Changing trends /certified fixed orthodontic courses by Indian dental academy

Changing Trends in Preadjusted
Edgewise system
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

In Andrew’s Original System:
Concerning the 1st
order information: There
is no antirotation system on any tooth, except
a 10° distal offset on upper molars.
Concerning the 2nd
order information:
Teeth of the buccal segments all present a
positive angulation, meaning that they all
have a mesial crown tip, mostly for the 1st
and
2nd
upper molars.www.indiandentalacademy.com

Concerning the 3rd
order information:
On the upper arch:
- The upper incisor only has a 7° torque
- The upper canine has a negative torque of –7,
equal to the torque of the biscuspids.
- The torque if slightly greater on molars.
On the Lower arch:
- The torque on the buccal segments is
progressive from the canines to the 2nd
molars.

Andrew’s system soon got the reputation
of being an “anchorage burning
appliance” - - -
A torque of 7° on central incisors was soon
found to be insufficient, since the play between
archwire and bracket slot, which wasn’t taken
into account, creates important loss of
information during retraction stages and hence
the amount torque necessary to compensate for
the unwanted lingual tipping was clearly
greater than 7°

In 1974, Ronold Roth:
Based on anticipation of relapse during and
after treatment came up with his fully
programmed universal appliance. Thus he
systematically included the information for
over correction in all three planes of space.

Concerning the 1st
order information: All
teeth in the buccal segment – anti rotation
system. Upper molars reinforce distal
offset from 10° to 14° and lower molars 4°
anti-rotation
 Concerning the 2nd
order information :
Canine angulation increased to 11° to 13°
Maxillary buccal segment lose their mesial
tip and are in more anchorage situation.

Concerning 3rd
order information: The torque
on the upper incisors is increased by 5°
- Torque on the upper canines decreased by 5°
- Torque is markedly greater on molars. (-14°
instead of -9°)
On the lower arch :
- Torque on the buccal segments stays identical to
Andrew’s except for a decrease from 35° to 30°
on the second molar which decreases the “rolling
effect” (lingual tip) sometimes noticed with
Andrews’ torque.www.indiandentalacademy.com

After Roth, Terrel Root 1981, proposed
‘Level Anchorage’ - Tweed Phylosophy
a. Medium or regular anchorage
b. Maximum or major anchorage
Removed Roth’s anti-rotation system and
increase the angulation on the lower molars
to 10°

The Mandibular buccal segments are available
with two types of anchorage preparation.
-“ Regular” anchorage with a -4°,-6° and -10°
distal tip respectively on the 2nd
bicuspid, the 1st
molar, and the 2nd
molar.
- “Major” anchorage with a -6 °, -10 ° and -15 °
distal tip respectively on the 2nd
bicuspid, the 1st
molar, and the 2nd
molar.

Wick Alexander :
Combination of Andrew’s and Roth
Hilgers :
- Upper incisors have a considerably
increased torque. 22° for the central incisor,
14 ° for the lateral incisor.
- Upper canine has a 7 ° torque, this creates a
transverse differential of 14 ° between canine
and biscuspid.

Bennett and McLaughlin:
-Combination of Andrew’s and Roth with few
changes
- Anti rotation system was removed, all the
mesial tip has been removed.
-Upper incisors have markedly increased
torque of 17 ° and 10 ° and upper canine -7 °
torque.
-The torque on the lower incisors increase to

Ricketts’ Bioprogresive Therapy :
-Modification of Andrew’s and Roth
-The angulation in buccal segment t is 0°
except for mandibular molar with -5°
-Upper incisor markedly increased torque
22° for the central, 14° for the lateral
-Upper canine has 7° torque

As Summary
-All the above prescriptions globally reflect
the treatment philosophy of their different
authors.
-It will be necessary for the practitioner to
complete the programme by adding
information to the wire.

“Fully Programmed Translation brackets”
by Andrew’s
- These are three sets of information mixed
according to the treatment needs.
-The come in 3 sets bearing values of
angulation, torque and anti rotation

“Minimum translation brackets”

“Medium Translation Brackets”

“Maximum Translation Brackets”

Andrews Roth Alex Root Benett Hilgers
Incisor torque

Andrews Andrews Roth Alex Root Bennett Hilgers
Max
Canine Position

Evolution toward facial type
This evolution is also taking place in
cephalometrics where the notion of mean
now tends to be replaced by growth
considerations. This corresponds to the
need for individualization of information.
Since variability in the morphology of the
facial skeleton necessarily implies
variability in the dento-alveolar
compensations.

