INTRODUCTION

AND HISTORY OF
ORTHODONTICS
Presented By:-
Dr.Chandrika Dubey
 CONTENTS
• INTRODUCTION • HISTORY
– Derivation of term – Ancient civilization
– Definition of orthodontics – Middle ages – 17th century
– Unfavorable sequelae – 18th century
– Malocclusion – 19th century
– Aims of orthodontic – 20th century
treatment – History of cephalometrics
– Branches of orthodontics
– Scope of orthodontics
– Benefits of orthodontic
treatment
INTRODUCTION
• Humans have attempted to straighten teeth for thousands
of years before orthodontics became dental specialty in
late 19th century.

DERIVATION OF THE TERM

TERM ORTHODONTICS WAS FIRST COINED BY “Le FELON” IN 1839

ORTHODONTICS

Orthos Odontos
(right/correct) (tooth)
• WHY PROPER ALIGNMENT IS ESSENTIAL ??
– Esthetics
– Function
– Overall preservation of dental health

• UNFAVORABLE SEQUELAE OF MALOCLUSSION !

– Poor facial appearance
– Poor oral hygiene maintenance
– Risk of dental caries
– Risk of periodontal disease
– Abnormalities of function
– Psychosocial problems
– Risk of trauma to teeth
– TMJ problems
 DEFINITION
• NOYES, 1911

– First definition of orthodontics

– “the study of the relation of the teeth-to the

development of the face-and the correction of arrested
and perverted development”
• THE BRITISH SOCIETY OF ORTHODONTICS- 1922

– “Orthodontics include the study of growth and

development of jaws and face particularly, and the body
generally, as influencing the position of teeth; the study
of action and reaction of internal and external influences
on the development, and the prevention and correction
of arrested and perverted development”
• AMERICAN BOARD OF ORTHODONTICS (ABO) and
AMERICAN ASSOCIATION OF ORTHODONTICS
(AAO)

– “orthodontics is that specific area of dental practice that

has, as its responsibility, the study and supervision of the
growth and development of the dentition and its related
anatomical structures from birth to dental maturity,
including all preventive and corrective procedures of
dental irregularities, requiring the repositioning of teeth
by functional or mechanical means to establish normal
occlusion and pleasing facial contours”
 WHAT IS MALOCCLUSION
• The term ‘malocclusion’ was coined by “Guilford”
• It refers to any irregularities in occlusion beyond the
accepted range of normal

• It must be noted that not all malocclusion needs

treatment.

• Malocclusion that are mildly unaesthetic and does

not harm the teeth and their supporing structures
may not need treatment.
 AIMS OF ORTHODONTIC
TREATMENT
Jackson’s Triad

• Fuctions like • t/t not only affects • t/t should enhance

mastication and teeth but also the the overall esthetic
phonation sift tissues and appeal of the
associated skeletal individual.
• t/t should enhance • Aim is to get result
the efficiency of structures. which go well with
the functions • t/t should maintain patient’s personality
performed. balance between and make him look
these. appealing.
FUNCTIONAL STRUCTURAL ESTHETIC
EFFICIENCY BALANCE HARMONY
 BRANCHES OF ORTHODONTICS
• PREVENTIVE ORTHODONTICS
– defined as “ action taken to preserve the integrity of what
appears to be the normal occlusion at the specific time.”

– Actions taken prior to onset of malocclusion to prevent

anticipated development of malocclusion.

– They include
• Care of deciduous dentition
• Restoration of carious lesion in deciduous
• Monitoring eruption and shedding
• Elimination of oral habits
• Removal of retained deciduous teeth
• Maintenance of space
• INTERCEPTIVE ORTHODONTICS
– Defined as
• “ that phase of the science and art of orthodontics employed to
recognize and eliminate potential irregularities and
malpositions in the developing dentofacial complex”

– Implies that
• When the action is taken, malocclusion already exists.

– Includes
• Serial extractions
• Correction of developing anterior crossbite
• Control of oral habits
• Removal of supernumerary teeth
• Elimination of bony barriers
• CORRECTIVE ORTHODONTICS

– Like interceptive, it Is also undertaken after the

manifestation of malocclusion

– It employs certain technical procedures to reduce,

correct or eliminate malocclusion.

– Includes
• Removable or fixed mechanotherapy
• Functional or orthopedic appliances
• Surgical approach
 SCOPE OF ORTHODONTICS
• Orthodontic t/t can bring about changes in
– Dentition
– Skeletal system
– Enveloping soft tissue

• ALTERATION IN TOOTH POSITION

– Malocclusion involving dental system

• ALTERATION IN SKELETAL PATTERN

– Malocclusion related with skeletal disharmony i.e Maxilla and mandible (size,
position)

• ALTERATION IN SOFT TISSUE PATTERN

 BENEFITS OF ORTHODONTIC
TREATMENT
• Improved confidence
• Well aligned teeth that are easier to clean
• Ideally positioned teeth, which lessen the chances
of gingivitis and advanced diseases
• Better functions like speech and mastication
HISTORY
• 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.

