This page intentionally left blank. # Development of Contemporary Fixed Appliances * **Angle's Progression to the Edgewise Appliance** * Other Early Appliance Systems * Begg Appliance * Contemporary Edgewise: The Modern Appliance - Angle's Progression to the Edgewise Appliance - Other Early Appliance Systems - Begg Appliance - Contemporary Edgewise: The Modern Appliance # Angle’s Progression to the Edgewise Appliance ## The E-Arch ## Pin and Tube ## Ribbon Arch ## Edgewise Angle’s Progression to the Edgewise Appliance The E-Arch Pin and Tube Ribbon Arch Edgewise # **E-Arch 1900**  **E-Arch 1900** Labelled diagram: This figure illustrates a dental arch form, specifically the 'E-Arch' (or 'U' arch), characterized by a broad, U-shaped configuration with parallel anterior teeth and flaring posterior sections. The drawing depicts an occlusal view of the upper jaw with attached orthodontic brackets on the molars. Pin and Tube 1910  Pin and Tube 1910 Labelled diagram: A schematic illustration of a dental appliance, specifically the Pin and Tube system from 1910, showing metal components attached to the lower anterior teeth. # Ribbon Arch 1915   Ribbon Arch 1915 Labelled diagram: A schematic illustration of a Ribbon Arch appliance showing two large upper dental casts fitted with brackets and archwires. Diagram of a ribbon arch wire appliance (B) with an associated bracket system. The illustration shows the curved metal band designed to encircle the dental arch, alongside a detailed view of the tooth engagement mechanism. **Edgewise 1925** **Edgewise 1925** Other Early Appliance Systems - Crozat Appliance - Labio-Lingual Appliance - Johnson Twin-wire Appliance Other Early Appliance Systems - Crozat Appliance - Labio-Lingual Appliance - Johnson Twin-wire Appliance Crozat 1920  Crozat 1920 Clinical photo: An intraoral view of the maxillary arch showing a fixed orthodontic appliance, specifically a Hawley retainer with a removable acrylic plate and metal wire components bonded to the molars. # Twin Wire 1930 A B    Twin Wire 1930 A B Labelled diagram: A schematic outline of a dental arch showing the arrangement of teeth and wire components, specifically illustrating a Twin Wire appliance with directional arrows indicating force vectors. Radiograph: This figure shows a radiographic image of the mandibular arch, displaying the arrangement of teeth and two distinct wire loops (indicated by arrows) situated within the posterior regions. Labelled diagram showing a metallic medical device, likely an intracranial electrode or stimulator. The illustration depicts the internal construction of the device, revealing two parallel cylindrical wires running through a central metal casing. # Begg Appliance   Begg Appliance Clinical photo of the right side of a patient's mouth showing fixed orthodontic appliances, specifically Begg brackets and wires, with visible elastics. Clinical photo showing a close-up of the maxillary and mandibular dental arches fitted with Begg light wire appliance brackets. The image displays a continuous archwire engaging into slots, alongside visible elastic ligatures and power chains connecting the molar units. # **Begg Appliance:** - Point contact only - Round wire exclusively - Multiple individual tooth auxiliaries **Begg Appliance:** - Point contact only - Round wire exclusively - Multiple individual tooth auxiliaries **Begg Appliance** - Molar Tube (round or oval) - Bracket (pin and tube)   **Begg Appliance** - Molar Tube (round or oval) - Bracket (pin and tube) A line drawing illustrating the bracket assembly of a Begg appliance, specifically highlighting the pin-and-tube configuration. The image depicts a wire running through a tube attached to the bracket. Clinical photo of a Begg Appliance showing a molar tube with round or oval cross-section attached to a bracket. The figure illustrates the specific 'pin and tube' connection method used in this orthodontic system. **Edgewise Appliance** This is the: "**Contemporary Fixed Appliance**" **Edgewise Appliance** This is the: "**Contemporary Fixed Appliance**" 3M Unitek Dentsply Sirona TOMY INTERNATIONAL INC. RMO Synergistic Solutions for Progressive Orthodontics # Orthodontics Market **Global Orthodontics Market Size, 2015-2026 (USD Billion)** In 2018: **$4.06 Billion** By 2026: **$9.72 Billion** **Global Orthodontics Market Share By Product Type, 2018** * Instruments * Supplies **North America Orthodontics Market Size, 2018** USD 1.84 Billion AO AMERICAN ORTHODONTICS HENRY SCHEIN® ORTHODONTICS Ormco™ OSE ORTHODONTIC SUPPLY & EQUIPMENT CO., INC.   #### Global Orthodontics Market Size, 2015-2026 (USD Billion) - In 2018: **$4.06 Billion** - By 2026: **$9.72 Billion** #### Global Orthodontics Market Share By Product Type, 2018 - Instruments - Supplies #### North America Orthodontics Market Size, 2018 - USD 1.84 Billion #### Key Market Players - 3M Unitek - Dentsply Sirona - TOMY INTERNATIONAL INC. - RMO Synergistic Solutions for Progressive Orthodontics - AO AMERICAN ORTHODONTICS - HENRY SCHEIN® ORTHODONTICS - Ormco™ - OSE ORTHODONTIC SUPPLY & EQUIPMENT CO., INC. A labelled diagram illustrating the growth of the Global Orthodontics Market, represented by five cartoon teeth on a dental arch. The first tooth displays the market size in 2018 as $4.06 Billion, while the last tooth shows the projected size by 2026 as $9.72 Billion. # **Major Elements of Contemporary Fixed Appliances** * **Bands / Bonded Brackets (Attachments)** * **Archwire** (in main bracket slot) * **Auxiliary Elements** (lingual arch and labial auxiliary elements, etc.) **Major Elements of Contemporary Fixed Appliances** - **Bands / Bonded Brackets (Attachments)** - **Archwire** (in main bracket slot) - **Auxiliary Elements** (lingual arch and labial auxiliary elements, etc.) Contemporary Edgewise Appliance: - **Horizontal Rectangular Slot** - **Round, Square or Rectangular Wire** Contemporary Edgewise Appliance: - **Horizontal Rectangular Slot** - **Round, Square or Rectangular Wire** # Components: Brackets Typically for anterior teeth and bicuspids Wings - twin or single All have horizontal slot Many variations in materials and size of the attachment depending upon the manufacturer   Components: Brackets Typically for anterior teeth and bicuspids. Wings - twin or single. All have horizontal slot. Many variations in materials and size of the attachment depending upon the manufacturer. Labelled diagram of a metallic orthodontic bracket, specifically highlighting the 'Gate' feature with a green arrow. # Brackets - Metal (Stainless Steel) - Clear or Tooth Colored (Ceramic or Plastic) - higher friction with ceramic brackets - Lingual (Stainless Steel or Gold) - Self-Ligating (Stainless Steel and combination of Ceramic and Stainless Steel) - become yellow in 2 weeks     - Metal (Stainless Steel) - Clear or Tooth Colored (Ceramic or Plastic) - higher friction with ceramic brackets - Lingual (Stainless Steel or Gold) - Self-Ligating (Stainless Steel and combination of Ceramic and Stainless Steel) - become yellow in 2 weeks Clinical photo showing a close-up of a mouth with metal braces on the upper teeth, accompanied by two isolated bracket examples: one metallic and one clear ceramic. This illustrates the visual difference between stainless steel and tooth-colored (ceramic) orthodontic brackets. Clinical photo of a self-ligating bracket, demonstrating the 'combination