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APPLIANCE AND MECHANICS
BY
RICHARD P MCLAUGHLIN
JOHN C BENNETT
HUGO J TREVISI
www.indiandentalacademy.com
HISTORY
OVERVIEW OF TREATMENT MECHANICS
APPLIANCE SPECIFICATION
VARITION AND VERSATILITY
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Introduction
•Andrews published his land mark article in 1972 and subsequently
designed an appliance based on his findings.
However , soon after the introduction of pea , it became clear that
the bracket required a whole new program of treatment mechanics
and force levels to fully realize its potential .
•Appliance design and treatment mechanics are closely interrelated .
to some extent ,bracket design can be scientific and based on
research and clinical experience.
• But devolpment of treatment mechanics takes years and have to
based on experience with numerous treated cases .
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FUNDAMENTALS OF TREATMENT MECHANICS
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THE WORK OF ANDREWS
Andrews is regarded as father of pea system
When original swa became available in 1972 , it was based on science
but included many features of siamese edgewise brackets .
Although swa was radically new , traditional heavy forces continued
to be used .
No anchorage control measures .This may have been due andrews
clinical experience as an edgewise orthodontist.
He also emphasiszed wagon wheel effect where tip is lost due to
addition of torgue . henc he chose to add tip to anterior brackets.
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The bracket positioning was based on centre of clinical crown
because less wire bending was needed , there was a trend to standardize
arch form ,
roth recommended broad or square arch form
Andrews continued to use basal bone of mandible as an arch form
reference
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Difficulties with increased tip and heavy forces
resulted in lateral open bite this became to
Known as - “ROLLER COASTER EFFECT”.
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These experience led andrews to introduce a series of modifications
For extraction cases ,canine bracket
anti tip ,anti rotation and power arm
Different incisor bracket for varying degree of torque
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THE WORK OF ROTH
Following his experience with original swa . Roth
Introduced measures to overcome day to day shortcomings .
Roth was anxious to avoid the inventory difficulties of a multiple
bracket system . he therefore recommended a single appliance system
Which will manage both extraction and non extraction cases .
he emphasized the use of articulators for diagnostic records , for early
Splint construction and use of gnathalogical positioners
to get correct condyle position.
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THE WORK OF MCLAUGLIN AND
BENNETT BETWEEN 1975 AND 1993
They worked mainly with standard swa
Instead of initially modifying the basic bracket design , for more
than 15 years they developed and refined treatment mechanics
based on sliding mechanics and continuous light forces .
These mechanics were published initially as series of papers in
early 1990 and then as a book in 1993.
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Also lace backs and bendbacks for early anchorage control
Sliding mechanics on .019 x .025 steel rectangular wires , with light .
014 finishing wires.
Unlike andrews non extraction cases , many patients were children
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THE WORK OF MCLAUGHLIN, BENNETT
AND TREVISI -1993 AND 1997
•Mclaughlin and bennett then worked with trevisi to re design the
entire bracket system to complement their proven philosophy.
•They re-examined andrews original findings and took into account
research input from japenese sources when designing mbt bracket
system.
•This is third generation bracket system , it is a pea specifically for
use with light ,continuous forces, lacebacks and bendbacks and it
was designed to work ideally with sliding mechanics .
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Additional anterior tip was a disadvantage
In roth and swa :
• it created a significant drain on anterio posterior anchorage
• it increased the tendancy to bite deepening during aligment stage
•It brought the upper canine root apex too close to first premolar in some
cases.
• As lighter forces were being used in all stages of treatment this anti tip
or second order compensation wasnot needed in mbt system
•A total of 10 deg less distal root tip in upper ant segment and 12 deg
less tip in lower ant segmentis needed.
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THE PEA SYSTEM IS A DEVELOPMENT OF EDGEWISE
BRACKET WHICH IS RELATIVELY INEFFIENCENT IN
DELIVERING TORGUE.
SO IN MBT SYSTEM IT WAS NECESSARY TO BUILD EXTRA
TORQUE IN INCISOR AND MOLAR REGION .
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UPPER CANINE BRACKET WOULD BE AVAILABLE WITH 7, 0
-7 DEG FOR LOWER CANINE 6, 0 AND –6 DEG .
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THE WORK OF MCLAUGHLIN ,BENNETT,AND
TREVISI BETWEEN -1997 AND 2001
It became nessecary to address the subjects of arch wire selection and
force levels
Although an ovoid arch form had proved useful in the early years
three basic arch form tapered , square and ovoid would be of use.
