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History Of Orthodontics

A Brief Presentation By
Dr. Nilofer & Dr.
Amrita
.
Saint Appolonia
Patron Saint Of Dentistry 15th
Introduction

Even Ancient people wanted straight


teeth since archeologists found crude
metal bands wrapped around
individual teeth .
Also Etruscans buried their people
with appliances to maintain space !
Ancient History Revisited ..
• According to Weinberger there were many
who mentioned crooked teeth namely
Hippocrates {460- 377 BC }
Aristotle {384 -322 BC }
Pliny & Celsus {Christ
contemporaries }
• The first documented evidence of ligature
wire is Gold wire .
• Catgut also surmised to do orthodontic wire
work .
• Aulius Cornelius Celsus 25 BC first to move
.
• First mechanical treatment for correction of
teeth suggested by Gaius Plinius Secundus
…and this was mechanical filing of teeth
• Paul Of Aegenia was first to mention
supernumerary teeth
• First to mention dentistry exclusively was
Pionus Dionis.
• Phillip Pfaff was first to use POP as
impression plaster & mention of casts in
dentistry was first made by Mattheus
Gottfried Purmann in the year 1692 .
• Eugene Solomon Talbot
First used X rays for orthodontic
daignosis
He implicated endocrine glands as
possiple agents for malocclusion.
• Carabelli was the first to analyse
occlusion Kneisel was the first to
attempt Classification of
Malocclusion …and the first and most
widely accepted ( according to
Morrees and Gron still the best !)
classification is Angles Classification
of Malocclusion .
• Joseph Herlock 1742 gave the book “
Practical treatise upon dentition or
the breeding of teeth in children in
london.
• 1757 Bordet dentist to king of france.
Wrote “the dentist’s art “,
Scientifically proved jaw growth, First
to recommend extraction of
premolars.
• Orthodontics is the second oldest medical board
,oldest in dentistry .
• Jacques Lefoulon in1839 was the first to give the
term “Orthodontoise“ in the Article “Orthopedia
Dentaire “ in “ The Gazette des Hopitaux”
• In 1849 Chapin Harris officially called the new branch
Orthodontics in the Dictionary of dental Sciences .
But according to Lischer it was Sir James Murray who
first used the term Orthodontics .
• The term Orthopedics was first used by Bunon in the
year 1743 with regards to correction of teeth .
• According to Masters Of Functional Orthodontics
“orthopedics “ first appeared in the work of Nicolas
Andryde Bois –Regard in 1741.
• Finally A.F. Talma used the terms “Dental Orthopedics
The Dark Ages ..

