Self-Ligating Brackets in Orthodontics (eBook)

Current Concepts and Techniques

Dirk Bister, Sebastian Baumgaertel, Björn Ludwig (Autoren)

eBook Download: EPUB

2011 | 1. Auflage
510 Seiten
Thieme (Verlag)
978-3-13-257913-2 (ISBN)

Infos

<p><strong><em>A comprehensive overview of modern orthodontic treatment using self-ligating bracket systems - with evaluations of systems currently available</em></strong></p><p>Promising numerous advantages in design, treatment efficacy, and reduced treatment time, self-ligating brackets have become a major part of modern orthodontic practice. <em>Self-Ligating Brackets in Orthodontics: Current Concepts and Techniques</em> summarizes contemporary information and clinical studies on these popular systems, integrating them with the authors' practical, hands-on experience. Encompassing all aspects of treatment with self-ligating fixed appliances from biomechanics to material properties, including diagnostic and therapeutic principles, this book provides a step-by-step visual guide to this groundbreaking field.</p><p><strong>Special Features:</strong></p><UL><LI>Provides more than 1,500 outstanding color photographs that show the sequence of steps for all procedures involving self-ligating brackets from start to finish <LI>Objectively evaluates the advantages and disadvantages of commercially available self-ligating bracket systems to help you make the best choices for your patients <LI>Covers the full scope of treatment, including oral hygiene, adhesive techniques, biomechanics, aesthetic choices, retention and stability, and more <LI>Includes multiple case studies as well as information on risks and pitfalls, practical tips, and clinical pearls that aid in decision-making and reinforce the treatment concepts</LI></UL><p>Written by a team of international specialists, this book is essential for all practitioners who want to keep up with the latest developments in self-ligating brackets, expand their services, and offer state-of-the-art treatment techniques. It is a useful introduction to newcomers to self-ligation as well as a guide for experienced orthodontists on how to successfully incorporate this highly popular technique into their practices.</p>

Textauszug

I   Basics

1 The Development and History of Fixed Appliances

Franziska Bock

Development of Self-Ligating Bracket Systems

The 1980s

The 1990s

The 21st Century

Expectations and Reality

For many centuries, in many regions and cultures of the world, attempts have been made to correct malocclusions caused by malaligned teeth, skeletal discrepancies of the jaws, or a combination of the two. The Habsburg dynasty, for example—one of Europe's most powerful reigning families—shaped Europe politically, but there was one thing that, despite all their wealth and influence, they were powerless against: the male Habsburgs, regardless of whether they had been crowned or not, were unable to overcome their class III malocclusion. Throughout the history of dentistry, the profession was well aware of malocclusions and sought ways to treat them. Pierre Fauchard, for example, dedicated an entire chapter of his 1728 textbook—the first dental textbook ever written—to the correction of malocclusions.

Fauchard's text is the first description in the literature of the use of fixed appliances. The fixed appliance he described was quite simple by today's standards and consisted of gold bands and either silk ties or metal wires that were attached to a misaligned tooth and the neighboring teeth.29 Many other authors have since described a large number of fixed appliances that used bands. Other appliances featuring very varied designs and adjuncts, such as wooden wedges, special ligatures, as well as “caps” or crowns, were also used to treat poorly aligned teeth.22 Further refining treatment mechanics, some orthodontists also used developments that were originally described by engineers; Carabelli (1842) developed a number of appliances in this way. He is also known as the first orthodontist who fitted appliances not directly on the patient but used plaster models of fixed appliances, which allowed him to manufacture the fixed appliances in the laboratory.22 Whilst most of the above-mentioned appliances were only suitable for treating specific malocclusions, Edward H. Angle was the first orthodontist to develop a ‘standardized’ fixed appliance. Angle not only established orthodontics as the first dental specialty, but also developed and categorized malocclusions, and his classification is still in use today. The appliances he developed were intended to be suitable for treating the types of malocclusion he identified. The expansion arch (E-arch, 1887) consisted of a band that was activated with a screw and an arch with a threaded end, which was fitted into a tube and tightened using a screw nut. The arch itself was then connected by ligatures to the individual teeth in order to align them.

The ribbon arch developed by Angle in 1916 was the starting point for the development of bracket systems whicht are still in use today.

In 1910, Angle developed the ‘pin-and-tube’ appliance in which small pins were soldered to the arch and then inserted into vertical tubes. Further development of the appliance utilising bands with vertical slots, also known as the ribbon arch appliance (Angle 1916), allowed three-dimensional control of tooth movement. This was the first fixed appliance that used a rectangular slot in a bracket, which was then soldered to a band. The ribbon arch appliance marked the birth of modern orthodontics; all of today's fixed appliances are derived from it.23 Subsequent improvements on the concept by Angle led to the invention of the ‘Edgewise’ appliance in 1928. This was another milestone, as a change in the archwire dimensions (turning the wire on its ‘edge’) allowed controlled expression of torque, tip, and rotation.23,24 All later developments of fixed appliances copied these early developments in bracket design, eventually leading to contemporary fixed appliance designs in terms of slot shape, size, and position, the number of slots, the contour of the bracket and its base, as well as the mechanism for ligating the archwire to the bracket.18 Advances in the manufacture of brackets were another (often underestimated) factor involved in further developments. With the invention of metal injection molding, it became possible to produce very complex bracket shapes of an extremely high level of precision and in large quantities, making it easy to incorporate precise values for torque, tip, and angulation in the bracket.16 In addition, the manufacturing technique allows smaller and flatter bracket designs.

