Removable Orthodontic

Appliances
Dr. Sarmad Sobhi Alqassar
BDS, MSc, PhD. Orthodontic
 ?Who needs orthodontics

Orthodontics comes from the Greek words ‘orthos’

meaning normal, correct, or straight and ‘dontos’ meaning
teeth.
Orthodontics is concerned with correcting or improving the
position of teeth and correcting any malocclusion.
 Orthodontics is considered the oldest speciality of
dentistry .
 Primitive appliances to move teeth have been
found in Greek excavations .
 Edward H. Angle(1855-1930) is considered the
‘Father of Modern Orthodontics’ for his numerous
contributions to the orthodontics.
 The scope of orthodontic
treatments

Orthodontic treatment involve three

main tissue system concerned in
dentofacial development, namely
 the dentition
 the skeleton
 the facial and jaw musculatures .
Orthodontic treatment can bring about
changes in the dentition , the skeletal
system and the enveloping soft tissue .
 Services offered by the
orthodontics

 Preventive orthodontics
 Interceptive orthodontics
 Corrective orthodontics
 Surgical orthodontics
 Essentially, there are three principal reasons for carrying
out orthodontic treatment:
 1.To improve dento facial appearance
 2.To correct the occlusal function of the teeth
 3.To eliminate occlusion that could damage the long-
term health of the teeth and periodontium
 The aims and objectives of
orthodontic therapy

 Functional efficiency
 Structural balance
 Esthetical harmony
 Orthodontic appliance

This may be defined as the “appliance by which mild

pressure may be applied to a tooth or a group of teeth and
their supporting tissue in a predetermined direction to
bring about the necessary reaction processes within the
bone and other tooth supporting tissues, to allow tooth
movement”
 IDEAL REQUIREMENTS FOR AN
ORTHODONTIC APPLIANCE

Generally:
 biological requirements
 Mechanical requirements
 Esthetical requirements
 Hygienic requirements
 IDEAL REQUIREMENTS FOR AN
ORTHODONTIC APPLIANCE

More spesifically:
1. Design of the appliance should be simple
1. It should be e comfortable to use and be aesthetically
acceptable
2. It should exert desired force in desired amount and
direction
3. It should not interfere with normal function and growth
4. It should have adequate retention
5. It should be tasteless, odorless, and inert in oral
secretions
6. It should be unbreakable
 IDEAL REQUIREMENTS FOR AN
ORTHODONTIC APPLIANCE
7. It should not be heavy or bulky
8. It should be easily repairable and addable
9. It should not cause any damage to the teeth or other tissue
10. It should be easy to remove and insert
11. It should be easy to clean
12. It should be readily cleaned
13. It should be dimensionally stable
14. Material for the appliance should be cheap and available

When designing an appliance, all these requirements should be

taken into consideration and attempt should be made to
incorporate as many as possible.
 Appliance choices
There are confusing range of different
orthodontic appliances. The appliance has to be
selected with care and used correctly as inappropriate
use can make the malocclusion worse.
 Removable appliances are only capable of very simple
movements
 whereas fixed appliances are sophisticated devices, which can
precisely position the teeth.
 Functional appliances are useful in difficult cases and are
primarily used for Class II Division I malocciusions.
 Extra-oral devices are used to re-enforce anchorage and can
be an aid in both opening and closing spaces.
Orthodontic appliances are divided
into three main groups:

A. Removable appliance:
 The term removable appliance is used to indicate an
appliance which can be removed for cleaning by the
patient or for adjustment by the Orthodontist. These
appliances can be taken out of the mouth by patient
when required.
Removable appliances are four
types:
1. Passive appliances:
These appliances remain
passive in the mouth and exert no
active pressure. Example as
 1. Space maintainer
 2. Retention appliances
 3. Tongue guard
2. Functional appliances:
This may be defined as the
“appliance by which mild pressure may
be applied to a tooth or a group of teeth
and their supporting tissue in a
predetermined direction to bring about
the necessary reaction processes within
the bone and other tooth supporting
tissues, to allow tooth movement”
Example as:
 twin block appliances
 Frankles functional regulators
3. Mechanical appliances:
These appliances carry some active components
which are activated to exert active forces.
Tooth movement with removable appliances in
children almost always falls into one of two major
categories:
 (1) arch expansion, in which groups of teeth are
moved to expand the arch perimeter;
 and (2) repositioning of individual teeth within the
arch.
4-sequential removable
orthodontic appliances (aligners): to move
teeth in a stepwise fashion (Invisalign, Align
Technology, Santa Clara, Calif). Invisalign is
a proprietary orthodontic technique that
uses a series of computer generated custom
plastic aligners to gradually guide the teeth
into proper alignment.
 B. Removable-Fixed appliances

Here some part of appliances can be

removed by the patient and other parts
remain fixed on the teeth.
Example as:
Removable appliances with modified finger
spring.
 C. Fixed appliances

These cannot be removed by the patient and consists of:

1. Bands- cemented on teeth (occasionally cast metal caps),
2. Attachments or brackets of different types attached on the
bands or on teeth directly with bonding materials
3. Labial or lingual arches – These may themselves be active
or passive and may carry auxiliary springs for movement of
teeth.