REVIEW ARTICLE

Evolution of Orthodontic Brackets

Dr. Tamizharasi1, Dr. Senthil Kumar2

ABSTRACT:
Orthodontics distinguishes and differs itself from the other
1& 2
Professors branches of medicine by its widespread use of an array of devices
made of almost all the biomaterials known. From metals to plastic and
Department of Orthodontics from ceramics to composites, these materials bring beauty and health.
KSR Institute of Dental Science & Research, Brackets evolutions from the introduction of pin and tube to lingual,
Tiruchengode, Tamil Nadu. magnetic and self ligating brackets are rapid in pace and play a
significant role in advancement of Orthodontic field. Though, we all
are using recent brackets which are currently available in the markets,
it is important to know the past history of brackets which was used
earlier. Thus, this article reviews the history of various orthodontic
brackets and it's advantages and disadvantages. We suggest that
many more review studies should come aiming at the biocompatibility,
aesthetics and treatment results of each bracket. Such studies will
help the practitioner to decide the bracket selection for his treatment
plan.

Introduction edgewise bracket with a horizontal slot (0.022” x 0.028”).

One of the most important passive components of Ever since many modifications had come in bracket design
fixed appliances is brackets. They are merely handles for and in bracket material.
attachment of the force producing agents. Brackets can
affect the directions of the force vectors when torque, Classification
angulations, and in/out are built into the brackets. Brackets can be classified according to:-
Orthodontic treatment is based upon specific force 1. Width of bracket
applications to the dentition, the maxilla and the mandible. a. Mesiodistally narrow ex., Ribbon arch bracket,
In order to obtain these forces, orthodontic brackets are Begg bracket
attached to the teeth. Previously, brackets were banded to b. Mesiodistally wide ex., Edgewise bracket, Straight
the teeth. But, after, the introductions of bonding resin, wire bracket
brackets are rarely banded to the teeth. 2. Slot of bracket
a. Horizontal slot ex., Edgewise bracket
History b. Vertical slot ex., Begg bracket
It is difficult to imagine that there was a period in 3. Materials
Orthodontics before the invention of brackets. Yet this was a. Metal – Stainless steel, Gold, Titanium, Nickel
the situation when Angle developed and perfected b. Plastics
treatment procedures with his “E” arch which provided no c. Ceramics
axial tooth control. During this time he also advocated the d. Combination – Metal reinforced plastics, metal
pre-treatment extraction of teeth and devised methods to reinforced ceramics
close extraction spaces "sans" brackets. 4. Movement of tooth
The pin and tube appliance1 overcame the weak a. Tipping movement – Begg bracket
point in his “E” arch. Thus the prototype of bracket was b. Bodily movement - Straight wire bracket
conceived. The problems of pin and tube appliance were c. Tipping & Bodily movement – Combination
overcome in ribbon arch appliance by Angle with the bracket, Tip-Edge bracket
introduction of first orthodontic bracket – “the ribbon arch 5. Ligation of bracket
bracket”1. It had a vertical slot facing occlusally and was a. Conventional ligation – Edgewise bracket, Begg
made in gold. The next major advancement in bracket bracket
design that had withstood the test of time was the first b. Self-ligation- Edgelok bracket, SPEED bracket

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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

Description of Brackets the edgewise bracket has been changed to permit free
Ribbon Arch Bracket crown tipping followed by controlled root uprighting.
The ribbon arch appliance introduced in 1915, Lateral extensions of the bracket behind the arch
was the next step in the evolution of tooth alignment wire provide maximum rotational control even when the
devices. It was actually the first bracket, as such, to be used tooth is tipped. The wings are lingual to the archwire and
in an orthodontic appliance. In the ribbon arch appliance, therefore not visible. Each bracket has a vertical slot to
the tube principle was abandoned for the bracket principle. accept rotating or uprighting springs, power pins and jigs
The mesial and distal walls of the tube were removed. Thus for accurate direct bonding. The slot is rectangular (0.020”
these brackets had a vertical slot facing occlusally in x 0.020”) with both the gingival and incisal ends chamfered
contrast to the Begg bracket which faces gingivally. to facilitate the insertion of auxiliaries from either direction.

