HISTORY OF ORTHODONTICS Presented by:- Anant Jyoti

P.G. 1st Year Department of Orthodontics & Dentofacial Orthopaedics

Seema Dental College & Hospital

Contents

• Introduction• History of Dentistry• Emergence and evolution of orthodontics• Middle ages (5th to 15th Century) to the 18th Century.• Pioneers of Early 19th Century• Pioneers of late 19th Century.• Contributions in Orthodontics in 20th Century • Appliances in 20th Century and• History of Indian Orthodontics

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

The Greek physician Hippocrates (460 to 377 Bc) isrevered as a pioneer in medical science, chiefly becauseof his medical authorship.

He was the first to separate medicine from fancy or religion, and with his reports of critical observation and experience, he established a medical tradition based on facts.

This collected information was gathered into a text known as the Corpus Hippocraticum,

Earliest description of irregularities - by Hippocrates in 400 B.C.

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.

EMERGENCE AND EVOLUTION OF ORTHODONTICS

Orthodontics is that branch of dentistry that is concerned with the study of growth and development of jaws and face particularly and body generally as influencing the position of the teeth, the study of action and reaction of external and internal influences on development and prevention and correction of arrested and perverted development. (BSO)

Definition

It could also be defined as “ Orthodontics is that specific area of the dentistry that is concerned with supervision , guidance and correction of growing or matured dentofacial structures including those conditions that require movement of teeth or correction of malrelationship and malformation of related structures by adjusting relationship between and among teeth and facial bones by application of forces or stimulation and redirection of functional forces within the craniofacial complex.”- Prpffit.

It was about 3000 years ago that we had the first written record of attempts to correct crowded or protruding teeth.

Primitive (and surprisingly well-designed) orthodontic appliances have been found with Greek and Etruscan artifacts.

Archaeologists have discovered Egyptian mummies with crude metal bands wrapped around individual teeth.

History and measurement of proportions

To ensure stipulations when commissioning and executing images of royalty and deity , the ancient Egyptions developed an intricate quantitative system that defined the proportions of the human body.This was known as the Divine Proportion.

From earliest available records , portrayals of the human body have been guided by system of proportionality among its parts. This procedure ensured harmonious relationship of facial features , torso,arms and legs. In the divine proportion, the major part is 1.61803 times larger than the minor part. This golden proportion constitutes an ideal that informs aesthetic assessments.

Changing perceptions in the field of Orthodontics Hippocrates wrote of the aesthetic benefit of straight teeth. Beauty seems to be the primary motivation behind the development of orthodontics up until the mid 1800s. It was during the 1800s that the initial theories about gums, teeth and jaws were investigated and bitterly contested.

During the last 150 years the science of orthodontics was described. The medical benefits of straight teeth and proper jaw closure were discovered during this time. Only recently has the general appreciation that patients come to orthodontists for cosmetic reasons reemerged.

Aristotle (384-322BC)

He may be regarded as the first comparative dental anatomist because, in his famous work entitled De Partibus Anhnalium (On the Parts of Animals), he compared the various dentitions of the known species of animals of that time.

The first treatment of an irregular tooth was recorded by Celsus (25 B.C- 50 A.D.)

Probably the first mechanical treatment for correcting irregularities-by Pliny (23-79A.D.) – Filed elongated teeth to produce proper alignment.

MIDDLE AGES

Leonardo da Vinci (1452 - 1519)

First artist to dissect the human body for the acquisition of anatomic knowledge.

Leonardo was the first to recognize tooth form and the first to realize that each tooth was related to another tooth and to the opposing jaw as well, thus perceiving the articulation of the teeth.

Ambrose Pare (1517- 1590), a French surgeon, paid specific attention to dentofacial deformities, especially to the cleft palate.

He was the first surgeon todevise an obturator for treatment.

The first mention of practicing dentistry - made by Pierre Dionis (1658-1718). He called dentists “operators for the teeth”

He also stated that they could also “open or widen the teeth when they are set too close togather.”