of Ceramic and Stainless Steel' type mentioned in the slide text. The image shows two views: a standard metallic finish on top and a translucent ceramic body with a metal wire mechanism below. Labelled diagram: This figure displays two distinct types of dental brackets, illustrating the 'Self-Ligating' category mentioned in the slide text. The top image shows a metallic bracket with a stainless steel housing and clip mechanism, while the bottom image depicts a combination design featuring a clear or tooth-colored plastic outer shell over a metal base. Clinical photo showing a close-up of a patient's upper teeth fitted with metal (stainless steel) orthodontic brackets and an archwire. Metal Brackets – Twin wing On upper central and lateral incisors     Metal Brackets – Twin wing On upper central and lateral incisors. Clinical photo showing the upper central and lateral incisors fitted with metal brackets featuring a distinct twin-wing design. Clinical photo showing a close-up of the upper anterior teeth fitted with metal brackets. The image highlights the 'Twin wing' bracket design on the central and lateral incisors, which features two vertical slots extending from the base. Clinical photo showing metal brackets with a 'twin wing' design installed on the upper central and lateral incisors. Clinical photo of a metal bracket assembly on upper central and lateral incisors featuring the 'Twin wing' design. The image highlights the horizontal crossbar connecting two vertical slots, indicated by a red arrow. Metal Brackets – Single wing On canines, bicuspids and lower incisors lossing system = more narrow = more interbracket distance = ↑ force ↓ ctrl    Metal Brackets – Single wing On canines, bicuspids and lower incisors. Lossing system = more narrow = more interbracket distance = ↑ force ↓ control. Clinical photo: A close-up view of the upper and lower anterior teeth fitted with metal brackets and archwires, illustrating the orthodontic appliance setup on canines, bicuspids, and incisors. Clinical photo of a patient's dental arches fitted with metal brackets and an archwire. The image illustrates the concept that on canines, bicuspids, and lower incisors, a 'lossing system' results in a more narrow configuration. Clinical photo of a patient's lower dental arch fitted with metal brackets and an archwire, illustrating the placement of orthodontic hardware on teeth. Ceramic Brackets In this case on the upper anterior teeth  Ceramic Brackets In this case on the upper anterior teeth. Clinical photo showing the upper anterior teeth fitted with clear ceramic brackets and a metal archwire. This illustrates the application of ceramic braces specifically to the front teeth. Change Alastics or Alastic Chain You should ensure you do this at least once or twice for a patient     Change Alastics or Alastic Chain You should ensure you do this at least once or twice for a patient. Clinical photo of a patient's maxillary and mandibular teeth fitted with fixed metal braces. A red arrow points specifically to the elastic power chain connecting the upper brackets, illustrating the orthodontic appliance used for tooth movement. Clinical photo: An intraoral view of the posterior teeth showing fixed orthodontic appliances, including metal brackets and archwires bonded to both the maxillary and mandibular dental arches. Clinical photo showing a close-up of the maxillary and mandibular posterior teeth fitted with metal fixed orthodontic brackets. A horizontal elastics chain is attached between the upper and lower arches, demonstrating the application of inter-arch traction to correct malocclusion. Clinical photo: A close-up view of upper anterior teeth with fixed orthodontic brackets and an archwire. A red arrow points specifically to the bracket on the left tooth, highlighting a gap or space between the metal bracket and the enamel surface. Lingual Brackets     Lingual Brackets Clinical photo: A close-up view of the upper anterior teeth fitted with lingual braces, demonstrating the placement of brackets on the inner (lingual) surfaces of the incisors and bicuspids. Clinical photo showing a close-up of the patient's upper right quadrant teeth fitted with lingual brackets and an archwire. The image illustrates the placement of orthodontic hardware on the inner (lingual) surfaces of the bicuspids and anterior teeth. Clinical photo showing a close-up of the upper left posterior teeth with fixed lingual orthodontic brackets. The image illustrates the placement of metal braces on the inner (lingual) surfaces of the bicuspids and anterior teeth, connected by an archwire. Clinical photo showing an intraoral view of the upper dental arch fitted with lingual orthodontic brackets on the anterior teeth and bicuspids. A red arrow highlights the palatal placement of the brackets. Self Ligating - Brackets In this case on the bicuspids, canines and incisors     Self Ligating - Brackets In this case on the bicuspids, canines and incisors. Clinical photo of a patient's anterior teeth featuring metal self-ligating brackets on the upper and lower incisors, canines, and bicuspids. Clinical photo showing the right side of a patient's dentition with fixed orthodontic appliances. The image displays metal brackets bonded to the upper and lower bicuspids, canines, and incisors, connected by archwires. Clinical photo showing the upper right quadrant of a patient's dentition fitted with metal self-ligating brackets on the bicuspids, canines, and incisors. Clinical photo showing the lower arch of a patient's teeth fitted with metal self-ligating braces and an archwire. A red arrow points specifically to the bracket on the left canine, illustrating the mechanical clip mechanism used to secure the wire within the slot. **Start here** **Opening and Closing of Self Ligating Brackets** You should ensure you do this at least once or twice for a patient    **Opening and Closing of Self Ligating Brackets** You should ensure you do this at least once or twice for a patient. Clinical photo showing a close-up of upper and lower teeth fitted with self-ligating orthodontic brackets. The image illustrates the mechanism where a metal clip is engaged into the bracket slot to secure the archwire. Clinical photo showing a close-up of the maxillary and mandibular dental arches fitted with fixed metal braces, illustrating the alignment of brackets and wires on the teeth. Clinical photo showing a close-up of metal self-ligating brackets on upper and lower anterior teeth with an archwire engaged. A red arrow points to the specific mechanism on the upper left bracket, illustrating the opening and closing action required for proper function. **Components- Bands** * Typically for molars and occasionally premolars * Horizontal tube (slot) * Heavy stress application * Lingual attachments * Auxiliary and headgear tubes   Components - Bands - Typically for molars and occasionally premolars - Horizontal tube (slot) - Heavy stress application - Lingual attachments - Auxiliary and headgear tubes Clinical photo showing two metal molar bands with visible lingual attachments and auxiliary tubes, demonstrating the hardware used for heavy stress application. A technical illustration of an auxiliary tube component, likely a headgear attachment, featuring a horizontal cylindrical body with a square cross-section and a curved hook extending from the rear. # Changing