Basic Edgewise

Technique
Dr. Rajshekhar Banerjee
II MDS, Dept. of Orthodontics and Dentofacial Orthopaedics,
ABSMIDS, Mangalore
 Contents

1. Introduction
2. Angle’s Appliances
3. Requirements of an Orthodontic Appliance
(According to Angle)
4. Appliance Description
5. Evolution of Brackets and Tubes
6. Tweed’s Observations
7. Tweed’s Philosophy
8. Classification of Anchorage Preparations
9. Tweed-Merrifield Edgewise Technique

2
Introduction

3
Edward H. Angle (1855 - 1930)
5
E - Arch

6
Pin and Tube Appliance

7
Ribbon Arch Appliance

8
Edgewise Appliance

9
 Requirements of an Orthodontic Appliance
(According to Angle)

1. Simplicity: It must push, pull, and rotate teeth.

2. Stability: It must be fixed to the teeth.
3. Efficiency: It must be based on Newton’s third
law and anchorage.
4. Delicacy: It must be accepted by the tissues,
and it must not cause inflammation and
soreness.
5. Inconspicuousness: It must be aesthetically
acceptable.
10
Appliance Description

11
Appliance Description

12
◈ Bracket slots were placed in the
horizontal plane instead of vertical.
◈ Archwire held in position by brass
ligature, later by delicate SS ligature.
◈ Brackets consisted of a rectangular box
with 3 walls within the bracket.
◈ Bracket dimention – 0.022 x 0.028 inch.

13
 Evolution of edgewise brackets
Original bracket - soft gold with .022 x .028
inch slot
Readily deformed by occlusal forces and by
tying ligature

1) Single width brackets

Original bracket 0.050 inch
wide & soldered to the gold band
material
Archwire rests on bottom of bracket slot
instead of surface orthodontic band

Ineffective for tooth rotation because of the

narrow width

Angle devised gold eyelets to be soldered on

bands
 2) Twin brackets
- Joining Two edgewise brackets on one base
-“Siamese twin brackets” by Swain
- space between two brackets was 0.050
inch (equal to width of one bracket )

Main advantage
- ability to effect tooth rotations without
using auxiliaries

Available in different widths:-

◈ Extra wide
◈ Standard
◈ Intermediate
◈ Junior
3) Curved base twin bracket
Curved bases to confirm to the
curvatures of the canines &
premolars

Advantages of twin brackets :

Offers in effecting rotation and
greater axial inclination

Disadvantages:
increased width decreases the
inter bracket span, thus
decreasing the resiliency
4) Lewis bracket
Developed by Lewis in 1950.

To overcome the problem of efficient tooth

rotation.

He soldered auxillary rotation arms that

abutted against the bracket itself, thus,
offered a lever arm to deflect the archwire
& rotate the tooth.

One piece bracket with integral rotation

wings
These wings do not interfere with
occlusogingival deflections of archwire &
do not decrease the interbracket span
5) Curved base Lewis bracket

Curved base confirms to the canine,

premolar surface
Wings lie close to the tooth
throughout their length ,so less
trapping of food
6) Vertical slot Lewis bracket
Incorporation of .020 x .020 inch vertical slot
Possible to use uprighting spring to correct axial inclinations if needed
Advantages of Lewis brackets:
1) complete rotational control
2)do not reduce the interbracket span
7) Steiner bracket
Given by Cecil C Steiner in 1931
Incorporated flexible rotation arms & hence
did not rely on the resiliency of the
archwire for tooth rotation
Introduced tie wings for ease of ligation

8) Broussard bracket
◈ Designed by Garford Broussard for use
in the Broussard technique
◈ Addition of a 0.0185 x 0.046 inch
vertical slot to accept a doubled 0.018
inch auxillary wire
Evolution of edgewise buccal tube

◈ The molar tube introduced In orthodontics in 1853 ‘by

Thomas Wiltberger Evans. (Evans TW: On regulation of
teeth;Am.J.Dental science ,pp 259-265,1853)