Universal Bracket Ceramaflex II – 256 Begg Brackets

The name “universal”2 only connotes that the The most exciting addition to the Begg appliance
bracket is effective to move and control tooth movement in component list, are the ceramic brackets. TP Orthodontics
all planes. It is truly a light wire bracket, designed to be Inc markets it as “Ceramaflex II – 256 Begg” brackets. This
used with light wires, but for stability purposes, heavy wires bracket is polycrystalline alumina and is manufactured by
are also accepted. This in itself makes the bracket injection moulding. The bonding surface has a
“universal” in its implementation. It has two separate slots polycarbonate base with a slot to enable easy debonding
to receive single or multiple wires for the various tooth and to avoid enamel fracture that occurs with ceramic
movements. The bracket also has wings that enhance the brackets2.
wire action.
Edgewise Bracket
Begg Bracket Angle's final achievement, the edgewise
These are modified ribbon arch brackets, which appliance, was the culmination of many years of effort and
are narrow mesio-distally and carry a vertical slot usually of many different appliance designs attempting to place the
0.022” size. The ribbon arch brackets designed by Angle teeth according to his “line of occlusion”. The original
were placed inverted by Begg3 with the slot facing edgewise bracket as designed by Angle1 was a soft gold
gingivally. The round arch wire is loosely fitted and held in bracket with a 0.022” x 0.028” slot which was readily
place by a lock pin or ligature tie wires. This is responsible deformed by the forces of occlusion and by tying ligature
for the free tipping and sliding of teeth during the initial wires to the bracket.
stages of treatment. But, because of the narrow bracket
and round wire, apical movements are not possible without Various modification of edgewise brackets are:
the use of auxiliary springs.
Single Width Bracket
Modern Begg Bracket It was designed to overcome the problem of tooth
Dr. William J. Thompson introduced the Modern rotation. He devised soldered gold eyelets to be placed in
Begg4 Technique in the year 1981. It comprises of the the bands.
advantages of the Begg light wire technique and Straight
Wire technique. The gingival, or ribbon-arch slot is Twin Bracket
designed to permit maximum crown and root tipping The next development was the joining together of
movements and the edgewise slot is designed for precise two edgewise brackets on a common base. It was named
final detailing. These bracket types provide adequate after the originator of the idea Swain1. The Siamese bracket
mesiodistal width for optimal rotations, tipping and torque. quickly gained popularity for use on upper central incisors
The base of the four-stage bracket is bevelled to reduce the and on molar teeth. Its main advantage was its ability to
possibility of friction or binding with the arch wire. The effect most of the tooth rotation without the use of auxiliary
specifications for torque, tip, and in-out placement vary for eyelet ties. After many years another evolutionary step was
each tooth. the curving of the base of the twin bracket to confirm to the
curvatures of the canines and premolar.
Tip Edge Bracket
Dr. Peter C. Kesling designed the Tip Edge Lewis Bracket
bracket5. From his experiences with differential tooth Lewis developed another approach to the problem
movement for 30 years and a thesis written in 1968, he of efficient tooth rotation. He soldered auxiliary rotation
determined that is necessary for each tooth to tip freely arms that abutted against the bracket itself and thus offered
either mesially or distally-not in both directions. The face of a lever arm to deflect the archwire and rotate the tooth. It
does not interfere with occlusogingival deflections of the

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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

