HISTORY OF

ORTHODONTICS

Contents
Part I
Introduction
History of Dentistry
Evolution of Orthodontics
Historical perspective of biophysical
aspects.
American Orthodontics Pre-Angle Era.
Angle Era

Introduction
The heritages of the past are the
seeds that bring forth the harvest
of the future
Awareness of our historical antecedents
has acquired more importance today,
since changes are occurring so rapidly,
that only by keeping our eyes steady
on what went before can we progress
with intelligence & confidence.

Not to know what has been

transacted in former times is to
continue always as a child. If no
use is made of the labors of the
past ages, the world must
remain
in
the
infancy
of
knowledge.
- Cicero, the great Roman orator

History of Dentistry
From the earliest times, humans have been
plagued by dental problems & have sought
a variety of means to alleviate them.
First dental healers were physicians.
Middle ages Barber-surgeons of Europe.
Learned by trial & error & observation.

Pierre Fauchard through his treatise

Le Chirurgien dentiste established
dentistry as a true profession.
No longer mired in superstition &
ignorance, the field was based at
last on sound rational & scientific
principles.

Baltimore College
of Dental Surgery

first
dental
college
in
the
world opened its
doors to a class of
5 students on Nov
3rd, 1840.

Evolution of the first

dental specialty
Orthodontics

Orthodontics is that branch of

dentistry concerned with the study of
growth of the craniofacial complex,
the development of occlusion & the
treatment of dentofacial anomalies.
Weinberger points out that there had
been an awareness of unsightly
appearance of crooked teeth

 Hippocrates (460-377B.C.) among the first

to comment about craniofacial deformity.

Among those individuals with long-shaped

heads, some have thick necks, strong
parts & bones. Others have strongly
arched palates, their teeth are irregularly
arrayed, crowding one another & they are
bothered by headaches & otorrhea.

 Adamandios (5th century A.D.)

Those persons whose lips are pushed out
because of cuspid displacement are illtempered, abusive shouters & defamers.
Celsus (25B.C.) advocated that persistent
deciduous teeth should be extracted &
that permanent teeth which erupt in the
wrong direction ought to be corrected by
finger pressure.

 Celsus
advise
mentioned in Artzney
Buchlein the oldest
dental
text
book
(1530).
If
a
second
tooth
should happen to grow
in children before the
first has fallen out,
that which ought to be
shed is to be drawn
out & the new one
daily pushed towards
its place by means of
the finger until it
arrives at its proper
position.

When in a child a
permanent
tooth
appears before the
fall of milk tooth, it is
necessary to dissect
the gum all around
the latter & extract
it; the other tooth
must then be pushed
with the finger, day
by day toward the
place
that
was
occupied by the one
extracted & this is to
be continued until it
has finally reached
its proper position.

 First mechanical treatment for correcting

irregularities suggested by Gaius Plinus
Secundus (Pliny) (23-79A.D.) advocated
filing of elongated teeth to produce proper
alignment.

Specimens dating
back to VIII century
B.C.
indicate
Etruscans
may
have been the first
people to employ
orthodontic bands
to improve tooth

Crude appliances designed to

regulate teeth have been found as
archaeologic artifacts in tombs of
ancient Egypt, Greece & the
Mayans of Mexico.

John Hunter (1728-1793)

Greatest surgeon of
18th century.
Detailed
study
of
mouth
&
jaws
of
cadavers.
1771- The Natural
History of the Human
Teeth: Explaining their
Structure,
Use,
Formation, Growth &
Diseases.

 Exceptionally
accurate plates.
Perfect understanding
of
growth
&
development of jaws
& their relations to
the
muscles
of
mastication.
Scientific
nomenclature

Incisors, Cuspids &

Bicuspids.

Disapproved extracting primary teeth

to permit permanent teeth to erupt.
But advocated first permanent molar
is tooth to be sacrificed if insufficient
room in the jaw for all teeth.
Maintained that teeth do not grow
throughout life time, only appear
longer because antagonist is missing.

 Orthodontics, as we think
of it today, has its root in
France in 18th century
when Pierre Fauchard
(1728) Father of
Dentistry described an
orthodontic appliance
Bandlette later known as
expansion arch.
Orthodontia derived from 2
Greek words
Orthos Right/Correct.
Dons Tooth

Term introduced by
Frenchman LeFoulon in
1839.

 1880 Norman Kingsley Father of

Orthodontics published Treatise on Oral
Deformities as a Branch of Mechanical
Surgery.
1888 John N. Farrar Treatise on the
Irregulations of Teeth & their Correction.
1889 Superseded by Simeon Guilfords
Orthodontia Standard text in dental
colleges.

 Emergence of orthodontics as a true

specialty was the result of dominant,
dynamic & influential leadership of
Edward H. Angle (1855-1930) The
Father of Modern Orthodontics.
Angle was embittered with dental
schools, dental school politics &
domination of the schools by the
operative & prosthetic departments.

Though he taught prosthetics he

found the mechanical procedural
aspects stultifying.
How could the moulding, guiding
biologic science of orthodontia for
children be thrown together with
artificial replacements for the elderly?
1901

American
Society
of
Orthodontics was established.

 Constitutions first article confirmed the name.

Second article to establish the science of
orthodontia as a distinct dental specialty.
Not until orthodontia is studied & practiced as
a distinct branch of dentistry will it ever obtain
the success it deserves. There should be a
specialist in orthodontia in every city & town of
any size; & the general practitioner should send
to the specialist freely.
- Angle before Nebraska Dental Society in May
1890.

 Angle urged one of his young

disciples Dr. Charles Tweed to
1. Dedicate
his
life
to
the
development
of
edgewise
appliance.
2. To make every effort to establish
orthodontics as a specialty within
the dental profession.