SYNERGY INFORMATION SYSTEM –
Rocky Mountain Company: This is
according to the mechanical requirements
depending on facial pattern in the vertical
dimension. The inclination of the upper
incisors varies from 12 ° to 22 ° from
dolichofacial to brachifacial while the
angulation remains identical for the
normofacial

-On the canines 0° torque for the
dolichofacial and mesofacial and positive
torque for the brachifacial.
- For dolichofacial torque values are higher
on the molars to prepare an anchorage.
-Anti rotation values are markedly increased
to 12° on the first molars in mesiofacial and
brachyfacial.

“Dolichofacia”

“Brachyfacial”

Swing Towards Facial Patterns
Normally, the dento-alveolar sysem acts as
a buffer between the skeletal bases, and
adjusts for the best according to sagittal
vertical and transverse discrepancies.
Incorporating dental compensations
according to skeletal relationships, facial
patterns and growth trends

Steiner’s recommended U/L incisor positions
relative to line NA & NB and varied according
to ANB angle.
-10
250
7
220
3.25
00
240
6
230
3.5
10
230
5
240
3.75
20
220
4
250
4
30
210
3
260
4.25
40
200
2
270
4.5
50
190
1
280
4.75
60
180
0
290
5
70
170
-1
300
5.25
80
160
-2
310
5.5

Cl. III Cl. I Cl.II Cl. III Cl. I Cl. II Cl. III Cl. I Cl. II

Maxillary deficiency Normal transverse
relationship
Mandibular deficiency
At the incisor level:

Hypo-maxillia Normo-transversal Hypo-mandibulie
At the Canine Level

Maxillary deficiency Normal transverse
relationship
Mandibular deficiency
At the Molar level:

Thus, In the absence of functional
anomalies:
1. The dento-alveolar compensations
(inclination and angulation) take place in a
coherent way, in accordance with every
single facial type, determined by skeletal
relationships, either established in the
three planes.

2. No matter what technique is used, the
information (torque and angulation) we
apply must also be coherent in the three
planes.
In the sagittal plane, the inclinations (or
torque ) of the incisors must be
coordinated with the angulations of the
buccal segments in a well balanced
dento-alveolar system

•The torque level is high on the
incisors, the angulation values in the
buccal segments, especially on the
canines will be greater.
•On the contrary, if the torque level on
the incisors is low, the angulations in
the buccal segments, especially on the
canines, will be smaller.

In a normodivergent
skeletal pattern with a
Class III tendency on the
upper arch, the high torque
value comes with a higher
positive value of the
angulation in the buccal
segments from the canine of the second molar. On
the lower arch, the lower incisor uprighting of the
canines bicuspids and molars.

On a normodivergent
Class I skeletal pattern,
coherence of 3rd
order
iformation on the
incisors (torque on
inclinations) with the
second order informaiton
in the buccal segments
(inclinations)

On a normodivergent skeletal
pattern with a Class II
tendency, coherence of the 3rd
order information on the
incisors (torque on
inclinations) with the 2nd
order
information in the buccal
segments (angulations).

In this case, the high torque
level on the incisors doesn’t
come with a sufficient
angulation of the buccal
segments; this creates a high
risk of root approximation.

Here, the high level of
torque on the incisors
comes with a sufficient
canine angulation but an
insufficient angulation of
the bicuspids; this creates
an occlusal disturbance
and a risk of root
approximation.

In a normodivergent Class
III skeletal pattern, incisor
angulations are less
pronounced, torque in a
buccal segments will be
more pronounced thus
rather positive.

In a normodivergent Class I
skeletal pattern, coherence
of 2nd
order incisor
information (angulations)
with the 3rd
information in
the buccal segments (torque
or inclinations)

In a normodivergent class
II skeletal pattern, incisor
angulations are more
pronounced, toruqe in the
buccal segments will be
less pronounced thus
rather negative.

Here, the canine has a positive torque, which is
adopted to the transverse skeletal relationships:
if the torque on the bicuspids is not coordinated,
an occlusal dysharmony is creted.

Class III transversal Class I transversal Class II transversal

“A normal face is no longer one where
cephalometric values are closest to the
mean, but one whose cephalometric values
show harmony in their relationships defined
in variable association tables. In this
concept, there is no such thing as a unique
normal face defined by a mean value, there
are a series of normal faces” - J. Dibbets.

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