◈ Angle used vertically placed round tubes on anterior teeth in

pin and tube appliance

◈ He applied them in horizontally on molar bands with his

ribbon arch appliance
Original appliance had .022x .028 inch gold or nickel silver
tubing soldered to the molar band
Length –3/16 or 1/8 inch and lumen size is .022x.028
Notched distal ends - to facilitate a tie back ligature
Hook – gingival to buccal tubes, soldered on the bands for
placement of elastics
Inconel tube - gold buccal tubes were discarded
Stamped buccal tube with welding flanges or
Inconel tube which could be soldered to the band
 Combination buccal tubes
Incorporates a round tube for
insertion of a face bow
Fairly close tolerances must be
maintained between archwire
& tube for effective
transmission of torque to the
tooth

Triple buccal tube

additional rectangular tube for
auxillary sectional & base
archwire
Charles H. Tweed

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◈ Continued with Angle’s Edgewise
Appliance

◈ Followed Angle’s philosophy

◈ Was most unhappy with his patient’s post-

treatment facial aesthetics

26
 Tweed’s Observations

◈ Upright mandibular incisors gave better

results in post-treatment facial balance
and treatment stability.

◈ Keeping the teeth over the basal bone

would require extraction of teeth in some
cases.

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 Tweed’s Contributions

1. He emphasized the four objectives of

orthodontic treatment—aesthetics, health,
function, and stability—with emphasis and
concern for balance and harmony of the
lower face.
2. He developed the concept of positioning teeth
over basal bone with emphasis on the
mandibular incisors.

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 Tweed’s Contributions

3. He made the extraction of teeth for

orthodontic correction acceptable.
4. He enhanced the clinical application of
cephalometrics.
5. He developed the diagnostic facial triangle to
make cephalometrics a diagnostic tool and a
guide in treatment and in the evaluation of
treatment results.

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 Tweed’s Contributions

6. He developed a concept of orderly treatment

procedures and introduced anchorage
preparation as a major step in treatment.

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 Tweed Philosophy

Treatment in 2 stage
1. Preparation of a stable form of anchorage
in the lower arch, and elimination of
stationary anchorage in the upper arch.
2. Distal movement of the anterior segment
en-masse

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 Lower Arch Anchorage Preparation

◈ Ideal arch with 0.021 x 0.02” Stainless

Steel.
◈ 0.001” clearance should be present
between the archwire and the anterior
brackets.
◈ Step back bends of a mild degree and
slight buccal root torque in the incisal
portion is incorporated into the wire.

32
 Lower Arch Anchorage Preparation

◈ Premolars are not banded at this stage to

take advantage of a large interbracket
space to tip the molar teeth up and back in
order to develop a toe-hold.
◈ The 2nd order bends are accentuated at in
interval of 2-4 weeks

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 Upper Arch Anchorage Preparation

◈ 0.021” round or square wire with Strang’s

Vertical Loops is incorporated in the arch.
◈ A T is soldered 1/8th inch mesial to the
molar band sheath.
◈ The loops are made to open or pull by
means of a ligature drawing the ‘T’
towards the molar band sheath.

34
 Upper Arch Anchorage Preparation

◈ This will cause the flared incisors to tip

back without much movement in their
apical region.
◈ When the desired incisor inclination is
achieved, a new archwire devoid of the
closing loops is placed.
◈ Hence this reduces the incisor’s toe-hold.

35
Classification of anchorage preparation
First degree -minimal anchorage preparation,
-applicable to all malocclusion with ANB =0
to 4 ,
-total discrepancy does not exceed 10 mm,
-terminal molars must be uprighted & or
maintained in an upright position to
prevent their being elongated when cl. II
intermaxillary force is used .
Second degree -for malocclusions with ANB more than
0° to 4°
-facial esthetics requires to move point
B anteriorly & point A posteriorly i,e
cl. II cases
-usually accompanied by type A, type A
subdiv.,type B & type B subdiv.
-degree of distal tipping of mandibular
molars more severe than first degree
anch.prep. –they should be tipped so
that their distal marginal ridges are at
gum level
Third degree -severe discrepancy cases –14-20mm or
more
-ANB does not exceed 5°
-generally cl.I bimaxillary cases
-sliding jigs are necessary
-2nd ,1st molars & 2nd premolar must be
tipped to such an extent that the distal
marginal ridges are below the gum level
also called total anchorage preparation
Levern Merrifield