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OVERVIEW OF MBT TREATMENT PHILOSPHY
•BRACKET SELECTION
•VERSATILITY OF BRACKET SYSTEM
• ACCURACY OF BRACKET POSITIONING
• LIGHT CONTINOUS FORCES
• THE .022 VERSUS .018
•ANCHORAGE CONTROL EARLY IN TREATMENT
• GROUP MOVEMENT
•THE USE OF THREE ARCH FORMS
• ONE SIZE OF RECTANGULAR STEEL WIRE
• ARCHWIRE LIGATION
• AWARENESS OF TOOTH SIZE DISCREPANCIES
• PERSISTENCE IN FINISHING
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Bracket selection
Standard metal , mid sized and clear bracket
Versatility of bracket system
To control inventory costs and avoiding needless wire bending.
Accuracy of bracket positining
gauges and individual bracket reposition charts are recommended.
Light continous forces
No clear defination and quantification .
Use of active tie backs , and .014 finishing wires.
.022 vs .018 slot
.022 is better as allows more freedom of movement of wires with
sliding mechanics.
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A
A
A
A
ANCHORAGE CONTROL EARLY IN TREATMENT
-Reduced tip ,
-light wire forces.
LACEBACKS AND BENDBACKS
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GROUP MOVEMENT
Crowding is resolved and then anterior segment moved as enmasse as
group of six or eight anterior teeth
The use of three arch forms
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ONE SIZE OF RECTANGULAR STEEL WIRE
.019X.025
THEORETICALLY , THERE IS APPROX 10 DEG OF SLOP , BUT
CLINICALLY WIRE PERFORMS BETTER DUE TO THE
RESIDUAL TIP IN WIRE
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www.indiandentalacademy.com
APPLIANCE SPECIFICATION
VARIATION AND
VERSATILITY
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ARCH WIRE HOOKS
• METHOD OF LIGATION
•PERSISTANCE IN FINISHING
•.014 WIRE AND BENDS IN WIRE IN FINAL STAGES
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DESIGN FEATURES OF MODERN BRACKET SYSTEM
RANGE OF BRACKET SYSTEM .
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RHOMBOIDAL SHAPE
REDUCES BULK OF EACH BRACKET
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TORQUE IN BASE THE COMPUTER AIDED DESIGN
FULL SIZE AND CLEAR - TORQUE IN BASE
MID SIZE- TORQUE IN FACE AND IN BASE COMBINATION
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IN OUT SPECIFICATION
UPPER SECOND PREMOLARS HAVE SMALL CROWNS
A BRACKET WHICH IS 0.5mm THICK
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TIP SPECIFICATION
EXPRESSION OF TIP
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www.indiandentalacademy.com
TORQUE SPCEFICATION
TORQUE IS NOT FULLY EXPRESSED IN PEA
SMALL AREA OF TORQUE APPLICATION
DUE TO SLOP OF 10 DEG
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INCISOR TORQUE
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CANINE TORQUE
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UPPER PREMOLAR AND MOLAR TORQUE
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LOWER PREMOLAR AND MOLAR TORQUE
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THE VERSATILITY OF BRACKET SYSTEM
SEVEN MAIN VERSATILITY FEATURES
• OPTIONS FOR PALATALLY DISPLACED LATERAL INCISOR
•THREE TORQUE OPTIONS FOR UPPPER CANINE
• THREE TORQUE OPTIONS FOR LOWER CANINE
• INTERCHANGEABLE LOWER INCISOR BRACKETS
• INTERCHANGEBLE UPPER PREMOLAR BRACKET
• USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLAR
IN NON HG CASES
• USE OF LOWER SECOND MOLAR TUBES FOR UPPER FIRST
AND SECOND MOLARS OF OPPOSITE SIDE
www.indiandentalacademy.com
PALATALLY DISPLACED LATERAL INCISOR
www.indiandentalacademy.com
TORQUE OPTIONS FOR UPPER CANINE
LOWER CANINE
www.indiandentalacademy.com
INTERCHANGEBLE LOWER INCISOR BRACKET
UPPER PREMOLAR BRACKET
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USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLARS
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USE OF LOWER SECOND MOLAR TUBES FOR THE FIRST
AND SECOND MOLARS OF THE OPPOSITE SIDE
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THANK YOU
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MBT appliance and mechanics

  • 1. APPLIANCE AND MECHANICS BY RICHARD P MCLAUGHLIN JOHN C BENNETT HUGO J TREVISI www.indiandentalacademy.com