EIGHTEENTH CENTURY

Pierre Fauchard (1678-1761) He had been called “Father of Orthodontia.”

He was the first to remove dentistry from the bonds of empiricism and put it on a scientific foundation.

In 1728, he published the first general work on dentistry, a 2-volume opus entitled The Surgeon Dentist: A Treatise on the Teeth. 

Fauchard described, , the bandeau, an expansion arch.It consisted of a horseshoe-shaped strip of precious metal to which the teeth were ligated .

This became the basis for Angle’s E-arch, and even today its principles are used in unraveling a crowded dentition.

He also “repositioned” teeth with a forceps, called a “pelican”

Fauchard’s bandeau was refined by Etienne Bourdet (1722-1789). His was the first record of recommending serial extraction (1757) and of extracting premolars to relieve crowding. He was also the first to practice “lingual orthodontics,” expanding the arch from the lingual.

In England, John Hunter (1728 to 1793), an anatomist, is numbered as one of the foremost surgeons of his day.

Hunter published, The Natural History of the Human Teeth: Explaining Their Structure, Use, Formation, Growth and Diseases, in 1771.

He demonstrated the growth, development, and articulation of the maxilla and mandible with the attached musculature.

He outlined the internal structure of the teeth (enamel) and bone (dentin) and their separate functions.

He established the difference between bone and teeth for the first time.

For the nomenclature of dentistry, he labeled incisors, bicuspids and molars.

EUROPEAN PIONEERS OF EARLY 19th CENTURY

Joseph Fox (1776-1816) - The first to classify malocclusion (1803).

Observed mandible grows mainly by distal extension beyond the molars .

According to Weinberger, Fox “was the first to give explicit directions for correcting the irregularities” of teeth.

He was particularly interested in the judicious removal of deciduous teeth, treatment timing, and the use of bite blocks to open the bite.

His other appliances included an expansion arch and a chincup (about 1802).

Orthodontia derived from 2 Greek words

‘Orthos’ – Right/Correct.

‘Dons’ – Tooth

Term introduced by Frenchman LeFoulon in 1841.

Christophe-Francois Delabarre (1787-1862; French) introduced the crib and the principle of the lever and the screw (1815)

He separated crowded teeth by means of swelling threads or wooden wedges placed between them.

J. M. Alexis Schange (1807, French) He introduced a modification of the screw, the clamp band.

In 1842, 3 years after the vulcanization process had been developed, rubber bands (actually, sections of rubber tubing). He also coined the term anchorage.

Friedrich Christoph Kneisel (1797-1847, German), he was the first to use a removable appliance.

Kneisel wrote the first French and German treatises devoted exclusively to orthodontics.

AMERICAN PIONEERS OF THE EARLY 19th CENTURY

Before the time of Edward Angle and Calvin Case, the treatment of malocclusions was chaotic. There was no rational basis for diagnosis and case analysis

In the United States before the 1830s, there was no dental degree .

Orthodontics had little literature until 1880.

However, during approximately the fourth decade of that century, most of these voids began to be filled, as this country gained the commanding position in dentistry.

In 1834, the first American dental association, the Society of Surgeon Dentists of the City and State of New York, was founded.

As early as 1797, Josiah Flagg (1763-1816) of Boston advertised that he “regulates teeth from their first teeth, to prevent pain and fevers in children, assist nature in the extension of the jaw, for a beautiful arrangement of a second set of teeth.” 

Philadelphia dentist Leonard Koecker (1728-1850) offered to supply ligatures “to teeth of an irregular position”

J. S. Gunnell invented occipital anchorage in 1822.

 Samuel S. Fitch, MD, devoted a significant amount of information to irregularities of the teeth.He was the first to classify malocclusion.

In 1839, the first dental journal, the American Journal of Dental Science, was established through the efforts of Solyman Brown (1790-1876), who wrote thefirst patient-education material (“Importance of Regulating the Teeth of Children”); Levi S. Parmly (1790-1859), founder of a dental dynasty; and Chapin A. Harris (1806-1860), who edited the journal from 1839 to 1858.