Alastic Modules Using the Mathieu or mosquito forceps grip and remove a Alastic module from its 'tree" Hook the module onto one wing of the bracket, then over the remaining wings to hold the archwire in place Proffit, CO Chapter 12     **Changing Alastic Modules** Using the Mathieu or mosquito forceps, grip and remove an Alastic module from its 'tree'. Hook the module onto one wing of the bracket, then over the remaining wings to hold the archwire in place. Proffit, CO Chapter 12 Clinical photo: A close-up view of a metal forceps tip gripping a small, translucent Alastic module against a blue textured background. The image illustrates the precise manual handling required to remove the module from its 'tree' or bracket structure. Clinical photo: This close-up view depicts a dental archwire being engaged with a metal bracket using a pair of pliers. The image illustrates the specific step of hooking an elastic module onto one wing of the bracket to secure the wire, consistent with the instructions for changing elastics provided in the surrounding text. Clinical photo: This close-up view demonstrates the placement of an elastic module (indicated by the blue bead) onto a metal bracket using forceps to hook it over the archwire wings. The image illustrates the specific step described in the text where the module is hooked onto one wing and then over the remaining wings to secure the wire. Clinical photo showing the use of a pair of forceps to manipulate an elastic module (power chain) on a dental archwire. The image captures the process of hooking the clear elastic onto one wing of a metal bracket and over the remaining wings to secure the wire, consistent with the slide's instructions for changing elastic modules. **Band Fitting** Proffit, CO Chapter 12 **Band Fitting** Proffit, CO Chapter 12 **Placing Separators** Separators are placed 7-10 days before band placement (often on the same visit as bond-up) to separate the molar teeth slightly. This facilitates band placement. Usually elastomeric separator are used, but either brass wire or Kesling separator can be used (see orthodontic staff for more information on these alternatives) Proffit, CO Chapter 12 <span style="background-color: black; color: white;">Proffit, CO Chapter 12</span>  **Placing Separators** Separators are placed 7-10 days before band placement (often on the same visit as bond-up) to separate the molar teeth slightly. This facilitates band placement. Usually elastomeric separators are used, but either brass wire or Kesling separator can be used (see orthodontic staff for more information on these alternatives). Proffit, CO Chapter 12 Clinical photo showing the placement of a blue elastomeric separator between two molar teeth in the lower jaw. This visual demonstrates the procedure described in the text for separating molars to facilitate future band placement. # Placing Separators Proffit, CO Chapter 12 ## Separator pliers or Dental Floss Separator Procedure (2 Methods) ### Separator pliers **Separators are placed over the end of the separator pliers and squeezed between the teeth. EXTREME CARE is needed in order that the pliers do not slip and cause injury**  **Placing Separators** Proffit, CO Chapter 12 #### Separator Pliers or Dental Floss Separator Procedure (2 Methods) **Separator pliers** Separators are placed over the end of the separator pliers and squeezed between the teeth. EXTREME CARE is needed in order that the pliers do not slip and cause injury. Clinical photo: This image illustrates the placement of dental separators using blue floss. The floss is looped around a tooth and held in place by metal separator pliers, which are being used to squeeze the material between the teeth. **Placing Separators** Separator pliers or Dental Floss Separator Procedure (2 Methods) Floss Proffit, CO Chapter 12    **Placing Separators** Separator pliers or Dental Floss Separator Procedure (2 Methods) Floss Proffit, CO Chapter 12 Clinical photo: A close-up view of the posterior teeth with a dental floss separator being used to create space between two molars. The image illustrates the procedure of threading two lengths of dental floss through the separator, as referenced in the slide text. Clinical photo showing the application of a blue dental separator string between two posterior teeth, illustrating the floss method for creating spacing. Clinical photo: A blue plastic dental separator is shown with a strand of white dental floss passed horizontally through its central opening. # Band Fitting Handpiece, rubber cup and oil free prophy paste Band fit Tray (Band pusher, bite stick, band removing pliers, etc.) Cotton wool rolls, Glass ionomer cement, glass mixing slab and spatula Proffit, CO Chapter 12   **Band Fitting** Handpiece, rubber cup and oil free prophy paste. Band fit tray (band pusher, bite stick, band removing pliers, etc.). Cotton wool rolls, glass ionomer cement, glass mixing slab and spatula. Proffit, CO Chapter 12 Labelled diagram of a dental tray titled 'BAND TRY IN SETUP (ON BRACKET)', displaying seven orthodontic instruments including a triple syringe, mouth mirror, college tweezers, sickle probe, Mershon band seater, nylon band seater, and posterior band removing pliers. Labelled diagram of a dental tray containing specific instruments for fitting bands on brackets, including a mouth mirror, college tweezers, sickle probe, Mershon band seater, nylon band seater, posterior band removing pliers, and a triple syringe. # Band Fitting Procedure Remove any separators present (use a Probe or Schure to hook them out) Proffit, CO Chapter 12  **Band Fitting Procedure** Remove any separators present (use a Probe or Schure to hook them out). Proffit, CO Chapter 12 Clinical photo: A close-up view of a molar tooth with an orthodontic ligature tie (green elastic) securing the bracket to the archwire. The image demonstrates the manual removal of this separator using a specialized instrument, likely a probe or Schure, hooked under the green elastic band. # Band Fitting Procedure Select the band size to be fitted and press into place using band seater. Proffit, CO Chapter 12    Select the band size to be fitted and press into place using band seater. Proffit, CO Chapter 12 Clinical photo showing the lower posterior teeth fitted with metal orthodontic bands, specifically illustrating a band seater tool being used to press the appliance into place. Clinical photo showing the placement of an orthodontic band on a lower molar tooth. A gloved finger holds the tooth while a metal instrument is used to seat the band into the gingival sulcus. ## Band Fitting Procedure Use the handle of the bite stick to have the patient bite lightly to start seating the band Proffit, CO Chapter 12   Use the handle of the bite stick to have the patient bite lightly to start seating the band. Proffit, CO Chapter 12 Clinical photo showing the use of a dental mirror to assist in seating a fixed orthodontic band on a posterior tooth. The image captures the gloved hand retracting the cheek and using the instrument to guide the band into place around the molar. Clinical photo showing a gloved hand using the handle of a bite stick to apply pressure against a tooth, illustrating the step in a band fitting procedure where the patient bites lightly to start seating the band. **Band Fitting Procedure** Use the flat side of the tip on the buccal attachment or on the top of the band **Mesial buccal bite on the edge** **of the band gently** Proffit, CO Chapter 12   **Band Fitting Procedure** Use the flat side of the tip on the buccal attachment or on the top of the band. **Mesial buccal bite on the edge of the band gently.