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Splints in orthodontics  /certified fixed orthodontic courses by Indian dental academy
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Splints in orthodontics /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.

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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Splints in orthodontics /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • 1. Splints in orthodontics INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com 1
  • 2. INTRODUCTION A Splint is a rigid or flexible appliance used to maintain in position a displaced or movable part or to keep in place and protect an injured part. The term splint is used in orthodontics to describe an appliance that unites the teeth in the dental arch so that they function as a single rigid unit. www.indiandentalacademy.com 2
  • 3. The various splints in orthodontics can be grouped based on their use: Splints used for TMJ disorders Splints used in bi jaw surgery Maxillary intrusion splint Splints used for anterior retraction Posterior anchorage splint Splints used for intermaxillary elastics Splints used as mandibular growth advancers. Invisalign Splints used for retention. www.indiandentalacademy.com 3
  • 4. SPLINTS USED FOR TREATMENT OF TMJ DISORDERS There is abundant evidence in both the dental and medical literature that incorrect restoration and orthodontic procedures can initiate and even complicate severe Temporomandibular dysfunction (TMD). Temporomandibular dysfunction can be due to either internal derangement or external derangement . Internal derangement simply means that there is a mechanical problem within the T.M.J. capsule. External derangement indicates that there is a problem within the musculo-skeletal system outside of the T.M.J. capsule. The use of splints as an initial step in the treatment of Temporomandibular dysfunction (TMD) is now widely accepted. Splints are thought to work by reducing the amount of Para functional activity and limiting the extent of potentially harmful movements. www.indiandentalacademy.com 4
  • 5. The most commonly used splints for treatment of TMJ disorders are : (1) The Flat Plane Splint (2) The Repositioning Splint - Anterior Mandibular repositioning splint - Gnathological splint (3) The Pivotal Splint (4) Soft or resilient splints The use of the occlusal appliance for treatment of TMJ disorders may be attributed to the following factors: 1) Alteration of the occlusal condition 2) Alteration of the condylar position-when the condyles are brought into a musculo-skeletally stable position ,there is a reduction in TMD symptoms. www.indiandentalacademy.com 5
  • 6. 3) INCREASE IN VERTICAL DIMENSION Initiating factors of facial pain and TMJ disorders (occlusal interferences, bruxism and emotional stress) Continuous contraction of muscle fiber without rest Increase in vertical dimension (stretching elevator muscles) Deceleration of cross-bridge cycling Between actin and myosin filaments and decrease in tension Excessive consumption of ATP Minimum ATP consumption (prevention of ATP exhaustion) Rigor like state Muscle spasm Relief of muscle spasm www.indiandentalacademy.com 6
  • 7. 4) Cognitive awareness- A patient who wears the occlusal appliance becomes more aware of their functional and Para functional behaviour. 5) Placebo effect 6) Increased peripheral input to the CNSocclusal appliances decrease the CNS activity and therefore reduces the CNS induced bruxism. Factors critical for successful splint therapy include: The patient must eat with the splint in place. The patient must not clench their teeth when the splint is removed for hygiene. The patient should eat relatively soft food placed on the posterior teeth. The patient should not incise with the front teeth. The patient must not open their mouth excessively wide. www.indiandentalacademy.com 7
  • 8. The Flat Plane Splint The primary use of a flat plane splint is to treat the acute phase of an external derangement problem. During this acute phase the muscles of mastication are in a hyper- active state and prevent the correct diagnosis of the underlying internal derangement. The objective is to allow the acute external derangement to become passive so that the appropriate appliance for internal derangement can be fabricated. The flat plane splint is usually best tolerated by the patient when it is placed on the lower arch. However, it is more advantages if it is placed in the upper arch. The maxillary device is more stable and covers more tissue, which makes it more retentive and less likely to break. www.indiandentalacademy.com 8