archwire. The next development in the Lewis rotation tooth positions prior to appliance removal that would
bracket was the curving of the base and wings of the allow the teeth in most instances to settle in
bracket to conform to the canine and premolar teeth. nonorthodontic normal's studied by Andrews. He
altered the prescription of the Andrews appliance to
Vertical Slot Lewis Bracket allow the teeth to be placed in a slightly overcorrected
A refinement in the Lewis bracket has been the position in all three planes.
incorporation of a 0.020” x 0.020” vertical slot, making 3. Swain Modification of The Roth Set-up
possible the use of uprighting springs to correct axial
inclinations if needed. Swain altered the prescription of the Andrews
appliance to what he thought would allow the teeth to
Steiner Bracket be placed in a slightly overcorrected position in all three
This bracket incorporated flexible rotation arms planes of space but not so far overcorrected that the
which afforded a rotational effect. It works satisfactorily as teeth would not “settle” into an idealized position1.
long as the flexible arms do not take on a permanent 4. Vari-simplex Brackets
deformation. The Vari-Simplex Discipline includes a specific bracket
system used in case treatment. Dr. Wick Alexander8
Broussard Bracket described it in the year 1978. The Vari-Simplex system
It was developed by Garford Broussard1. It is a is designed for 0.018” bracket slots and 0.017” wire.
conventional bracket with a closed, rectangular, vertical slot Though 0.022” brackets can also be used, he feels
0.018” by 0.046” which is formed when the bracket is patient comfort is improved, treatment time is
welded onto the band material. decreased, and the teeth are more easily moved into
their proper positions with the 0.018” slot.
Other Modifications:
5. Bennett & Mclaughlin Technique
SVED MODIFICATION1
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT The authors Richard P. McLaughlin & John C. Bennett9
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT AND introduced this technique, in the year 1995. They
NARROW LIGATURE SLOT produced a “Theoretical Bracket Placement Chart” by
SINGLE EDGEWISE BRACKET WITH VERTICAL SLOT AND measuring the distance from the incisal or occlusal
WIDE LIGATURE SLOT edge to the centre of the clinical crown. Values at
LEE-FISHER EDGEWISE BRACKET +0.5mm and +1.0mm were added for larger teeth,
MODIFIED LEE-FISHER EDGEWISE BRACKET and values at -0.5mm and -1.0mm for smaller teeth.
6. Segmental Arch Technique
Preadjusted Edgewise Bracket
Dr. Charles J. Burstone introduced this technique which
In this bracket system the need for the first, second
uses the Medium Diamond Twin brackets of the Orthos
and third order bends has been reduced by producing a
prescription. His Vertical Tube Cuspid Bracket10 is very
custom bracket for each tooth, in which a combination of
popular featuring an horizontal auxiliary tube.
varying thickness of bracket base, inclinations of slot and
torque of the slot are used to minimize the wire bending for 7. Bioprogressive Technique
ideal archwire. These characteristics for each tooth are Dr. Robert Murray Ricketts 1 1 introduced the
called the “appliance prescription” or “building treatment Bioprogressive therapy in the year 1976. There are 3
into the appliance”. combinations - standard progressive setup where
torque is built into upper incisor and all 4 canines, full-
1. Andrews Prescription torque setup where torque built in lower molars and
Dr. Lawrence F. Andrews6 introduced the Straight Wire premolars, triple-control setup with rotational control.
Appliance to Orthodontic profession in 1970. His 8. Linear Dynamic System
appliance was based on six keys to normal occlusion.
He divided the appliance as nonprogrammed, The linear dynamic System is a simplified version of the
partially programmed and fully programmed Bioprogressive11 therapy given by Dr. James J. Hilgers
appliances. Non programmed brackets are without in the year 1987. According to him, if double or triple
slot or base inclination. Partly programmed bracket buccal tubes on upper or lower molars are used ideal
contains 220 slot inclinations. Fully programmed orthodontic occlusion can be achieved.
brackets have 220 base inclination. 9. The Level Anchorage System
2. The Roth Set-up It consists of a banded or bonded edgewise appliance
The Roth Set-up7 was introduced in the year 1976. The with built-in tip, torque, and offset and an analysis and
purpose of the Roth setup was to provide idealized treatment-planning chart with a step-by-step treatment

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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

