BRACKETS

In Orthodontics

By Sonal
Mds 2nd Year
 CONTENTS

Introduction
Classification of brackets
Materials used
manufcaturing
Evolution of Bracket Systems And
Philosophy
Straight Wire Brackets
Roth Brackets
Ricketts Bioprogressive Brackets
MBT Brackets
Tip Edge Brackets
Lingual Brackets
Conclusion
References
Parts of a fixed orthodontic system
 INTRODUCTION

The term bracket was used first by Edward Hartley angle in 1916

An orthodontic attachment secured to a tooth for the purpose of engaging

arch wire.
- Raymond C.Thurow

One arm is
projected
horizontally to
One arm which support weight
is fixed to a
vertical surface

-Edward
H.Angle
 CLASSIFICATION OF BRACKETS
I. On The Type Of Material Used
–
•Metal
•Ceramics
•plastics
II. According To Type Of Slot-
•Ribbon arch slot
•Edgewise bracket
•combination

III. Based On Mode Of Attachment To Tooth-

•Weldable
•Bondable
Light cure
Self cure

IV. According to placement

•Labial
•lingual
V. Dr.Andrews classification of
brackets
•Non programmed
•Partially programmed
•Fully programmed
VI. Dr.Andrews extractional series
Minimum translation brackets
Medium translation brackets
Maximum translation brackets

VII.Based on bracket design(torque

incorporation)
•Torque in base
•Torque in base
VIII.Based on mode of ligation
•Passive Self ligation
•Active self ligation
IX.Based on friction produced by bracket and arch wire
•Minimum friction
•Medium friction
•Maximum friction
 Gold brackets
The original brackets as designed by Angle were made of gold.

Gold alloys
Gold at least 75%
platinum, iridium and silver alloys
Lacked flexibilty and tensile strength.
Metal

Before Angle began his search or new materials,

orthodontists made attachment from noble metals and
their alloys.
In 1887 angle tried replacing noble metals with German
silver.
However the mechanical and chemical properties of
German silver were well below the modern demands.
The material that has truly displaced noble metals is
stainless steel.
Stainless Steel Bracket

Stainless steel entered dentistry in 1919 introduced at

Krupp’s dental polyclinic in Germany
Brackets made of Stainless Steel are alloys formulated
according to the American iron and steel institute

Titanium Bracket

One of the contents nickel in stainless steel being a

potentially allergic material causes cutaneous
sensitisation when in contact with the tissues.
This lead to the advent of new metal which is more
corrosion resistant and biocompatible.
The alternative was being the titatinum.
Manufacturing Methods For Metal Brackets

From thin metal strip that is stamped to shape

Milling- one piece brackets are made by casting

Sintering- the partial welding together of metal particles below their

melting point

Metal injection molding-This technique requires the use of computer

aided design, along with computer-numerical controlled machines tools.

 Plastic Brackets

Morton Cohen and Silverman introduced the first commercially available

plastic brackets(IPB brackets), manufactured by GAC in 1963.
They are made of acrylics,nylons, polysulfonyl

Advantages Disadvantages
Clarity Discoloration
Heat resistance Breakage under
Less irritation to soft tissues stress
Resilient Fragility
Flexibilty Deformation under
No odor or bad taste compression from
Non toxic ligation
Composite Brackets
Ceramic brackets
Ceramic orthodontic brackets were introduced in late 1980s.
Ceramics used for the manufacturing of ceramic brackets were
alumina and zirconia.
ZIRCONIA BRACKETS
Parts of a orthodontic
bracket
 Base of the bracket
Welding tab, solder or a bonding mesh
 Curved to conform tooth structure
Mode of retention of bracket bases may be:
 mechanical retention
 micromechanical retention
Chemical adhesion
Mechanical and chemical retention

Mesh type
(the sizes of the wire mesh used in the
manufacturing of the various single mesh type
Bracket base types- bases were 40,60,80 and 100 meshes.