 • Hippocrates
ANCIENT • Aristotle
CIVILIZATION • Aulius Cornelius Celsus

MIDDLE AGE – • Paulus Aeginata

17TH CENTURY • Ambrose Pare

• Pierre Fauchard
18TH CENTURY • John Hunter

• William lintott
• J.S Gunnell
• Emerson C Angel
19TH CENTURY • William And Magill
• John Nutting Farrar
• Norman Kingsley
• Henry A. Baker
 ANCIENT
CIVILIZATION
 Hippo crates (460 to 377 BC)
• the Greek physician
• His text, Corpus hippocraticum –
• many references to the “crooked teeth” and the tissues of the
jaws as part of the medical text.

 Aristotle (384 to 322 BC)

• the Greek philosopher
• The first comparative dental anatomist
• His famous work entitled De Partibus Animalium (On the Parts of
Animals)
• Compared the various dentitions of the known species of
animals of that time.

 Aulius Cornelius Celsus (25 BC to 50 AD)

– Described finger pressure to move teeth in his work “De Re
Medicina”
MIDDLE AGE
(476 – 1450)
Little reference to dentition during this period

Paul of Aegina (625 – 690 AD)

– First person to mention supernumerary teeth.
PERIOD BETWEEN
(1470-1800)

renaissance period
Leonardo da Vinci (1452 –1519 AD)
– First to recognize tooth form
– First to realize that each
tooth was
related to another tooth
and to the opposing jaw

– Described maxillary and

frontal sinuses and established their relationship to
facial height
Andreas Vesalius (1514 – 1564 AD)
• a Belgian physician and anatomist.
• in his classic work, On the Fabric of the
Human Body- described the minute
anatomy of the teeth, particularly the
dental follicle and subsequent pattern of
tooth eruption.

Ambrose Pare (1517 – 1590 AD)

– paid specific attention to dentofacial
deformities, especially to the cleft palate.
– first to devise an obturator for
treatment.
Pierre Dionis (1658 – 1718 AD).
• Advocated “operators for the teeth”;
• “To open or widen the teeth when they are set too
close together”.
• considered at length the etiology of dental irregularity
and corrective therapy.

 Matthau's Gottfried Purmann (1692)

First time mention about casts in dentistry
The impressions were taken in wax but the method
was not described.

 Phillip Pfaff (1756)

First reported the use of plaster of Paris for
impressions
18 TH CENTURY
PIERRE FAUCHARD

• France became the leader in dentistry

throughout the world in the 18th century

• Primarily attributed to one man Pierre

Fauchard
• Referred to as the “founder of modern
dentistry”
• His two-volume book The surgeon Dentist,
A Treatise on the Teeth, completed in
1723 and published in 1728.
 • If teeth are much out of line and cannot be corrected by
• Bandelette – for means of thread, it is necessary to use a band of silver or
expansion of gold
dental arches. • Width should be less than height
• Band should neither be stiff not too flexible.
• Two holes are made at each end. A thread passing partially
through forms a loop
• Works By the pressure and support given by the band
• Pierre Fauchard through his treatise ‘Le
Chirurgien dentiste’ established dentistry as a true
profession.

• the field was based 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.
Robert Bunon (1702 – 1788 AD).
French dental surgeon
– Advocated serial extraction
– First used the term orthopedics in connection with the
correction of malocclusion.

Etienne Bourdete (1757)

– Recommended only gold strips on the labial surface for the
upper arch and on the lingual surface for the lower arch.
– Recommended the extraction of the first premolars to
preserve the symmetry of the jaws.
– In children who had protruding chins, advocated extraction
of the mandibular first molars shortly after eruption
 Petrus Camper ( 1722-1823AD)
• A Flemish artist and anatomist

• Used a series of primate skulls and

heads represented in lateral view and
constructed a method of measuring
prognathism, Camper’s line and
Camper’s angle.

• Provided illustrations indicating a

progression of skeletal prognathic
types, from monkeys to apes, and
finally to humans.
John Hunter (1728-1793)

– Anatomy teacher in England

– He had a valuable series of publications,
– One of which was “the natural history of human teeth:
explaining their structure, use, formation, growth and
diseases”
– He demonstrated growth, development and articulation
of maxilla and mandible with attached musculature
– Also outlined the internal structure of teeth enamel and
dentin and their separate function.
1800-1840
Weinberger
• Weinberger classifies orthodontics in the United States as

– (1) Early Orthodontia, 1839 – 1880, or from Harris to Kingsley

– From 1880 – 1900, or from Kingsley to the establishment of

Angle School of Orthodontia and the organization of American
Society of Orthodontists

– (2) Modern Orthodontics, from 1900 to the present time.