procedure for seven different extraction and non remained the most widely used material in the manufacture
extraction choices. of orthodontic attachments. Plastics were introduced in the
10. The “ORTHOS” System late sixties and ceramics have been introduced in the mid
eighties. Titanium bracket have solved the problems of
Dr. Craig Andreiko12, applied computer-aided nickel sensitivity, corrosion, and inadequate retention. It's
engineering technology to orthodontic appliance one-piece construction requires no brazing layer, and thus
design in developing the Orthos System, truly incited a it is solder and nickel-free. TP orthodontics has introduced
worldwide movement away from pre-adjusted the Nu-Edge bracket in the year 1997. It uses cobalt
appliances based on 1960s metrology. chromium alloy that is essentially nickel free.
11. The Bios System Polycarbonate brackets were described and tested
“Bios” is a light-wire, higher-torque version of the by Newman in 1969. Later,polyurethane, fiber-reinforced,
Orthos appliance system. Dr. Jim Hilgers designed the and filler-reinforced brackets became available18. They
Bios system13 to allow for earlier torque control with have limited popularity because of clinical problems of
lighter wires. It differs from the Orthos prescription by staining – rendering them unaesthetic, distortion and
virtue of its increased torque in upper incisors and in the tearing of the bracket –particularly from torsional forces.
mandibular posterior segment, as well as lingual root More efforts are directed improving the strength of
torque in upper and lower cuspids. polycarbonate/ polymeric brackets by reinforcing the weak
plastic matrix. These types of brackets are reinforced with
Lingual Brackets
ceramic, glass or even with metal inserts.
Dr. Kinya Fujita14 introduced the Mushroom arch wire Ceramic brackets were first introduced in 1987
appliance in the year 1979. In the lingual bracket, the and it has found wide acceptance and still holds more
opening of the slot was set on the occlusal surface of the promise. The number of problems such as excessive bond
teeth in order to facilitate the fitting of the wire. The groove strength, enamel fracture on debonding, brittleness of the
for lockpin insertion was set mesiodistally in the slot and an bracket and surface finish has been largely addressed in
auxiliary groove was set in the occlusogingival direction to the second generation of ceramic brackets.
facilitate correction of the mesiodistal tipping of the teeth. Magnetic brackets were introduced by Kawata et
Self Ligating Brackets al19., in 1987. The magnetic material that first employed
clinically was a cast alloy consisting of 25% to 30%
Self ligating brackets were introduced in the
chromium, 15% to 25% cobalt, and 45% to 60% iron.
seventies with the Edgelok bracket. These brackets have
Recently, a new material that contains a rare earth metal
the advantage of aesthetics and comfort. The possibility of
–samarium has been included in the magnet. The magnet
puncture wounds from ligature ties is nil. The most
has at the present time the highest available coercivity and
common used brackets are “Mobil-Lok brackets”, “Insert
maximum energy product.
bracket”, “SPEED brackets15”, “ Activa Brackets”, “Damon
SL Brackets” , “Time Bracket” etc., Shortened chair time and
slightly less incisor proclination appear to be the significant Bracket Width
advantages of self-ligating system16. Recently, the The wider the bracket, all other things being equal,
introduction of active and passive self-ligating brackets has the easier it will be to generate the moments needed to
presented a challenge to the speciality because of the novel bring roots together at extraction sites or to control
ligation mode and the potential alterations in load and mesiodistal position of roots in general. The wider bracket
moment expression during mechanotherapy. reduced both the force needed to generate the moment
and the contact angle, and is thus advantageous for space
Bioefficient Brackets
closure by sliding.
Dr. Anthony D. Viazis designed the Bioefficient
Despite their advantage, wider brackets also have
brackets17 in the year 1995. These triangular brackets are
disadvantage. The wider the bracket on a tooth, the
twin brackets with a single-slot type. It was designed to
smaller the interbracket span between adjacent teeth, and
provide the first differential stiffness bracket to
therefore the shorter the effective length of the archwire
accommodate the new, differential-force superelastic wire.
segments between supports. The maximum practical width
Adhesive Precoated Brackets of a wide bracket is about half the width of a tooth, and
The orthodontic resources of United and the adhesive even narrower brackets have an advantage when teeth are
expertise of 3M have combined to create the first Adhesive malaligned, because the greater interbracket span gives
Precoated metal brackets. It does not set until it's light cured. more springiness.
Bracket Materials
The first orthodontic attachments were made of
Bracket Slot
Good torque is possible with steel wires and 18mil
gold. Since the introduction of Stainless steel it has
edgewise brackets. The original 22-slot would have some