  • 9. Minimum thickness for the occlusal acrylic is 1.5 mm clearance between the most posterior teeth. The splint should be adjusted so that all posterior teeth are in balanced contact no matter how the patient occludes. This allows the hyperactive musculature a chance to rest and become more passive. The occlusal appliance is fabricated by various methods. In the frequently used one the casts are mounted on an articulator, undercuts are blocked out, the appliance is developed in wax and the waxed appliance is invested and processed with heat cured acrylic resin and is then adjusted for final fit intraorally. Another common technique is by using self curing acrylic. www.indiandentalacademy.com 9
  • 10. Sometimes the patient's acute external derangement is so severe that they are unable to open their mouth to make an impression for fabrication of the splint. In this situation a temporary splint should be constructed chair side using crown and bridge acrylic. As the treatment progresses and the patient gains more vertical opening, a more accurate flat plane splint can be made using models. www.indiandentalacademy.com 10
  • 11. The forces of occlusion should be directed axially, therefore the contacting surface in the anterior area is determined by the long axis of the mandibular anterior teeth. The acrylic on the labial surface of the incisors can be cut back to 1 millimeter for improved esthetics and patient comfort. www.indiandentalacademy.com 11
  • 12. CANINE PROTECTED SPLINTS It is a modified flat plane splint. The splint is designed to prevent disturbing influences to the neuromuscular system from occlusal contacts on mandibular closure and movements. The canine-protected splint is particularly effective when lateral movements are to be greatly limited within the splint design, so that the patient opens the mouth almost straight vertically. Thus, provisions are made for smooth gliding mandibular movements and the elimination of centric and eccentric occlusal interferences. www.indiandentalacademy.com 12
  • 13. Inclines are positioned labial to the cuspid centric occlusion contact to provide cuspid guidance during lateral and protrusive excursions. The only tooth in contact with the splint during working excursions is the cuspid tooth on the working side. Only two teeth (cuspids) contact the splint in a straight forward protrusive movement . www.indiandentalacademy.com 13
  • 14. THE REPOSITIONING SPLINT THE ANTERIOR MANDIBULAR REPOSITIONING SPLINT They are also known as" pull - forward splints" The anterior positioning appliance cause the mandible to assume a forward position, creating a more favourable condyle-disc relationship, providing the opportunity for the tissues to repair and adapt. The goal of the treatment is not to alter the mandibular position permanently but only to change the position temporarily so as to enhance adaptation of retrodiscal tissues. www.indiandentalacademy.com 14
  • 15. The appliance is used primarily to stabilise the muscle hyperactivity and disc derangement disorders (patients with joint sounds and chronic or intermittent locking of the joints) so that the patients true centric relation can be registered and a suitable appliance can be fabricated. The construction bite is taken at an edge to edge relationship of the upper and lower incisors with a 4 mm vertical thickness between the incisors. This routine mandibular position is sometimes modified through clinical experience, transcranial radiographs, and electromyography, but it is a very practical starting position for most T.M.D. patients suffering from self-reducing anterior displacements of the menisci.The maxillary appliance is preferred since the anterior guiding ramp can easily be fabricated. www.indiandentalacademy.com 15
  • 16. The appliance is fabricated with acrylic resin.The acrylic covering all of the teeth is fully indexed to allow the patient only vertical motion. This is an extremely important point. If the patient is wearing a pull forward splint, there should be no rotary motion of the mandible when the patient is in full occlusion. Any rotary motion will irritate the lateral head of the pterygoid muscle and make the external derangement more acute. www.indiandentalacademy.com 16