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Tweed – Merrifield
Edgewise Appliance

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 Brackets and Tubes

The neutral 0.022 slot edgewise appliance

consists of
◈ Single, double width 0.022 brackets on
the 6 anterior teeth
◈ Intermediate single width brackets on the
premolars
◈ Twin brackets on the 1st molar band
◈ Heave edgewise 0.022 tubes with mesial
hooks on 2nd molar bands.
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Brackets and Tubes

42
◈ All bands have lingual cleats (to correct
and control rotations)
◈ Brackets and Tubes placed at right angles
to the long axis of the tooth.
◈ No tip, torque or variation in thickness are
present in the bracket

43
 Archwires

◈ Resilient edgewise archwire is used with

the Tweed-Merrifield 0.022 Edgewise
Appliance.
◈ Commonly used wire dimensions are:-
○ 0.017 × 0.022
○ 0.018 × 0.025
○ 0.019 × 0.025
○ 0.020 × 0.025
○ 0.0215 × 0.028

44
 Archwires

◈ Allows sequential application of force.

◈ Tooth movement is controlled by proper
edgewise archwire at the appropriate time

45
 Bends

◈ Three types of bends are incorporated in

the archwire
○ First-Order Bends
○ Second-Order Bends
○ Third-Order Bends

46
 First-Order Bends

◈ These are also called ‘In-out’ bends

◈ Used for buccolingual tooth positioning

47
 Second-Order Bends

◈ Also called Tip bends

48
 Third-Order Bends

◈ Torque bends
◈ For labio-lingual root positioning

49
 Third-Order Bends

◈ Ideal Third-order bends in the mandibular

archwire are as follows
○ Incisors: 7º
○ Canines and 1st premolars - 12º
○ 2nd Premolars and Molars - 20º
◈ Ideal Third-order bends in the maxillary
archwire:
○ Incisors – 0º
○ Canines and 1st premolars - 7º
○ 2nd Premolars and Molars - 12º

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51
 Auxilliaries

Auxilliaries routinely used with the Tweed-

Merrifield Edgewise system
◈ Elastics
◈ Directionally oriented headgear
○ High-Pull J-hook Headgear
○ Straight-Pull J-hook Headgear

52
Treatment with the Tweed-
Merrifield Edgewise Appliance

53
Sequential Appliance Placement

◈ Initially 1st molars are left unbanded

◈ Incisors and canines are bonded
◈ Anterior teeth that are malaligned are not
engaged or the archwire or are ligated
passively

◈ Causes less trauma to the patient

◈ Easier and less time consuming for the
orthodontist
54
Sequential Appliance Placement

◈ Due to longer interbracket width, there is

○ Greater efficiency in the action of the
archwire
○ 2nd molar movement is more rapid
◈ It also gives the orthodontist more
leverage to place an archwire of larger
dimension without subjecting it to
occlusal or bracket engagement distortion

55
Sequential Appliance Placement

◈ Subsequently the maxillary first molars

are banded after one appointment
◈ The mandibular 1st molars are banded
after the 2nd appointment

56
 Sequential Tooth Movement

◈ Tooth movement is sequential

◈ En-masse movement introduced by Tweed
is not used.
◈ Individual teeth are moved rapidly and
with precision as they are moved singly or
in small units.

57
Sequential Mandibular Anchorage
Preparation
◈ Allows mandibular anchorage to be
prepared quickly and easily by tipping
only two teeth at a time to their anchorage
prepared position
◈ This system uses high-pull headgear

58
Sequential Mandibular Anchorage
Preparation
◈ Uses 10 teeth as ‘anchorage units’ to tip
two teeth.
◈ Referred to as the Merrifield “10-2”
system

◈ The 2nd molars are tipped to its desired

anchorage position

59
Sequential Mandibular Anchorage
Preparation
◈ Subsequently a compensating bend is
placed mesial to the 2nd molar to maintain
its tip while the 1st molar is tipped to an
anchorage prepare position.
◈ Once the 1st molar is tipped, a
compensation bend is placed mesial to it
to maintain its tip and the 2nd premolar is
tipped distally to its anchorage prepared
position.

60
 Directional Force

◈ Hallmark of the Tweed-Merrifield

Edgewise System
◈ Used directional forces to move the teeth.