 Dr. Tweed launched a one-man blitz by

canvassing & arousing patients, persuading
dentists, influencing politicians, speaking at
meetings, having petitions signed & taking
patients before the legislature.
1929 Arizona legislature passed the first
law limiting the practice of orthodontics to
specialists.
Dr. Tweed received Arizonas Certificate
No. 1 & became the first certified specialist
in orthodontics in United States.

Historical Perspective of
the Biophysical Aspects
1863 Harris Orthodontic
tooth movement is a result of
bone resorption on one side
& bone deposition on the
other side of the root.

Supported by Talbot (1888), Guilford

(1896).
Kingsley (1877) supported by Farrar
(1888) claimed that bending of
alveolar bone would take place during

Theories
based
on
clinical
observation & macroscopic studies.
Sandstedt - First histological study
of the problem of tooth movement.
Importance of his observations on
hyalinization
&
undermining
resorption appreciated only 10 yrs
later.

 Most important in development of

orthodontic thinking- Albin Oppenheim
(1911) disciple of E.H. Angle.
Refuted Walkhoffs pressure theory
overcoming the tension of bone by
strong pressure for a very short time.
Oppenheims
investigations
with
Angles appliances won recognition
throughout the world.

Orthodontic treatment regarded as

tantamount to an artificially effected
resorption & deposition of bone.
Schwarz recognized the intimate
relationship of force magnitude &
tissue response.
He classified orthodontic forces in 4
degrees of biological efficiency.

Immense practical importance of tissue

reaction to orthodontic treatment
highlighted by Ketchams observations
on root resorption subsequent to
treatment with orthodontic appliances.
German-speaking
&
American
orthodontists reacted differently to the
findings leading to a parting of ways.

In the United States

Pathologic effects of orthodontic
therapy recognized.
Heavy rigid appliances abandoned
for resilient & efficient devices.
E.H.
Angle
dominated
the
orthodontic scene in U.S. more
than any one person in Europe.

In Europe
Early leaders studied more the role
of craniofacial skeleton in dentofacial
anomalies and malocclusion.
So orthodontics referred in Europe
as
- Orthopedics
- Orthopedie dentofaciale

Development of American
Orthodontics The PreAngle Era

First scientific attempt

at tooth movement by Pierre Fauchard
using the Bandlette
Flat strip of metal
formed into an arch.
Pierced with holes
for tying teeth with
threads.

Simple anchorage.
Tipping movement.
Lacked stability.
No effective way to firmly fix it in
position on the teeth.

Etienne Bourdet (17221789)

Fauchards follower.
Advocated
extraction
of first bicuspids to
alleviate overcrowding.
Described shifting of
misaligned teeth into
place
by
attaching
them with threads to a
splint of ivory.

1841Schange
a
Frenchman
invented the adjustable clamp band
with introduction of a lingual screw.

1846 Tucker described the use of

rubber elastics though no importance
given until Case & Baker used it to
provide
intermaxillary
force
&
intermaxillary anchorage in 1893.

1861 Coffin introduced flexible

piano wire.
1861 Kingsley introduced the
headgear to apply extraoral force
& provide occipital anchorage.

Norman Williams Kingsley

(1829-1913)
Orthodontias
greatest
genius E.H. Angle.
Born on 2nd Oct 1829.
Joined Dr. A.W. Kingsley,
Pennsylvania.
1852 first office in
Oswego, New York.
1859 made his first
obturator.
Prosthetic restorations for
cleft patients - restored
normal speech, improved
facial appearance.

 1865 founder & first dean of New

York University College of Dentistry.
1871

Honorary
degree
from
Baltimore College of Dental Surgery.
1880 A Treatise on Oral Deformities
as a Branch of Mechanical Surgery.
Cleft palate prostheses.
Artificial replacement of missing parts.
External immobilization.

 Over 100 articles on

Cleft palate rehabilitation.

Inadequacies of cleft palate surgery.
Obturators.
Orthodontic diagnosis.
Orthodontic appliances.

1880 described his plate for jumping the

bite forerunner of modern functional
appliances.
Early awareness of orthodontic potential for
adults patients.

Practice of orthodontics altered

forever with the invention of
dental cement by Magill of Erie,
Pennsylvania.

In this period
Treatment

modalities
formulated
without
benefit
of
scientific
methodology.
Goal of treatment improved cosmetics.
No consideration to occlusal function or
biological concepts.
Injudicious extractions.
Controlling factors in appliance design
- Ease of appliance manipulation.
- Patient management.

The Angle Era

Most dominant, dynamic &
influential
figure
in
orthodontics

Edward
Hartley Angle (1855-1930).
Father
of
Modern
Orthodontics.
Born
on
a
farm
in
Pennsylvania on June 1st,
1855 fifth of seven
children.
Never
an
outstanding
student in book-learnin
Marked ability to improve &
create
mechanical
equipment on the farm.
Developed a passion for
simplicity in design.

 Apprenticed himself to a dentist at his

mothers request.
1878- Graduated from Pennsylvania
College of Dentistry.
Being at heart an inventor, the field of
general dentistry offered little interest
in original mechanical investigation.
Angle became keenly interested in
orthodontics.

Experienced
many
technical
problems
&
frustrations
in
treatment
which
irritated,
motivated & inspired him to
develop a standard appliance.

 5 properties of an ideal orthodontic

appliance1. SIMPLE Push, Pull & Rotate
2. STABLE Fixed to teeth.
3. EFFICIENT Based on Newtons 3rd law
of anchorage.
4. DELICATE Accepted by tissues.
5. INCONSPICUOUS

Esthetically
acceptable.