Samuel S. Fitch (1829)

– book entitled “A System of Dental Surgery” is considered the first

definitive work on dentistry in this country,

– devoted a significant amount of information to irregularities of the

teeth. He was the first to classify malocclusion.

• Orthodontics was part of prosthetic dentistry, and the

literature on the subject described orthodontics in the area
of partial and total replacement of missing teeth
• CLASSIFICATION OF MALOCCLUSION ACCORDING
TO FITCH:

① When one central incisor is turned in and the under teeth came
before it whilst the other central incisor keeps its proper place
standing before the under teeth.

② When both the central incisors are turned in and both go behind
the under teeth and lateral incisors are in its place

③ When central incisors are placed properly and lateral incisors are
turned in and when the mouth is shut, the under teeth project
before them and keep them backwards

④ When all the incisors of upper are turned in and those of under
jaw show before them
1840-1875
Chapin A. Harris (1840)
– One of the most influential dental surgeons
during this period, published the first modern
classic book on dentistry, The Dental Art,
in 1840.

– Gave much attention to various orthodontic

treatment procedures

– His personal technique included the use of

gold caps on molars to open bite and knobs
soldered to a band for tooth rotations.

 J. S. Gunnell (1840)
– Introduced the chinstrap as occipital
anchorage for the treatment of
mandibular protrusion.
William Lintott (1841)
 Introduced the use of screws.
Described the premature loss of deciduous teeth
as a cause of malocclusion.

 Recommended that treatment begin at the age of

14 or 15 years .

 Described a bite-opening appliance

 Consisted of a labial arch of a light bar of gold or silver
passed around the front surfaces of the teeth by means
of ligatures (known as Indian twist), and the necks
of the irregular teeth with pressure applied for
movement.
J. M. A. SCHANGE
(1841)
– Introduced modification of the
screw, called the crib.
– Also introduced the use of the
clamp band
– For retention “use a rubber
band attached to some hooks
on the appliance surrounding
the molars”


Simon Hullihan (1848 )

– Performed the first successful Orthognathic surgery, a
partial autoplastic resection of a prognathic mandible.

William Dwinelle (1849)

– Introduced the jack screw.
Thomas W. Evans (1854)

– Published requirements for an appliance in dental

newsletter

① A firm support which shall not loosen or in any way injure the
teeth to which it is attached

② Steady and sufficient pressure

③ Great delicacy in construction so that appliance may be as

light as possible

④ Mechanism as simple as possible.

Emerson C. Angell (1860)

– Probably the first person to advocate the opening of the

median suture to provide space in the maxillary arch,
since he took a strong stand against extraction.
James D. White (1860)
– Perfected a removable vulcanite appliance with a
hinge in a split palate

George J. Underwood (1864) of New York

– Presented his graduation thesis at the
(Philadelphia)
entitled “Orthodontia."
O. A. Marvin (1828 to 1907 AD)
 in 1866, outlined the objectives of orthodontic treatment:

1. the preservation of correct facial expression

2. the restoration of such expression

3. the proper articulation of the teeth for better mastication

4. their orderly arrangement, with a view to preventing

• William E. Magill (1871)
– cemented bands on the teeth.

• The period of the last three decades of the

nineteenth century is studied in the framework of
individual dentists and their contributions.

• Each practitioner developed his own theory and

practice, some to a greater degree of excellence
than others.
1875-1900
 John Farrar - (1839-1930)

• John Farrar could be referred to as the Father of

American Orthodontics.

– Investigated the physiologic and pathologic changes occurring in

animals as the result of orthodontically induced tooth movement
(1975)

– Published a series of articles between 1881 and 1887 in the

Dental Cosmos, one of the leading dental journals, enunciating
the principle that "in regulating teeth, the traction must be
intermittent and must not exceed certain fixed limits.
  Also published Irregularities of the Teeth and Their
Correction, Vol. 1 in 1888 and Vol. 2 in 1889, in which he
demonstrated the many uses of the screw as the motivating
attachment and the basis of what he referred to as a “system of
orthodontia”

 He stressed the "importance of the observance of the physiologic

law which governs tissues, during movement of the teeth, the
subject being to prevent pain."

He was the originator of the theory of intermittent force,

and the first person to recommend root or bodily
movement of the teeth.
• Piezoelectric Theory by FARRAR (1876)
– When orthodontic force is applied to teeth, it causes deformation
or bending of alveolar bone.

– This deformation causes bone to become electrically charged and

exhibits a phenomenon called piezoelectricity

– Many crystalline substance exhibit piezoelectricity.

– Both hydroxyapatite and collagen fibers present in bone are

crystalline material with piezoelectricity

– Deformation of the crystal structure produce a flow of current as a

result of displacement of electrons from one part of crystal lattice
to other.
Norman W. Kingsley (1866)
 He experimented with appliances for the correction
of cleft palate

 Associated with a technique known as jumping

the bite with the use of a bite plate. It was the
treatment for protrusion of the maxilla, not
necessarily with extractions, shaping the dental
arches to be in harmony with each other.