Harris was also instrumental, with Horace H. Hayden (1769-1844), in founding the first school of dentistry that year at the University of Maryland, where he gave the first lectures on “irregularities of the teeth.”

The invention of vulcanite by Charles Goodyear in 1839 greatly reduced the cost and weight of dental plates and other appliances.

In 1852, the first national dental association in this country (the American Society of Dental Surgeons, 1840), formed a committee on dental irregularities.

ORTHODONTIC PIONEERS OF THE LATE 19thCENTURY

Norman W. Kingsley (1825-1896) A splendid thinker and skilled artisan, he introduced several innovations such as:- He introduced the headgear to apply extraoral force & provide occipital anchorage.

Initially, he extracted teeth and moved the anterior teeth back into the space thus created. Later, he gave up extraction and added an inclined plane of vulcanite to his mechanism to “jump the bite.”

He was also the first to discuss cleft palate treatment in terms of orthodontics, perfecting a gold obturator and an artificial vellum of soft rubber (1859).

After 1850, the first texts that systematically described orthodontics appeared; the most notable was Kingsley’s book, A Treatise on Oral Deformities (1880), the first to recommend that etiology, diagnosis, and treatment planning should be the foundations of practice.

Emerson C. Angell was the first to open the median palatal suture with a split plate (1860).

About that time, several dentists showed an interest in widening the maxillary arch.  Amos Westcott used a telescopic bar in the maxilla to correct a crossbite (1859).

That same year, C. R. Coffin, Kingsley’s student developed “Coffin Spring ”

After World War II, acrylic replaced vulcanite.

• John Nutting Farrar (1839-1913) began the era of biologic tooth movement. • He advocated specific limits for the movement of teeth . •He recommended the bodily movement of teeth (1888).

• His Treatise on Irregularities of the Teeth and Their Correction (1888) is considered the first great work devoted exclusively to orthodontics.

• For these reasons, he has been called the “Father of American Orthodontics.”

• Farrar gave the theory of intermittent force and developed a screw to deliver this force in controlled increments .

Eugene S.Talbot (1847-1925), a prolific inventor, was one of the first to use the Roentgen ray in orthodontic diagnosis.

He was the first one to carry out Model Analysis procedures.

In 1893, Henry A. Baker introduced intermaxillary rubber bands to correct protrusions. His method came to be known as “Baker anchorage.”

•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-learning” •Marked ability to improve & create mechanical equipment on the farm.•Developed a passion for simplicity in design.

1878- Graduated from Pennsylvania College of Dentistry.

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.

“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.

•Angle’s 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.

On being asked about his ‘discovery’ of the constancy of the upper first molar Angle said – “I thought 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.

Course of instruction included art, rhinology, embryology, histology, comparative anatomy & dental anatomy in addition to Angle’s appliances.

Among his early students were Dewey, Pullen, Mershon, McCoy, Oppenheim, Weinberger & Fred Noyes.

In May 1900 at a banquet in Dr. Angle’s 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.

Angle also founded the first Orthodontic journal The American Orthodontist in 1907.

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, - 6 week sessions at 200$ till 1911.

Decided to give up practice of orthodontia & devote himself to study, teaching & development of better appliances.

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.

The society ceased to exist after his passing away in 1930.

At this meeting ‘The Angle Orthodontist’ was born.

Mrs. Angle – Editor-in-chief.

Nov 17, 1930 – society reorganized & restarted from former members.

Angle held 37 patents; his most noteworthy appliances are the E-arch (1900), the pin-and-tube appliance (1910), the ribbon arch (1916), and the edgewise appliance (1925). The latter, with modifications, is the one most commonly used today in orthodontics.

Another distinguished orthodontist was Calvin S. Case (1847-1923)

Born on April 24 ,1847 in Michigan.