 1880 First real appliance the jack & traction screw with pushing action.

Combination of adjustable clamp band of Schange & regulating screw of Dwinelle.

1887
System.

introduced

the

Angle

1887 Appointed to chair of

orthodontia in dental department of
University of Minnesota.
Read his paper, Notes on Orthodontia
with a New System of Regulation &
Retention at 9th International Medical
Congress.
1887 Ohio Journal of Dental Science.

1888 Lecture to Iowa State

Dental Society demonstrated
expansion arch & its auxiliaries.
1894 Professor of Orthodontia
at Marian Sims College, receiving
MD degree the following year.
Concepts of Prosthetic occlusion
developed in the late 1800s.

 The best balance, the best harmony, the

best proportions of the mouth in its
relation to the other features require that
there shall be a full complement of teeth
& that each tooth shall be made to occupy
its normal position - i.e. normal occlusion.
Angle
developed
classification
of
malocclusion based on this principle
Dental Cosmos in 1899.

Angles postulates
Upper first molars are the key to occlusion.
Most
remarkably
stable
landmark

in

craniofacial anatomy upper first molars.

Upper & lower molars should be related so
that the mesiobuccal cusp of the upper molar
occludes in the buccal groove of the lower
molar.
Line of occlusion The line with which, in form
& position according to type, the teeth must be
in harmony if in normal occlusion.

Angles
classes:

classification

has

On being asked about his discovery

of the constancy of the upper first
molar Angle said I though about it
& I thought about it & all at once it
came to me. Anybody who disagrees
with me must be a fool.
Angle was influenced by Rousseau
& the German physiologist Wolff.

 Rousseau emphasized the perfectability of

man.
This led Angle to believe that every person
has the potential for an ideal relationship of
all 32 natural teeth.

 German physiologist Wolff discovered in early 1900s that

the internal architecture of bone responds to stresses
placed on that part of the skeleton.

So Angle reasoned that if the teeth were placed in proper

occlusion, forces transmitted to the teeth would cause
bone to grow around them & stabilize them even if a
great deal of arch expansion had occurred.

Angle consulted the famous artist of

the day Professor Wuerpel for the
ideal facial form.
Wuerpel ridiculed that it is impossible
to specify any one facial form as ideal.
Hence Angle concluded that the ideal
facial esthetics for a person would
result when the teeth were placed in
ideal occlusion for that person.

 Angle stated The idea of a postgraduate

school was forced upon me because I
wished to see those who had a desire to
study orthodontia better receive the
opportunity to do so.
Angle had commenced informal instructions
in orthodontia in his office in 1900.

He placed the following advertisements for

the Angle School of Orthodontia
For the fitting of teachers & specialists in
orthodontia. Two short sessions are held
each year, beginning Nov 1st & May 1st.
Postgraduates in dentistry & only those
thoroughly ethical, received. Class limited
to 15 members. For information, address
Edward H. Angle, MD, DDS, 1107 North
Grand Ave., St. Louis, Mo.

Course of instruction included art,

rhinology,
embryology,
histology,
comparative
anatomy
&
dental
anatomy in addition to Angles
appliances.
Among his early students were
Dewey, Pullen, Mershon, McCoy,
Oppenheim, Weinberger & Fred
Noyes.

In May 1900 at a banquet in Dr.

Angles office, the students &
teachers decided that the time was
ripe for an Orthodontic Society.
Thus was born The American
Society of Orthodontists.
On June 11, 1901, 10 charter
members elected Angle as president.

The constitution of the society had

these 3 articles 1st confirmed the
name
2nd to establish science of
orthodontia as a distinct dental
specialty.
3rd invited ethical dentists with a
special interest in orthodontia to
become active members.

In his presidential speech, Angle

paid his respects to Norman Kingsley,
John Farrar, Simeon Guilford, Calvin
Case, Henry Baker, Rodrigues Ottolengui,
Victor Hugo Jackson & others, who
helped extricate orthodontics from the
web of prosthetics.
hit at politics in dental organizationbane & cause of dry rot
within
organizations.

emphasized that the ultimate

development of orthodontia will
not come about until the present
rotten & disgraceful method of
dental education is abolished &
supplanted by correct principles
which
reject
the
damnable
practice of extracting first molars.

1 among the 2 women of the 10

charter members was Anna Hopkins
of St. Louis.
Later became Anna Hopkins Angle
Mother Angle.
Cecil Steiner said She was a suitable
counterfoil for Edward H. & also she
was the power behind the throne.

 1907 moved his school to New York.

1908 moved his school to New London,
Conn., - 6 week sessions at 200$ till 1911.
Decided to give up practice of orthodontia
& devote himself to study, teaching &
development of better appliances.
1916 made Pasadena, California their
permanent home to avoid the hardships of
Eastern winters.

James Angle first student of

Edward H. Angle College of
Orthodontia in California.
1922 Graduates of Pasadena, St.
Louis & New London formed the
Edward H. Angle Society.
No officers, no bylaws, society run
by Angle.

Angle attended the last society

meeting on June 1928 in New
London, Conn.
The society ceased to exist after
his passing away in 1930.
Nov
17,
1930

society
reorganized & restarted from
former members.

At this meeting The Angle

Orthodontist was born.
Mrs. Angle Editor-in-chief.
First official address by Charles
Tweed on The History &
Revision of Arizona Law.

1907-E -Arch Appliance

Simplicity.
Heavy interrupted forces.
Tipping of teeth to new
position.
Not possible to precisely
position any individual
teeth.

1912-Pin and Tube

Appliance

Move the teeth bodily.