 He used vulcanite in conjunction with ligatures,

elastic bands made of rubber, jackscrews, and the
chin cap.
Among the first to use extraoral force to correct protruding
teeth. He introduced the terms bite plane and occipital
anchorage in year 1861.
• 1880 published A Treatise on Oral Deformities,
which remained a textbook for many years.

• Emphasized the importance of the relationship

between mechanics and biology as the principle
on which orthodontics should be based.

• His book was the first to recommend that etiology,

diagnosis, and treatment planning were the
acceptable bases of practice. "Much success in
treating irregularities will depend upon a correct
diagnosis and prognosis."
Isaac B. Davenport, (1881)
– developed a theory that the masticatory apparatus was
subject to the laws of nature, that imperfect occlusion
was deleterious to the dentition, that extraction of teeth
in treatment could affect the efficiency of the
masticatory apparatus.

 Walter Coffin
• In 1881, Coffin Plate was introduced.

 L.E Cluster
• The principles of resorption and
deposition of alveolar bone during
tooth movement were discussed by
L. E. Custer (Ohio) in March, 1888.
 Henry A. Baker (1893)
–introduced the Baker anchorage, or
the use of intermaxillary elastics with
rubber bands.
–The introduction of intermaxillary
elastics was interpreted by some
practitioners to mean the elimination
of the need for extraction.

• In 1899 the Items of Interest was the first dental journal to devote a
section of each issue to orthodontia because of the recommendation of
its editor, R. Ottolengui (1861 to 1937 AD).
Clark Goddard
– Gave acceptance of an expansion screw for the forcible separation
of the maxilla.

– Also attempted to classify malocclusion, which included 15

separate types of irregularities.

Eugene S. Talbot
– He stressed the study of the causes of malocclusion to be the key
to treatment.
– He advised close attention to disproportion in the size of the
maxilla and mandible, "general contour and profile of the face,"
and "the family history including hereditary factors."
• He was one of the first to recommend the surgical exposure of
impacted canines.

• Also, he was the first to use X- rays for orthodontic diagnosis.

• In 1891, demonstrated intraoral measurements on casts with such

instruments as the registering calipers and the T-square with
graduated sliding indicator. This was one of the earliest attempts
applying specific analysis of casts that reflected measurements of the
jaws.
1900-1910
 ERA OF MODERN ORTHODONTICS

• The year 1900 is arbitrarily selected as a date for

the beginning of the oldest specialty of dentistry

– Because it was in that year that the Angle School of

Orthodontia was founded and in the following year that
the American Society of Orthodontists was
formed.
FATHER OF ORTHODONTICS
• The most dominant, dynamic, and influential figure in the
specialty of orthodontics.

• Through his leadership, orthodontics was separated from

the other branches of dentistry (e.g., crown and bridge,
prosthetics), and the result was the specialty of
orthodontics.

• Angle was the first to limit his practice to

orthodontics.
• 1880 – “First real appliance” – the jack & traction screw
with pushing action.

• Combination of adjustable clamp band of Schange &

regulating screw of Dwinelle.
• 1887 – introduced the Angle System.
• Angle’s classification has 4 classes:
 1907-E -Arch Appliance
E-arch appliance depends on rigid framework to which teeth were attached.

Only caused tipping movement

Only Molars are Banded
Heavy force .
 1912-Pin and Tube Appliance
• Bands on teeth
• Teeth other than the molars also banded .
• Vertical tube soldered to band and pin to wire
• This pin is repositioned from time to time
 1915-Ribbon Arch Appliance
• Better spring qualities .
• Poor control of root resorption
• rectangular gold wire held firmly with Pins
• Vertically positioned rectangular slots
 1928-Edgewise Appliance
• First to move the teeth in all 3 planes Simultaneously
• Re-oriented the slots from vertical to horizontal and inserted a
rectangular wire
• In 1878, Angle received his DDS degree from the
Pennsylvania College of Dental Surgery.

• In 1887 he was appointed to the chair of orthodontia in

the Dental Department of the University of Minnesota.

• He read his "revolutionary ideas" at the ninth

International Medical Congress (District of
Columbia), which received wide attention. The paper was
entitled "Notes on Orthodontia with a New System of
Regulation and Retention." It was later published in the
Ohio Journal of Dental Science (1887).
• In 1888, during a lecture to the Iowa State Dental
Society on his "system of orthodontia," Angle
demonstrated for the first time the expansion arch
and its auxiliaries.

• In 1894 he was appointed the first professor of

orthodontia at Marian Sims College, receiving the MD
degree from that college the following year.
• His classification of malocclusion was published in the
Dental Cosmos in 1899.

• The next year, he organized the first school of

orthodontia— The Angle School of Orthodontia
at St. Louis.