** Proffit, CO Chapter 12 Clinical photo: A gloved hand uses a white instrument to apply mesial buccal bite on the edge of an orthodontic band, which is fitted onto a molar. Clinical photo showing a dental band being fitted on the upper left molars, with a white instrument pressing against the buccal surface of the tooth and band. **Band Fitting Procedure** Proffit, CO Chapter 12 Use one of the points of the triangle to lightly push the edge of the band Have the patient bite gently on the lingual and hold the buccal attachment with the thumb to avoid over seating  **Band Fitting Procedure** Proffit, CO Chapter 12 Use one of the points of the triangle to lightly push the edge of the band. Have the patient bite gently on the lingual and hold the buccal attachment with the thumb to avoid over seating. Clinical photo showing the intraoral application of a metal band fitting procedure, where a dental instrument is being used to manipulate the band against the teeth. # Band Fitting Procedure **Band seated and now to** **inspect for band fitting** **to contours of the tooth** **Notice a small gap on the** **distal lingual cusp** Proffit, CO Chapter 12    **Band seated and now to inspect for band fitting to contours of the tooth.** Notice a small gap on the distal lingual cusp. Proffit, CO Chapter 12 Clinical photo showing the inspection of a band fitting on the lower left first molar, where the text highlights a small gap visible on the distal lingual cusp. Clinical photo showing a close-up of a dental band on a molar tooth, with a yellow arrow pointing to a visible gap between the band and the distal lingual cusp. Clinical photo of a band fitting procedure on the lower posterior teeth. The image highlights a small gap between the band and the tooth contour at the distal lingual cusp, indicated by a yellow arrow. # Band Fitting Procedure Proffit, CO Chapter 12 Take the band file or Schure and contour the band into the distal lingual cusp if necessary Check the tooth for any gaps and use the file to contour areas if gaps are seen  Proffit, CO Chapter 12 Take the band file or Schure and contour the band into the distal lingual cusp if necessary. Check the tooth for any gaps and use the file to contour areas if gaps are seen. Clinical photo: A close-up view of a dental band being fitted onto a molar, with a metal file actively used to contour the band into the distal lingual cusp area. **Band Fitting Procedure** **Proffit, CO Chapter 12** **Band seated after contouring;** **no gaps on the distal cusps** **Notice the relative position of** **the band to the occlusal** **margins of the tooth**  **Band Fitting Procedure** Proffit, CO Chapter 12 Band seated after contouring; no gaps on the distal cusps. Notice the relative position of the band to the occlusal margins of the tooth. Clinical photo showing a band seated on a molar tooth during the fitting procedure. The image highlights the relative position of the band to the occlusal margins and demonstrates that there are no gaps on the distal cusps. # Band Fitting Procedure **Proffit, CO Chapter 12** Some but not all of you will get the opportunity to fit bands. Ask if you can . . . when you see the procedure being completed as you will benefit immensely *Note: The provided PDF text does not contain verbatim caption strings for the specific figure labeled BOX_A, despite the image showing a tooth with an orthodontic band.*  Proffit, CO Chapter 12 Some but not all of you will get the opportunity to fit bands. Ask if you can... when you see the procedure being completed as you will benefit immensely. Clinical photo: A close-up intraoral view of a molar tooth with an orthodontic band and metal ligatures applied to the bracket. # Band Cementation Proffit, CO Chapter 12 **Band Cementation** **(DCA MIXING BENCH)** Band cementation is **much like cementing a crown with the cement placed at the gingival margins of the band and just repeat the process of band fitting/seating**  **Band Cementation** Proffit, CO Chapter 12 **Band Cementation (DCA MIXING BENCH)** Band cementation is **much like cementing a crown with the cement placed at the gingival margins of the band and just repeat the process of band fitting/seating.** A labelled diagram displaying the materials and tools required for band cementation, arranged on a blue drape. The image identifies a mixing tile, spatula, glass ionomer luting cement (powder and liquid), and gauze. Archwires - Continuous or Segmented - Round, Square or Rectangular - First, Second and Third Order Bends **First** **Second** **Third**     - Continuous or Segmented - Round, Square or Rectangular - First, Second and Third Order Bends **First** **Second** **Third** Labelled diagram showing the 'Second' order bend in orthodontic archwires, depicted as a vertical offset or displacement of the wire along its long axis to correct tooth rotation. Labelled diagram showing the upper dental arch with a wire bent to demonstrate the first order bend (tip). The figure is titled 'First' and illustrates the initial stage of wire bending in orthodontics. A labeled diagram illustrating a rectangular archwire, specifically demonstrating the 'First' order bend where the ends are angled in opposite directions. A diagram illustrating a 'Third Order Bend' in an archwire, shown on the right side of the slide. The figure displays a wire outline shaped like a molar tooth with two distinct bends at the top, representing the specific configuration for third-order corrections. **Auxiliaries** Elastic Tie **Wire** Elastic Power Chain Headgear Tube **Long Wire** Steel Tie Coil Wire Slots Rubber Band Post Steel Tie Pig Tail Molar Band **Powerchain:** **To achieve movement** **Auxiliaries** Elastic Tie **Wire** Elastic Power Chain Headgear Tube **Long Wire** Steel Tie Coil Wire Slots Rubber Band Post Steel Tie Pig Tail Molar Band **Powerchain:** **To achieve movement** Bracket / Band Auxiliaries **Auxiliary tubes** (buccal, palatal or lingual) **Headgear tubes** **Hooks**   Bracket / Band Auxiliaries **Auxiliary tubes** (buccal, palatal or lingual) **Headgear tubes** **Hooks** Labelled diagram: This crop displays a set of orthodontic auxiliary tubes, including a large headgear tube and smaller buccal or lingual auxiliaries. Red arrows point to the specific openings and structural features of these metal components. Clinical photo showing an intraoral view of upper and lower dental arches fitted with fixed orthodontic brackets. A red arrow points specifically to a hook auxiliary attached to the bracket on the maxillary right first molar. **Standard vs "Straight wire"** **Bracket** Standard bracket 0° Tip Straight-wire bracket 8° Tip 0° Torque 7° Torque 0° Tip 0° Torque  **Standard vs "Straight wire"** **Bracket** Standard bracket 0° Tip Straight-wire bracket 8° Tip 0° Torque 7° Torque 0° Tip 0° Torque A diagram illustrating the cross-sectional profile of a dental bracket, showing the specific geometry designed to deliver 0° Tip and 0° Torque. The figure depicts the vertical slot angle and horizontal base shape required for these standard orthodontic values. •Each brand has different