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 deformities-Case 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.

Martin Dewey (1881-1933).

Born in 1881, Kansas.

1902-attended one of the first classes of Angle school of orthodontics.One of Angle’s star pupils, Dewey became an educator, an author, a debater, and an editor.

He was the first editor of The American Orthodontist and then helped found the International Journal of Orthodontia (1914), which he edited until his death.

1911-Dewey school of orthodontia.

1911-Annual meeting of the National Dental Association now ADA.

Debate between Dewey & Case-one of the most sharpest and most heated controversies,also known as “The Great Extraction Debate”

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.

CONTRIBUTIONS IN ORTHODONTICSIN 20th CENTURY

Victor Hugo Jackson (1850-1929)

Pioneer of removable appliances in US.

Jackson's crib-Auxiliary spring (finger).

Benno Lischer (1876-1959)

1912 - ‘Principles & methods of Orthodontia’.

Stressed relationship between muscles, malformation & malocclusion.

He advocated early treatment.

“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”.

Alfred Rogers (1873-1959) introduced the concept of myofunctional therapy (1918).

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 Angle’s arbitrary pronouncements.•A great teacher & guide- ‘Ketcham Seminar’.

•Milo Hellman (1873-1947)

•Angle’s student.

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

•1935 – Introduced craniometric measurements & classification of dental development.

•Believed in biologic concept & scientific method.

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.Under the guidance of Albert H. Ketcham, the American Board of Orthodontics was created in 1929 and incorporated in 1930. 

1931 – Holly Broadbent published in the first issue of Angle Orthodontist – ‘A New X-ray Technique & Its Application to Orthodontia’.

Along with Holfroth, Introduced cephalometric roentgenography, cephalometric tracing & evaluation.

1940 – Oren A. Oliver introduced labiolingual appliance.

1948 - Cephalometric analysis introduced by William B. Downs (1899-1966)

Its significance was that it presented an objective method of portraying many factors underlying any 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)

APPLIANCES IN 20th CENTURYParallel Developments In European and American 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-paid emphasis on limited treatment by general practitioners

3. Precious metal for fixed appliances less available.

EVOLUTION OF REMOVABLE APPLIANCES

•In the European approach at that time, Removable appliances were differentiated into

•Active plates – aimed at moving teeth.

•Activators or Functional Appliances- aimed at modifying growth.

Active plates 1)Split plate appliance – which could produce various type of tooth movements. It was developed by Martin Schwartz.1881 – Coffin plate by Coffin.

1911 – J.H. Badcock - expansion plate with screw.

Philip Adams in Belfast -• Adams crib • Basis for English removable

appliances

Development of Functional AppliancesCategories of Functional Appliances•Passive tooth born appliance

1)Activator2)Bionator3)Herbst appliance4)Twinbloc appliance

•Tissue borne appliance1) Frankel appliance

Activator – the Monobloc developed by Pierre Robin in the early 1900s is generally considered the forerunner of all functional appliances , but the Activator developed in Norway by Viggo Andresen in the 1920s was the first to be widely accepted.

PASSIVE TOOTH BORN APPLIANCE

Bionator – originated by Balters and is best described as a cut down activator

Herbst appliance – developed in 1905 by Emil Herbst and reintroduced in the 1970s by Hans Pancherz.

The maxillary and mandibular arches are splinted with frameworks and usually are cemented or bonded but can be removable, and are connected with a pin and tube device that holds the mandible forward.

Twin block Appliance – introduced by William Clark. Maxillary and mandibular portions are configured so the interaction of the two parts control how much the mandible is postured forward and how much the jaws are separated vertically.

Advantage - Allows nearly full range of mandibular movement , easy acclimation and reasonable speech so that it can be worn most of the time.

Tissue borne appliance  Frankel appliance – is the only tissue borne functional appliance. Given by Rolf Frankel.

Exercise device – eliminates lip trap, hyperactive mentalis, aberrant buccinator & orbicularis oris action.