  • 17. GNATHOLOGICAL SPLINT The ideal condylar position is the commonly referred to as Centric relation. Centric relation can be defined as the maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of the their respective discs with the complex in anterior superior position against the slopes of the articular eminence, independent of tooth contact. True centric relation of the mandible is the stable position of the condyles against the articular discs, that can be captured clinically and reproduced time and again. Normal condyle fossa relationship www.indiandentalacademy.com 17
  • 18. Once a patient has been stabilized , any good centric registration technique will yield identical and verifiable centric positions of the mandible. Without first stabilizing the mandibular position, different types of centric registrations will yield different mandibular positions, True centric can be stabilized if there are no degenerative joint changes. The objective in making the gnathological splint is to achieve maximum neuromuscular release and eliminate all occlusal proprioceptive interferences with an accurate registration, also to seat the condyles in the most superior position possible on every visit, and to adjust the occlusal surface of the splint to achieve maximum intercuspation at this position of the mandible at the most closed vertical dimension obtainable. The splint is constructed on the maxillary arch with the help of an anatomical articulator. www.indiandentalacademy.com 18
  • 19. PIVOTING APPLIANCE The pivoting appliance is a hard acrylic device that covers one arch and usually provides single posterior contact in each quadrant. This contact is established as far posteriorly as possible. This creates a fulcrum aound the second molar area and thereby pivoting the condyle downward and away from the fossa. However for the pivoting action to occur the forces that close the mandible should be located anterior to the pivot, but since the elevator muscles are located posterior to the pivot , extra oral force pulling the chin upward should be provided . The efficacy of this appliance is still debated. www.indiandentalacademy.com 19
  • 20. This appliance loads the joint if extraoral force is not applied. Distraction occurs when extraoral force is applied anterior to the elevator muscles www.indiandentalacademy.com 20
  • 21. SOFT OR RESILIENT APPLAINCE The soft appliance is a device fabricated with resilient material that is usually adapted to the maxillary dentition. Treatment goal is to achieve even and simultaneous contact with the opposing teeth .However, Since most of the soft materials do not adjust readily to the exact requirements of the neuromuscular system it is difficult to achieve the treatment goals. It is most commonly indicated as a protective device for persons likely to receive trauma to their dental arches www.indiandentalacademy.com 21
  • 22. PRESSURE FORMED SPLINT A protective splint used as a temporary anti-bruxism splint. Especially useful for patients who suffer from chronic sinusitis, that result in sensitive posterior teeth. These splints are made from 3mm durable polyethylene material. www.indiandentalacademy.com 22
  • 23. SPLINT FOR BI-JAW SURGERY Whenever bi-jaw surgery is planned, and both jaws are to be sectioned from their articulations with the cranium, a base of reference must be maintained so that the orientation of these bones in space is not lost. This is accomplished by osteotomizing the maxilla, thereby losing its articulations with the cranium, and establishing its predetermined position by use of the mandible, with its cranial articulations intact via the condyles. Once the maxilla is then secured to the cranium, the mandible is sectioned and repositioned to the maxilla. www.indiandentalacademy.com 23
  • 24. Preoperative Planning The patient's maxillary and mandibular dental casts are mounted on a semi-adjustable articulator using a facebow transfer and a centric relation interocclusal registration. The articulator enables the operator to evaluate the existing relationship more critically, and to transfer the planned relationships to the patient at the time of surgery more carefully and precisely. www.indiandentalacademy.com 24
  • 25. The maxillary model surgery is performed, and the freed maxilla is repositioned on the articulator to a planned location determined by preoperative clinical and radiographic analysis. This may include translatory and rotational movements in all three planes of space. If segmental surgery in the maxilla is required, it is also performed at this time and the segments are secured to the remaining maxillary cast and mounting ring. The deformity on the articulator at this point is usually much worse in appearance, due to the relationship of the repositioned maxilla with the preoperative mandibular cast. The mandibular dental cast and mounting ring are now removed from the articulator. A second mandibular cast is then articulated with the repositioned maxilla in the planned final occlusal relationship and mounted on the articulator. www.indiandentalacademy.com 25