Non mesh type

Mesh base brackets
NON-MESH TYPES
Manufacturing method for metal brackets
Various methods used for manufacturing metal brackets were,

I. Milling- one-piece attachment is milled on the lathe

II. Casting- where one-piece brackets are made by casting
III.Sintering- the partial welding together of metal particles below their
melting point.

IV.Metal injection molding- metal and ceramic injection molding are

derivatives of powder metallurgy. Powders can be shaped in a semi-fluid
state, but after heating to high temperatures the particles bond into
strong, coherent masses. This techniques requires the use of computer-
aided design, along with computer-numerical controlled machines
MIM process include following

1. Feedstock preparation
2. Injection molding
3. Debinding or debunking
4. Sintering
5. Finishing procedure
 Evolution Of Orthodontic
Brackets
21st century

20th century

19th century

18th
century
 The 18th century

USES-
Straighten teeth and
used for expansion as
Pierre Fauchard well
bandeau or bandelette appliance in
1728 DRAWBACKS-
Lacked stability
No effective means of
firmly fixing it.
The 19th century
In 1841 had introduced screw force

In 1847, in New York Dwinell invented the regulating jack screw

Uses-
Pushing force was
delivered

In 1887 Angle’s

retraction screw developed
the prototype of the 1st
bracket attachment a
delicate metal tube
soldered to the band
In 1907 Dr.Edward Angle discontinued the use of jack screws and used E
arch.
E arch

1. Basic E arch 2.Ribbed E arch

E arch without threaded
ends
E arch with hooks for intermaxillary elastics
Uses-
Crown movement and simple anchorage
Teeth expanded into normal occlusion

Drawbacks-
This could only deliver heavy interrupted
forces
Capable of only tipping/ no axial inclination
Was not able to precisely position any
individual teeth
Long term retention was required
 The 20th century

Angle’s pin and tube attachment developed in 1910

USES-
Could control
rotations

Drawbacks-
Difficult to solder and
unsolder pins
Time consuming
Regular visits of patients
RIBBON ARCH APPLIANCE BY ANGLE (1915)

Uses
Effective in rotation of
incisors
Offers control of bucco
lingual and labio lingual and
both inciso gingival and
occlusogingival movements.
Good spring qualities

Drawbacks-
Mesiodistal axial movements
Mesial and distal tipping
bends
Premolar teeth could not be
moved
No correction of curve of spee
No movements to torque
roots
 The edgewise appliance Angle EH. The latest and the best in
orthodontic mechanism. Dent Cosmos
1928;70:1143-1158
In 1925 angle began to develop edgewise appliance

In 1926 Alan Brodie 1st time treated a case with this new mechanics

In 1928 a long article was published in Dental Cosmos about the edgewise
appliance

To overcome the deficiences of the ribbon arch ,

Angle oriented the slot from vertical to
horizontal and inserted a rectangular wire
rotated 90 degree to the orientation it had with
the ribbon arch thus the name edgewise.
 The bracket has 3 walls
and consisted of a
rectangular box with
0.022x0.028 inch
dimension slot opening
horizontally
The slot was 0.050 inch
wide and made of soft
gold.

Drawbacks-
The tooth width was naroow so
ineffective tooth rotation.
It was readily deformed by the
forces of occlusion and by tying
ligature wire into the bracket
Modification of original edgewise bracket

Angle soldered
eyelets on the
bands and
ligature wire was
tied so rotation
was observed.

Drawback-
Narrow width
ineffective tooth
movements
 (Begg PR. Differential force in
Begg Appliance orthodontic treatment. Int J Orthod
1956;42:481-489)

By Dr.R Begg in 1956

 It utilizes the ribbon arch type

brackets and was manufactured to
accept 016’ round wire
 Wire was held in position with
the lock pins .020 x .045 slot
 Johnson JE. Twin wire alignment
Twin appliance. Int J Orthod 1934;20:946-
bracket 963
Introduced by Joseph Johnson in 1930s.

