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Activator /certified fixed orthodontic courses by Indian dental academy

Activator /certified fixed orthodontic courses by Indian dental academy



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



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    Activator /certified fixed orthodontic courses by Indian dental academy Activator /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

    • Activator Modifications of activator Bionator INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
    • 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
    • Origin of activator • • • • Modified Kingsley plate retainer Biomechanic working retainer –Andresen Denmark to Oslo in Norway Karl Haupl & Viggo Andresen -activator www.indiandentalacademy.com
    • 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
    • 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
    • • 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
    • • Transitional type of action • Eschler 1952 muscle stretching method • Cycle of isotonic and isometric contractions • Ahlgren’s electromyographic research 1970 www.indiandentalacademy.com
    • • Reiten 1951 –no special histologic results from use of functional appliances • Witt 1981, Scmuth 1994, • Witt & Komposh 1979, www.indiandentalacademy.com
    • Mechanism of action of activator The neuromuscular basis www.indiandentalacademy.com
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    • 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
    • 3-D Skeletal & dentoalveolar effects • Trimming-dental • Construction bite • Condylar cartilage is secondary typeMoss, Woodside & Petrovic-LPM Stutzmann angle www.indiandentalacademy.com
    • • 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
    • Activator therapy • • • • • Diagnostic preparation Treatment planning Bite registration Laboratory procedures Management of the appliance – Trimming of activator www.indiandentalacademy.com
    • Diagnostic preparation • History • Growth status • VTO -‘instant correction’ • Patient compliance • Study models • • • • • Molar relations Midlines Asymmetries Curve of spee Dental discrepancies www.indiandentalacademy.com
    • • 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
    • 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
    • • 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
    • 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
    • • 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
    • Vertical dimension during bite registration • Postural rest – – – – Phonetic Command Non command Combined • In occlusion • Freeway space www.indiandentalacademy.comWith the bite •
    • Laboratory procedures • Mounting the casts to a fixator www.indiandentalacademy.com
    • • Preparation of wire elements • Labial bow –0.9 mm • Additional wire elements – Stabilizing wire – Active springs www.indiandentalacademy.com
    • • Fixation of jackscrews and wire elements • Fabrication of acrylic portion • Finishing and polishing www.indiandentalacademy.com
    • Management of the appliance • • • • • • • • Insert the appliance & give instructions Worn for 2-3 hrs day time in the 1 st week Night wear & 1-3hrs day wear for 2 nd week Patient recalled for check up on 3 rd 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
    • 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 www.indiandentalacademy.com guide planes
    • Trimming for 3-D control • Trimming the activator for vertical control – Intrusion of teeth www.indiandentalacademy.com
    • • Extrusion of teeth • Selective trimming of activator www.indiandentalacademy.com
    • 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
    • • 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
    • 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
    • Sagital movement of posteriors www.indiandentalacademy.com
    • Movement of teeth in transverse plane • Asymmetric constriction bite • Guide planes loading & trimming • Jack screw • Wire elements www.indiandentalacademy.com
    • summery • Cl II div I with hypodivergent jaw bases H-activator • Normodivergent www.indiandentalacademy.com
    • • 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
    • 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
    • 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
    • Harvold-Woodside activator –Cl-II • Construction bite – Vertical opening of 12-15 mm • Flanges • Labial arch wire • Palatal contact and expansion www.indiandentalacademy.com
    • Dislodging springs • Cl III www.indiandentalacademy.com
    • 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
    • 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
    • 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
    • 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
    • Kinetor –Stockfisch www.indiandentalacademy.com
    • Propulsor-Muhlemann www.indiandentalacademy.com
    • Cybernator-Schmuth www.indiandentalacademy.com
    • Palate-free activator-Metzelder www.indiandentalacademy.com
    • Elastic open activator-G.Klammt www.indiandentalacademy.com
    • Combined activator and head gear therapy • rationale www.indiandentalacademy.com
    • Pfeiffer and Grobety therapy • Labial bow has a spur • Long and rolled out lingual flanges www.indiandentalacademy.com
    • Stocklie and Teuscher therapy www.indiandentalacademy.com
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    • 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
    • Hickham approach • Hooks on labial bow to receive J hook head gear www.indiandentalacademy.com
    • Bass appliance -Neville M Bass www.indiandentalacademy.com
    • Bonded activator-Hamilton • Mainly used in non compliant patients • Used for expansion along with forward positioning of jaws www.indiandentalacademy.com
    • 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
    • Appliance design • Horse shoe shaped acrylic lingual plate • Upper anterior part kept free for proper tongue function www.indiandentalacademy.com
    • Labial bow with buccinator loops Palatal bar www.indiandentalacademy.com
    • Basic Cl II appliance www.indiandentalacademy.com
    • Open bite appliance www.indiandentalacademy.com
    • Class III or reversed bionator www.indiandentalacademy.com
    • 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
    • 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
    • Terminology used to describe trimming of bionator • • • • • Articular plane Loading area Tooth bed Nose Ledge www.indiandentalacademy.com
    • 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 molarlower pre molars –upper premolars • Additional anchorage from – Lower incisal margins – Deciduous molars and edentulous areas – Noses www.indiandentalacademy.com
    • references • Dentofacial orthopedics with functional appliancesGraber,Rakosi & Petrovic • Removable orthodontic appliances-Graber & Neumann • Orthodontics- current principles & technique-Graber & Swain • Orthodontics- current principles & technique-Graber & Vanarsdall www.indiandentalacademy.com • Bass Orthopedic Appliance System Part 1 - Design and Construction - Neville M Bass -JCO April 1987
    • Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com