• The course of instruction included art (taught by artist

Edmund Wuerpel), rhinology, embryology, histology,
comparative anatomy, and dental anatomy, in addition to his
appliances.
Angle’s postulates
① Upper first molars are the key to occlusion.

② Most remarkably stable landmark in craniofacial anatomy –

upper first molars.

③ Upper & lower molars should be related so that the mesiobuccal

cusp of the upper molar occludes in the buccal groove of the
lower molar.

④ Line of occlusion – The line with which, in form & position

according to type, the teeth must be in harmony if in normal
occlusion.
His office in 1900
• the members organized the first orthodontic society - "The
Society of Orthodontists."

• In 1935, the society adopted the name it bears today: The

American Association of Orthodontists (AAO).

• They also established the magazine, a quarterly titled The

American Orthodontist, which we read today as the
American Journal of Orthodontics
1903 - Dr. Anna Hopkins
was elected the Society’s first
secretary.

• She completed one of the early Angle

courses, but was never to practice
orthodontia.

• In 1906 she became Mrs. Edward

Hartley Angle.
• In 1907, Angle started a school in New York City, and then,
from 1908 to 1911, his school was in New London, Conn.,
where 6-week sessions were offered at tuition of $200.

• In 1916 Angle moved again, this time to Pasadena,

Calif., for reasons of health.

• From 1924 to 1927, his course was extended for 1 year.

School at Pasadena, CF
• Angle had an uncompromising position against
extraction. It was his credo that

"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, and that each tooth shall be
made to occupy its normal position— i.e.,
normal occlusion."
• Angle filed 32 patents, the first was in 1889 and the last
was in 1934, after his death.

• His 30 patents focused on arches, on tools to modify them,

and on the best means of engaging banded teeth.

• His first patient was a regulating screw, with an ingenious

push-type jackscrew for increasing width.

• His other patents include E-arch appliance, pin and tube

appliance, ribbon arch appliance, and edgewise appliance.

• He also introduced soldering and a nickel-silver alloy to

orthodontics.
Calvin Case - 1847-1923
• His interest in
orthodontics, devising
original appliances and
the use of
intermaxillary elastics
(a technique for which
both he and Baker
were to claim
originality).

His special attention to the cleft palate patient was a

pioneering work,

He developed a classification of malocclusion that

included 26 divisions.
• He was the leader of the group that advocated extraction
of teeth.

• It was his reintroduction of the concept that the removal of

certain teeth will enable the correction of malocclusion and
improve general health and comfort that proved to be a
"bombshell."

• It met with great opposition from many practitioners,

especially those influenced by Angle.
• In 1921 Case published his major work, A Practical Treatise on the
Technics and Principle of Dental Orthopedia and Prosthetic
Correction of the Cleft Palate.

• Case was a strong advocate of the relationship of malocclusion to

facial improvement. Facial improvement was a guide to treatment.

• He developed a technique for root movement, introduced the use of

rubber elastics, pioneered the use of retainers and was the first to
use thinner and resilient wires for tooth movement.

• He introduced the use of plaster casts of the face to illustrate

different kinds of facial features.
CASE/ANGLE
CONTRAVERSY
 Originally, Case was a genuine
admirer of Angle. In fact, he
gave up the general practice
of dentistry because of
Angle's influence.
EDWARD CALVIN S. CASE
HARTELY ANGLE
 Case thought that he
 Angle attributed the origin of should have received that
the use of intermaxillary elastics credit.
to Baker
 Angle's thesis was that "there
Case defended the discreet use
shall be a full complement of of extraction as a practical
teeth, and that each tooth shall procedure, while Angle believed
be made to occupy its normal in nonextraction
position
Martin Dewey
• The extraction story was continued
into 1911 with Martin Dewey (1881-
1933) an ardent champion of
nonextraction. He modified Angle’s
classification of malocclusion.

• The climax of this conflict was a

debate in 1911 at the annual
meeting of the National Dental
Association (former name of the
ADA).
George C. Ainsworth 1904
– patented a regulating appliance that used vertical
tubes and the principle of the loop wire.

Victor H. Jackson (1850-1929)

– Devised a specially designed appliance known as the
Jackson crib, which incorporated the use of an
auxiliary spring (finger) as an aid in tooth movement.
– His appliance was one of the first "systems" of
treatment to influence the development of modern
orthodontics.
 Charles Hawley - 1861-1929
• Used a celluloid sheet
containing a geometric
figure that, when adapted
to a model, determined the
extent of proposed tooth
movement (1905)

• Introduced the
retainer appliance
that bears his name
(1908).
Benni Lischer - 1876-1959
• In 1907 founded the International School of Orthodontia

• in 1912, he published Principles and Methods of Orthodontia.

• He was an advocate of early treatment.