Appliance musculature confined to oral vestibule – shields buccal and labial away from teeth & investing tissues.

Other Removable Appliances  Evolution of the Crib  Victor H. Jackson (1850-1929) designed a wire crib in 1887 (patterned much after the design of Schange) to which were soldered a number of finger springs for tooth movement.  The Jackson appliance was taken up by William E. Walker (1863-1914), who used precious metals. Although Walker died before he crossed paths withGeorge B. Crozat, the latter became familiar with the Jackson applicance as a student at the Dewey School.

Crozat (1894-1966) . , Crozat modified Walker’s device and introduced it in 1919.

Originally called the “invisible brace,” it later became known as the Crozat appliance..

For many years, the “Crozat technique” was of the most popular in use.

Hawley retainer Henry Baker used maxillary and mandibular vulcanite removable retainers. The retainers (1919) of Charles A. Hawley (1861- 1929); Angle School, 1905 were an improvement over Baker’s. In the late 1930s, vulcanite was replaced by acrylic.

Mershon lingual arch John V. Mershon developed in 1909 the removable lingual arch, designed to apply gentle pressure on the teeth to keep them (if otherwise rigidly connected) from interfering with the forward growth of the jaws.

It might be considered the first “invisible” appliance.

EVOLUTION OF FIXED APPLIANCES

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

Angle began placing bands on other teeth and used a vertical tube (1910) on each tooth into which a pin, soldered to the archwire, was placed. To move the teeth, he repositioned the pins at each appointment by the laborious process ofresoldering them.

This tedious procedure proved toodifficult for the average clinician, so the pin-and-tube,or “bone-growing,” appliance never achieved widespread use.

Disadvantage

1915-Ribbon Arch Appliance

The pin-and-tube appliance could not control the tooth roots because of the round archwires, so Angle modified the bracket to receive a rectangular arch fitted closely into a machined bracket. The ribbon arch (1916), was held firmly with pins. Compared with its predecessors, it was small enough to have good spring qualities

Disadvantage - The ribbon arch lacked premolar control .Lack of ease in seating between the horizontal molar tubes and the vertical bracket slots.

Despite these drawbacks, the ribbon arch was an immediate success and continued in use for a decade after introduction of its successor, the edgewise appliance.

• Angle reoriented the slot from vertical to horizontal and inserted a rectangular wire “edgewise”—with its greater dimension perpendicular to the long axis of the teeth. •The edgewise appliance was the first bracket able to move teeth in all 3 planes simultaneously.

1925-Edgewise Appliance

Charles Tweed (1895-1970) 1941 – introduced edgewise appliance based on basal bone concept.

Worked with Angle for 7 weeks to write an article in Dental Cosmos.

Returned to Arizona – First pure edgewise specialty practice in U.S.

He emphasized the 4 objectivesof orthodontic treatment with emphasis and concern for facial esthetics, serial extraction, uprighting teeth over basal bone and extractions made more acceptable.

He developed the diagnostic facial triangle.

Other Fixed appliances to be used were

1) Labiolingual Appliance

2) Universal Appliance

3) Twin wire

4) Begg’s Appliance

Begg’s Appliance - P . R . Begg.

Born on October 13th, 1898 in Coolgardie, Western Australia.

1923 – B.D.S. from Melbourne University,

1924 – Angle School of Orthodontia, Pasadena.

Raymond Begg had thought of using ribbon arch appliance on his return from Angle school. However Begg modified it for his use. Begg’s adaptation took three forms:-•He replaced the precious metal ribbon arch with high strength stainless steel wire.•He turned the original ribbon arch bracket upside down so that the bracket slot pointed gingivally rather than occlusally;and•He added auxillary springs to the appliance for control of root positions.

In the resulting Begg appliance, friction was minimized because the area of contact between the narrow ribbon arch bracket and the archwire was very small and the force of the wire against the bracket was also small.

The Merger

50s & ‘60s – dissolution of cross-continental barriers.