Bone growing appliance.
Capable of great precision in
movement.
Incredible degree of craftsmanship.
Impractical in clinical use.
Poor spring qualities.

tooth

Main disadvantages of pin and

tube appliance
- Lack of mesiodistal control
- Archwire placement.

1915-Ribbon Arch
First bracket. Appliance
Vertically positioned
rectangular slot with ribbon
arch of 10 x 20 gold wire.
Good spring qualities.
Allowed versatile
movements.
Unable to achieve
mesiodistal tipping
movements.
Not possible to provide
stabilization or anchorage of
posterior teeth.
Did not allow to torque roots
to a new position.

1928-Edgewise Appliance
Latest and the best.
Rectangular
wire
of
0.022
x
0.028
inch
inserted in a horizontal
slot.
Excellent
control
of
crown & root position in
all three planes of space.
Mastered
complex
metallurgy
&
had
immense knowledge of
noble metals.

Angle-The controversial
man
Possessed extraordinary technical skills,
very inventive mind & an unbending,
uncompromising, maverick nature.
His national stature, his close relations
with members of the medical profession
& his writings served to create
jealousies among dental faculties.
incestuous interquote- a term coined
by Doris Graber, political scientist.

 New school of orthodontics - Angles gospel of

non-extraction, expansionist, occlusion-oriented
orthodontic orthodoxy.
Dr. Calvin Case-(1847-1923).
Born on April 24 ,1847 in Michigan.
Military service in the civil war.
1871-Graduated from Ohio college of dental
surgery.

 1884-University
of
Michigan
Medical
School.
1890-General Dentistry in Chicago &
Professor of Prosthodontic Dentistry &
Orthodontia at the Chicago College of
Dental Surgery.
1892-First to stress on root movement &
used rubber elastics in treatment.
Rehabilitation of cleft palate deformitiesCase type of obturator still in use.

Case was a genuine admirer of Angle.

1903-The Discord -Angle attributed
the origin of the use of intermaxillary
elastics to Baker.
The Bombshell - Case reintroduced
the concept of removal of certain
teeth
to
enable
correction
of
malocclusion and improve general
health.

The Great Extraction

Controversy of 1920s
Martin Dewey (1881-1933).
Born in 1881, Kansas.
1902-attended one of the
first classes of Angle
school of orthodontics.
1914Practical
orthodontics
orthodontic
philosophy
and
mechanical
procedures.
1911-Dewey school of
orthodontia.

1915-with Dr.C.V. Mosby, Dewey

founded and became editor of the
International Journal of Orthodontia
(now AJO).
Editor for 17 years.
1931 - President of ADA.
Merciless in fighting for truth and
against the empiricism of the day.
Science Knows No Friends.

 1911-Annual meeting of the National Dental

Association now ADA.
Debate between Dewey & Case-one of the
most
sharpest
and
most
heated
controversies.
But Angle & his followers won the day.
Extraction of teeth for orthodontic purpose
essentially
disappeared
from
the
orthodontic scene in the period between the
two world wars.

 Angles
unbending
anti-extraction,
expansionist, dogmatic philosophy may have
hindered as much as helped orthodontic
development.
His students blindly & uncompromisingly
followed the leader.
Angle died on August 11, 1930 but his
influence is still felt very strongly in
orthodontics.
I have finished my work, it is as perfect as I
can make it.

1900-1910
Era of manufacture of standardized appliances.
Dental supply companies sold appliances made
as sets, dentists could make required fitting by
soldering.
Victor Hugo Jackson (1850-1929)
Pioneer of removable appliances in US.
Jackson's crib-Auxiliary spring (finger).
1904 - Orthodontia and Orthopedia of the
face.

Benno Lischer (1876-1959)

1912 - Principles & methods of Orthodontia.
Translated Paul Simons German book
Diagnosis of Dental Anomalies.
Stressed relationship between muscles,
malformation & malocclusion.
It is my firm belief that irreparable damage
is done by oft repeated advice to wait until
the permanent teeth are all erupted before
beginning operations for correction of
malocclusion.

1910-1920
1911 - Albin Oppenheim - Serious
study of tissue changes during
orthodontic tooth movement.
John. V. Mershon (1867-1953)
introduced
removable
lingual
arch based on the principle that
teeth must be free & unrestricted
for adaptation to normal growth.

Albert. H. Ketcham - (1870-1935)

Devoted researcher & great pioneer.
1902 - Graduate of Angle School of Orthodontics.
First to introduce Roentgenogram & Photography
An inveterate reader & deep thinker questioned
some of Angles arbitrary pronouncements.
A great teacher & guide- Ketcham Seminar.

Milo Hellman (1873-1947)

Angles student.
1912-Research in Anthropology & its
relation to the growth & development
of human dentofacial complex.

 Linked development of human dental

occlusion to evolution of dentition as whole.
1935
Introduced
craniometric
measurements & classification of dental
development.
Believed in biologic concept & scientific
method.
Perfection is the goal, adequacy is the
standard.

 1922 - James. D. Mc Coy

introduced open tube appliance.
1928- George Crozat developed
Crozat
appliance - precious
metal, Class II elastics
employed with Crozat
appliance to treat Class
II malocclusions.

 Spencer Atkinson introduced Universal

appliance a combination of ribbon arch
appliance & edgewise appliance using a
flat wire & round wire in combination.

 1924 - Paul Simons studies of facial

bones, introduced orbital-canine rule,
Gnathostatics.
1929 - American board of Orthodontics
was created, incorporated in the state of
Illinois in 1930.
American
Board
of
Orthodontics
established specialty's most coveted
prize- The Albert. H. Ketcham memorial.