  • 26. Any necessary mandibular segmental surgery must be accomplished on this mandibular dental cast prior to articulating it with the repositioned maxilla, in order to obtain the proper postoperative occlusal relationship. The occlusal vertical dimension is then increased by opening the articulator with the incisal pin. The vertical dimension opening should be limited to a thickness adequate for the needed strength of the acrylic resin splint. www.indiandentalacademy.com 26
  • 27. FINAL SPLINT FABRICATION: The final splint is fabricated of cold-cure acrylic, with indentations of the maxillary and mandibular teeth in the planned occlusal relationship. The lingual surfaces of the maxillary teeth and a portion of the cusps should be incorporated into the splint. Extending laterally from the splint is a buccal flange in which holes are drilled to accommodate both the wires around the maxillary orthodontic brackets (or circumdental wires) and the suspension wires (for both superior suspension of the maxilla and mandibular suspension). The splint is then finished and polished. The initial preoperative mandibular cast is then replaced on the articulator and the final splint secured to the repositioned maxilla. If interference exists between the maxillary splint and the pre-operative mandibular cast, the occlusal vertical dimension can be altered. If excessive space exists, the vertical dimension should be closed. www.indiandentalacademy.com 27
  • 28. A second (interpositional) acrylic splint— as thin as possible— is made to cover the occlusal surfaces of the mandibular teeth and index with the entire exposed surface of the final splint, with the exception of the buccal flange. In the anterior region, however, the interpositional splint extends forward and keys with the maxillary splint. Areas of this anterior extension of the interpositional splint must be relieved to avoid potential interferences where the maxillary dental wires will have been twisted through the buccal flange of the final splint during the operation. www.indiandentalacademy.com 28
  • 29. The interpositional splint will interdigitate with the final splint on the lingual, posterior, and anterior aspects, and relate the freed maxilla to the unoperated mandible with precision and accuracy. At surgery, the maxilla is down-fractured and segmentalized as planned. The final splint is wired to the maxillary teeth. The interpositional splint is placed between the mandibular teeth and the final splint. The mandible is temporarily wired to the final splint with the interpositional splint in place. www.indiandentalacademy.com 29
  • 30. MAXILLARY INTRUSION SPLINT In the treatment of a Class II malocclusion the anteroposterior discrepancy between the dental arches is of paramount importance, and in its correction some or all of the following objectives, in various combinations, may be desirable: (1) inhibition of the forward growth of the maxillary complex, (2) inhibition of the normal forward migration of the maxillary dentition, (3) reduction in the normal downward and forward eruption of the maxillary teeth, www.indiandentalacademy.com 30
  • 31. (4) posterior translation of the entire maxillary dentition, (5) enhancement of the horizontal growth of the mandible, and (6) acceleration of normal eruption of the posterior mandibular teeth. In addition, in some cases the following factors need consideration: (1) increased vertical mandibular growth, (2) forward translation of the entire mandibular dentition, and (3) relief of crowding when a true dentoalveolar size disproportion is present, by the serial extraction of teeth. Since the maxillary traction splint moves the teeth en masse, the dentoskeletal changes are due primarily to the headgear force. www.indiandentalacademy.com 31
  • 32. Restraint of maxillary growth has been investigated by many authors, the general consensus of clinical investigations is that forces applied to the maxilla of a growing face may result in a more distal relationship to the skull base than otherwise would occur. Heavy extraoral forces of approximately 1,000 gm. per side have been shown clinically to have a profound and rapid effect on the maxilla and maxillary dentition. www.indiandentalacademy.com 32
