History Of Orthodontics

History Of Orthodontics A Brief Presentation By Dr. Nilofer & Dr. Amrita

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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

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• 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

(1916) (1925)

Ribbon Arch Edgewise

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

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History

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The history of the European Orthodontic Society

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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

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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.

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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.

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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 funktionator . 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 secretarytreasurer. 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.

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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.

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Consultant - Parsee General Hospital, Mumbai.

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Professor Emeritus at the Govt. Dental College and Hospital, Mumbai.

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Former Dean DYP Dental College and Hospital, New Mumbai

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Director DYP Dental College and Hospital, New Mumbai and Member Managing Council Medical and Dental DYP Deemed University.

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President of the Rotary Club of Bombay North 1900-2000.

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Assistant Governor - Rotary International Dist 3140 (02-03).

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Assistant Trainer - Rotary International Dist 3140 (04-05).

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District Secretary - Rotary International Dist. 3140 (05-06).

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Dr. Mistry has been the recipient of several National and International Awards

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Awarded National Gold Medal and B. C. Roy Award for Medico-Social Relief Work in India - 1984

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Best Citizens Award by the National Council of Metro Citizens 1991.

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Hind Gaurav Award - 1993 by AIAC, New Delhi.

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Asian Pacific Dental Federation Award in 1994 for Originating the concept of the year of Oral Health - 1994.

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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,

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Vikas Ratan Award - 1994 from Shri M, Veerappa Molly Chief Minister of Karnataka for enriching Human Values.

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Indian Dental Association Bombay Brave award for Meritorious Service to Dentistry 1994 and 1996.

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"Mother India International Award" in 1995 at the 16th International Conference of Indian and Non-Resident Indians

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The Dental Students Appreciation Award for outstanding guidance and cooperation in 1993, 1996 and 1997.

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The 1997 appreciation Award at the World Congress on Orthodontics.

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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.