1930-1940
1931 Holly Broadbent published in the
first issue of Angle Orthodontist A
New X-ray Technique & Its Application
to Orthodontia.
Introduced cephalometric
roentgenography, cephalometric tracing
& evaluation.
Bolton point a new point of reference
on skull in honour of his sponsor.

 1938 Joseph Johnson introduced twin arch appliance.

1940 Oren A. Oliver introduced labiolingual appliance.

Part II
Contents
Parallel developments in Europe.
Back in U.S. (1940-1950).
The Merger.
Evolution
of
Biomaterials
Orthodontics.
Summary of Appliances.
History of BOS.
History of EOS.
Indian History.
Emerging trends in Orthodontics.

in

Parallel developments in
European Orthodontics
American Orthodontics Fixed
appliances
European
Orthodontics

Removable appliances

3 reasons
1. Angles dogmatic approach to
occlusion less impact in Europe.
2.
Social
welfare
systems
developed
rapidly.
3. Precious metal for fixed
appliances
less available.

2 types of devices
1.

ACTIVE

PLATE
2. ACTIVATOR

Development of the
Active Plate
1839 Charles Goodyear invented vulcanite.
1881 Coffin plate by Coffin.
1902 Monobloc by Pierre Robin.
Single block of vulcanite.
To prevent glossoptosis in micromandible
& Cleft lip & palate patients.

1908

appliance.

Hawleys

retainer

1911 J.H. Badcock - expansion

plate with screw.
Next 3 decades eclipsed by
Angles fixed appliances.
Only Hawley retainer stayed.

1929 European orthodontic

society meeting in Heidelberg
C.F.L. Nord presented simple
screw split plates.
1936 9th International Dental
Congress in Vienna - M.Tischler
- sophisticated active plates.

A.M. Schwarz Biologist, scientist, cephalometrician,

clinician & teacher.
1938

Lehrgang
der
Gebissregulung - Orthodontic bible
in Europe.

Schwarz
double
plate
combination of activator & active
plate for treatment of class II div
1.

Philip Adams in Belfast Adams crib

Basis for English removable
appliances

Britain simple removable plates.

Central Europe functional appliances.
European
criticism
orthodontics

of

British

1. Overemphasis of simple treatment.

2. Undergraduate orthodontics.
3. Disunity among British orthodontists.

Development of the
Activators
Simple appliances using muscle
forces Group I forces transmitted
directly to teeth.
Ex: Inclined planes
Oral screens
Lip bumpers

Group II Activate muscles

attached to the mandible.
Ex:
Andersen Hupl
activator.
Herbst appliance.
Bionator.
Bimler appliance.

Group I Appliances
INCLINED PLANE
Catalan, more than 200 yrs ago.

Developed into Oppenheim splint.

- Hawley type retainer with splint.

VESTIBULAR SCREEN
Newell in 1912
Advocated by Nord,
Kraus & Fingeroth.

Hotz,

Group II Appliances
Norman Kingsley in 1879 bite

plate to jump the bite.

Modified by Ottolengui.
Combined with fixed appliances

Herbert A. Pullen, J.Lowe Young &

Oren A. Oliver.

Plane & Spur retention Angles sliding

device fitted to upper & lower first
molars.
Vorbisskronen crowns on upper &
lower second deciduous molars by A.M.
Schwarz.
Pin & tube sliding device of Herbst.

1918 Alfred P. Rogers exercises for development of

muscles of face to increase
functional activity.
First to recognize importance of
muscles
for
growth
&
development.
Importance of lip exercises
Hotz, Duyzings & Frankel.

The Andresen Haupl

Activator
Unaware of Pierre Robins Monobloc.
Correcting sagittal malrelationships
in the growing child by changing the
functional pattern of stomatognathic
system.
Modified retainer after correction of
distocclusion for his daughter.

1908 - Introduced Activator.

1925 director of orthodontic

department of Dental School in Oslo.
Karl Haupl pathologist, periodontist,
eminent scientist.
Andresen & Haupl wrote about their
appliance & interpretations of its
actions.
Functional Jaw Orthopedics.
Activator ability to activate muscle
forces.
The Norwegian System.

1909 Herbst presented Scharnier or

joint - fixed bite-jumping device at
International Dental Congress in Berlin.
1934 Herbst & Schwarz - series of
articles.

Uses
1. For
treating
Class
II
malocclusions.
2. Facilitate
healing
after
mandibular ramus fractures.
3. T.M.D. clicking & bruxism.
After 1934 - appliance forgotten.

Most frequently used activator

modification Bionator by Balters.

Tongue as the essential factor for

development of dentition.

H.P. Bimler myodynamic appliance.

Expanding the maxillary arch by
cross
wise
transmission
of
transverse mandibular movements.
elastischer Gebissformer Oral
adaptor.
Combined
active
components.

&

passive

Stockfish Kinetor.

Early 1950s Reitans research

on actual effect of functional
appliances.
Schwarzs division of forces too
theoretical.
Force effect related to anatomical
environment & time factor.

Back in the U.S. 19401950

Charles Tweed (1895-1970)

1941 introduced edgewise
appliance based on basal bone
concept.

Graduated from improvised Angle

course by George Hahn in 1928.
Worked with Angle for 7 weeks to
write an article in Dental Cosmos.
Returned to Arizona First pure
edgewise

specialty

practice

U.S. + Non-extraction.

in

Discouraging results
during retention.

in

patients

Dedicated 3 yrs in study of results.

Upright mandibular
basal bone.

incisors

on

Prepare anchorage + Extract teeth

Tweeds contributions
1. 4
objectives
of
orthodontic
treatment with emphasis for facial
esthetics.
2. Upright mandibular incisors over
basal bone.
3. Acceptance of judicious extraction
of teeth.
4. Clinical
application
of
cephalometrics.

