Professional Documents
Culture Documents
Edgewise
Edgewise
Technique
Dr. Rajshekhar Banerjee
II MDS, Dept. of Orthodontics and Dentofacial Orthopaedics,
ABSMIDS, Mangalore
Contents
1. Introduction
2. Angle’s Appliances
3. Requirements of an Orthodontic Appliance
(According to Angle)
4. Appliance Description
5. Evolution of Brackets and Tubes
6. Tweed’s Observations
7. Tweed’s Philosophy
8. Classification of Anchorage Preparations
9. Tweed-Merrifield Edgewise Technique
2
Introduction
3
Edward H. Angle (1855 -
1930) 5
E-
Arch
6
Pin and Tube
Appliance
7
Ribbon Arch
Appliance
8
Edgewise
Appliance
9
Requirements of an Orthodontic Appliance
(According to Angle)
11
Appliance Description
12
◈ Bracket slots were placed in the
horizontal plane instead of vertical.
◈ Archwire held in position by brass
ligature, later by delicate SS ligature.
Main advantage
- ability to effect tooth rotations without
using auxiliaries
Disadvantages:
increased width decreases the
inter bracket span, thus
decreasing the resiliency
4) Lewis bracket
Developed by Lewis in 1950.
◈8) Broussard
Designed by bracket
Garford Broussard for use
in the Broussard technique
◈ Addition of a 0.0185 x 0.046 inch
vertical slot to accept a doubled 0.018
inch auxillary wire
Evolution of edgewise buccal tube
25
◈ Continued with Angle’s Edgewise
Appliance
28
Tweed’s Contributions
29
Tweed’s Contributions
30
Tweed Philosophy
Treatment in 2 stage
1. Preparation of a stable form of anchorage
in the lower arch, and elimination of
stationary anchorage in the upper arch.
31
Lower Arch Anchorage
Preparation
33
Upper Arch Anchorage
Preparation
& or
maintained in an upright position to
prevent their being elongated when cl. II
intermaxillary force is used .
Second degree -for malocclusions with ANB more than
0° to 4°
-facial esthetics requires to move point
B anteriorly & point A posteriorly
i,e cl. II cases
-usually accompanied by type A, type A
subdiv.,type B & type B subdiv.
-degree of distal tipping of mandibular
molars more severe than first
degree anch.prep. –they should be
tipped so
that their distal marginal ridges are at
gum level
Third degree -severe discrepancy cases –14-20mm or
more
-ANB does not exceed 5°
-generally cl.I bimaxillary cases
-sliding jigs are necessary
-2nd ,1st molars & 2nd premolar must be
tipped to such an extent that the
distal
marginal ridges are below the gum level
also called total anchorage preparation
Levern Merrifield
39
Tweed – Merrifield
Edgewise
Appliance
40
Brackets and Tubes
42
◈ All bands have lingual cleats (to correct
and control rotations)
◈ Brackets and Tubes placed at right angles
to the long axis of the tooth.
◈ No tip, torque or variation in thickness are
present in the bracket
43
Archwires
44
Archwires
45
Bends
46
First-Order Bends
47
Second-Order Bends
48
Third-Order Bends
◈ Torque bends
49
Third-Order Bends
52
Treatment with the Tweed-
Merrifield Edgewise
Appliance
53
Sequential Appliance
Placement
◈ Initially 1st molars are left unbanded
55
Sequential Appliance
Placement
◈ Subsequently the maxillary first molars
are banded after one appointment
◈ The mandibular 1st molars are banded
after the 2nd appointment
56
Sequential Tooth Movement
57
Sequential Mandibular Anchorage
Preparation
58
Sequential Mandibular Anchorage
Preparation
59
Sequential Mandibular Anchorage
Preparation
66
Steps of
Treatmen
t
67
Steps of Treatment
1. Denture preparation
2. Denture correction
3. Denture completion
4. Denture recovery
68
1. Denture Preparation
69
Denture Preparation
◈ Objectives
1. Levelling
2. Individual tooth movement and
rotation correction
3. Retraction of maxillary and
mandibular canines
4. Preparation of the terminal molars for
stress resistance
70
Initial archwires consist of a 0.017- × 0.022-inch resilient maxillary archwire
and a 0.018- × 0.025-inch resilient mandibular archwire.
71
The canines are retracted with a J-hook headgear
72
End of Denture Preparation
73
At the end of Denture Preparation
75
Objectives of Denture Correction
76
77
78
Sequential Mandibular Anchorage
Preparation
79
◈ 0.019- × 0.025-inch archwire with the
loop stops bent flush against the second
molar tubes.
81
◈ The third and final step of sequential
mandibular anchorage preparation is to
place a 5-degree distal tip 1 mm mesial to
the second premolar brackets.
◈ A compensating bend is placed mesial to
the first molars to maintain them in
their anchorage prepared position
82
83
◈ Following anchorage preparation, a
mandibular 0.0215 × 0.028 inch
stabilizing archwire is fabricated.
86
Class II Correction
87
◈ Eight-ounce Class II elastics are worn
from the hooks on the mandibular second
molar tubes to the Class II hooks on the
maxillary archwire. Anterior vertical
elastics are worn from the spurs on the
mandibular archwire to the gingival
extension hooks on the maxillary
archwire.
◈ The highpull headgear is worn on the
maxillary headgear hooks
88
◈ This force system is used for about 1
month to sequentially move the maxillary
second molars distally.
89
2nd Molars in Class I relation
90
◈ A closed coil spring is wound distal to the
second premolar spur and compressed
between the spur and the first molar
bracket. (The coil spring length should be
1.5 times the space between the second
premolar and the first molar brackets.)
95
96
◈ Finishing mandibular and maxillary
0.0215×0.028-inch resilient archwires are
used.
◈ The forces used during denture
completion are based on a careful study of
the arrangement of each tooth in each
arch.
◈ The necessary first-, second-, and third-
order adjustments are made in each
97
At the end of the denture completion stage of treatment,
the following characteristics should be readily
observed
1. The incisors must be aligned.
2. The occlusion must be overtreated to a
Class I relationship.
3. The anterior teeth must have minimal
incisal guidance.
4. The maxillary canines and second
premolars must be locked tightly into a
Class I dental relationship.
98
At the end of the denture completion stage of treatment,
the following characteristics should be readily
observed
5. The mesiobuccal cusp of the maxillary
first molar must occlude in the
mesiobuccal groove of the mandibular
first molar.
6. The distal cusps of the first molars and
the second molars should be slightly out
of occlusion.
7. All spaces must be closed tightly from
the second premolars forward.
99
4. Denture Recovery
100
◈ When all appliances are removed and the
retainers are placed, a most crucial
“recovery” phase occurs.
101
Transitional Occlusion/ “Tweed Occlusion”
102
Transitional Occlusion/ “Tweed Occlusion”
103
Transitional Occlusion/ “Tweed Occlusion”
105
Transitional Occlusion/ “Tweed Occlusion”
106
107
References
108
References
109
Thank You!
110