Philosophy- By virtue of 2 light wires placed

in the same bracket more
physiologic tooth movement
could be obtained than with one
heavy wire.
Uses-
Permits rapid
reduction of rotations
with little discomfort
for the patient
Used on upper Drawbacks-
central incisors and Lack of anchorage
molar teeth. Lack of control of
canine and premolar
after rotation
correction
The next development was the joining together of two edgewise
brackets. These were named “Siamese twin Brackets” by Dr. Brainerd
Swain in 1952.

Standard
Extra wide

Intermediate Junior twin

 Curved base twin bracket
Confirm to the buccal surfaces of canines and premolars.

Advantages-
Maintain and control of
axial tooth inclinations
Positive control to retain
corrected rotations
Ability to effect most of the
tooth rotation without use of
auxillary eyelet ties

Disadvantages
Interbracket distance is
decreased
Resilency in arch wire is
increased
Difficulty in employing
closing loop arch wire and
2nd order bends.
 LEWIS
LEWIS PD. SPACE CLOSURE IN EXTRACTION CASES. AM J
BRACKET ORTHOD 1950;36:172-191.
Dr. D Lewis soldered auxillary rotation arms that abutled to the bracket
itself and then offered a lever arm to deflect the arch wire and rotate the
teeth.

Advantages Disadvantages
100% tooth rotation can be Less control of axial
obtained inclination
Do not interfere with the
activation of closing loops, 2nd
order bends and others
Deflection of the resilient
arch wire themselves.
Types of Lewis Brackets:

Long wide  upper central

Long upper centrals
Short lower Anteriors
 STEINER BRACKET

 This bracket incorporated flexible rotation arms and

therefore did not rely entirely on the resiliency of arch
wire for tooth rotation.

 It uses a single width edgewise bracket and has the

inherent advantage and disadvantage of the same
Broussard bracket

 Was designed by
“Grayford broussard”
 Modified edgewise
bracket in which there
is addition of 0.0185 x
0.046 slot –to accept
0.018 auxiliary wire
 special torque
brackets.- 0,7˚,17˚,22˚
1965- concept of directly bonding brackets to the surface of the

teeth by NEWMAN.

1972- SELF LIGATING BRACKETS WERE PROPOSED BY

ALEXANDER WILDMAN

1998- DAMON BRACKET

The 21st Century
Custom made brackets to make
appliances more comfortable
SELF LIGATING BRACKETS

 The first self ligating bracket

 Russell attachment, which was developed by New
York orthodontic pioneer DR .Jacob Stolzenberg in early
1930’s.
 Design –
SELF LIGATING
BRACKETS
Bracket had a flat head screw seated snugly in a circular
,threaded face of the bracket which could be loosened or
tightened .
SELF LIGATING
BRACKETS

 Between 1996 and 1999 Dr Dwight Damon

introduced the Damon SL I and Damon SL II
brackets.
 CONCEPT OF STRAIGHT WIRE
APPLIANCE
120 non orthodontic models were acquired from 1960
to 1964. models selected were of the patients teeth
which-
•Had never had any orthodontic treatment
•Pleasing in appearance
•Had a bite that looked generally correct
•Would not benefit from orthodontic treatment

These 120 models were compared with 1150 treated

cases which he collected from orthodontist all over
USA.
So the best in treatment results and best in nature
revealed the differences between the right and
wrong, which gave birth to SIX KEYS OF OPTIMAL
OCCLUSION.
 NO ROTATION
CLASS I MOLAR RELATION

CORRECT CROWN ANGULATION NO SPACES

FLAT TO SLIGHT CURVE

CORRECT CROWN OF SPEE
INCLINATION
Straight wire appliance

Andrews classified brackets into three

types

Non programmed appliance-

Same for all teeth
Relying totally on wire bending

Partly programmed appliance-

Some built in features, but require some wire bending.

Fully programmed appliance-

Guide teeth directly to their positions using unbent wires.
TERMINOLOGI
ES

1.Andrews plane

2.Clinical crown

3.Angulation

4.Inclination angle
 NON PROGRAMMED EDGEWISE BRACKET FEATURE
Design shortcomings
Bracket base perpendicular to bracket stem

This feature causes problems of slot inclination and

occlusogingival position.
Bracket bases are not contoured.
Occlusogingivally the base of a non-
programmed brackets is flat.