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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

advantage during space closure but would be a definite curing time and change in light direction may increase the
disadvantage when torque was later added. If only steel bond strength and reduce enamel fracture during
wires are to be used, the 18-mil slot system has advantage debonding. The bracketless invisible aligner technique has
over the larger bracket size. NiTi alloys with springback been considered as a new developed orthodontic technique
and resistance to permanent deformation have overcome since its appearance during the period of late 1990s.
some of the alignment limitations of steel wires in 22 mil slot According to Bai YX22 there have been many opportunities
brackets, while rectangular NiTi and Beta-Ti wires offer for further development and clinical application for this
advantages over steel for the finishing phases of treatment technique with the developments of material sciences,
and torque control17. computer software and hardware technology, rapid
prototyping techniques, et al.
Bracket Bases Regarding bracket materials, Eliades T23 states that
One of the most important factors in retention of manufacturing techniques might be modified to include laser-
an Orthodontic bracket is type of bracket base. The most welding methods and metal injection molding. Esthetic
common bracket bases are perforated bases, foil mesh bracket research will involve the synthesis of high-crystallinity
bases, photoetched bases and integrated cast type bases. biomedical polymers with increased hardness and stiffness,
The use of small, less noticeable, metal bases helps avoid decreased water sorption, and improved resistance to
gingival irritation. The wire size of the mesh as well as the degradation. Further, he describes that new plastic brackets
size and topography of spot welds are also considered in might incorportate ceramic wings23.
bond strength. Sims MR24 has viewed the future of brackets from a
Today's favourite bases are die cut from laminates technical point. According to him, in the next millennium,
made of a fine mesh, pressed under heat to a foil that can the genome revolution and knowledge of protein
have various thickness. A still promising forward step is production and control could lead to the genetic correction
the micromechanical retention, achieved by coating the of dentofacial anomalies and pain-free, biomolecular
bases with porous metal powder. methods of malocclusion correction and long-term stability.
Coating of bonding agents on bracket bases also A fundamental change would be in the abolition of bracket
increases retention. The coating process increases systems and their replacement with preprogrammed
mechanical retention by creating undercuts on the top and microchips driven by computers, and the control of PDL
sides of the wire mesh. The brackets are also silanated as a blood vessels and cells by pharmacological targeting.
final step which creates higher additional bond strength Future survival of this profession will depend on a radically
due to chemical bonding of the bracket with the adhesive. different specialist who will be educated with a
postgraduate curriculum based on molecular biology and
Recycling computer engineering24.
Though there are still concerns about the possible
increased risk of cross infection, yet recycled brackets are Summary And Conclusion
still used to reduce the cost per case. Brackets can be Orthodontia has attained unmeasurable goals in
recycled either by application of heat to burn off the the past century. Today, we are surprised to know that there
adhesive or by using chemical solvents to strip off the was a period when Orthodontia was functioning without
adhesive. brackets. The advancement of the size, shape, material
and technology of brackets of today is amazing. Hence, it is
Discusssion necessary for the Orthodontist to keep in pace with rapid
Although Orthodontia started to function without changing technology of Orthodontic brackets and
the use of brackets, yet today it has become an integral materials to be a successful clinician.
part of it. With the advent of aesthetic brackets and Though various authors have predicted the future
aesthetic archwires the field is becoming more refined day of brackets in their own ways yet at present tooth
by day. But, still metal brackets have more advantages movements produced by bracket-archwire combination
than aesthetic brackets in reducing the friction during will be the ultimate method for years to come. Periodic
retraction and also facilitates easy debonding procedures. reviews are necessary for the orthodontist to update his
The invention of self ligating brackets has knowledge as well as to decide a better treatment plan
shortened the treatment duration, reduces the patient visits and provide better comfort zone to the patient. This
and enhances better patient co-operation. The recent article has only reviewed the evolution of brackets. We
introduction of zirconia-based ceramics as a restorative suggest that many more review studies should come
dental material has generated considerable interest in the aiming at the biocompatibility, aesthetics and treatment
dental community. According to Koutayas SO et al20., results of each bracket. Such studies will help the
zirconia based orthodontic brackets can be technologically practitioner to decide the bracket selection for his
feasible. Heravi F21 states that in future, the reduction in the treatment plan.

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Evolution of Orthodontic Brackets Tamizharasi & Senthil Kumar

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