prescription **Common Prescriptions Chart** **TIP**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    5    9    11    2    2    5    5       Roth    5    9    13    0    0    0    0       MBT    4    8    8    0    0    0    0 LOWER     Andrews    2    2    5    2    2    2    2       Roth    2    2    7    -1    -1    -1    -1       MBT    0    0    3    2    2    0    0 **TORQUE**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    7    3    -7    -7    -7    -9    -9       Roth    12    8    -2    -7    -7    -14    -14       MBT    17    10    +7/0/-7    -7    -7    -14    -14 LOWER     Andrews    -1    -1    -11    -17    -22    -30    -30       Roth    -1    -1    -11    -17    -22    -30    -30       MBT    -6    -6    +6/0/-6    -12    -17    -20    -10 **ROTATION**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    0    0    0    0    0    10    10       Roth    0    0    4    2    2    14    14       MBT    0    0    0    0    0    10    10 LOWER     Andrews    0    0    0    0    0    0    0       Roth    0    0    2    4    4    4    4       MBT    0    0    0    0    0    0    0 **Straight-Wire Orthodontics (1st Edition) - 2014 - Shadi Samawi** •Each brand has different prescription **Common Prescriptions Chart** **TIP**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    5    9    11    2    2    5    5       Roth    5    9    13    0    0    0    0       MBT    4    8    8    0    0    0    0 LOWER     Andrews    2    2    5    2    2    2    2       Roth    2    2    7    -1    -1    -1    -1       MBT    0    0    3    2    2    0    0 **TORQUE**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    7    3    -7    -7    -7    -9    -9       Roth    12    8    -2    -7    -7    -14    -14       MBT    17    10    +7/0/-7    -7    -7    -14    -14 LOWER     Andrews    -1    -1    -11    -17    -22    -30    -30       Roth    -1    -1    -11    -17    -22    -30    -30       MBT    -6    -6    +6/0/-6    -12    -17    -20    -10 **ROTATION**    **1**    **2**    **3**    **4**    **5**    **6**    **7** UPPER       Andrews    0    0    0    0    0    10    10       Roth    0    0    4    2    2    14    14       MBT    0    0    0    0    0    10    10 LOWER     Andrews    0    0    0    0    0    0    0       Roth    0    0    2    4    4    4    4       MBT    0    0    0    0    0    0    0 **Straight-Wire Orthodontics (1st Edition) - 2014 - Shadi Samawi** **can rotate upper 6's** # Auxiliary Arches * **Trans-palatal** * **Palatal** * **Nance Button** * **Lingual** * **Lip Bumper** **Trans palatal** **Nance button** **Lingual bar** **Lip bumper**   **can rotate upper 6's** Auxiliary Arches * **Trans-palatal** * **Palatal** * **Nance Button** * **Lingual** * **Lip Bumper** **Trans palatal** **Nance button** **Lingual bar** **Lip bumper** Clinical photo of an occlusal view showing a translucent blue Nance button appliance attached to the maxillary arch. The device features acrylic buttons seated on the palatal rugae and metal arms engaging with the first molars, which are fitted with orthodontic bands. Clinical photo showing a lingual arch appliance with the anterior segment removed, creating a U-shaped 'Lip bumper' designed to sit against the labial surface of the lower incisors. The metal bar is anchored by bands on the molars and rests within the vestibule. # Auxiliary Arch Wires * Intrusion Arches (also referred to as auxiliary arch) * Sectional arches  Auxiliary Arch Wires * Intrusion Arches (also referred to as auxiliary arch) * Sectional arches Labelled diagram: This figure illustrates the mechanics of intrusion arches and sectional arches using a dental model with various colored arrows indicating forces such as vertical intrusion (red), torque, and retraction. **Elastomeric Auxiliaries** ⚫ Elastic ligature thread ⚫ Elastomeric modules ⚫ Power Chains ⚫ Elastics – Intermaxillary – Intra-arch **Elastomeric Auxiliaries** ⚫ Elastic ligature thread ⚫ Elastomeric modules ⚫ Power Chains ⚫ Elastics – Intermaxillary – Intra-arch Auxiliaries **Elastic Tie** **Wire** **Elastic Power Chain** **Headgear Tube** **Long Wire** **Coil** **Wire Slots** **Molar Band** **Steel Tie** **Rubber Band Post** **Steel Tie Pig Tail** Auxiliaries **Elastic Tie** **Wire** **Elastic Power Chain** **Headgear Tube** **Long Wire** **Coil** **Wire Slots** **Molar Band** **Steel Tie** **Rubber Band Post** **Steel Tie Pig Tail** **Auxiliary Hooks** * Incorporated into the bracket * Soldered brass * Kobayashi ligature wires (k-ties) * Sliding * Surgery  **Auxiliary Hooks** * Incorporated into the bracket * Soldered brass * Kobayashi ligature wires (k-ties) * Sliding * Surgery Clinical photo showing the upper arch of a patient with fixed orthodontic braces. A red arrow points to an auxiliary hook on one of the brackets, illustrating the hardware used for anchorage or attachment of elastics. Auxiliary Coils ⚫ Push (open) coil spring ⚫ Pull coil spring ⚫ Closed coil spring  Auxiliary Coils ⚫ Push (open) coil spring ⚫ Pull coil spring ⚫ Closed coil spring Clinical photo of a maxillary archwire featuring auxiliary coil springs attached to brackets on the posterior teeth. The red arrow points specifically to a spring, illustrating the application of orthodontic mechanics for tooth movement. # Types of Ligatures - Stainless Steel wire - Elastomeric donut-shaped modules - Elastic Thread <div align="right"> <h4>Stainless Steel wire</h4> </div> <div align="center"> <h4>Elastomeric donut-shaped modules</h4> </div> <div align="center"> <p>PETRO 'O' 110</p> </div> <div align="right"> <h4>Elastic Thread</h4> </div>   Types of Ligatures - Stainless Steel wire - Elastomeric donut-shaped modules - Elastic Thread <div align="right"> <h4>Stainless Steel wire</h4> </div> <div align="center"> <h4>Elastomeric donut-shaped modules</h4> </div> <div align="center"> <p>PETRO 'O' 110</p> </div> <div align="right"> <h4>Elastic Thread</h4> </div> Clinical photo of a coiled stainless steel wire ligature, identified by the slide context as an example of 'Stainless Steel wire' used in orthodontics. A labeled diagram of a dental arch model featuring a central bar engraved with 'WER 'O' 110', flanked by rows of white, donut-shaped elastomeric modules representing ligature components. Orthodontic Arch Wires **Auxiliary arches** **Arch wire materials** **Arch wire types** **Arch wire forms** **Auxiliary arch wires** Orthodontic Arch Wires **Auxiliary arches** **Arch wire materials** **Arch wire types** **Arch wire forms** **Auxiliary arch wires** # Auxiliary Arches - Trans-palatal - Palatal - Lingual - Nance Button - Lip Bumper Auxiliary Arches - Trans-palatal - Palatal - Lingual - Nance Button - Lip Bumper Arch Wire Materials - Precious Metal Alloys - Stainless steel and Cobalt-Chromium Alloys - **Nickel Titanium (NiTi) Alloys** A-NiTi and M-NiT (austinitic / martinsitic) - Beta-Titanium - Composite plastics > Electric current on NiTi can cause it to change. > Used to correct deep bite. Arch Wire Materials - Precious Metal Alloys - Stainless steel and Cobalt-Chromium Alloys - **Nickel Titanium (NiTi) Alloys** A-NiTi and M-NiT (austinitic / martinsitic) - Beta-Titanium - Composite plastics > Electric current on NiTi can cause it to change. > Used to correct deep bite. Arch Wire Types **Continuous** or **segmented**  Arch Wire Types **Continuous** or **segmented** Clinical photo: A composite of three