  • 2. HISTORY OVERVIEW OF TREATMENT MECHANICS APPLIANCE SPECIFICATION VARITION AND VERSATILITY www.indiandentalacademy.com
  • 3. Introduction •Andrews published his land mark article in 1972 and subsequently designed an appliance based on his findings. However , soon after the introduction of pea , it became clear that the bracket required a whole new program of treatment mechanics and force levels to fully realize its potential . •Appliance design and treatment mechanics are closely interrelated . to some extent ,bracket design can be scientific and based on research and clinical experience. • But devolpment of treatment mechanics takes years and have to based on experience with numerous treated cases . www.indiandentalacademy.com
  • 4. FUNDAMENTALS OF TREATMENT MECHANICS www.indiandentalacademy.com
  • 5. THE WORK OF ANDREWS Andrews is regarded as father of pea system When original swa became available in 1972 , it was based on science but included many features of siamese edgewise brackets . Although swa was radically new , traditional heavy forces continued to be used . No anchorage control measures .This may have been due andrews clinical experience as an edgewise orthodontist. He also emphasiszed wagon wheel effect where tip is lost due to addition of torgue . henc he chose to add tip to anterior brackets. www.indiandentalacademy.com
  • 6. The bracket positioning was based on centre of clinical crown because less wire bending was needed , there was a trend to standardize arch form , roth recommended broad or square arch form Andrews continued to use basal bone of mandible as an arch form reference www.indiandentalacademy.com
  • 8. Difficulties with increased tip and heavy forces resulted in lateral open bite this became to Known as - “ROLLER COASTER EFFECT”. www.indiandentalacademy.com
  • 10. These experience led andrews to introduce a series of modifications For extraction cases ,canine bracket anti tip ,anti rotation and power arm Different incisor bracket for varying degree of torque www.indiandentalacademy.com
  • 12. THE WORK OF ROTH Following his experience with original swa . Roth Introduced measures to overcome day to day shortcomings . Roth was anxious to avoid the inventory difficulties of a multiple bracket system . he therefore recommended a single appliance system Which will manage both extraction and non extraction cases . he emphasized the use of articulators for diagnostic records , for early Splint construction and use of gnathalogical positioners to get correct condyle position. www.indiandentalacademy.com
  • 14. THE WORK OF MCLAUGLIN AND BENNETT BETWEEN 1975 AND 1993 They worked mainly with standard swa Instead of initially modifying the basic bracket design , for more than 15 years they developed and refined treatment mechanics based on sliding mechanics and continuous light forces . These mechanics were published initially as series of papers in early 1990 and then as a book in 1993. www.indiandentalacademy.com
  • 15. Also lace backs and bendbacks for early anchorage control Sliding mechanics on .019 x .025 steel rectangular wires , with light . 014 finishing wires. Unlike andrews non extraction cases , many patients were children www.indiandentalacademy.com
  • 16. THE WORK OF MCLAUGHLIN, BENNETT AND TREVISI -1993 AND 1997 •Mclaughlin and bennett then worked with trevisi to re design the entire bracket system to complement their proven philosophy. •They re-examined andrews original findings and took into account research input from japenese sources when designing mbt bracket system. •This is third generation bracket system , it is a pea specifically for use with light ,continuous forces, lacebacks and bendbacks and it was designed to work ideally with sliding mechanics . www.indiandentalacademy.com
  • 17. Additional anterior tip was a disadvantage In roth and swa : • it created a significant drain on anterio posterior anchorage • it increased the tendancy to bite deepening during aligment stage •It brought the upper canine root apex too close to first premolar in some cases. • As lighter forces were being used in all stages of treatment this anti tip or second order compensation wasnot needed in mbt system •A total of 10 deg less distal root tip in upper ant segment and 12 deg less tip in lower ant segmentis needed. www.indiandentalacademy.com