1.Inclination
2.occluso-gingival position
Mesio distal base contour
Slots are not
angulated
Bracket stem are of equal
faciolingual thickness
Maxillary molar offset built in
Bracket sitting techniques are
unsatisfactory

Various authors have their own way of positioning

brackets.
1. Angulation

2. Long axis crown

3. Long axis tooth

4. Incisal edges curved, worn

5. Marginal ridges

6. Contact points
 Andrews new design of edgewise bracket

1.Every tooth type had a specifically designed bracket

2.Slots were cut at an angle to the vertical edges for attaining built-in
angulation in the bracket.
3.The base of the brackets were inclined in order to effect the torque needed
for a particular tooth type
4.The thickness of the bracket stem was varied according to the facial
prominence of each tooth.
5.The bracket bases were contoured.

Thus it became possible to use unbent archwires in the appliance through

most of the treatment.
 Feature 1- mid transverse planes of
the slot stem and crown must be the
same

Feature 2- base of the

bracket for each tooth
type must have same
inclination as the facial
plane of the crown.

Feature 3- each bracket

inclined base must be
contoured occlusogingivally
Feature 4- mid saggital plane of the
slot stem and crown must be the
same.

Feature 5-the plane of the bracket base

at its base point must be identical to
the facial plane of the crown at the FA
point

Feature 6- base should

match the mesiodistal
contour of the tooth
Feature 7- the vertical
component should be parallel
to one another.- when
positioned they parallel
FACC. The horizontal
components should be
equidistant form the gingiva
and the cusp tips.

Feature 8-all slots point

must have same distance
between them and the
crown embrassure line.
 The straight wire appliance

Convenience feature-
The gingival tie wings
of the posterior
brackets extend farther
laterally.

Bases are inclined.

3. Facial surace of the incisor and
canine brackets are designed to
parallel their bases-lip comnfort.
4. In mandibular brackets the tie wings
are designed with least amount
occlusofacial prominence.
5.Bracket identification.
The straight wire appliance

Auxiliary feature

Power arms

Hooks

Face bow tubes

Utility tubes

Rotational wings
Inclination and angulation for 3-7

Tooth 2nd molar 1st molar 2nd premolar 1st premolar canine

Maxillary 5/-9 5/-9 2/-7 2/-7 11/-7

Mandibular 2/-35 2/-35 2/-22 2/-17 5/-11

Inclination and angulation for central and lateral
incisors

Tooth central lateral

Maxillary 5 9
Mandibular 2 2
 Few other features

Counter buccolingual tip- a slot sitting

feature for maxillary molar that
counteracts buccolingual tip during
translation and then overcorrect.

Counter mesiodistal tip- a slot sitting

feature that counteracts mesial or distal
tipping during translation and then
overcorrects.

Counter rotation- a slot sitting feature

that counteracts rotation during
translation and then overcorrects.
 Translating problems
Translation- uniform movement of
the body in a straight line.
For translation to occur, the force
must be applied at the object’s
centre of resistance.

However bracket is
placed in wrong place in
two ways-
It is occlusal
It is located laterally.
 Translating solutions

Optimal lever lengths are dictated by the

distance between site and tooth’s centre of
resistance.
Partly programmed brackets

By definiton partly programed brackets are the one

which lack at least one slot sitting feature because of
which it would fail to fully direct each slot to its tooth
slot site.

1. Slot inclination
2. slot angulation
3. Slot prominence
4. Horizontal base contour
 Criticism on straight wire appliance.

The main drawback of the straight wire appliance is that it overlooks

biological variations in the anatomy of teeth of different individuals.
1.Dellinger- the basic data should have been collected from individuals having
malocclusion and not from ideal occlusion casts as was done by Andrews.
2.A uniform torque value in the bracket slots for any given tooth of all the
patients is based on the premise that individual teeth of any given type would
exhibit identical curvatures.
3. The point that Andrews had laid great stress on the consistency of the long
axis point is not accepted by other authors.
The clinicians can place the brackets within an error of +- 2 degrees torque.
4. The angle between the long axis of crown and the long axis of root differs
from tooth to tooth and also for the same tooth in diferent person.
Roth’s prescription
(The straight wire appliance-17 years later-Ronald H Roth JCO VOL
1987 sep(632-42)

In 1968 R.H.Roth was introduced to Dr. L.F.Andrews.

