• Save
Activator (2)ppt/certified fixed orthodontic courses by Indian dental academy
Upcoming SlideShare
Loading in...5
×
 

Like this? Share it with your network

Share

Activator (2)ppt/certified fixed orthodontic courses by Indian dental academy

on

  • 387 views

The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

Statistics

Views

Total Views
387
Views on SlideShare
387
Embed Views
0

Actions

Likes
0
Downloads
17
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Activator (2)ppt/certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • 1. Activator Modifications of activator Bionator www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 2. Introduction and history • Genes / perioral muscles / dentition • Ortho- 3rd order of articulation-Moffett • Fox–application of extra oral force-1803 • Kingsley –Jumping the bite –1880 • Hotz –Vorbissplatte • Angle- Cl-II elastics –1907 • Robin-monobloc www.indiandentalacademy.com
  • 3. Origin of activator • Modified Kingsley plate retainer • Biomechanic working retainer –Andresen • Denmark to Oslo in Norway • Karl Haupl & Viggo Andresen -activator www.indiandentalacademy.com
  • 4. Classification Based on the kind of malocclusion Activator is best suited for achieving gross changes in growing patients – Cl II div I,div II – Cl III – Open bite • Based on various modifications • Classification of views www.indiandentalacademy.com
  • 5. Classification of views • Myotatic reflex activity and isometric contractions induce musculoskeletal adaptation to new mandibular closing pattern-Kinetic energy – Andresen-Haupl –1938-based on ‘shaking of bone ‘hypothesis of Roux 1883 – Petrik 1957 – McNamera –1973 – Petrovic –1984 www.indiandentalacademy.com
  • 6. • Grude 1952-mismatch of bite & mechanism • Viscoelastic property of muscle and stretching of soft tissues -potential energy • Emptying of vessels • Pressing out of interstitial fluid • Stretching of fibers • Elastic deformation of bone • Bioplastic adaptation of bone • Selmer,Olsen,Herren 1953-incisal crossbite • Woodside 1973 10–15 mm vertical opening • Harvold 1974 www.indiandentalacademy.com
  • 7. • Transitional type of action • Eschler 1952 muscle stretching method • Cycle of isotonic and isometric contractions • Ahlgren’s electromyographic research 1970 www.indiandentalacademy.com
  • 8. • Reiten 1951 –no special histologic results from use of functional appliances • Witt 1981, Scmuth 1994, • Witt & Komposh 1979, www.indiandentalacademy.com
  • 9. Mechanism of action of activator The neuromuscular basis www.indiandentalacademy.com
  • 10. www.indiandentalacademy.com
  • 11. www.indiandentalacademy.com
  • 12. www.indiandentalacademy.com
  • 13. Mechanism of action of activator • Force analysis • Static force • Gravity, posture, elasticity of soft tissues • Dynamic force • Swallow, mastication • Rhythmic force • Activator works by • Force application • Force elimination www.indiandentalacademy.com
  • 14. 3-D Skeletal & dentoalveolar effects • Trimming-dental • Construction bite • Condylar cartilage is secondary type- Moss, Woodside & Petrovic-LPM Stutzmann angle www.indiandentalacademy.com
  • 15. • Factors which determine activator function – Individual facial skeleton – Growth status – Nature of malocclusion – Inter occlusal clearence, head posture – State of mind ,level of consciousness – Treatment goal - Constriction bite www.indiandentalacademy.com
  • 16. Activator therapy • Diagnostic preparation • Treatment planning • Bite registration • Laboratory procedures • Management of the appliance – Trimming of activator www.indiandentalacademy.com
  • 17. Diagnostic preparation • History • Growth status • VTO -‘instant correction’ • Patient compliance • Study models • Molar relations • Midlines • Asymmetries • Curve of spee • Dental discrepancies www.indiandentalacademy.com
  • 18. • Functional analysis • Postural rest position in NHP • ICP habitual occlusion • path of closure-Prematurities • Freeway space –inter occlusal clearence • TMJ & RCP • Respiration • Cephalometric analysis • Direction of growth • Position & size of jaw bases • Morphologic peculiarities of mandible • Position &inclination of incisors www.indiandentalacademy.com
  • 19. Treatment planning-constriction bite • Low construction bite with marked forward positioning H-activator • High construction bite with slight anterior positioning V-activator www.indiandentalacademy.com