images showing the upper and lower dental arches with fixed orthodontic appliances. The figure illustrates the appearance of different arch wire types, specifically demonstrating continuous wires that run through the brackets in the top and bottom panels, as well as a segmented or looped wire configuration visible in the middle panel. **Solid or multistranded** **Round, square or rectangular**    **Solid or multistranded** **Round, square or rectangular** A close-up view of a single, solid metallic rod with a circular cross-section, demonstrating the 'Round' wire option listed in the slide's context. Diagram showing the cross-section of a twisted wire bundle, illustrating how multiple individual strands are arranged together. Labelled diagram: This figure illustrates a rectangular wire cross-section, highlighting the difference between the exterior and interior structures. The top surface features a textured, segmented pattern resembling a braided or multistranded outer layer, while the cutaway end reveals a solid brick-like internal core. # Arch Wire Form * **Bonwill-Hawley** * **Cantenary curve** * **Brader arch form** * **Lingual appliance arch forms (mushroom Arch)** * Most if not all arch wires require some form of modification to match the patient's arch form Arch Wire Form * **Bonwill-Hawley** * **Cantenary curve** * **Brader arch form** * **Lingual appliance arch forms (mushroom Arch)** * Most if not all arch wires require some form of modification to match the patient's arch form # Traditional Stages of Orthodontic Treatment * Stage 1 - Leveling and Alignment * Stage 2 - Space Management * Stage 3 - Finishing * Stage 4 - Retention - Stage 1 - Leveling and Alignment - Stage 2 - Space Management - Stage 3 - Finishing - Stage 4 - Retention **Critical Fixed Appliance Limitations**- Fixed appliances are limited to moving teeth within the confines of the alveolar bone. Therefore, fixed appliances depend upon an adequate and healthy periodontium Fixed appliances are limited to moving teeth within the confines of the alveolar bone. Therefore, fixed appliances depend upon an adequate and healthy periodontium. # Critical Fixed Appliance Limitations - Fixed appliances often require a high degree of patient cooperation. The best treatment results depend upon faithful wearing of elastics, headgear and/or other orthodontic or orthopaedic auxiliaries Fixed appliances often require a high degree of patient cooperation. The best treatment results depend upon faithful wearing of elastics, headgear and/or other orthodontic or orthopaedic auxiliaries. Critical Fixed Appliance Limitations **Fixed appliances require an acceptable level of oral hygiene to allow movement of the teeth with minimal loss of crestal bone, as well as to prevent dental caries.** Fixed appliances require an acceptable level of oral hygiene to allow movement of the teeth with minimal loss of crestal bone, as well as to prevent dental caries. # Critical Fixed Appliance Limitations * Fixed appliances require an acceptable skeletal relationship prior to the completion of treatment. The skeletal relationship may be achieved before or during fixed appliance treatment by the use of extraoral traction, functional appliances or orthognathic surgery. Fixed appliances require an acceptable skeletal relationship prior to the completion of treatment. The skeletal relationship may be achieved before or during fixed appliance treatment by the use of extraoral traction, functional appliances or orthognathic surgery. # Orthodontic Complications - Pain – Appliance impinging on soft tissues - pain associated with tooth movement - Appliance Breakages – Bracket/bond/wire - Oral Hygiene – Periodontal/Dental caries issues - Root Resorption – due to patient susceptibility or treatment mechanics - **Pain** – Appliance impinging on soft tissues; pain associated with tooth movement - **Appliance Breakages** – Bracket/bond/wire - **Oral Hygiene** – Periodontal/Dental caries issues - **Root Resorption** – due to patient susceptibility or treatment mechanics **Orthodontic Complications** - **Devitalization** - **Muscle and/or TM Joint Pain** - **Relapse** - **Tooth mobility** – due to bone loss or tooth movement into area of inadequate osseous support - **Loss of crestal bone** – due to gingival inflammation - **Devitalization** - **Muscle and/or TM Joint Pain** - **Relapse** - **Tooth mobility** – due to bone loss or tooth movement into area of inadequate osseous support - **Loss of crestal bone** – due to gingival inflammation # Orthodontic Complications * **Atypical Growth** – growth that distorts the skeletal relationship beyond the orthodontist’s ability to compensate. * Compliance * Ceramic Brackets – potential enamel damage * Complimentary Aesthetic Dentistry * Loose or Debonded Fixed Retainer - **Atypical Growth** – growth that distorts the skeletal relationship beyond the orthodontist’s ability to compensate. - **Compliance** - **Ceramic Brackets** – potential enamel damage - **Complimentary Aesthetic Dentistry** - **Loose or Debonded Fixed Retainer** # **Complications Orthognathic Surgery** - Altered Sensation / Anesthesia - Surgical Relapse - Fixation Time - Tooth Devitalization/Root Resection - Condylar Resorption - Reduced TM Joint Mobility - TM Joint Pain - Altered Sensation / Anesthesia - Surgical Relapse - Fixation Time - Tooth Devitalization/Root Resection - Condylar Resorption - Reduced TM Joint Mobility - TM Joint Pain # Complications Orthognathic Surgery - Pain - Inflammation Swelling - Hemorrhage - Avascular Necrosis At the end of this course, you **DO** **NOT** have the didactic knowledge or clinical skills to treat comprehensive orthodontic cases. ## Case: Early Orthodontic Device (Angle Edgewise Precursor) **Question/Prompt:** "From the very beginning we have some rudimentary arch wires... have a look, we have bands across all the teeth, all right? No bonding. So we have to figure out a way to deliver our force." **Findings and Reasoning:** * **Appliance Design:** In the early 90s (1890s), bonding was not available, so clinicians could not etch enamel. The device used screws to tighten bands (similar to a "rhyme ball") and a buccal/labial arch wire. * **Mechanism:** The teeth were "laced" to the arch wire to correct rotations. * **Limitations:** Biomechanics were limited compared to modern standards because the force was delivered at a distance from the center of resistance due to the thickness of the bands and attachments. ## Case: Pin and Tube Appliance **Question/Prompt:** "Then it's evolved for a pin and tube 10 years later, more or less... have a look, we have bands across all the teeth, all right? No bonding." **Findings and Reasoning:** * **Attachments:** A pin was attached to the bands on every tooth. * **Clinical Challenge:** Because every tooth required a cemented band, there was a high risk of white spot lesions. * **Rotation Control:** Clinicians used "eyelets" (metallic devices soldered to the band) to pin the wire. Wings on the mesial or distal could be used to control rotation. * **Technical Difficulty:** Soldering these devices by hand with a torch without blocking the inner slot required high manual dexterity. ## Case: Begg Appliance **Question/Prompt:** "Then we got the Begg appliance, as you can see here... The arch wire was connected like on a vertical pins... within Begg did not use a kind of a