5. Tweeds diagnostic facial triangle.

6. Introduced anchorage preparation.

7. Serial extraction of primary &
permanent teeth.
Tweed philosophy.

1945 H.D. Kesling, used a rubber

tooth positioning device.
1947 Danish orthodontist, Arne
Bjork published The Face in Profile
anthropologic & radiographic
study of effects of variations in jaw
growth using facial diagnosis.
J.A. Salzmann classification of
malocclusion
for
handicapping
problems.

1948 Cephalometric Analysis by

William Downs.

Significance
1. Objective method of portraying
underlying factors.
2. Causes
of
malocclusion

Other analyses
1. C.C. Steiner (1953)
2. C.H. Tweed (1953)
3. S.E. Coben (1955)
4. R.M. Ricketts (1966)
5. V.Sassouni (1969)
6. H.D. Enlow (1969)
7. J.R. Jarabak (1970)
8. A. Jacobson (1975)

The Merger
50s & 60s dissolution of crosscontinental barriers.
Egil Harvold faculty at University
of Toronto, introduced Norwegian
system in U.S.
Frantisek Kraus of Prague
introduced Double oral screen.
Combination of oral & vestibular
screen.

Vestibular screen not allowed to touch teeth,

extended to the mucosal transitional folds.

Precursor of Frankel Philosophy.

Rolf Frankel Frankel Function Regulator in

1950s.

Appliance confined to oral vestibule shields

buccal and labial musculature away from
teeth & investing tissues.
Exercise device eliminates lip trap,
hyperactive mentalis, aberrant buccinator &
orbicularis oris action.

Prof. Rudolf Hotz, Zurich

Vorbissplatte / guide plane plate /
forward biting plate / removable
inclined plane plate.

Refined propulsor conceived by

Muhlemann.

1977 Pancherz resurrected

Herbst appliance. Add here
Oct. 1979 AJO stimulation of
mandibular growth by Herbst
appliance.
Severe Class II malocclusions.

1977 Clarks Twin Block.

Rapid functional correction of malocclusion.

In Europe
Fixed
appliances
removable appliances.

replaced

Introduction of bonding.
Raymond Begg of Australia
introduced
multiple-loop,
light-force wire appliance.

P.R. Begg
Born on October 13th, 1898 in
Coolgardie, Western Australia.
1923 B.D.S. from
Melbourne
University,

L.D.S.
from
Victoria.
1924
School

Angle
of

Begg & Fred Ishii first to treat

patients
with
Angles
new
appliance.
Nov. 1925 - returned to Adelaide.
- Edgewise mechanism + nonextraction.
Serious relapses & poor posttreatment profiles.
Feb. 1928 began extraction.
Edgewise no rapid closure of
extraction spaces.

Combined edgewise bracket & round

archwires undesired root movements.
Ribbon arch brackets with slot facing
gingivally.
Early 1940s Arthur J. Wilcock,
metallurgist
at
University
of
Melbourne.
Modified ribbon arch brackets, lock
pins, special buccal tubes & Australian
stainless steel.

Natural wear of teeth in Australian

aborigines.
1939 Doctoral dissertation The
Evolutionary
Reduction
&
Degeneration of Mans Jaws &
Teeth.
1954 Stone Age Mans Dentition.
- Attritional occlusion.
- New round wire technique
0.018
round stainless steel
archwires in
modified
ribbon arch brackets.

1956 Differential force concept.

1957 H.D. Kesling visited Begg.
Return to U.S. Begg Technique
practice with Dr. Robert A. Rocke.

 Demand for organised training in U.S.

1959- first course in Begg technique at
Kesling & Rocke Orthodontic Centre in
Westville, Indiana.

Begg Revolution.
1964 North American Begg Society of
Orthodontists.

 CONVENTIONAL / TRADITIONAL BEGG

Technique outlined by Begg & Kesling.
MODIFIED BEGG Begg principle with
brackets other than ribbon arch bracket.
REFINED BEGG Current Begg practice
using same Begg brackets Mollenhauer,
Wagers, Sims, Hocevar, Swain, Kameda
& Dr. Jayade.

Integrated Orthodontics
Advantages of Begg technique1. Light continuous forces.
2. Rapid alignment, leveling &
rotation of anterior teeth.
3. Rapid overbite correction.
4. Simultaneous
crown
tipping
retraction of all anterior teeth.
5. No extraoral force necessary.

Advantages of Straight Wire Appliance

1. Precise control of premolar & molar

torque.
2. Bilateral symmetry.
3. Straight wires.
4. Precise control of finishing in both
arches in all 3 planes.
5. Stabilization of teeth during final
detailing.

Begg principles applied through

1. Unmodified edgewise brackets.
2. Modified edgewise brackets.
3. Combination
of
Begg
&
Edgewise bracket.
4. Alternative use of Begg &
Edgwise bracket.
Unmodified edgewise brackets
1. Ackerman et al 1969, 1975.
2. De Angelis 1976.

Modified edgewise brackets

1. Perlow 1967.
2. Hocevar Bedditiot 1985.
3. Kesling Tipedge 1988.

Combination of Begg & Edgewise

bracket
1. Universal brackets 1928.
2. Begg Chun Hoon 1960.
3. Fogel Magill 1963.
4. Thompson Bracket.
5. Jayade J Bracket

Levern Merrifield
Tweed course in 1953.
1970 Course director.
Reliable, precise, efficient & practical
protocol of diagnosis & treatment.
Sequential Directional Force Technology.
7th
objective
of
Tweed-Merrifield
philosophy clinical objectives pursued
in ethical, moral & compassionate
manner with concern for publics
welfare.