  • 33. The appliance effectively converts the entire maxillary dental arch into a rigid unit to which heavy extraoral forces in the neighborhood of 1,000 to 2,000 gm. on each side can be applied in an upward and backward direction, with the direction of the force vector arranged either anterior to or through the center of resistance of the maxilla. The design is intended to allow these forces to be distributed evenly throughout the maxillary teeth. The dentition transmits this force to the maxilla and then to the sutures of the craniofacial skeleton, namely, the zygomaticotemporal, zygomaticofrontal, frontomaxillary, zygomaticomaxillary, and pterygopalatine sutures. www.indiandentalacademy.com 33
  • 34. Compression of these sutures leads to a reduction and possibly cessation of growth at this level, and hence forward growth of the maxilla is inhibited. If, at the same time, the patient is growing sufficiently for significant mandibular growth to take place, a reduction in the anteroposterior dental base discrepancy is observed clinically. Several forms of headgear will allow heavy forces to be applied in an upward and backward direction . www.indiandentalacademy.com 34
  • 35. ANTEROPOSTERIOR TRACTION SPLINT Anteroposterior traction splint can be used for an advancement of the maxilla by heavy extra-oral posteroanterior traction on an orthodontic mask The Delaire facial mask uses heavy maxillary traction in early Class III treatment to open the palatal sutures and the naso-frontoethmoid complex while influencing the nasal cavity floor. Forces are usually around l kg, but sometimes as high as 5kg. Anchorage must therefore be quite reliable. www.indiandentalacademy.com 35
  • 36. www.indiandentalacademy.com 36
  • 37. To construct the splint, place a dry model in the Biostar and form a l mm Imprelon plate over it for one minute at 5 bars of pressure. Trim the plate l mm from the gingival margin. Affix two .032 " hooks in the acrylic between the cuspids and the first deciduous molars. An .064 " x .032 " rectangular wire can be added if a transpalatal arch is desired. The splint can be bonded . After about 30 seconds, the elastics can be attached between the hooks on the splint and the facial mask. The splint should not be worn for more than six months. www.indiandentalacademy.com 37
  • 38. POSTERIOR ANCHORAGE SPLINT Used for treatment of deep bites in mixed dentition. Treatment of deep bites is often complicated by secondary tooth movements. The sooner the deep bite is reduced, the longer the appliance can act as a retainer during the remainder of treatment. Also, in the mixed dentition, it can be difficult to cement bands to deciduous teeth or to bond labial attachments on lower incisors. A thermoformed posterior anchorage splint avoids these problems. It consists of a 1 mm plate of polycarbonate Imprelon, formed over the occlusal surfaces in the Biostar. Solder an .032" Adams clasp to an .018 " x .025 " or .022 " x .028 " double molar tube . Fix the tube above the center of resistance of the anchorage unit with methyl-methacrylate resin. A lingual arch or transpalatal bar can be added as with the traction splint. www.indiandentalacademy.com 38
  • 39. After checking for occlusal enamel infiltration, etch the occlusal surfaces and bond the splint as described above. Once the splint is in place, the upper and lower incisors can be bonded . www.indiandentalacademy.com 39
  • 40. One or two intrusion springs can later be inserted into each tube to activate the appliance. A spring bent at two right angles and inserted into the distal end of the tube is flexible and can be lengthened if necessary. The anterior spring can be chosen according to the desired movement. Intrusion mechanics with the splint are the same as with traditional segmented arch mechanics, but secondary movements are eliminated, especially with masticatory forces contributing to stability . The splint can be used in either arch or (rarely) in both, with bonded labial brackets as desired. Debonding is the same as with the traction splint. www.indiandentalacademy.com 40