• In the Dark Ages , Dentistry as a


whole saw great neglect and a
French Dentist named Pierre
Fouchard is credited to have brought
it out of this slump.
Individual Dentists …
Pierre Fouchard
Pierre Fouchard {1678 -
1761 }
FATHER OF MODERN
DENTISTRY …
Achievments
1. First to use the
termSurgeon
Dentist.
2. First to give discussion
on
regulating teeth .
3. Wrote the first book on
Also Fouchard gave the
Bandllete or the first
Kneisel
1. Wrote the book “Der Scheifstand
Der Zahn “
2. First attempt to classify
malocclusion
3. First to advocate use of removable
appliance
4. Introduced modern impression tray .
Norman Willliam Kingsley
FATHER OF ORTHODONTIA
1. Wrote various articles with
353 illustrations .
5. Organised various dental
societies .
6. Was given an Honorary
Degree from Baltimore
College Of dental Surgery
7. In 1859 his first Obturatorwas
a pioneer in Cleft treatments
.
8. Gave the Occipital traction
and Bite planes “to jump the
bite “
9. Did the external
immobilisation of fractures
8. Gave illustration on artificial
replacement on missing parts .
9. Also wrote the book “A Treatise On
Oral Deformities As A Branch Of
Mechanical Surgery “ in 1880.
Wrote a letter to Alumna Society of
Angles School Stating “ The success
of Orthodontia as a science lies in
retention device “
John Nutting
Farrar
2. Father Of American
Orthodontics
3. First volume of basic work “
Treatise On The
Irregularities Of Teeth And
Their Correction “
4. Gave basic concepts of
Biologic tooth movement .
5. His writings were to later
inspire many including
Viggo Andersen whose
Calvin Case (1847
-1923 )1. Contributed vastly to
orthodontic literature .
2. First to try bodily tooth
movement and contouring
apparatus .
3. Suggested the term “Facial
Orthopedics”.( however
1743 Bunon first to use the
term Orthopedics with
regards to correction of
teeth )
4. Staunch supporter of
EXTRACTION if the facial
5. Gave cephalometrics with facial
plaster casts
6. Pioneered use of retainers .
7. With H Baker gave class 2 elastics .
8. Used rubber elastics for treatment .
9. Stressed importance for root
movements .
10.First to use small gauge light resilient
wires for treatment .
11. Helped in Cleft palate rehabilitation .
12.Wrote the book “The Technique And
Principles Of Facial Orthopedics “
13.Had the Great Extraction Debate with
Case’s Contouring Appliance ..
Edward Hartley
Angle !
(1855-1930)
1. Very rightfully “Father Of Modern
Orthodontics “
2. Was strictly against extraction and also
gave the term Malocclusion .
3. In 1880 he invented his "first real
appliance" the jack and traction screw
which marked the beginning of his life
work.
4. Founded Orthodontics as a different branch
of dentistry altogether hence it is one of
the oldest recognised specialities today
This was mainly due to Angle School Of
Orthodontics in St. Louis ,Connecticut in
1900 . And Pasadena in 1920’s
• he believed all of his life a scientific truth, viz:
"That Nature through her own power strives to
build the human denture in accordance with a
well-defined pattern which we call the normal
pattern and varies only as each human being
varies from every other human-and that the
establishment of normal occlusion of the teeth
should be the highest aim of the orthodontist.“
• In 1892 he gave up general practice and
became the first man to specialize in the
teaching and practice of orthodontia. This was
in St. Louis and among his early students were
Dewey, Pullen, Mershon, McCoy, Oppenheim,
Weinberger, Fred Noyes and a host of others
whose names have been familiar in orthodontia
6. In 1887 gave his first book “ The
Angle System Of Regulation And
Retention Of Teeth & Treatment Of
fracture Of Maxilla In Circulation “
7. The 5th and last Edition of this was
in 1901.
8. His first contribution to appliances
was the E-Arch and last was
Edgewise ..
E – Arch
Ribbon Arch
(1916)

Edgewise
(1925)