Development of Self-Ligating Bracket Systems

The technique today uses metal or elastomeric ligatures to attach an archwire to a bracket. Ligating the archwire to the bracket slot in this way can be quite time-consuming, particularly when metal ligatures are used, and this is why self-ligating brackets were first developed. The earliest examples (all developed in the United States) date back to the 1930s.

The term “self-ligating bracket” (SL bracket) is used for brackets that incorporate a locking mechanism (such as a ring, spring, or door mechanism) that holds the archwire in the bracket slot.

There are essentially two main types of self-ligating bracket, depending on the design of the locking mechanism, the dimensions of the slot, and the dimensions of the archwires: active brackets and passive brackets. In passive systems (such as the Damon System, Ormco Corporation, Orange, California; and Discovery SL, Dentaurum Ltd., Ispringen, Germany), the slot is locked or shut with a rigid locking mechanism. Once it is engaged, the bracket is effectively turned into a tube, ideally allowing archwires to slide freely within the tube. In active systems (such as Quick, Forestadent Ltd., Pforzheim, Germany; and SPEED, Strite Industries, Cambridge, Ontario, Canada), the locking mechanism generally consists of a flexible but resilient clip that can actively engage wire into the bracket slot once the archwire reaches a certain size or deflection.26

Fig. 1.1 a, b    Russell attachment (1935)

a Open.

b Closed.

Fig. 1.2a, b    Boyd bracket (1933)

a Archwire slot open.

b Archwire slot closed.

Fig. 1.3a, b    Ford bracket (1933)

a Slot open.

b Slot closed.

Fig. 1.4a, b    EdgeLok bracket (a). The bracket slot is closed with a sliding mechanism (b)

Stolzenberg invented the Russell attachment in 1935 and is one of the pioneers of self-ligating brackets (Fig. 1.1).5,12,25 Although Boyd (1933) (Fig. 1.2) and Ford (1933) (Fig. 1.3) developed passive, ligature-free systems earlier, these were never widely used.10 Other designs were patented, but only very few of them eventually became commercially available.

It was not until the 1970s that interest in the development of self-ligating brackets resurfaced. In 1972, Wildman introduced the passive EdgeLok bracket,10,12,30 which in its earlier incarnations had a round bracket body as well as a labial sliding door (Figs. 1.4 and 1.5). This was the first self-ligating bracket to become widely available commercially, but it was eventually taken out of production as more advanced systems appeared. At about the same time (1973), the Mobil-Lock bracket (Fig. 1.6) was introduced by Sander.27 This was the first self-ligating twin bracket that had a variable slot. Due to the eccentric movement of the locking system, the wire could either be locked tightly into the bracket or, with proper adjustment, achieve partial ligation, which was designed to allow the wire to glide freely through the slot.20 These were all passive systems, and none of them are still in use today, as they have been superseded by newer and improved designs.

Fig. 1.5a, b    EdgeLok bracket

a Slot open.

b Slot closed.

Fig. 1.6a–c    Mobil-Lock bracket

a Open.

b Closed–sliding.

c Closed–locked.

The 1980s

In the 1980s, Hanson developed a completely new approach to self-ligation: the SPEED bracket (Fig. 1.7). This was the first active self-ligating bracket. The locking mechanism is formed by a flexible clip.5,9,12 This bracket is still in use today, but has undergone significant modifications during the past 20 years of clinical experience. As mentioned earlier in the text, changes in bracket manufacture techniques have had a significant impact on the bracket design. For example, the locking mechanism, the resilient spring had originally been made from stainless steel, but this has recently been replaced with nickel–titanium (NiTi).

The SPEED bracket was quickly accepted in clinical practice and is still in use today.

Fig. 1.7    The Speed bracket was the first active self-ligating bracket. (Reproduced with permission from Bock et al.2)

Fig. 1.8 a, b    Activa bracket

a Slot open.

b Slot closed.

Following the clinical acceptance and commercial success of the SPEED bracket, further self-ligating systems...

Produkt-Details

• Erscheint lt. Verlag: 14.12.2011
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Zahnmedizin
• Schlagworte: Active Bracket Systems • adhesive techniques • adhesive techniques for brackets • Archwire • Bonding of Brackets • Brackets • Bracket Systems • Clarity SL (3M Unitek) • Damon 3 • Debonding of the Fixed Appliances • Development of Self-Ligating Bracket Systems • Discovery SL (Dentaurum) • In-ovation C (GAC) • In-ovation R (GAC) • Leveling and Alignment of Brackets • ligating • Ligation of Archwires • NiTi-Coil Springs • Opal M (Ultradent) • Opal (Ultradent) • oral and dental hygiene • oral/dental hygiene • oral hygiene • Orthodontics • Orthodontic Treatment • Passive Bracket Systems • Quick 2 (Forestadent) • Reduction of Chair Time • Reduction of Overall Treatment Time • retentions • Self-ligating brackets • self-ligating bracket therapy • Smart Clip (3M Unitek) • Space Closure and Finishing • Speed (Strite Industries Ltd) • stability • Standard Diagnostic Tools in Orthodontics • Symptoms and Etiology of Caries • Time 2 (American Orthodontics) • Time 3 (American Orthodontics) • Treatment • treatment: diagnostics • useful aids • Vision LP (American Orthodontics)
• ISBN-10: 3-13-257913-0 / 3132579130
• ISBN-13: 978-3-13-257913-2 / 9783132579132