• He introduced the terms neutro-occlusion, disto-occlusion and

mesio-occlusion to describe the varieties of malocclusion

• Gave the suffix “version” to describe the wrong position of

individual tooth.
1910-1920
Albin Oppenheim (1911)
– The serious study of tissue changes during orthodontic tooth
movement
– Beginning of a major interest in diet, nutrition, and genetics as
reflected in orthodontic diagnosis .

Alfred Rogers (1918)

– Introduced the concept of myofunctional therapy

John V. Mershon (1867-1953 D)

– Introduced the removable lingual arch based on the principle
that teeth must be free and unrestricted for adaptation to normal
growth.
Albert H. Ketcham (1930)
a devoted researcher, was one of the first
to introduce the roentgenogram and
photography into orthodontic practice.

• Under the guidance of Albert H.

Ketcham, the American Board of
Orthodontics was created in 1929 and
incorporated in 1930.

He did studies on root resorption

A. LeRoy Johnson

– reemphasized the biologic concept in
orthodontics.
Milo Hellman – 1935
• Research in the science of anthropology
and its relation to the growth and
development of the human dentofacial
complex.

• Introduced craniometric measurements

and a classification of dental
development (1935).

• He coined the term ‘divergence of

face’

• His motto was “Perfection in the Goal,

Adequacy in the Standard.
• Demonstrated a high percentage of upper first molar
rotation and warned against categorizing malocclusion
without first checking this rotational tendency and mentally
replacing the tooth.

• pioneered in the use of hand and wrist X-rays to

determine the growth age and status for patients.
• The INTERNATIONAL JOURNAL OF ORTHODONTIA AND ORAL
SURGERY was started in 1915.

• Decade of the 1920’s was noted for the introduction of several

new appliances:

 Open tube by James D. McCoy (1922)

 Removable appliance with springs George Crozat (1928)

 Introduction of stainless steel to appliance fabrication by- Lucien de

Coster

 Spencer Atkinson introduced Universal appliance – a combination

of ribbon arch appliance & edgewise appliance using a flat wire &
round wire in combination.
1920-1940
Pacini (1922)
– Introduced a method for standardized head
radiography. The disadvantage was the high
amount of distortion because of head
movement during prolonged exposure time.

B. Holly Broadbent (1931)

– Published an article in the first issue of the
new Angle Orthodontist entitled "A New X-
ray Technique and Its Application to
Orthodontia."

– It was the introduction to the specialty and

to dentistry of cephalometric
roentgenography and of course,
cephalometric tracing and evaluation.
Broadbent’s Radiographic
Cephalometer(1931)
Hofrath (Germany )
 In the same year independently introduced a
standardized cephalometric technique using a high-
powered X-ray machine and a head holder called a
cephalostat or cephalometer.

 Broadbent
 Devised the roentgenographic cephalometer, which is
the instrument that accurately positions the head relative
to the film and x-ray source.

 His study, supported by the Bolton family, consisted of a

longitudinal study of 3500 schoolchildren from birth to
adulthood. In honor of his sponsor,
 Established a new point of reference on the skull, known as the Bolton
point.
• Schwartz (1932)
– described the pressure-tension theory to
explain the movement of teeth during
orthodontic treatment.
– defined the optimum orthodontic force
as 28 g per sq. cm of root
surface.

• The principle of panoramic radiography

was described by Numata (1933)
and independently by Paatero
(1948).
 Oren A. Oliver (1887-1965 )
– Established the labiolingual appliance (1940).

 Robert R. W. Strang
(1881-1982)
Founded a postgraduate school in
Connecticut
His book, A Textbook of
Orthodontia (1933), was widely
used and became a guide to the
"Strang technique."
1940-1950
Wilton M. Krogman (1903-1987 )
– Applied the principles of physical anthropology
to the dentofacial complex with craniometry and
roentgenographic cephalometry. (1940’s)

Allan G. Brodie
– Contributed to the study of the growth patterns
of the human head from the third month of life
to the eighth year.

 Weinmann and Sicher (1940’s)

–The Sutural theory of growth control
 Charles S. Tweed - 1895-1970

• In 1941 introduced into the

literature an "edgewise" appliance,
based on the basal bone concept.

• Developed the concept of uprigthting the

teeth over the basal bone with emphasis
on the mandibular incisors.

• Made the extraction of teeth for the

Orthodontic correction acceptable and
popularize the extraction of first
premolars.
• Enhanced the clinical application of Cephalometrics.

• Developed diagnostic facial triangle.

• Developed the concept of orderly treatment procedures

and introduced the concept of anchorage preparation as a
major step.

• Developed serial extraction of primary and permanent

teeth.
H. D. Kesling (1945)
– introduced his philosophy of tooth movement by using a
rubber tooth-positioning device in which the teeth were
moved into a more ideal cuspal relationship after major
correction had been accomplished

William Wilding (1940’s)

– received a basic patent for the use of alginate as a
dental impression material.
Adolf Marten
– A German metallurgist introduced martensitic
stainless steel.

