Begg technique has undergone many modifications from the way it was practiced by Begg originally. Though it repositioned the mandible forward it was originally designed to prevent glossoptosis in micromandible& cleft lip & palate patients (later known as Pierre-Robin Syndrome).6 and Haupl gave the name ‘activator’. Adv Dental Research All Right Res REVIEW ARTICLE Downs4 introduced his cephalometric analysis.P. Louis on May 17th 1917. Lawrence F. 6 In 1972.M. Rickett’s Quad Helix made of 0. He was the Editor-in-chief of AJO for 15 years and was responsible for changing its name to AJO-DO in 1985. and not as a functional appliance to stimulate mandibular growth. R.2.. Ricketts developed his cephalometric analysis & cephalometric growth prediction technique in 1960s. Enlow (1969). Coffin plate was introduced by Coffin with the spring that is still part of present appliances. A. They named the technique as ‘Functional Jaw Orthopedics’5.In 1934 Herbst& Schwarz presented a series of articles on their experiences with the appliance.4 Evolution of functional appliances: Andresen6 developed a mobile. C. It was the introduction of multiple-loop. but was then made of piano wire. Therefore Frankel conceived his Frankel Function Regulator in 1950s as an ‘ought to be matrix’ that allowed the muscles to exercise and adapt. It was ‘Lehrgang der Gebissregulung’ which became the Orthodontic bible in Europe. In 1977 Hans Pancherz6 resurrected the Herbst appliance.V. Robert M. Robert Murray Ricketts developed the bioprogressive therapy. 180 publications in journals & 930 book & journal abstract reviews. He graduated from the Washington University in St. H.5.J. He popularized computerized cephalometrics for VTOs & STOs.

7.P. 2.M. Adv Dental Research All Right Res REVIEW ARTICLE stressed the importance of soft-tissues while treating a patient and introduced his E-line for evaluating the position of lips in relation to the profile.M. Rakosi. Cephalometrics for Orthognathic Surgery. 8. 3.3. Chinese NiTi and Fibre reinforced composite and introducing newer approaches like Holography & use of Occlusograms. William R Proffit. No. AJO.B. T. These third generation brackets retained the best in original design but introduced range of improvements and specifications to overcome the clinical shortcomings. Contemporary Orthodontics. Petrovic. Sept. Dentofacial Orthopedics & Functional Appliances. Ronald H.J. 2nd edition. 1966. AJO-DO. Orthodontics: Current Principles & Techniques.5 ‘Vick’ Alexander : In 1978 Alexander introduced his Vari-Simplex Discipline to get high quality results in a large practice using a relatively simple appliance technique. Sept. Graber. 11 Bennett. He also devised the segmented arch technique 11. 5.V. McLaughlin and Trevisi They have modified Andrews’s standard SWA bracket system to MBT bracket system. Orthodontics in 3 millennia. May 2000. Philadelphia. Neumann. Orthodontics: Current Principles & Techniques. To avoid the difficulties of a multiple bracket system. Vol.176-83 4. Vol. Vanarsdall. 2nd Edition. May 1976. AJO-DO. 6. Graber.1999. Swain. Journal of Advanced Dental Research VolI : Issue I: October. 69. W. Philadelphia. Saunders 1975. 127 No. 98. Graber: An Orthodontic Perspective after 75 years. 11 Charles Burstone : Charles Burstone is credited with introducing newer materials in orthodontics like . 2010 14 . 1990. Graber. Saunders 1977. Mosby. 516-524. He came out with innovation self-ligating brackets. Orthodontics: Principles & Practice. 5. T. Saunders Company. Graber.TMA. 2005. Mosby. Removable Orthodontic Appliances. Vol. No. Burstone also developed the surgical planning analysis – COGS i.M. III Ed. 117. Graber.Jayade. No. e.749-53. Milton Asbel: A Brief History of Orthodontics. 2nd edition Mosby. 6. 4th Edition. 2007 9. V. 11. Graber. Lee Graber: Vignette – T. Philadelphia. Published by A. Chapter 3: The professionalization of orthodontics AJO-DO. 1st edition. Jayade: Refined Begg for Modern Times. 2005. 3rd Edition. Henry W Fields. Hubli 10. Dr. Roth recommended the 2nd generation of preadjusted brackets (roth prescription) which consisted of minimum extraction series brackets and could be used in both non-extraction and extraction cases. Roth :(1933-2004) In 1976 –Ronald Roth published a report entitled “Five year clinical evaluation of the Andrews Straight Wire Appliance. References: 1. Vol.