Edward H. Angle (1855 – 1930) was the most influential orthodontist of the 20th century; putting orthodontics on a scientific basis and making it an independent specialty of the medical profession. Angle coined the term malocclusion and his classification of malocclusion, which he published in 1899, is still in use today.

Angle patented 45 inventions including orthodontic appliances, instruments and laboratory equipment. At a time when appliances were individually made by practitioners, he produced a system of prefabricated components making orthodontic treatment more accessible and affordable.

Angle’s most well known innovations were the E-arch (1899), the pin and tube appliance (1910), the ribbon arch (1916) and the edgewise appliance (1925).

In 1900 after teaching orthodontics in several dental schools Angle founded the first postgraduate school of orthodontics, the Angle School of Orthodontia. Practitioners from all over the world would attend and many prominent British orthodontists attended, including Harold Chapman, H. Visick and E.S. Friel.

E-arch appliance

The E-arch appliance consisted of molar bands joined by a heavy labial arch wire. The ends of the arch wire were threaded to the buccal aspects of the molar bands and extended beyond the band. The arch wire would be adjusted with a nut advance it. Individual teeth were ligated to the archwire with 0.010” ligature wire. The E-Arch was only capable of tipping the teeth.

Pin and Tube appliance

The pin and tube appliance was a fully banded appliance, with a vertical tube soldered to the labial surface of the tooth. Pins were soldered to the arch wire and inserted into the tubes. To move the teeth, the pin positions were adjusted by resoldering them to the arch wire at each appointment.

Ribbon Arch appliance

The pin and tube appliance could not control the movement of tooth roots due to the circular arch wire so it was modified to create the ribbon arch appliance. This appliance consisted of a rectangular arch wire used in conjunction with a bracket with an occlusally facing vertical slot soldered to the bands on the labial surface of the teeth. It was the first appliance to use a true bracket. The arch still had threaded ends for expansion.

Edgwise appliance

The edgewise appliance was developed to give more control over individual tooth movement. The edgewise bracket had a labially facing rectangular slot which received a rectangular arch wire inserted ‘edgewise’. This enabled control of tooth movement in three planes of space, the first appliance to do so. The accuracy of the control asserted over the tooth was increased due to the design of the bracket. It had two occlusal and two gingival wings increasing the contact between the arch wire and the bracket slot and thus allowing greater control over the movement of the tooth.

The edgewise bracket became the most popular appliance in the United States and the concept still remains valid.