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ORTHODONTIC
APPLIANCES
214 DDA
DEFINITION
Orthodontic appliance is a device
that is used to produce changes
in the relationships of the teeth
and the skeletal structures.
TYPES OF ORTHODONTIC
APPLIANCES


REMOVABLE .
FIXED .
REMOVABLE APPLIANCES
They are designed to be placed
& removed by the patient as
directed by the orthodontist.
TYPES OF REMOVABLE
APPLIANCES
1. INTRAORAL .
2. EXTRAORAL .
1. INTRAORAL APPLIANCES
Types are Either
I. Removable such as :
1. Functional appliances.
2. Active retainers.
3. Passive retainers & positioners.
OR
II. Fixed :
Space maintainers.
FUNCTIONAL APPLIANCE
Is a removable device that is
frequently used during growth to
correct skeletal imbalance and
produce changes in the differential
growth rate , before placement of
fixed appliances .
ACTIVE RETAINERS
Are used to achieve minor
tooth movement (tipping
movement) .
RETAINERS & POSITIONERS
Are removable appliances that
are used to hold or retain
alignment of the teeth after
fixed appliance therapy.
SPACE MAINTAINERS
Are constructed to maintain
the spaces for the permanent
teeth after deciduous teeth
loss .
2. EXTRAORAL APPLIANCES
It is an appliance that is worn outside
the mouth to gain force from the head
& neck to change the differential
growth rate.
EX:
Headgear
HEADGEAR

Is an orthopedic device that can be
used in conjunction with fixed or
removable appliances ,it is used to
control growth & tooth movement.

It is made of tow parts :
Facebow & the traction device .

Facebow :
* It is used to stabilize or move the
maxillary 1st molar distally to create
more space in the arch.
* It has an intra & extra oral parts ,the
intra will fit into the buccal tube of
the maxillary 1st molar .The outer
part of the bow attaches to the
traction device .
• Traction Device
It applies the extraoral force used to
achieve the desired Tx results .
 It has four types :
High pull ,cervical ,combination &
chin cap .

 HIGH
PULL : It is a caplike
device that fits around the pt
head &hooks perpendicular to
the occlusal plane. It is used to
control growth of the maxilla or
retraction of anterior teeth.
 Cervical
pull : It fits around
the pt’s neck. The exerted force
is parallel to the occlusal plane.
It is used to stabilize or distalize
the 1st maxillary molars

Combination : It is a
combination of high pull &
cervical traction devices It
exerts a force along the occlusal
plane & upward .

Chin cap : It is a combination of
high-pull strap & a chin cup that
fits on the mandible. It controls
mandibular growth in Cl III
patients .
FIXED APPLIANCES
They are attached to the teeth which
are removed by the orthodontist.
 It is called braces.
 It can move teeth in six directions:
Mesially, distally , lingually, facially,
apically & occlusally ,as well as
rotationally.

COMPONANTS OF FIXED
APPLIANCE:
Attachments include bands (esp on 1st &
2nd molars) & brackets bonded directly to
the teeth (esp on anterior & premolar
teeth) .
2. Axillaries (attach arch wire to brackets &
bands to move teeth such as tubes, hooks
& elastics .
3. Arch wires are attached to the brackets by
bending the wire it will give force &
pressure that cause teeth to move in the
desired direction .
1.
After decision has been made
that fixed appliance should be
used Tx plan will be discussed &
pt will be prepared to receive
separators.
SEPARATION OF TEETH

Separator is a device that force or
wedge the teeth a part so bands can
be fitted easily.

It involves three separating methods :
Brass wire separators ,steel separating
springs, & elastomeric separators.
1. ORTHODONTIC
ATTACHMENTS
ARE :
BANDS .
BRACKETS .

BANDS SELECTION:
- Bands are preformed stainless steal
rings which has to be selected properly on
diagnostic cast or by visual inspection of
the size.
- They are divided into maxillary &
mandibular (R & L).
CEMINTATION OF
ORTHODONTIC BANDS

Cement has to have strength to aid in
retention with enamel as (zinc
phosphate), as well as a timereleased fluoride to prevent decay
under the bands as (glass ionomer) .
• BRACKETS
The most common type is the
edgewise brackets .
 It is made of stainless steal &
attached to a backing pad ,it has four
wings to attach the arch wire to it after
placing it horizontally .
 It has auxiliary attachments such as
headgear tubes ,edgewise tubes ,labial
hooks ,lingual arch attachments .

PREPARATION OF TEETH

Teeth should be polished by pumice
& rubber cup to remove pellicle &
food debris .

Acid etching will be placed on the
tooth surface for 15 seconds then
washed & dried .
Monomer agent will be applied on the
tooth surface as well as the bracket .
 In addition to the agent the boding
material will be placed on the bracket
only .
 The bracket pressed on the tooth
surface & the excess will be removed .

2. ARCH WIRES
It is shaped like a horse shoe ,when
it is tied to the brackets it provides
sufficient force to move teeth .
 It has several types with each has
different properties eg Nickel
titanium ,Stainless steal wires .
 In addition it has different shapes &
sizes (Round ,Square & Rectangular).

3. AUXILARIES
It has tow types :
1. Ligature wires are twisted around
the bracket to hold the wire in place .

Kobyashi hooks has a hook for
attachment of elastics .
2. elastomeric ties are made of plastic
or rubberlike material & available in
many colors .
3. Power products it can move teeth &
the tow commonly used types are
elastic chain ties (to close spaces) &
elastics (rubber bands) from one
tooth to another in the same arch or
teeth in opposing arches to move
teeth in certain direction.
ASSISTANTS
RESPONSIBILITIES :
1.




Assistant should check the pt
appliance for any
Broken or missing arch wires
Loose brackets & bands
Loose or broken or missing ligatures
Loose or broken or missing elastics .
2. Oral hygiene & dietary instruction:
-Should be given to avoid food
trapment & plaque accumulation
because bad oral hygiene will lead to
rampant caries & periodontal disease .
-Also ice ,popcorn ,nuts & sticky foods
should be avoided because they will
cause band loosening , bracket
popping off & arch wire bending .
COMLETED TREATMENT
When Tx finished the appliance will
be removed & teeth should be
cleaned and polished .
 All records will be retaken
(Impression , radiographs and
photographs ) .
 As well as a removable or fixed
retainer will be constructed .

RETENTION
Is necessary to :
Allow gingival & periodontal tissues
reorganization .
 Support unstable teeth to prevent
relapse .
 Control growth changes .

TYPES OF RETENTIVE
APPLIANCES
1. POSITIONERS .
2. HAWELY RETAINERS .
3. LIGUAL RETAINERS .
1. POSITIONERS
Is a custom appliance made of
rubber or pliable acrylic that fits over
the dentition after orthodontic Tx
completion .
 It is designed to :
 Retain teeth in desired position .
 Allows alveolus rebuilding around the
teeth before retainer is given .
 Massage the gingiva .

2. HAWELY RETAINER
It is constructed of clear ,selfpolymerizing acrylic to hold wire
clasps on molar teeth .
 In maxilla it covers the palate ,while
in the mandible it covers the anterior
floor of the mouth .
 It passively hold the teeth after fixed
appliance removal ,also it allows
some tooth movement to close band
spaces & control incisors .

3. LINGUAL RETAINER
It is a cuspid to cuspid fixed
retainer which is fabricated from
light stainless steal wire & bent to
rest against the lingual surface of
the teeth to maintain incisor
position during late growth .
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