rectangular slot." **Findings and Reasoning:** * **Components:** Used molar tubes and vertical pins rather than standard brackets. * **Wire Type:** Used exclusively round wires, not rectangular wires. * **Biomechanics:** Because it lacked a square/rectangular slot, third-order (torque) control was limited compared to modern systems. * **Tipping:** Begg had a specific way to manage uncontrolled tipping using pins and elastics to achieve results similar to bodily movement, though modern rectangular slots provide superior control. ## Case: Self-Ligating Bracket System **Question/Prompt:** "But now we have the system, the self-ligating system. This is more or less the same bracket, but it has a lid. So you can open and close the lid. The lid is this one like a gate." **Findings and Reasoning:** * **Mechanism:** Instead of using elastomeric rings (O-rings) to hold the wire in the slot, a mechanical "gate" or lid is opened with a probe and closed over the wire. * **Advantages:** Elastomeric materials degrade in the mouth (due to pH, temperature, and moisture), losing their performance and allowing the wire to become loose. They also attract biofilm. The self-ligating gate provides a more stable, lower-friction system. * **Risks:** If oral hygiene is poor, calculus can build up on the edges of the gate, causing it to get stuck. If the gate cannot be opened after 6-7 weeks, the entire bracket may need to be replaced. ## Case: Early Orthodontic Device (Angle Edgewise Precursor)  **Question/Prompt:** "From the very beginning we have some rudimentary arch wires... have a look, we have bands across all the teeth, all right? No bonding. So we have to figure out a way to deliver our force." **Findings and Reasoning:** * **Appliance Design:** In the early 90s (1890s), bonding was not available, so clinicians could not etch enamel. The device used screws to tighten bands (similar to a "rhyme ball") and a buccal/labial arch wire. * **Mechanism:** The teeth were "laced" to the arch wire to correct rotations. * **Limitations:** Biomechanics were limited compared to modern standards because the force was delivered at a distance from the center of resistance due to the thickness of the bands and attachments. ## Case: Pin and Tube Appliance  **Question/Prompt:** "Then it's evolved for a pin and tube 10 years later, more or less... have a look, we have bands across all the teeth, all right? No bonding." **Findings and Reasoning:** * **Attachments:** A pin was attached to the bands on every tooth. * **Clinical Challenge:** Because every tooth required a cemented band, there was a high risk of white spot lesions. * **Rotation Control:** Clinicians used "eyelets" (metallic devices soldered to the band) to pin the wire. Wings on the mesial or distal could be used to control rotation. * **Technical Difficulty:** Soldering these devices by hand with a torch without blocking the inner slot required high manual dexterity. ## Case: Begg Appliance    **Question/Prompt:** "Then we got the Begg appliance, as you can see here... The arch wire was connected like on a vertical pins... within Begg did not use a kind of a rectangular slot." **Findings and Reasoning:** * **Components:** Used molar tubes and vertical pins rather than standard brackets. * **Wire Type:** Used exclusively round wires, not rectangular wires. * **Biomechanics:** Because it lacked a square/rectangular slot, third-order (torque) control was limited compared to modern systems. * **Tipping:** Begg had a specific way to manage uncontrolled tipping using pins and elastics to achieve results similar to bodily movement, though modern rectangular slots provide superior control. ## Case: Self-Ligating Bracket System    **Question/Prompt:** "But now we have the system, the self-ligating system. This is more or less the same bracket, but it has a lid. So you can open and close the lid. The lid is this one like a gate." **Findings and Reasoning:** * **Mechanism:** Instead of using elastomeric rings (O-rings) to hold the wire in the slot, a mechanical "gate" or lid is opened with a probe and closed over the wire. * **Advantages:** Elastomeric materials degrade in the mouth (due to pH, temperature, and moisture), losing their performance and allowing the wire to become loose. They also attract biofilm. The self-ligating gate provides a more stable, lower-friction system. * **Risks:** If oral hygiene is poor, calculus can build up on the edges of the gate, causing it to get stuck. If the gate cannot be opened after 6-7 weeks, the entire bracket may need to be replaced. Case: Early Orthodontic Device (Angle Edgewise Precursor) A screenshot of a Windows desktop environment featuring the default blue abstract wallpaper, a taskbar with various application icons, and several desktop shortcuts on the left side. Labelled diagram: A schematic illustration of a dental appliance, specifically the Pin and Tube system from 1910, showing metal components attached to the lower anterior teeth. Clinical photo showing a close-up of the maxillary and mandibular dental arches fitted with Begg light wire appliance brackets. The image displays a continuous archwire engaging into slots, alongside visible elastic ligatures and power chains connecting the molar units. Clinical photo of the right side of a patient's mouth showing fixed orthodontic appliances, specifically Begg brackets and wires, with visible elastics. A line drawing illustrating the bracket assembly of a Begg appliance, specifically highlighting the pin-and-tube configuration. The image depicts a wire running through a tube attached to the bracket. Clinical photo showing the lower arch of a patient's teeth fitted with metal self-ligating braces and an archwire. A red arrow points specifically to the bracket on the left canine, illustrating the mechanical clip mechanism used to secure the wire within the slot. Clinical photo of a patient's anterior teeth featuring metal self-ligating brackets on the upper and lower incisors, canines, and bicuspids. Clinical photo showing the right side of a patient's dentition with fixed orthodontic appliances. The image displays metal brackets bonded to the upper and lower bicuspids, canines, and incisors, connected by archwires. ## Case: Ceramic Brackets **Question/Prompt:** "We have also the ceramic brackets, okay? So the ceramic brackets, they're very nice. They usually when I have the single crystal brackets, they are very clear, okay; like glass." **Findings and Reasoning:** * **Aesthetics:** Highly aesthetic and clear. * **Drawbacks:** They are very brittle, which can make debonding difficult. They also have higher friction between the wire and the slot compared to metal. * **Design Variations:** Some ceramic brackets have a metallic slot insert to reduce friction, though this compromises the "clear" look. If using non-self-ligating ceramic brackets, clear elastomeric rings are used, but these tend to stain yellow within two weeks. ## Case: Twin vs. Single Bracket Systems **Question/Prompt:** "So twin system, like you have like this, these double wings here... We have this kind of just a single system here." **Findings and Reasoning:** * **Single Brackets:** These are narrower, which increases the "inter-bracket distance" (the amount of wire between brackets). This reduces stiffness and increases resilience, delivering lower forces but offering less rotational control. * **Twin