T.M. Graber
Born in St.Louis on May 17th 1917.
Graduation Washington University,
St.Louis.
Army Medical Regiment in II World War.
Orthodontics Northwestern University.
1950 First PhD to Dentist by
Northwestern
University
Medical
School.

20 textbooks, 22 chapters in other

textbooks, 180 publications in
journals & 930 book & journal
abstract reviews.
1964 Kenilworth Dental Research
Foundation.
Editor-in-chief of AJO for 15 years.
Changed to AJO-DO.

Joseph R. Jarabak
One of the earliest authors to
describe
the
mechanics
of
treatment.
Introduced
Jarabak
cephalometric analysis.

Jarabak Ratio

First to introduce combination of

tip & torque in edgewise bracket.
Combination of loops in edgewise
treatment 0.016 Elgiloy round
wire.

Jarabak
Light-wire
Edgewise
Technique
Light-wire
1. Small cross-section geometrics
Dewey, Atkinson & Johnson.
2. Light forces.
Vertical loop appliance by
Storey &
Smith in 1952.
- Begg in 1956.
Precursor to pre-adjusted edgewise
appliance.

Lawrence F. Andrews

Father of pre-adjusted bracket system.

Natures best-120 non-orthodontic
normal cases.
6 keys of occlusion 1972.
Orthodontias best 1150 treated
cases.

Mismatch due to
1. Bracket siting variable.
2. Wire bending inconsistencies.
3. Wire bending side effects.
Answer not in wire but in bracket.
Straight Wire Appliance.

Robert Ricketts

Developed the bioprogressive

therapy from a background of
edgewise and Begg technique.
Introduced utility arch.
Use of preformed bands.
Ricketts Quad Helix 0.40 blue
elgiloy wire.

Cephalometric
cephalometric
technique.

analysis
&
growth prediction

Computerized cephalometrics for

VTOs & STOs.
E-line.
1982 American Institute of
Bioprogressive Education.

Terrel L. Root
Level Anchorage System straight
wire
appliance
with
anchorage
preparation as described by Holdaway.
To
reach
predetermined
goals
routinely.
Step-by-step treatment procedure for 7
non-extraction & extraction choices.
Timing & self check chart.

Vick Alexander
1964 University of Texas.
1978 Vari-Simplex Discipline.
Philosophies
1. Efforts = Results.
2. Altruistic egoism Dr. Hans Selye.

Advocated the word Retractor for

headgear, introduced by Fred
Schudy.

Charles Burstone
Notable
authority
on
Biomechanics.
Introduced TMA, Chinese NiTi,
Fibre reinforced composite.
Holography & Occlusograms.
Surgical planning analysis COGS.
Segmented arch technique.

Ronald Roth
Roths interests
1. Functional dynamics.
2. To prove treatment not harmful
for patients.
3. To disprove premolar extractions
not good for TMJ health.
Roth
prescription

2nd
generation preadjusted brackets.

Bennett, McLaughlin and

Trevisi
Re-examined
Andrews
SWA
bracket system.
MBT
brackets-3rd
generation
preadjusted brackets.

Others Moyers, Proffit, Holdaway,

Woodside,
McNamara,
Williamson, Swain etc.

Evolution of Biomaterials
in Orthodontics
Earliest material documented Gold
ligature wire, Roman tomb in Egypt.
Fauchard Silk thread.
Delabarre (1819) Wire crib.
Schange Gold wire crib.
Kingsley Elastic straps, forged
Stubbs steel, swaged silver.

Angle era Gold, platinum, silver,

steel, gum rubber; wood, ivory,
zinc, copper, brass.
Wrought alloys Springiness,
fewer cracks at tension points.
Stainless quality first reported by
Monnartz in Germany, 1900-1910.
Dumas,
Guillet
&
Portevin
developed
stainless
steel
in
France.

I World War
Germans - Austenitic
British - Martensitic
Americans - Ferritic
1930s Gold & Stainless steel
conflicts.
Edgewater tradition Edgewater
Beach Hotel, Chicago.
1940s Begg & Wilcox Australian
Stainless Steel.
1960s Gold abandoned, steel
adopted.
1960s Cobalt-chromium.

1962 Buelher NITINOL.

Nickel-Titanium

Naval

Ordnance

Laboratory.
1977 Titanium-Molybdnum Alloy (III).
1986 Japanese NiTi-Fujio Miura.
Copper NiTi-Rohit Sachdeva.
Ni-free, Titanium-Niobium wires for
finishing.

 Acrylic-1937.
Vulcanite,
Phenolformaldehyde,

Cellulose,
Vinyl

polymers, Styrene, Alkyl resins.

Plastic brackets Aromatic polymer
/

polycarbonate,

single-crystal

sapphire, polycrystalline alumina /

zirconia.

Recent advances in materials 1.Self ligating brackets.

2.Composite
advantages.

ceramic+polymer

3.Bonding adhesive pre-coated brackets.

4.Curing Light emitting diodes, Plasma
arc lights (Xenon), Laser lights (Argon
laser).