  • 20. • Construction bite without forward mandibular positioning – Vertical problems • Deep overbite • Open bite – Crowding in mixed dentition • Construction bite with opening & posterior positioning of mandible • Construction bite for asymmetries • Exaggerated construction bite • Step wise advancement of bite www.indiandentalacademy.com
  • 21. Bite registration • Mark the midlines, molar relation & desired mesial shift on the cast • Train the patient after seating him in a upright & relaxed posture • Soften a sheet of bees wax roll it (1cm dia) shape it press it on the lower arch and mark the midline www.indiandentalacademy.com
  • 22. • Transfer the wax to the patients mouth & fit it on the mandible • Move the mandible as previously practiced • Remove the wax chill it & remove the excess • Place it on the cast and check • Replace the hard wax in patients mouth and check after asking him to bite hard www.indiandentalacademy.com
  • 23. Vertical dimension during bite registration • Postural rest – Phonetic – Command – Non command – Combined • In occlusion • Freeway space • With the bite www.indiandentalacademy.com
  • 24. Laboratory procedures • Mounting the casts to a fixator www.indiandentalacademy.com
  • 25. • Preparation of wire elements • Labial bow –0.9 mm • Additional wire elements – Stabilizing wire – Active springs www.indiandentalacademy.com
  • 26. • Fixation of jackscrews and wire elements • Fabrication of acrylic portion • Finishing and polishing www.indiandentalacademy.com
  • 27. Management of the appliance • Insert the appliance & give instructions • Worn for 2-3 hrs day time in the 1st week • Night wear & 1-3hrs day wear for 2nd week • Patient recalled for check up on 3rd week • Check up appointments every 6 weeks • Trimming according to the plan • Activation of wire elements • Jackscrew activated by pt at 2 weeks interval www.indiandentalacademy.com
  • 28. Trimming for tooth guidance • Force application and force elimination • During use the acrylic areas that contact the teeth are likely to become polished and shiny • Acrylic surfaces that transmit the desired intermittent force and contact the teeth are called guide planes www.indiandentalacademy.com
  • 29. Trimming for 3-D control • Trimming the activator for vertical control – Intrusion of teeth www.indiandentalacademy.com
  • 30. • Extrusion of teeth • Selective trimming of activator www.indiandentalacademy.com
  • 31. Trimming for sagital control • Incisors • Protraction of incisors • Loading – entire lingual surface – incisal 3rd of lingual surface • Protraction springs • Wooden pegs • guttapercha www.indiandentalacademy.com
  • 32. • Passive bow • Active bow & its position • Retrusion of incisors – Interaction between labial bow and acrylic decides the type of force and tooth movement • Incisal-C rtn at apex • Gingival –C rtn junction of apex and middle 3rd • Incisal with fulcrum- C rtn middle 3rd www.indiandentalacademy.com
  • 33. Importance of lower incisors • Activator loads the lingual surface of lower incisors and tips them labially • If this is necessary labial tipping further enhanced by loading the lingual area • Prevent labial tipping by relieving lingual acrylic • Or by incisal capping www.indiandentalacademy.com
  • 34. Sagital movement of posteriors www.indiandentalacademy.com
  • 35. Movement of teeth in transverse plane • Asymmetric constriction bite • Guide planes loading & trimming • Jack screw • Wire elements www.indiandentalacademy.com
  • 36. summery • Cl II div I with hypodivergent jaw bases H-activator • Normodivergent www.indiandentalacademy.com
  • 37. • Cl II div I with hyper divergent jaw bases V activator • Cl II div II • Cl I ,Cl I with deep bite,Cl I with Open bite • Cross bites • Cl III www.indiandentalacademy.com
  • 38. Modifications of activator • Harvold-Woodside activator • Herren-Shaye activator (LSU) • Wunderer activator • Bow activator- A.M.Schwarz • U-bow activator –Karwetzky • Kinetor –Stockfisch • Propulsor-Muhlemann • Cybernator-Schmuth www.indiandentalacademy.com
  • 39. Modifications of activator • Palate-free activator-Metzelder • Elastic open activator-G.Klammt • Combined activator and head gear – Pfeiffer and Grobety therapy – Stocklie and Teuscher therapy – Stockfisch approach – Hickham approach • Bass appliance-Neville M Bass • Bonded activator-Hamilton www.indiandentalacademy.com
  • 40. Harvold-Woodside activator –Cl-II • Construction bite – Vertical opening of 12-15 mm • Flanges • Labial arch wire • Palatal contact and expansion www.indiandentalacademy.com