  • 41. SPLINT FOR INTERMAXILLARY ELASTICS It is often necessary to hook intermaxillary elastics to a perfectly aligned arch during part or all of treatment. A bonded, thermoformed splint, made from a l mm polycarbonate Imprelon plate, allows the use of intermaxillary traction without banding or bonding individual teeth in the arch . The splint prevents the possibility of premature contacts (for instance, between upper cuspids and the lower arch when moving the cuspids distally). It also allows full bonding to be postponed until the dentition is complete. Vestibular and lingual support and masticatory forces help avoid unwanted tooth movements. For proper function, the labial portion of the acrylic must be as deep as possible. Also, the embedded elastic hooks must have a lingual extension for stability. www.indiandentalacademy.com 41
  • 42. www.indiandentalacademy.com 42
  • 43. BICUSPID RETRACTION SPLINTS In cases requiring extraction of first-permanent molars, the extraction sites can be closed either by mesial movement of the second permanent molars or distal movement of the bicuspids. If the second molars are used as anchorage, but treatment requires partial bicuspid retraction, then two small, thermoformed splints can be used for headgear retraction without producing any adverse mesial movement of the second molars. An occlusal splint using l mm polycarbonate Imprelon is made in the Biostar. the bicuspid portions are cut out , and light .038" headgear tubes are attached with self-curing acrylic resin. After etching, bond the splints to the bicuspids with a liquid acrylic adhesive. www.indiandentalacademy.com 43
  • 44. Adjust a short extraoral facebow so that the outer bow corresponds to the centers of resistance of the two bicuspids, as identified from headfilms. The elastics will apply a diagonal, superior-posterior force without unwanted secondary tooth movements www.indiandentalacademy.com 44
  • 45. ANTERIOR RETRACTION SPLINT A removable splint offers several advantages over fixed appliances in the initial phase of anterior retraction: • Less risk of caries and gingivitis than with banded or bonded appliances. • An opportunity to assess patient cooperation before bonding. • Shorter treatment time in the fixed appliance stage, reducing the possibility of brackets loosening or breaking. Before the splint is formed in the Biostar, a silicone coating must be applied to the molars and bicuspids. The silicone should fill all the occlusal grooves of the posterior teeth, except for the labial and lingual aspects of the bicuspids and the mesolabial, distobuccal, and lingual cusps of the molars . This provides only a few points of contact with the splint and prevents retraction of www.indiandentalacademy.com 45 the posterior teeth during anterior retraction.
  • 46. If the splint contacted the labial aspects of the posterior teeth, it would hinder the anterior retraction. This blocking effect can be prevented by placing a silicone pad a few millimeters from the edge of the splint and the buccal surfaces of the posterior teeth on the model in the Biostar. After thermoforming, trim the splint at the level of the labial incisor surfaces and polish the edges. Affix the inner facebow with self-curing acrylic resin. The outer bow must be carefully positioned so that the retraction force is exerted in exactly the same direction as the centers of resistance of the anterior teeth, as determined from headfilms. www.indiandentalacademy.com 46
  • 47. Anterior retraction splint The thermoformed appliance is designed only for initial retraction, since it cannot perform individual tooth movements or detailing. Treatment will have to be finished with fixed appliances www.indiandentalacademy.com Posterior retraction splint 47
  • 48. MANDIBULAR GROWTH ADVANCER(MGA) The MGA is a functional appliance for mandibular protraction. It is a modified activator. It is initially composed of two separate splints . With this appliance, the mandible is advanced progressively with a mandibular splint. The objective is to remodel the condyle and the glenoid fossa in the temporomandibular joint with concomitant adaptation of orofacial muscles.it is used for correction of class II div 1 cases in the growth period. Extraoral forces can be applied making use of the maxillary splint to restrict the growth of maxilla. www.indiandentalacademy.com 48
  • 49. MANDIBULAR GROWTH ADVANCER(MGA) Upper and lower splints. Both surfaces are flattened parallel to the occlusal plane . www.indiandentalacademy.com Acrylic is put at three points (arrows; one on anterior point, two on posterior point) to attach both splints. It is inserted into the mouth to 49 take a construction