14.Also Angle gave the Normal


Occlusion Theory
15.The Angle Orthodontist Journal was
The E-Arch ……

• Given in 19000
• Only Molars are
banded
• Ligatures of
o.oo36” – 0.006”
used .
• Heavy forces .
• Only tipping
possible .
Pin and Tube Appliance….
• Given in 1910 .
• Teeth other than
the molars also
banded .
• Vertical tube
soldered to band
and pin to wire
• This pin is
repositioned from
time to time .
• Cumbersome
Ribbon Arch
• Given in 1916
• 0.036” * 0.022 “
rectangular gold
wire held firmly with
pins into vertically
positioned
rectangular slots
• Better spring
qualities .
• First appliance with
3 axis control of
tooth movement .
• Poor root position
control .
Edgewise
• Rotated
rectangular ribbon
arch wire slot by 90
deg (0.022” *
0.028 “).
• It therefore
became a
horizontal slot .
• First to move the
teeth in all 3
planes
simultaneously .
• In 1916 Dr. and Mrs. Angle decided to make their
permanent home in California where they could avoid
the hardships of the Eastern winters. He felt that he
had given enough of his life to teaching in addition to
which his physician had told him that his life
expectancy was not great. He planned to spend the
remainder of his life in the revision of Malocclusion of
the Teeth and in the development of newer and more
efficient orthodontic mechanisms.
• About a year after they were settled in their new home
in Pasadena, a young man by the name of James
Angle [no relation] called upon them. The young man
had recently completed one of Dewey's courses in San
Francisco and wished to meet the man whose name
he bore and who was known as the father of his
chosen profession. He stayed a year, and finally he too
made his home in California. This was the beginning of
Martin Dewey …
1. Product of Angle sschool Of
Orthodontics.
2. In 1915 with Dr. Mosby became editor
of International Journal Of Orthodontics
now American Journal of Orthodontics
and Dentofacial Orthopedics.
3. Dewey School Of Orthodontics 1911.
4. Started American Board Of
Orthodontics in1929 {oldest dental
board of speciality & second oldest in
medical}.
5. Wrote the book “ Practical Orthodontics
Raymond Begg…
• 1889- 1983
• In 1933 developed his
own bracket .
• Begg’s Appliance
consisted of Ribbon Arch
bracket turned upside
down .
• Single stainless steel
arch wire
• Useful for treatment of
extraction cases.
• Introduced auxillary
springs to control root
positions in 1960’s
• And multi loop light wire
• Due to poor finish
combination of twin
edgewise & light wire
technique used .
First using Stainless steel
single strand (0.016”) for
tipping .
Second stage multistrand
(6*0.008” / 4*0.009”) for
general alignment .
Third stage engaging a
Lawrence Andrews ..
• Straightwire Appliance 1970.
• Gave Andrews 6 Keys of Occlusion .
• Extensive measurements of average tip
and torque angles ,in/out dimensions of
each tooth relative to a flat labial arch
wire plane coined Andrews plane .
• Designed individual bracket for each
tooth .so when each preadjusted
bracket positioned correctly on mid
point of each tooth facial axis the
brackets form Straight Wire Appliance.
Milestones And
Development of Functional
Orthopedics
• It started in the late 1700’s & early
1800’s .
• Was propagated essentially by
people who didn’t belong to the
world of dentistry .
• Jean Baptist Pierre de Lamarck
(1744-1829)
• Charles Robert Darwin (1809 -1882)
• Wilhelm Roux (1850 -1924 )
• Julius Wolff (1836-1908)
• John Hunter
• John Hunter published “The Natural History Of
The Human Teeth “ devoting 3 chapters to
malocclusion , Basic theories of Orthodontic
treatment & proposing a classification.
• John Hunter proposed the use of an inclined
silver plane as a jaw bone rest to help correct
dental relations in case of anterior negative
overjet using functional forces generated
muscles .
• L J Catalan he formed the catalans inclined
plane consisting of a metal plate fixed to
mandibular anterior teeth to which were
soldered other little plates inclined towards the
plate to guide eruption of maxillary anterior
teeth anteriorly by muscle action later modified
• The processes of new bone formation on the
pposterior edge of the mandible and
resorption on its anterior edge were later
shown by G Humphry
• Joseph Fox was a student of Hunter
published first English book containing
valuable instructions for correcting
maloccllusions .
• The Natural History Of The Human Teeth
Including a particular Elucidation of the
Changes Which Take Place During The
Second Dentition And To Prevent
Irregularities Of The Teeth 1771 by Joseph
Fox.
• John Nutting Farrar 1839 -1913
• 1873 C Tomes formulated the
concept of balance between the
forces of perioral musculature and
tongue.
• Was also the creator of Chin Cap .
• 1890 Walter Harris Coffin anticipated
the Principles of the functional
Orthopedics (The Coffin Plate ).

• 1825 Joseph Sigmond corelated Habit & malocclusion.
• Maury- Hereditary and rickets as cause of
malocclusion.
• 1834 William Imrie Assigned thumbsucking a role in
malocclusion . He paid great attention to parents
writing the “The Parents Dental Guide “
• 1836 F Kneisel introduced the term Removable
Appliance .
• 1838 First dental college Chapin Haris , Baltimor
Dental School.
• 1839 Rodrigues Abnormal muscular pressure in
eitiology of dental abnormalities.
• Therefore inclined plane had its own historic evolution
from hunter 1778 TO FOX 1803 AND LASTLY
MORTIMER IN 1845.
From Foetal to Birth
• Emerson C Angell expansion bar
using split plate .
• October 26 1902 important date as
Dr P Robin read a paper to the French
Stomatologysociety describing a new
tooth straightening device this was
the BIRTH OF REOVABLE
ORTHODONTICS APPLIANC E
(MONOBLOC)
• European Orthodontic society
• History
• The history of the European Orthodontic Society
• 16th May 1907 Foundation of the European Orthodontic Society by 10 Charter members 27th
September 1907 The first meeting of the Society in Berlin at the Grand Hotel de Russie
President: Dr W G Law
The constitution of the Society was agreed
Dr E H Angle was elected an Honorary Member