  • 19. THE PEA SYSTEM IS A DEVELOPMENT OF EDGEWISE BRACKET WHICH IS RELATIVELY INEFFIENCENT IN DELIVERING TORGUE. SO IN MBT SYSTEM IT WAS NECESSARY TO BUILD EXTRA TORQUE IN INCISOR AND MOLAR REGION . www.indiandentalacademy.com
  • 20. UPPER CANINE BRACKET WOULD BE AVAILABLE WITH 7, 0 -7 DEG FOR LOWER CANINE 6, 0 AND –6 DEG . www.indiandentalacademy.com
  • 22. THE WORK OF MCLAUGHLIN ,BENNETT,AND TREVISI BETWEEN -1997 AND 2001 It became nessecary to address the subjects of arch wire selection and force levels Although an ovoid arch form had proved useful in the early years three basic arch form tapered , square and ovoid would be of use. www.indiandentalacademy.com
  • 23. OVERVIEW OF MBT TREATMENT PHILOSPHY •BRACKET SELECTION •VERSATILITY OF BRACKET SYSTEM • ACCURACY OF BRACKET POSITIONING • LIGHT CONTINOUS FORCES • THE .022 VERSUS .018 •ANCHORAGE CONTROL EARLY IN TREATMENT • GROUP MOVEMENT •THE USE OF THREE ARCH FORMS • ONE SIZE OF RECTANGULAR STEEL WIRE • ARCHWIRE LIGATION • AWARENESS OF TOOTH SIZE DISCREPANCIES • PERSISTENCE IN FINISHING www.indiandentalacademy.com
  • 24. Bracket selection Standard metal , mid sized and clear bracket Versatility of bracket system To control inventory costs and avoiding needless wire bending. Accuracy of bracket positining gauges and individual bracket reposition charts are recommended. Light continous forces No clear defination and quantification . Use of active tie backs , and .014 finishing wires. .022 vs .018 slot .022 is better as allows more freedom of movement of wires with sliding mechanics. www.indiandentalacademy.com
  • 25. A A A A ANCHORAGE CONTROL EARLY IN TREATMENT -Reduced tip , -light wire forces. LACEBACKS AND BENDBACKS www.indiandentalacademy.com
  • 26. GROUP MOVEMENT Crowding is resolved and then anterior segment moved as enmasse as group of six or eight anterior teeth The use of three arch forms www.indiandentalacademy.com
  • 27. ONE SIZE OF RECTANGULAR STEEL WIRE .019X.025 THEORETICALLY , THERE IS APPROX 10 DEG OF SLOP , BUT CLINICALLY WIRE PERFORMS BETTER DUE TO THE RESIDUAL TIP IN WIRE www.indiandentalacademy.com
  • 30. ARCH WIRE HOOKS • METHOD OF LIGATION •PERSISTANCE IN FINISHING •.014 WIRE AND BENDS IN WIRE IN FINAL STAGES www.indiandentalacademy.com
  • 31. DESIGN FEATURES OF MODERN BRACKET SYSTEM RANGE OF BRACKET SYSTEM . www.indiandentalacademy.com
  • 32. RHOMBOIDAL SHAPE REDUCES BULK OF EACH BRACKET www.indiandentalacademy.com
  • 33. TORQUE IN BASE THE COMPUTER AIDED DESIGN FULL SIZE AND CLEAR - TORQUE IN BASE MID SIZE- TORQUE IN FACE AND IN BASE COMBINATION www.indiandentalacademy.com
  • 34. IN OUT SPECIFICATION UPPER SECOND PREMOLARS HAVE SMALL CROWNS A BRACKET WHICH IS 0.5mm THICK www.indiandentalacademy.com
  • 35. TIP SPECIFICATION EXPRESSION OF TIP www.indiandentalacademy.com
  • 37. TORQUE SPCEFICATION TORQUE IS NOT FULLY EXPRESSED IN PEA SMALL AREA OF TORQUE APPLICATION DUE TO SLOP OF 10 DEG www.indiandentalacademy.com
  • 41. UPPER PREMOLAR AND MOLAR TORQUE www.indiandentalacademy.com
  • 42. LOWER PREMOLAR AND MOLAR TORQUE www.indiandentalacademy.com
  • 43. THE VERSATILITY OF BRACKET SYSTEM SEVEN MAIN VERSATILITY FEATURES • OPTIONS FOR PALATALLY DISPLACED LATERAL INCISOR •THREE TORQUE OPTIONS FOR UPPPER CANINE • THREE TORQUE OPTIONS FOR LOWER CANINE • INTERCHANGEABLE LOWER INCISOR BRACKETS • INTERCHANGEBLE UPPER PREMOLAR BRACKET • USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLAR IN NON HG CASES • USE OF LOWER SECOND MOLAR TUBES FOR UPPER FIRST AND SECOND MOLARS OF OPPOSITE SIDE www.indiandentalacademy.com
  • 44. PALATALLY DISPLACED LATERAL INCISOR www.indiandentalacademy.com
  • 45. TORQUE OPTIONS FOR UPPER CANINE LOWER CANINE www.indiandentalacademy.com
  • 46. INTERCHANGEBLE LOWER INCISOR BRACKET UPPER PREMOLAR BRACKET www.indiandentalacademy.com
  • 47. USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLARS www.indiandentalacademy.com
  • 48. USE OF LOWER SECOND MOLAR TUBES FOR THE FIRST AND SECOND MOLARS OF THE OPPOSITE SIDE www.indiandentalacademy.com