very time consuming and it took hours to get fixed appliances onto a patient.
In 1970, Lawrence Andrews developed the preadjusted edgewise appliance which is still popular today, and this changed much in orthodontics. The difference with this appliance was that the brackets were made for each specific tooth and contained prescriptions such as in and out, tip and torque within the bracket. These prescriptions all helped with tooth movement and reduced the need for wire bending. Today these prescription brackets are available with different angulations, slot sizes and base types.
Aesthetic brackets first become available in 1963, which are very popular today, as are lingual appliances, the first of which were developed in the 1980s. Since then a wide range of different systems have been developed by orthodontists, including the standard edgewise appliance, Begg appliance, tip edge appliance, preadjusted edgewise appliance, self‐ligating appliance, and the lingual appliance system. We will look at each of these in turn.
1.2 Standard Edgewise Appliance
Edward Angle (1855–1930):
Developed the standard edgewise appliance in 1925.
Was an American dentist and was known as the ‘Father of orthodontics’.
Attended Pennsylvania College of Dental Surgery and qualified in 1878 as a dentist.
Founded the Angle School of Orthodontia in 1890, where orthodontics become known as a specialism.
Angle’s classification of malocclusion that we use today was developed by him in 1890.
Established many appliances within his lifetime, such as the E arch appliance (1907), the pin and tube appliance (1910), the ribbon arch appliance (1915) and the edgewise appliance (1925).
In 1930 he died at the age of 75.
Figure 1.1 Standard edgewise bracket. The same bracket is used for every tooth which contains a passive bracket slot with no inbuilt prescription.
Figure 1.2 First‐, second‐, and third‐order bends.
Standard edgewise appliance (Figure 1.1):
The design of the bracket was the same for every tooth which had a passive bracket slot.
All brackets were rectangular in shape.
The size of the bracket was determined by the width of the bracket slot.
The brackets came in two different sizes:Width usually 0.018 or 0.022 in.Depth usually 0.025 or 0.028 in.
The appliance had three‐dimensional control of the teeth.
To aid tooth movement all archwires were dependent on bends being added. However, this was time consuming and difficult for the orthodontist, as it was required at every visit.
The bends created were to achieve the following (Figure 1.2):First‐order bend – in and out:To compensate for the different tooth widths, bends are placed in the horizontal plane of the archwire.The bends correct the tooth widths in the bucco‐lingual and labial‐palatal direction (anterio‐posterior [AP] plane – anterior/posterior movement, front to back).For example: in modern‐day orthodontics, central incisors are always slightly in front of the lateral incisors, which sit slightly back. Canines sit in the same anterio‐posterior position as the central incisors, which helps to create the canine eminence (corner of the mouth).Second‐order bend – tip:To compensate and correct the angulation of the teeth, bends are placed in the vertical plane to achieve the correct mesiodistal angulation of the teeth.For example: distally angulated laterals would need bends to help upright the laterals mesially, which ensures that teeth gain the desired angulation.Third‐order bend – torque (rectangular wire only):This is achieved with rectangular archwires only.Orthodontists would place a bend in the archwire to help correct the torque of the roots.For example: buccal root torque is achieved by the archwire being twisted forwards; palatal root torque is achieved by the archwire being twisted backwards.
Closing loops were placed within the archwire and used as a method of space closure.
This system placed a high demand on anchorage.
Tooth movement can be effected due to the inter‐bracket span, the distance between the brackets:Narrow brackets (more span): a greater span of the archwire between the brackets has the ability to make the archwire more flexible, which can achieve faster alignment.Wider brackets (less span): a reduced span of the archwire between the brackets is more efficient for de‐rotation and mesiodistal control of teeth.
1.3 Begg Appliance
P. Raymond Begg (1898–1983):
Developed the Begg appliance in the 1950s.
An Australian dentist.
Attended the Angle School of Orthodontia in Pasadena, California in 1924 and was one of the first at the school to treat patients with the standard edgewise appliance.
In 1925 he travelled back to Adelaide, South Australia to treat his own patients in orthodontics.
Became a professor at the University of Adelaide.
Was also known to develop the Australian orthodontic wires.
In 1980 he retired and then died in 1983.
Begg appliance (Figure 1.3):
This appliance was designed to overcome the high anchorage demand of the standard edgewise appliance and is a light anchorage appliance.
Another name for the Begg appliance is the lightwire appliance.
The components of the appliance are the bracket, pin, and archwire.Figure 1.3 A Begg appliance. The components of the bracket are labelled.Figure 1.4 How the Begg appliance works. (a) The teeth are tipped into the desired position by the use of inter‐maxillary elastics. The lines on the photograph show the inclination of how the upper and lower teeth sit. (b) The roots of these teeth are uprighted by the use of auxiliary springs.
To ensure full engagement of the archwire, the pin is used to hold the archwire within the bracket slot.
The appliance