• 1914-1919 World War I: No meetings 1931 Co-operation in the Second International Orthodontic
Congress 1939-1946 World War II: No meetings 1952 The 28th Congress of the Society
President: Dr J A C Duyzings
Special event: a regatta was held and a model of a Dutch windmill was presented to the winners
from Belgium.
• 1953 The Dutch Society for the Study of Orthodontics gave to the EOS a
magnificent silver model of a windmill, which was to be presented each year to the winner of the
Silver Mill competition. The Silver Mill competition: A light-hearted competition with a national
flavour which is not too serious but is judged fairly
It is a sport or a game for teams of the different countries represented at the annual congress
The secret is only displayed just before the competition starts, it is a surprise.
Each winner is presented with a certificate with the outline in silver of the Silver Mill
The original Silver Mill resides permanently in the European Orthodontic Society's headquarters in
Hallam Street, London, and its base is inscribed with the names of the winners and the sport.
• 1970 Death of Sheldon Friel: Past President and Honorary Member of the EOS
• 1908 LINGUAL ARCH –John V Mershon,first invisible
appliance also gave LABIO LINGUAL APPLIANCE.
• 1908 Viggo Andersen experimented with removable
retention device for his daughter following active
multiband theory and was surprised to achieve further
clinical improvements calling it ACTIVATOR /
Norwegian system.
• In 1912 Newell gave Vestibular screens .
• In 1914 Alfred Korbitz proposed use of vestibular plate
called lip shaper .
• 1930 STAINLESS STEEL invented.
• 1955 Bunocore etched
• 1956 Frantisek Kraus published a book containing
case reports of patients treated with oral screen which
can be considered as variations on Korbitz Vestibular
• Kraus also reintroduced the Activator in
1930’s but without Coffin Spring /or
other auxilliary element .
• Rolf Frankel functional regulator
(skeletal vestibular plate )
• Alfred Paul Rogers 1929 published
article calling muscles “ living
orthodontic appliances” giving the
theory of myofunctional therapy
• R E moyers did an in depth studt of the
role of orofacialmusculature
,swallowing and gave its classification .
• J A Salzmann 1943 published
principles of orthodontics .
• 1952 Wilhelm Balters gave the
Bionator .
• Functional matrix theory M Moss &
his wife L Salentijn bw 1951- 1960
• 1963 W.R Profitt thesis on pressures
exherted by the tongue on
swallowing and speaking showing
how former was stronger than latter .
The Golden Years …
• From 1930’s to World war II to 1960’s
• Journals published newly conceived
appliances
- Balter’s bionator
- Bimler’s
Gebissformer(elastic occlusal
modeler )
-Klammt’s activator
derived from Andersen’s .
-Frankl’s functional
regulator
• 1930’s Carl Breitner advancment of
jaws by Advancment Plates .
• 1933 Rudolf Hotz “Orthodontists must
not be slave to one method “
• Reider Selmar Olsen from Oslo
University was a young assistant of
Andersen and first to criticise
Norwegian system
• Jurai Bocak treated Class II
malocclusion with activator
• 1936 Curt Scheidt made distinction
between orthodontist and functional
• Arthur Martin Schwarz headed the
criticism of Norwegian system
• Supporters of Norwegian suytem
3. Gustav Korkhaus
4. Erwin Reichanback
5. Leopold Petrick
• meanwhile between 1939
-1940 H Gerlach and H Stockfish were
testing the first open elastic functional
appliance
The War & The Post War Years
• 1949 Arne Bjork created the elastic occlusal
modeler
• In 1950’s studied facial growth
• At this time the Bionator was given
• In 1952 Joseph Eschler deviced the funk-
tionator . Unfortunatly Echler’swork was not
continued by anyone until 1970 -1980 E Witt &
F G Sanders returned to his work .
• More or less contemporay with the funktionator
was Hans Muhlemann Propulsor.
• 1953 Hugo Stockfish deviced the Kinator .
• 1954 H van Thiel created Activator devoid of
Maxillary part .
• Kraus took up study of Vestibular
Plate & Oral Screens
• He caaled his method Inhibition
Therapy
• 1960 Rolf Frankl gave his Functional
Regulator.
1950’s -1960’s
• The work in this decade was greatly
influenced by C J Van Der Klaauwwho
insinuated that the cranium is a
complex of separate and relatively
independent functional parts .
• In early 60’s Micheal Chateau perfected
his four piece appliance .
• 1960 George Klammt student of Bimler
modified his teacher’s appliance to
elastic open activator .
• 1960 J Ahlgren studied EMG activity
of masticatory muscles during
mandibular function & after Activator
therapy.
The Contemporary Period
• 1960 Thomas Rakosi gave the definition of
Cephalometrics .
• 1963 E Grapf discussed alteration of
balanced between the protractor and
retractor muscles caused by Activator.
• 1967 Alexander Petrovick explained his
basic his theories about the different kind of
cartilages involved in Osteogenesis.
• End of 1960 J P Pfeiffer & D Grobety –
Activator + Extraoral Traction .
• 1969 P Stockly & U Teuscher – Activator +
Cervical Traction
• 1969 Jose Dahn published experiences with
Bioactivator.
• Early 1970 A Cerbera presented his C-modeller