He started designing his own prescription as a clinical trial and error

evaluation that lasted several years.

Cases were evaluated by the use of

intraoral photographs and mounted
models for tooth positions
During treatment and at the end of the
appliance therapy.
According to teeth tend to relapse back from which they started.

If counter tip, counter rotation, counter-torque, and leveling of the curve of

spee were applied to the SWA in every possible direction, then it should be
possible to use primarily one prescription for most cases, and to finish to
an “ end of appliance therapy” goal in which all tooth positions are slightly
overcorrected and from which the teeth will \most likely settle into non-
orthodontic normal positions.

So with the concept of overcorrection he designed his

comprehensive prescription using the available andrews extraction
brackets.
In 1979, Roth introduced a
bracket setup containing
modifications of the tip, torque,
rotations and in out movement
of the Andrews standard setup
brackets.
The major difference-
with the manner in which the teeth are moved and not necessarily the
desired result or the result attained.

Andrews attempts to translate teeth

throughout treatment without ever
tipping teeth.

In the Roth approach, tipping of teeth is allowed, by using round

wires in the initial phase of the treatment, but the attempt is to
keep the tipping to a minimum wherein it is not necessary to
resort to complex mechanics to do the uprighting.
Andres occlusion study was based purely upon
anatomical measurements of tooth positions on
untreated normals.
According to him teeth should be positioned from
an anatomical standpoint.

Roth’s occlusion study was based

purely upon pantographically
recorded and a large number of post
treatment orthodontic cases.
What made roth to modify andrews
sw applaince

Inventory problem- to treat different

cases clinicians were to buy band kits
for all andrews sets and series.

Anchorage loss- when mesially

angulated brackets are placed on the
posterior teeth, the teeth tend to tip
mesially and migrate forward that
resulted in anchorage loss.

Problem in finishing- to achieve

desired tooth positions with the
standard swa it was necessary to
finish the mechanotherapy phase of
treatment by placing compensating
and reverse curve in the upper and
lower archwire.
roth’s rationale for his bracket set up

The purpose of the roth setup was to provide over

corrected tooth positions prior to appliance removal
that would allow the teeth in most instances to settle to
what was found in non orthodontic normals studied by
andrews

With the appliance in place, it is virtually impossible,

because of bracket interference, to position the teeth
precisely into occlusion shown by the non orthodontic
normal sample.
Extracted teeth with
roth rx SWA brackets,
showing over correction
built in to the brackets.

Extracted teeth with

andrews SWA brackets
showing non-
orthodontic normal
tooth positions.
Roth steup

Roth setup is available in both 0.018

and 0.022 slot

Roth preferred 0.022 slot brackets

because it offered more advantages.

1. In terms of wire size selection,

2. In terms of stabilizing arches
as anchor units and for
orthognathic surgery and
3. For control of torque in the
buccal segments, which is very
important from the standpoint
of functional occlusion.
The roth setup incorporated into it a
member of hooks for various types of
elastics configuration and also double
triple and lip bumper tube for the use of
auxillary wires and attachments.
Upper arch

Central tip torque rotation

Andrews 5 7 0
Roth 5 12 0

Lateral
Andrews 9 3 0
Roth 9 8 0

If tip is increased the resultant axial inclination is

esthetically and fucntionally undesirable

The 5 degree increase in torque improves esthetics by

preventing flattend profile,straight upper lip and
obtuse nasolabial angle.
 Upper canine
\

Andrews 11 -7 0
Roth 13 -2 4

Tip is increased because they are being retracted

in most treatment.
Less negative torque to offest the reciprocal
effect of building more positive torque into the
incisors.