◈ Directional forces can be defined as

controlled forces that place the teeth in the
most harmonious relationship with their
environment.

61
 Directional Force

◈ Upward and forward force system

62
 Directional Force

◈ Upright mandibular incisor and maxillary

incisor moved up and back
63
 Directional Force

◈ Downward and backward force system

64
 Timing of the Treatment

◈ Should be initiated at a time when

treatment objectives can be accomplished
most readily.
◈ This may mean
○ interceptive treatment in the mixed dentition
○ Selected extractions in the mixed dentition
○ Waiting for permanent 2nd molar eruption before
initiating treatment
◈ Diagnostic discretion is the determinant

65
 Standard Edgewise Technique
5 concepts compose the treatment philosophy
i. Sequential appliance placement
ii. Sequential and/or individual tooth movement
iii. Sequential mandibular anchorage preparation
iv. Directional forces including control of vertical
dimension to enhance mandibular response
v. Proper timing of treatment

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Steps of
Treatment

67
 Steps of Treatment

1. Denture preparation
2. Denture correction
3. Denture completion
4. Denture recovery

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1. Denture Preparation

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 Denture Preparation

◈ Objectives
1. Levelling
2. Individual tooth movement and
rotation correction
3. Retraction of maxillary and
mandibular canines
4. Preparation of the terminal molars for
stress resistance
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Initial archwires consist of a 0.017- × 0.022-inch resilient maxillary archwire
and a 0.018- × 0.025-inch resilient mandibular archwire.
71
The canines are retracted with a J-hook headgear
72
End of Denture Preparation
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 At the end of Denture Preparation

◈ The dentition should be level

◈ The canines should be retracted

◈ All rotations should be corrected

◈ The mandibular terminal molars should be
tipped distally into an anchorage prepared
position

74
2. Denture Correction

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 Objectives of Denture Correction

1. Complete space closure in both arches

2. Sequential anchorage preparation in the
mandibular arch
3. An enhanced curve of occlusion in the
maxillary arch

4. A Class I intercuspation of the canines and

premolars.

76
77
78
Sequential Mandibular Anchorage
Preparation
◈ 10-2 Anchorage System

◈ The archwire produces an active force on

only 2 teeth while remaining passive to
the other teeth in the arch, acting as
anchorage units.

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◈ 0.019- × 0.025-inch archwire with the
loop stops bent flush against the second
molar tubes.
◈ First and third-order bends are ideal.
◈ Gingival hooks for high-pull J-hook
headgear are soldered distal to the central
incisors.

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◈ A 10º distal tip is placed 1mm mesial to
the first molar brackets.

81
◈ The third and final step of sequential
mandibular anchorage preparation is to
place a 5-degree distal tip 1 mm mesial to
the second premolar brackets.
◈ A compensating bend is placed mesial to
the first molars to maintain them in their
anchorage prepared position

82
83
◈ Following anchorage preparation, a
mandibular 0.0215 × 0.028 inch
stabilizing archwire is fabricated.
◈ Ideal 1st, 2nd and 3rd-order bends are
incorporated into the archwire.
◈ A loop stop is placed 0.5 mm short of the
molar tubes
◈ Gingival spurs are soldered distal to the
mandibular lateral incisors.
84
◈ A 0.020- × 0.025-inch maxillary archwire
with 7.5-mm closed helical bulbous loops
bent flush against the second molar tubes
is fabricated.
◈ A gingival spur is attached to the archwire
immediately distal to the maxillary second
premolar bracket.
◈ Gingival high-pull headgear hooks are
soldered distal to the central incisors.
85
◈ Class II “lay on” hooks with a gingival
extension for anterior vertical elastics are
soldered distal to the lateral incisors.
◈ The closed helical bulbous loops are
opened 1 mm on each side such that the
anterior segment of the archwire will be 1
millimeter labial to the maxillary incisor
brackets.

86
Class II Correction
87
◈ Eight-ounce Class II elastics are worn
from the hooks on the mandibular second
molar tubes to the Class II hooks on the
maxillary archwire. Anterior vertical
elastics are worn from the spurs on the
mandibular archwire to the gingival
extension hooks on the maxillary
archwire.
◈ The highpull headgear is worn on the
maxillary headgear hooks
88
◈ This force system is used for about 1
month to sequentially move the maxillary
second molars distally.