  • 50. The MGA functions as follows. 1. As the upper and lower splints are made separately and are fixed by cold-curing acrylic in a new construction bite within the oral cavity, the MGA can be fit more easily and effectively in three-dimensional mandibular adjustments. In other words, this appliance achieves an exact construction position and changes it progressively. 2. To correct a Class II relationship into a Class I relationship, the mandibular position must sometimes be overcorrected into a Class I relationship horizontally, namely, a Class III relationship. With this appliance, it is possible to go from a Class II to a Class III relationship with only one appliance throughout the treatment period. www.indiandentalacademy.com 50
  • 51. 3. While improving the horizontal problem, it is possible to selectively allow the vertical eruption of posterior teeth by trimming the occlusal shelf, as anterior teeth are impeded by an anterior ledge. 4. Since this appliance is simple, it can be used concomitantly with a fixed appliance. Thus tooth irregularity can be corrected simultaneously with the correction of the skeletal discrepancy. After successful mandibular forward induction has been achieved, MGA is again separated into two splints to allow further mandibular forward induction. www.indiandentalacademy.com 51
  • 52. Three stages of mandibular forward induction. Splint with the facebow in place for maxillary growth restriction www.indiandentalacademy.com 52
  • 53. MANDIBULAR ADVANCEMENT SPLINT (MAS) Mandibular advancement splints are also used in treatment of obstructive sleep apnea. Mandibular advancement appliances,used in the treatment of OSA, widen the oropharyngeal airway by repositioning the mandible downwards and forwards during sleep. www.indiandentalacademy.com 53
  • 54. ESSIX RETAINERS Essix retainers are fabricated using thermoplastic copolyester materials. www.indiandentalacademy.com 54
  • 55. INVISIBLE RETAINERS It is used either at the end of orthodontic treatment or as a transitional retainer between certain stages of treatment. www.indiandentalacademy.com 55
  • 56. INVISALIGN It is an orthodontic technique that uses a series of clear plastic aligners to move teeth. The aligners are made from thin, see through plastic, which fits over the buccal, lingual (palatal), and occlusal surfaces of the teeth. The aligners are worn for a minimum of 20 hours per day and are changed (and advanced) on a 2-weekly basis. Each aligner is designed to move a tooth or small group of teeth about 0.25–0.3 mm. These appliances are worn full time by the patient to move the teeth according to the programmed stages of movement. www.indiandentalacademy.com 56
  • 57. REFERENCES 1. JCO 1982 Sep (619-622): Modified Splint Design for Two-Jaw Surgery 2. AJO-DO, Volume 1983 Nov (361 - 383): Orthopedic coordination of dentofacial development in skeletal Class ll malocclusion in conjunction with edgewise therapy - Bas 3. AJO-DO, Volume 1995 Mar (229 - 234): Effectiveness of splints in TMD treatment -Willis 4. JCO 1990 Jun (351-359): Thermoformed Orthodontic Appliances - DR. MICHEL AMORIC 5. Research paper by clinical foundation of orthopedics and orthodontics. 6.AJO-DO 1993 Sep (211-223): Mandibular forward induction - Yokota, Murakami, and Shimizu www.indiandentalacademy.com 57
  • 58. REFERENCES 7. AJO-DO 1984 May (376-384): Maxillary traction splint - Caldwell, Hymas, and Timm. 8. AJO-DO 1982 Jan (65-70): Posteroanterior traction in maxillonasal dysplasia - Rune et al. 9. Three-Dimensional Diagnosis and Orthodontic Treatment of Complex Malocclusions With the Invisalign Appliance-Robert L. Boyd and Vicki Vlaskalic ( Semin Orthod 2001;7:274-293.) 10. JCO 1981 Feb (100-123): Functional Occlusion for the Orthodontist - Part 2 . 11. J Clin Orthod. 1993 Feb;27(2):94-5. Gnathological orientation splint for presurgical orthodontics 12. JCO 1981 Mar (174-198): Functional Occlusion for the Orthodontist - Part 3 -Finishing To Gnathological Principles -RONALD H. ROTH, DDS 13.JCO 1989 Nov (756-762): Simplified Bass Appliance - NEVILLE M. BASS, BDS, LDS, FDS, DOrth RCS. 14. AJO-DO 1993 Nov (484-491): Increase in vertical dimension alters mechanical properties and isometric ATPase activity - Paik, Satomi, Saeki, Yanagisawa, www.indiandentalacademy.com 58
  • 59. 15.JCO 1993 Jan (37-45): Essix Retainers: Fabrication and Supervision for Permanent Retention - JOHN J. SHERIDAN, DDS, MSD, WILLIAM LEDOUX, DDS, ROBERT 16.JCO 1985 Aug (570-578): Invisible Retainers - JAMES A. MCNAMARA, DDS, PHD, KAREN L. KRAMER, CDA, JAMES P. JUENKER www.indiandentalacademy.com 59
  • 60. www.indiandentalacademy.com 60