Summary
Pierre
Fauchard
Etienne
Bourdet
Catalan

1728

Bandlette

17221789
--

Ivory splint

Charles
Goodyear
Schange

1839

Vulcanite

1841

Adjustable clamp band

Tucker

1846

Rubber elastics

Dwinelle

1849

Jacks screw

Emerson
Angell
Coffin

1860

Expansion of palate

1860

Flexible piano wire

Kingsley

1861

Headgear

Magill

1870

Dental cement

E.H. Angle

1880

Jack & traction screw

E.H. Angle

1887

Angle system

Inclined plane

E.H. Angle

1889

Pierre Robin

1902

Classification of
malocclusion
Monobloc

E.H. Angle

1907

E-Arch

Charles Hawley

1908

Retainer

Andresen

1908

Activator

Balter

--

Bionator

H.P. Bimler

--

Myodynamic appliance

John Mershon

--

Removable lingual arch

E.H. Angle

1912

Pin & tube appliance

Newell

1912

Vestibular screen

E.H. Angle

1915

Ribbon arch appliance

James McCoy

1922

Open tube appliance

Paul Simon

1924

Gnathostatics

E.H. Angle

1928

Edgewise appliance

Spencer Atkinson

--

Universal appliance

George Crozat

1928

Crozat appliance

Broadbent

1930

Cephalometrics

Herbst

1934

Herbst appliance

Joseph Johnson

1938

Twin-arch appliance

Oren A. Oliver

1940

Labio-lingual appliance

Tweed

1941

Edgewise-Tweed philosophy

H.D.Kesling

1945

Positioner

C.P. Adams

1948

Adams crib

Martin Schwarz

--

Schwarz double plate

Hotz

--

Guide plane plate

William Downs

1948

Downs analysis

Kraus

--

Double oral screen

Hotz

--

Propulsor

P.R. Begg

1956

Begg technique

Jarabak

--

Light-wire technique

Rolf Frankel

1967

Frankel appliance

Andrews

1972

Ricketts

--

T.L. Root

--

Pancherz

1977

Straight wire
appliance
Bioprogressive
therapy
Level anchorage
system
Herbst appliance

Clark

1977

Twin block

Alexander

1978

Vari-Simplex
Discipline

British Orthodontic
Society
Disunity among British organizations
1. British
Society
for
Study
of
Orthodontics (1907).
2. Consultant Orthodontists Group (1964).
3. British Association of Orthodontists
(1965).
4. Community Orthodontists Section (1978)
July 1st 1994 British Orthodontic
Society.

European Orthodontic
Society
Founded on 16th May 1907 by 10
charter members.
First meeting 27th Sept. 1907.
President Dr. W.G. Laws.
Dr. E.H. Angle elected honorary
member.
Meetings
discontinued
between
1914-1919 & 1939-1946.

Indian History
Oldest orthodontic department
Nair Dental College, Bombay.
M.D.S. 1959 Nair Dental
College & Govt. Dental College,
Bombay.
Study group in Bombay in 1963.

Indian Orthodontic Society Oct.

5th 1965.

 7 visionaries
Dr. Prem
Prakash,
Dr. H.D.
Merchant, Dr.
H.S. Sheikh,
Dr. A.B. Modi,
Dr. K.N.
Mistri,
Journal
of Indian Dr.
Orthodontic Society,
Naishadh Parikh,
1965.
Dr. conference 1967 in New
First annual
Mohandas Bhat.
Delhi.
P.G. convention every year since 1996.

Library & first Dental Museum in

India, 1998.
Free Dental Specialty
Vellore Aug. 1999.

Centre,

Indian Board of Orthodontists

1998.
Member of World Federation of
Orthodontics (San Francisco, U.S.A.
1995).

Emerging Trends in
Orthodontics
1.
2.
3.
4.

Shift in paradigms.
Technology driven practice.
Evolution of newer materials.
Changes in research.

Shift in Paradigms
1.
2.
3.
4.

One phase treatment.

Fullness of face.
Smile analysis & function.
Non-extraction.

Technology Driven
Practice
1. Computerization.
2. 3D reconstruction
3. Simulation
of
treatment results.
4. Computerized
bracket position.
5. Robots
to
bend
wires.
6. Custom made trays
for tooth movement
(INVISALIGN).

Clinical Practice Scenario

1. Inter-disciplinary approach.
2. Implants
reinforcing
anchorage.
3. Distraction osteogenesis.

 The longer you look back, the

greater you can leap ahead .

References
1.

Proffit Contemporary Orthodontics, II Ed.

2.

Proffit Contemporary Orthodontics, III Ed.

3.

Graber, Vanersdal Orthodontics: Current

Principles & Techniques, II Ed.

4.

Graber, Swain Orthodontics:

Principles & Techniques, III Ed.

5.

T.M. Graber Orthodontics: Principles &

Practice, III Ed.

6.

Strang Textbook of Orthodontia, I Ed.

7.

Graber, Rakosi, Petrovic Dentofacial

Orthopedics & Functional Appliances, I Ed.

8.

Graber, Neumann Removable Orthodontic

Appliances, I Ed.

Current

9.

McLaughlin,

Bennet,

Trevisi

Systemized

Orthodontic Treatment Mechanics.

10. New Vistas in Orthodontics, III Ed.
11. Dr. V.P. Jayade Refined Begg for Modern Times.
12. Jarabak Jarabak Lightwire Technique.
13. Alexander Alexander Discipline.
14. George Hahn: History & Philosophy of Edward
H.

Angle

Society

of

Orthodontia

25 th

Anniversary of the Society, Chicago, Nov. 6 th

1955.
15. T.M. Graber: An Orthodontic Perspective After
75 years, AJO, May 1976, Vol. 69, No. 5.

16.T.M. Graber: The Past as a Prelude to the

Future Part IV, Heritage Lecture at AAO.
17.Milton

Asbel:

Brief

History

of

Orthodontics, AJO-BO, Sept. 1990, Vol. 98,

No. 3.
18.Dr. V.P. Jayade: Personal Perception of 3
Ps of Indian Orthodontics 32nd IOS
Conference, Bangalore.
19.Claude

Matasa:

Angle,

the

Innovator,

Mechanical Genius & Clinician, AJO-DO,

2000, Vol. 117, No. 4.
20.Lee Graber: Vignette T.M. Graber, AJODO, May 2000, Vol. 117, No. 5