Elgin Watch Company

– Also in 1950’s the developed a complex alloy whose
primary ingredients were cobalt, chromium, iron
and nickel. This alloy was marketed as Elgiloy by
Rocky Mountain Orthodontics.
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 and that there
could be a variety of causes of malocclusion exclusive of
the teeth (1948).

– Wendell L. Wylie (1913-1966), whose research was

directed to some underlying determinants of facial
pattern applied to the anteroposterior relationships,
called assessment of anteroposterior dysplasia.
• . Other analyses were presented by

– C. C. Steiner (1953)

– C. H. Tweed (1953)

– S. E. Coben (1955)

– R. M. Ricketts (1966)

– V. Sassouni (1969)

– H.D. Enlow (1969)

– R. Jarrabak (1970)

– A. Jacobson (1975)
James Scott (1950’s)
The nasal septum theory to explain growth control,
which states that cartilage is the primary determinant of
skeletal growth, while bone responds secondarily and
passively.

Melvin Moss (1960)

–The functional matrix theory of growth, which
stated that the soft tissue matrix in which the skeletal
elements are embedded is the primary determinant of
growth, and both bone and cartilage are secondary
followers.
Buonocore (1955)
– Introduced of the acid etch technique

Bowen (1962)
– Developed BIS-GMA system by combining acrylic and epoxy resin.

Newmann (1965)
– introduced bonding in orthodontics.

• Wilson and Kent (1972)

– Introduced glass ionomer cement
White (1986)
– Popularized glass ionomer cement in orthodontics.

Maijer and Smith (1979)

– introduced crystal growth theory for promoting
bonding between resin and enamel by using sulfated
polyacrylic acid solution.

Silverman (1995)
– introduced light cure GIC in orthodontic bonding
procedure.
Percival Raymond Begg(1898-1983)
• Raymond Begg of Adelaide, Australia
introduced his multiple-loop light-
force wire appliance in 1954, which
continues to be in use today.

• In 1924 he was accepted at the Angle

School of Orthodontia in Pasadena,
California.

• He worked with Angle from March

1924 to November 1925.
• In November 1925 he returned to Australia and began to use
edgewise mechanism.

• In February 1928 he began, when indicated, to remove teeth

and/ or reducing their widths by stripping.

• In the early 1940s, Begg met Arthur J. Wilcock, a

metallurgist at the University of Melbourne. After many years
of research, Wilcock produced a cold-drawn, heat-treated
wire that combined a balance between hardness and
resilience with the unique property of zero stress relaxation.
• In 1954, Begg summarized this work on attritional occlusion
in a classic paper entitled “Stone Age Man’s Dentition”, at
the end of which he described his new ‘round wire’

technique featuring the use of .018” round stainless

steel wire in modified ribbon arch brackets.
In 1956 Begg introduced the concept of differential force. In his
1956 article, Begg also reported that more than 200 patients
could be treated each year demonstrated that his technique and
theories of treatment were able to produce acceptable results in
unbelievably short treatment times for all types of
malocclusions.
 H.D. Kesling and Robert Rocke introduced Begg
concept in the United States.
1959- first course in Begg technique at
Kesling & Rocke Orthodontic Centre
 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 public’s
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.
Enlow (1965)
– The area relocation theory to explain craniofacial
growth.

Alexandre Petrovic (1970’s)

– Servo system theory of craniofacial growth.

– He reasoned that it is the interaction of a series of casual

change and feedback mechanism, which determines
craniofacial growth.

– The control of primary cartilage takes a cybernetic form

of command whereas that of secondary cartilages has
the direct effect of cell multiplication.
van Limborgh (1970)

– Multifactorial theory to explain craniofacial growth.

– He suggested that intrinsic genetic factors, local epigenetic
factors, general epigenetic factors, local environmental factors
and general environmental factors control growth.

Hounsfield (1972)

– Announced the invention of the first CT technique, which he called

computerized axial transverse scanning.
– Recently, dedicated three-dimensional CT scans for the
maxillofacial area has been introduced (NEWTOM –9000).
Lawrence Andrew
• In 1972, developed Straight Wire
appliance.

• It was a modification of edgewise

appliance, in which the brackets are fully
pre-programmed to accomplish the
desired tooth movement in all the three
planes of space.

• This is considered a major advancement in

improving orthodontic treatment results
with minimal possible wire bending.
Peter Kesling (1980)
– introduced tip-edge appliance, as a combination of Begg and the
straight wire appliances.

• The history of archwire starts from piano wire, passes

through stainless steel and cobalt-chromium to nickel-
titanium wires.
– George Andreasen( 1970’s) nickel-titanium alloy named Nitinol

– Burstone (1980) developed a stabilized beta-phase titanium

alloy, marketed as TMA
• While the American orthodontists were
showing keen interest in improving fixed
appliances, their European counterparts
continued to develop removable and
functional appliances for guidance of growth.