Brackets:** These have two points of contact with the wire. This reduces the inter-bracket distance, resulting in higher forces but providing much greater control over tooth movement. ## Case: First, Second, and Third Order Bends (Straight Wire vs. Edgewise) **Question/Prompt:** "See how the wires are bent here on this first image? So all of these bands we had to do by our own... Now we can just use a straight wire." **Findings and Reasoning:** * **Standard Edgewise:** Requires the clinician to manually bend the wire to achieve: * **First Order:** Labio-lingual/bucco-lingual positioning (in-and-out). * **Second Order:** Mesio-distal tip/angulation. * **Third Order:** Torque (torsion of a rectangular wire to control root position). * **Straight Wire System:** These compensations are built directly into the bracket slot and base. For example, the thickness of the bracket base provides the first order, the angulation of the wings/slot provides the second order (tip), and the inclination of the slot provides the third order (torque). ## Case: Auxiliary Anchorage Devices (Lingual Arch, Nance, TPA) **Question/Prompt:** "For example, a lingual arch here... as we have the lingual arch in the lower one, we have the Nance button of the top." **Findings and Reasoning:** * **Lower Lingual Arch:** Connects the lower sixes to provide extra anchorage control, preventing molars from moving forward when retracting canines. * **Nance Button:** Features a button resting on the palate to block the mesial drift of upper molars. It is a very efficient way to maintain anchorage in the upper arch. * **Transpalatal Bar (TPA):** An analogous upper version of the lingual arch; it provides anchorage and allows for the rotation or de-rotation of the upper first molars. ## Case: Ceramic Brackets    **Question/Prompt:** "We have also the ceramic brackets, okay? So the ceramic brackets, they're very nice. They usually when I have the single crystal brackets, they are very clear, okay; like glass." **Findings and Reasoning:** * **Aesthetics:** Highly aesthetic and clear. * **Drawbacks:** They are very brittle, which can make debonding difficult. They also have higher friction between the wire and the slot compared to metal. * **Design Variations:** Some ceramic brackets have a metallic slot insert to reduce friction, though this compromises the "clear" look. If using non-self-ligating ceramic brackets, clear elastomeric rings are used, but these tend to stain yellow within two weeks. ## Case: Twin vs. Single Bracket Systems    **Question/Prompt:** "So twin system, like you have like this, these double wings here... We have this kind of just a single system here." **Findings and Reasoning:** * **Single Brackets:** These are narrower, which increases the "inter-bracket distance" (the amount of wire between brackets). This reduces stiffness and increases resilience, delivering lower forces but offering less rotational control. * **Twin Brackets:** These have two points of contact with the wire. This reduces the inter-bracket distance, resulting in higher forces but providing much greater control over tooth movement. ## Case: First, Second, and Third Order Bends (Straight Wire vs. Edgewise)    **Question/Prompt:** "See how the wires are bent here on this first image? So all of these bands we had to do by our own... Now we can just use a straight wire." **Findings and Reasoning:** * **Standard Edgewise:** Requires the clinician to manually bend the wire to achieve: * **First Order:** Labio-lingual/bucco-lingual positioning (in-and-out). * **Second Order:** Mesio-distal tip/angulation. * **Third Order:** Torque (torsion of a rectangular wire to control root position). * **Straight Wire System:** These compensations are built directly into the bracket slot and base. For example, the thickness of the bracket base provides the first order, the angulation of the wings/slot provides the second order (tip), and the inclination of the slot provides the third order (torque). ## Case: Auxiliary Anchorage Devices (Lingual Arch, Nance, TPA)   **Question/Prompt:** "For example, a lingual arch here... as we have the lingual arch in the lower one, we have the Nance button of the top." **Findings and Reasoning:** * **Lower Lingual Arch:** Connects the lower sixes to provide extra anchorage control, preventing molars from moving forward when retracting canines. * **Nance Button:** Features a button resting on the palate to block the mesial drift of upper molars. It is a very efficient way to maintain anchorage in the upper arch. * **Transpalatal Bar (TPA):** An analogous upper version of the lingual arch; it provides anchorage and allows for the rotation or de-rotation of the upper first molars. Case: Ceramic Brackets Clinical photo showing a close-up of a mouth with metal braces on the upper teeth, accompanied by two isolated bracket examples: one metallic and one clear ceramic. This illustrates the visual difference between stainless steel and tooth-colored (ceramic) orthodontic brackets. self ligating self ligating Clinical photo of a metal bracket assembly on upper central and lateral incisors featuring the 'Twin wing' design. The image highlights the horizontal crossbar connecting two vertical slots, indicated by a red arrow. Clinical photo showing metal brackets with a 'twin wing' design installed on the upper central and lateral incisors. Clinical photo showing a close-up of the upper anterior teeth fitted with metal brackets. The image highlights the 'Twin wing' bracket design on the central and lateral incisors, which features two vertical slots extending from the base. A labeled diagram illustrating a rectangular archwire, specifically demonstrating the 'First' order bend where the ends are angled in opposite directions. A diagram illustrating a 'Third Order Bend' in an archwire, shown on the right side of the slide. The figure displays a wire outline shaped like a molar tooth with two distinct bends at the top, representing the specific configuration for third-order corrections. Second Clinical photo of an occlusal view showing a translucent blue Nance button appliance attached to the maxillary arch. The device features acrylic buttons seated on the palatal rugae and metal arms engaging with the first molars, which are fitted with orthodontic bands. Lip bumper [^1]: Original PDF page 1: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=1|04 - DENT5311 Contemporary Fixed Appliances, p.1]] [^2]: Original PDF page 2: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=2|04 - DENT5311 Contemporary Fixed Appliances, p.2]] [^3]: Original PDF page 3: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=3|04 - DENT5311 Contemporary Fixed Appliances, p.3]] [^4]: Original PDF page 4: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=4|04 - DENT5311 Contemporary Fixed Appliances, p.4]] [^5]: Original PDF page 5: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=5|04 - DENT5311 Contemporary Fixed Appliances, p.5]] [^6]: Original PDF page 6: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=6|04 - DENT5311 Contemporary Fixed Appliances, p.6]] [^7]: Original PDF page 7: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=7|04 - DENT5311 Contemporary Fixed Appliances, p.7]] [^8]: Original PDF page 8: [[04 - DENT5311 Contemporary Fixed Appliances.pdf#page=8|04 - 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