• 1972 E P Harvold –Activator + Construction Bite


.
• 1972 Jan Van Limborgstudied the genetic and
environmental factors in controlling craniofacial
growth .
• 1977 William J Clark Twin Block .
• 1977 Hans Pancherz called attention to the
appliance invented by Emil Herbst at the start
of the century .
• 1980 J J Jasper ..Jasper Jumper
• 1986 Peter Kesling TIP EDGE
BRACKET
• Alexander Vardimon perfected
Functional Orthopedic Magnetic
Appliance
• 1989 Jean Michael Salgnac Tongue
Elevator .
• Georgio Maj1951 Y plate
• R Karwetzky 1965 U Bow Activator
“Put your Plaster on the
Table” Charles Tweed …
• Charles H. Tweed applied to the Angle school in Pasadena in
1925 but was refused admittance. Angle told him to study
and to become more serious about orthodontics.
• A letter from Glen Terwilliger describes the course of study
undertaken by Tweed and his classmates. It also gives
insight into orthodontic training during that period in
history. The letter, displayed on the wall at the Charles
Tweed Memorial Center applied again and was
acceptedAngle and Tweed worked closely together for the
last two years of Angle's life. Tweed banded his patients
with an edgewise appliance and Angle acted as the advisor.
The system worked in the following manner: Tweed made
progress records of his patients every 4 months. He packed
the records in a suitcase and took them to Pasadena, where
Angle studied them and outlined a treatment plan for the
next 4 months. This was repeated every 4 months for the
next 2 years. This was a very productive time during
Tweed's education and for the evolving edgewise appliance.
Angle was so pleased with Tweed's work, that he was
• In 1932, Tweed published his first article in The Angle
Orthodontist. It was titled "Reports of Cases Treated with
the Edgewise Arch Mechanism.
• Tweed held to Angle's firm conviction that the practitioner
must adhere to the line of occlusion concept and never
extract teeth. This conviction lasted for 3 years after
Angle's death. After 5 years of orthodontic practice, Tweed
became disheartened with his work for two reasons: (1) the
protrusive faces that he was creating, and (2) the unstable
dentitions. He became so disappointed that he almost left
orthodontics. He resolved to study his many failures and his
few successes by devoting each morning he was in his
office to the making of progress records of his patients.
After studying these records, he came to realize that the
patients who had pleasing facial balance and harmony also
had mandibular incisors that were upright over basal bone.
He selected some failures, extracted first premolars, and
retreated them. He reached the conclusion that carefully
planned extractions allowed him to improve appearance as
• Tweed decided to form a study club. His
first "course" was held as a study club
meeting in 1941. Thirty-six
orthodontists met for instruction at the
first session. The group elected Sam
Lewis to be its president. Copeland
Sheldon was elected secretary-
treasurer. In attendance at the first
meeting were Robert Strang, Cecil
Steiner, Bill Downs, Herb Margolis, Paul
Lewis, and Hays Nance. The same
group met in 1942. Because of World
War II, no meetings were held in 1943,
• His Philosophy included –
Extraction without fear
limiting Expansion
Importance given to
profile .
Positioning of lower incisor
on the
mandibular plane .
But ignored muscle functioning &
• in 1947 that the group proposed the
founding of the Charles H. Tweed
Foundation for Orthodontic Research.