Egil Harvold – faculty at University of Toronto, introduced ‘Norwegian system’ in U.S.

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.

Contemporary Edgewise The contemporary edgewise appliance has evolved far beyond the original design while retaining the basic principle .

Major steps in the evolution of the edgewise appliance include:- Automatic Rotational Control In the original appliance, Angle soldered eyelets to the corners of of the bands. Now rotation control is achieved without the necessity for an additional ligature by using either twin brackets or single brackets with extension wings that contact the underside of the archwire to obtain the necessary moment in the rotational plane of space. 

     

Straight Wire Prescriptions Angle used the same bracket on all teeth, as did the other appliance systems. In the 1980s Andrews developed bracket modifications for specific teeth, to eliminate the many repetitive bends in the archwires that were necessary to compensate for differences in tooth anatomy. The result was the ‘’straight wire’’ appliance. This was the key step in improving the efficiency of edgewise appliance.   

Advantages of Straight Wire System –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.

Lawrence F. Andrews

In 1972, Dr. Lawrence F. Andrews ushered in the preadjusted era with the introduction of the Straight Wire

Straight wire system was hailed as a revolutionary.

Development with the dual advantage of less wire bending and improved quality of finished cases.

Another landmark contribution of Andrew’s is the 6 keys of occlusion which he gave in 1972.

Bennett, McLaughlin and Trevisi

They modified Andrews‟s standard SWA bracket system to MBT bracket system. These third generation brackets retained the best in original design but introduced range of improvements and specifications to overcome the clinical shortcomings.

Development of Tip edge bracket system

Peter Kesling modified brackets with both an edgewise slot and a gingival slot in which a wire can be pin retained , allowing a combination of Begg and Edgewise mechanics.

Development of orthopaedic appliances

Headgear milestones● 1802: Joseph Fox used a chincup attached to a skullcap.● 1822: Gunnell wrote on the use of headgear for occipital anchorage.● 1844: Westcott used chincups to treat Class III patients.● 1850: Kingsley was among the first to use occipital anchorage to retract anterior teeth.  

● 1863: Kneisel reported on occipital anchorage to correct mandibular protrusion ● early 1900s: Calvin Case used extraoral anchorage extensively to treat blocked-out canines.

● 1936: Albin Oppenheim reintroduced extraoral anchorage after a long period of disuse.

 

● 1947: Silas Kloehn introduced the facebow with a cervical strap.

● 1974: John H. Hickham (1934-2004) developed a line of headgears based on the concept of “directional force” and he developed protraction headgear however this modality was made famous by Delaire.

● 1988: Patrick K. Turley (1949- ) researched on correction of Class III malocclusions using palatal expansion and protraction headgear. 

DEVELOPMENT OF ORTHOGNATHIC SURGERY

1st Person to carry out Orthognathic surgery - Simon P. Hullihen

Surgery for mandibular prognathism began in the early 20th century with occasional treatment that consisted of body ostectomy .

1st subapical osteotomy of anterior mandible

Sagittal split osteotomy in 1957

It was introduced by Schuchardt in 1942 but the correct technique follows description followed by Trauner and Obwegeser in 1957.

It was further modified by Dalpont(1961) , Hunsuk(1968) , Gallo et al(1976) and Epker (1977)

LeFort 1 downfracture technique.

Von Langenbeck described it in 1859 Wassmund used it in 1927.

It allowed repositioning of maxilla in all three planes of space , and reposition dentoalveolar segments surgically as required. 

Introduction of Facial Distraction Osteogenesis around the turn of the century. It developed rapidly as it braught about :- - large jaw movements

- treatment at an early age became possible for patients with the most severe problems.  

1st literture about it appeared in 1905 and was described by Codivilla to elongate a femur bone. However this concept was lost and reintroduced by Ilizarov , the Father of Distraction osteogenesis in early 1950s.

Robert Ricketts

Developed the bioprogressive therapy from a background of edgewise and Begg technique.