◈ The activation of the maxillary arch-wire

is repeated until the second molars have a
Class I dental relationship

89
2nd Molars in Class I relation
90
◈ A closed coil spring is wound distal to the
second premolar spur and compressed
between the spur and the first molar
bracket. (The coil spring length should be
1.5 times the space between the second
premolar and the first molar brackets.)
◈ An elastic chain is stretched from the
second molar to the distal bracket of the
first molar.

91
92
93
A 0.020- × 0.025-inch maxillary closing loop archwire is used
to close the maxillary anterior space.
94
3. Denture Completion

95
96
◈ Finishing mandibular and maxillary
0.0215×0.028-inch resilient archwires are
used.
◈ The forces used during denture
completion are based on a careful study of
the arrangement of each tooth in each
arch.
◈ The necessary first-, second-, and third-
order adjustments are made in each
archwire as needed
97
At the end of the denture completion stage of treatment,
the following characteristics should be readily observed

1. The incisors must be aligned.

2. The occlusion must be overtreated to a
Class I relationship.
3. The anterior teeth must have minimal
incisal guidance.
4. The maxillary canines and second
premolars must be locked tightly into a
Class I dental relationship.
98
At the end of the denture completion stage of treatment,
the following characteristics should be readily observed

5. The mesiobuccal cusp of the maxillary

first molar must occlude in the
mesiobuccal groove of the mandibular
first molar.
6. The distal cusps of the first molars and
the second molars should be slightly out
of occlusion.
7. All spaces must be closed tightly from
the second premolars forward.
99
4. Denture Recovery

100
◈ When all appliances are removed and the
retainers are placed, a most crucial
“recovery” phase occurs.

◈ Forces involved are those of the

surrounding environment, primarily the
muscles and the periodontium.

101
Transitional Occlusion/ “Tweed Occlusion”
102
 Transitional Occlusion/ “Tweed Occlusion”

1. Disclusion of the second molars.

2. Mesiolingual cusp of the maxillary first
molar is seated into the central fossa of
the mandibular first molar
3. Mesial inclined plane of the mesial cusp
of the maxillary first molar contacting the
distal inclined plane of the mesial cusp of
the mandibular first molar.

103
 Transitional Occlusion/ “Tweed Occlusion”

◈ This arrangement allows the muscles of

mastication to effect the greatest force on
the “primary chewing table” in the
midarch area.

◈ The slightly intruded distally inclined

maxillary and mandibular second molars
now can “reerupt” to a healthy functional
occlusion without trauma or premature
contact.
104
 Transitional Occlusion/ “Tweed Occlusion”

◈ The edge-to-edge relationship of the

incisors will rapidly readjust to an ideal
overjet and overbite relationship.

105
 Transitional Occlusion/ “Tweed Occlusion”

◈ The concept of a transitional occlusion to the

period of recovery is based on the belief that
○ each individual’s oral environment will
determine the ultimate position of the
dentition
○ overtreatment allows the patient the
greatest opportunity for maximum stability
and functional efficiency.

106
107
 References

◈ Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics:

current principles and techniques. Elsevier Health Sciences;
2016 Jul 15.
◈ Angle EH. The latest and best in orthodontic mechanism.
Dental Cosmos. 1929;71:409-21.
◈ Vaden JL, Dale JG, Klontz HA. The Tweed-Merrifield
edgewise appliance: philosophy, diagnosis and treatment.
Orthodontics—current principles and techniques. St Louis:
Mosby Year Book Inc. 1994 Dec:627-84.
◈ Tweed CH. The application of the principles of the edgewise
arch in the treatment of class II, division 1, malocclusion. The
Angle Orthodontist. 1936 Jul;6(3):198-208.

108
 References

◈ McGuinness NJ. Standard edgewise technique and its

relevance in contemporary fixed appliance therapy part 1.
Orthodontic Update. 2010 Jul 2;3(3):76-80.
◈ Vaden JL. A century of the edgewise appliance. APOS Trends
in Orthodontics. 2015 Nov 1;5(6):239.

109
Thank You!

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