• Angle gave orthodontics the edgewise


bracket, but Tweed gave orthodontists a
way to use it. The orthodontic world beat a
path to his door in Tucson. Tweed, the
innovative and perceptive diagnostician and
master clinician, kept his promise to his
mentor, Edward Angle. He devoted all 42
years of his professional life to the use and
refinement of Angle's invention, the
edgewise appliance.
• One of the first dental specialists to bring the concept of Orthodontics and
specialty dentistry to India.
• In 1999, he was awarded the Lifetime Achievement Award for Clinical
Competence by the Indian Orthodontic Society.
• Consultant to the Indian Armed Forces Medical Services.
• Consultant - Oral Health Expert - World Health Organization.
• Was the Originator of the First WHO Oral Health Day.
• Dr. Mistry has headed many Dental Institutions and has been President of
almost all Dental Organizations in India.
• Past President of the Indian Dental Association at both the State and National
Level.
• Founder Member and Past President of the Indian Orthodontic Society.
• Past President of the Asian Pacific Dental Federation (FDI).
• Past President - International College of Dentists (India & Sri Lanka Section).
• Past President - Zoroastrian Dental Organization
• First Chairman of the Special Committee for Oral Health Promotion of the World
Dental Body, Federation Dentaire International.
• Former Professor and Head of Orthodontics at Govt. Dental College and
Hospital, Mumbai.
• Consultant - Parsee General Hospital, Mumbai.
• Professor Emeritus at the Govt. Dental College and Hospital, Mumbai.
• Former Dean DYP Dental College and Hospital, New Mumbai
• Director DYP Dental College and Hospital, New Mumbai and Member Managing Council Medical and Dental DYP Deemed
University.
• President of the Rotary Club of Bombay North 1900-2000.
• Assistant Governor - Rotary International Dist 3140 (02-03).
• Assistant Trainer - Rotary International Dist 3140 (04-05).
• District Secretary - Rotary International Dist. 3140 (05-06).
• Dr. Mistry has been the recipient of several National and International Awards
• Awarded National Gold Medal and B. C. Roy Award for Medico-Social Relief Work in India - 1984
• Best Citizens Award by the National Council of Metro Citizens 1991.
• Hind Gaurav Award - 1993 by AIAC, New Delhi.
• Asian Pacific Dental Federation Award in 1994 for Originating the concept of the year of Oral Health - 1994.
• Bharat Udyog Award on 16th July 1994 by Shri Krishan Kumar Union Minister of Non-Conventional Energy Services and
Agriculture, for outstanding health work amongst industrial workers,
• Vikas Ratan Award - 1994 from Shri M, Veerappa Molly Chief Minister of Karnataka for enriching Human Values.
• Indian Dental Association Bombay Brave award for Meritorious Service to Dentistry 1994 and 1996.
• "Mother India International Award" in 1995 at the 16th International Conference of Indian and Non-Resident Indians
• The Dental Students Appreciation Award for outstanding guidance and cooperation in 1993, 1996 and 1997.
• The 1997 appreciation Award at the World Congress on Orthodontics.
• The Outstanding Personality Award 1998 from the Management Studies promotion Institute New Delhi.
Materials
• Early 1900 ‘s- 14 to 18 carat gold,
platinum, silver, gum rubber,
vulcanite.
Rarely – wod , ivory, zinc , copper used
for loops hooks and ligature.
ORIGINAL METAL MOUTH REAL GOLD
OR SILVER
• 1935- self ligating wire
conceptualised but not available till
edge lock system in 1972.
• X rays not used routinely till 1950’s
Advances in1970
• Before 1970 braces was wrapped
around teeth then direct bonding
became reality.
• Though brackets were available first but
were not used as adhesives were not
available.
• The first commercially available
adhesive was OIS ADHESIVE SYSTEM
1960( Then it was benzyl peroxide
amine catalyst.)
• 1975 Lingual orthodontics Dr CRAVEN
• With the aid of digital computer
imaging custom brackets can be
made for patients tooth .
• Lingual braces Ceramic brackets
combination
• NASA developed heat activated wires
. They are activated at body
temperatures , they are flexible at
room temp.

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