Introduced utility arch. Ricketts’ Quad Helix – 0.40 blue elgiloy wire. E-line

McNamara is the author of over 190 scientific articles, has written, edited or otherwise contributed to 53 textbooks and has presented lectures in 30 countries.Of particular note is his seminal work,Orthodontics and Dentofacial Orthopedics, used as a text in many orthodontic courses. He developed a form of cephalometric analysis referred to as the McNamara method of analysis.

James A. McNamara

‘Wick’ Alexander

1964 – University of Texas.

1977 – Vari-Simplex Discipline.

An outgrowth of the Tweed technique, these basic principles have been developed empirically over many years in the author’s own practice. Specific components include:-

A unique bracket prescription that features specific designs for individual teeth An arch form that fits most patients within one standard deviation

The use of single brackets with rotation wings to control labial flare of mandibular incisors.

Moreover, several of the author’s biomechanical concepts have been widely adopted as standard orthodontic practice, including the maxim to treat one arch at a time beginning with the maxillary arch.

Charles Burstone

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

Dr. William Proffit

He is the author of Contemporary Orthodontics, now published in ten languages, and co-author of Contemporary Treatment of Dentofacial Deformity and two other books on surgical treatment. Other publications include over 170 scientific papers in peer-reviewed journals and more than 50 book chapters and invited contributions.

Indian History

1st Orthodontist of India - Dr. H.D.MerchantOldest 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 founded on – Oct. 5th 1965.

7 visionaries – Dr. Prem Prakash,

Dr. H.D. Merchant,

Dr. A.B. Modi,

Dr. K.N. Mistri,

Dr. H.S. Sheikh,

Dr. Naishadh Parikh,

Dr. Mohandas Bhat.

Journal of Indian Orthodontic Society, - published in 1965.

First annual conference – held in 1967 at New Delhi.

P.G. convention every year since 1995.

Library & first Dental Museum in India formed in 1998.

Free Dental Specialty Centre, Vellore – Aug. 1999.

Indian Board of Orthodontists – 1999.

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

Other renowned contributories in Indian Orthodontics

Dr. Ram S Nanda- Transition of molar relationships in different skeletal growth patterns and posttreatment changes in the temporomandibular joint Dr.Ravindra Nanda - Nanda is the associate editor of Journal of Clinical Orthodontics and on the editorial board of nine National and International Orthodontic Journals. His major contributions include in the field of Biomechanics in clinical orthodontics and in studies about development of clleft palate.

CONCLUSION

“ The longer you look back, the greater you can leap ahead .”

one must know the past to look ahead for a better future….

BIBLIOGRAPHY

Asbell MB; A Brief History Of Orthodontics; Am J Orthod Dentofacial Orthop;August 1990;98;176-183

Asbell MB; A Brief History Of Orthodontics; Am J Orthod Dentofacial Orthop; September1990;98;206-213

Jacobson A; Radiographic Cephalometry; Second edition;27-29

Norman Wahl; Orthodontics In 3rd Millennia . Chapter 1 (American J Orthod Dentofacial Orthopedics 2005;127; 255-259

Norman Wahl; Orthodontics In 3rd Millennia . Chapter 2 (American J Orthod Dentofacial Orthopedics 2005;127;510-515)

Norman Wahl; Orthodontics In 3rd Millennia . Chapter 5 (American J Orthod Dentofacial Orthopedics 2005;128;535-540)Norman Wahl; Orthodontics In 3rd Millennia . Chapter 6 (American J Orthod Dentofacial Orthopedics 2005;128;206-213)

Proffit Fields Sarver ; Contemporary Orthodontics ; third Edition

Proffit Fields Sarver ; Contemporary Orthodontics ; Fourth Edition;395-430;686-711

T.M. Graber; Orthodontics: principles and practice ; Third edition;1-10

Vijayalakshmi PS, Veereshi AS; Orthodontics in the past millenium; Journal of Advanced Dental Research VolI : Issue I: October, 2010