  • 41. Dislodging springs • Cl III www.indiandentalacademy.com
  • 42. Herren-Shaye activator • Paul Herren of Zurich • L.S.U of Robert Shaye • Mandible positioned 2-3 mm beyond neutroclusion • Incisal edges are 2-4 mm apart • Trangular arrow head clasps • Lingual flanges www.indiandentalacademy.com
  • 43. Wunderer activator • Used for Cl III malocclusion • Appliance is split horizontally • Screw is embedded in the acrylic behind the incisors • Occlusal surfaces are covered with acrylic • Weise screw www.indiandentalacademy.com
  • 44. Bow activator- A.M.Schwarz • Upper and lower parts are connected by a elastic bow • Transverse mobility is believed to provide additional stimulus • Independent expansion is possible • Step wise advancement is possible • Can be used in unilateral distoclusion • Distortion and breakages common www.indiandentalacademy.com
  • 45. U-bow activator –Karwetzky • Maxillary and mandibular active plates are joined in the 1st perm molar region using a U shaped bow made of 1.1mm ss wire www.indiandentalacademy.com
  • 46. Kinetor –Stockfisch www.indiandentalacademy.com
  • 47. Propulsor-Muhlemann www.indiandentalacademy.com
  • 48. Cybernator-Schmuth www.indiandentalacademy.com
  • 49. Palate-free activator-Metzelder www.indiandentalacademy.com
  • 50. Elastic open activator-G.Klammt www.indiandentalacademy.com
  • 51. Combined activator and head gear therapy • rationale www.indiandentalacademy.com
  • 52. Pfeiffer and Grobety therapy • Labial bow has a spur • Long and rolled out lingual flanges www.indiandentalacademy.com
  • 53. Stocklie and Teuscher therapy www.indiandentalacademy.com
  • 54. www.indiandentalacademy.com
  • 55. Stockfisch approach • Bands on first molar with tubes to receive head gear • Clasp on the kinetor snaps above the buccal tube assemblage www.indiandentalacademy.com
  • 56. Hickham approach • Hooks on labial bow to receive J hook head gear www.indiandentalacademy.com
  • 57. Bass appliance -Neville M Bass www.indiandentalacademy.com
  • 58. Bonded activator-Hamilton • Mainly used in non compliant patients • Used for expansion along with forward positioning of jaws www.indiandentalacademy.com
  • 59. Bionator-Balters 1960 • Balters concept-position of the tongue is decisive • Equilibrium between tongue and circumoral muscles is responsible for shape of dental arches and inter cuspation • Bite taken in an edge to edge relation – Dorsum of tongue in contact with soft palate – Lip closure www.indiandentalacademy.com
  • 60. Appliance design • Horse shoe shaped acrylic lingual plate • Upper anterior part kept free for proper tongue function www.indiandentalacademy.com
  • 61. Labial bow with buccinator loops Palatal bar www.indiandentalacademy.com
  • 62. Basic Cl II appliance www.indiandentalacademy.com
  • 63. Open bite appliance www.indiandentalacademy.com
  • 64. Class III or reversed bionator www.indiandentalacademy.com
  • 65. Other differences • Less bulky more patient compliance • Can be worn all time except during meals • Vulnerable to distortion • Simultaneous requirement of stabilization of the appliance and selective grinding for eruption guidence www.indiandentalacademy.com
  • 66. Ideal cases for bionator therapy • Mild Cl II in mixed dentition • Well aligned arches • Abnormal muscle pattern • Buccal teeth are in infraclusion,-large freeway space • Adults with TMJ problems • Bruxism and clenching during REM www.indiandentalacademy.com
  • 67. Terminology used to describe trimming of bionator • Articular plane • Loading area • Tooth bed • Nose • Ledge www.indiandentalacademy.com
  • 68. Sequence of trimming of bionator • Trimming of acrylic and elimination of influence of tongue and cheeks allow the teeth to erupt up to the articular plane • Sequence –lower molar & upper molar- lower pre molars –upper premolars • Additional anchorage from – Lower incisal margins – Deciduous molars and edentulous areas – Noses www.indiandentalacademy.com
  • 69. references • Dentofacial orthopedics with functional appliances- Graber,Rakosi & Petrovic • Removable orthodontic appliances-Graber & Neumann • Orthodontics- current principles & technique-Graber & Swain • Orthodontics- current principles & technique-Graber & Vanarsdall • Bass Orthopedic Appliance System Part 1 - Design and Construction - Neville M Bass -JCO April 1987 www.indiandentalacademy.com
  • 70. www.indiandentalacademy.com Thank you For more details please visit www.indiandentalacademy.com