• The principle of functional appliances was

first articulated in a paper in Germany by
Roux in 1883 .
Pierre Robin (1902)
– introduced Monobloc, which protruded the mandible
forward in patients with Pierre Robin Syndrome.
 Viggo Andresen of
Norway (1910)
developed the
ACTIVATOR
(Norwegian system),
which made use of
the facial
musculature to guide
the growth of the
jaws.
Bimler developed the Bimler appliance
(Elasticher Gebissforner).

• Bionator by Balters in early 1950s

 Rolf Frankel in 1969-1973 proposed the Function
Regulator to treat a variety of skeletal malocclusions.

 William Clark developed the Twin Block technique in

1977
Phillip Adams(1948)
– Introduced Adams Clasp. It is the most widely used
clasp in orthodontics today.

Emil Herbst (1909)

– Introduced the first fixed functional appliance,
Scharnier or Joint, which is a fixed bite jumping
device, and it was popularized by Hans Panchers in
1977.

– Also developed Quad-helix appliance, which was popularized by

Ricketts.
 Summary
Pierre Fauchard 1728 Bandlette

Etienne Bourdet 1722-1789 Ivory splint

Catalan -- Inclined plane

Charles Goodyear 1839 Vulcanite

Schange 1841 Adjustable clamp band

Tucker 1846 Rubber elastics

Dwinelle 1849 Jacks screw

Emerson Angell 1860 Expansion of palate

Coffin 1860 Flexible piano wire

Kingsley 1861 Headgear

Magill 1870 Dental cement

E.H. Angle 1880 Jack & traction screw

E.H. Angle 1887 Angle system

E.H. Angle 1889 Classification of malocclusion

Pierre Robin 1902 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 Adam’s crib

Martin Schwarz -- Schwarz double plate

Hotz -- Guide plane plate

William Downs 1948 Down’s analysis

Kraus -- Double oral screen

Hotz -- Propulsor

P.R. Begg 1956 Begg technique

Jarabak -- Light-wire technique

Rolf Frankel 1967 Frankel appliance

Andrews 1972 Straight wire appliance

Ricketts -- Bioprogressive therapy

T.L. Root -- Level anchorage system

Pancherz 1977 Herbst appliance

Clark 1977 Twin block

Alexander 1978 Vari-Simplex Discipline

ORTHODONTICS IN
• The beginning of orthodontics in India was made in 1935,
as Dr. H.D.Merchant gave the first series of lectures in
orthodontics at the Nair Hospital Dental College, Bombay.

• He is considered to be the “the father of Indian

orthodontics”.

• The first department of orthodontics was properly

established in 1939 in Nair Hospital Dental College
under him.
• At that time, the appliances used were
– Mershon’s Lingual Arch and High Labial Arch, Hawley’s
Plate, Catalan’s Appliance
– later on Badcock’s Expansion Plates and Norwegian
Appliances were introduced.

Dr. N.H. Parikh (1957)

– Introduced Jarabak’s Technique.

Dr. A.B. Modi

– Introduced Frankel’s Appliance and functional
appliances.
Dr. Prem Prakash (1954)
– Introduced edgewise appliance

Dr. Henriques (1955).

– Introduced labio-lingual appliance

Dr. Prem Prakash (1963)

– Introduced Begg’s technique.

• The Post-Graduate courses were started at the

Bombay colleges in 1959
 INDIAN ORTHODONTIC SOCIETY

• The Indian Orthodontic Society was established on

Friday the 5th October 1965 at Mumbai with (Late) Dr.
H.D.Merchant as the Founder President and Dr. Parikh as
the Founder Secretary and Treasurer.

• The First Annual Conference of the Indian Orthodontic

Society was held along with the Indian Dental Conference
during January 1967 at New Delhi with a scientific
session.
• The quarterly publication of the Journal of Indian
Orthodontic Society (JIOS) was started by Dr.H.D.Merchant
as the first Editor.

• In 1996, first Post Graduate Student Convention was

conducted in Mangalore, to expose the postgraduate
students of the entire country to a cross section of teachers
on different facets of orthodontics.

• In 1999, the Indian Board of Orthodontics, first

dental specialty to establish a professional certifying
board in India, was formed and the first specialty Board
Examination was conducted on 29th September at
Bangalore.
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,
Dr. Naishadh Parikh,
Dr. Mohandas Bhat.
 CONCLUSION
Orthodontics has achieved the status of a recognized specialty
of dentistry because of a long period of craftsmanship
and professional expertise.

Our objective has always been to provide for the

preservation of dental health through the conservation
of oral structures and the maintenance of dental
function.

 Orthodontics, and indeed all of dentistry if it is to survive as a

profession, must continually reexamine its history and find
relevant and significant ideals to meet the crises of today.
 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: Current 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.
9. Special Article – A brief history of orthodontics, Milton B. Asbell
THANKU