Myo-Functional Appliances. Removable orthodontic appliance ✨ Professor Rolf Frankel ✨ 1967 Maxillary changes mean movement of the maxilla of - -0·2mm - a slight increase of forward growth, the range being from –7·1 to 5·8 mm Mandibular changes • 12·8 mm of advancement to –1·4 mm of relative backward movement.. Molar Changes • U6- mesial direction -1·1 mm • The relative contributions to total upper molar movement were a mean –0·4 mm of tip and –0·7 mm of bodily movement, • L6- (mean 0·9 mm) • The net correction of the position of the lower molar in the FR group was due to the bodily movement(1·6 mm), the mean tip (–0·7 mm) opposing the Class II correction. In the FR group a mean total molar correction of 3·8 mm Incisor change ▪ 4·1 mm of retroclination in the upper incisors ▪ 2·2 mm of proclination in the lower. ▪ Bodily movement of the upper incisors- –4·9 to 3·7 mm with a mean movement of –0·9 mm (forward direction). To evaluate cephalometrically the effects of Fränkel's function regulator (FR-4) appliance on the treatment of Angle Class I skeletal anterior open bite malocclusion. ▪ Forty Turkish children (26 girls and 14 boys), with Angle Class I skeletal anterior open bite, were randomly divided into two groups of 20 (13 girls and 7 boys). ▪ Patients who had not undergone treatment served as the control group, whereas a second group was treated with lip-seal training and the FR-4 appliance. ▪ Chronologic mean decimal age at initial period of the investigation was 8.7 years in the treated group, and 8.9 years in the control group. ▪ Treatment and observation periods were 2 years. ▪ a spontaneous downward and backward growth direction of the mandible observed in the control group could be changed to a upward and forward direction by FR-4 therapy. ▪ The skeletal anterior open bite was successfully corrected through upward and forward mandibular rotation. CAPPED FR • controls tipping • Indicated in deep bite cases MODIFIED FR FOR VME • Posterior part of maxilla –important for vertical growth control • 1⁄2 -1/3 mm posterior eruption increases AFH by 1mm. • Molars intruded chin translated forward improving profile • Modified FR for VME by adding posterior bite blocks • Added head gear tubes

1. FUNCTIONAL
REGULATOR
MANASA.P
II MDS

2. CONTENTS
☀ Introduction
☀ Frankel’s philosophy
☀ Fabrication of the appliance
☀ Appliance delivery & Clinical handling
☀Modification of FR
☀ Studies on FR
☀ Comparison b/w FR and other functional appliances
☀ Conclusion
☀ References

3. INTRODUCTION
✨Removable orthodontic appliance
✨Professor Rolf Frankel
✨1967

4. FRANKEL’S PHILOSOPHY
activator
functional
appliance
mixed results
functional
deviations of
muscles are also
corrected along
with dentition
treatment
outcome –
stable
allowed the maxillary and
mandibular muscles to
play an important part in
an orthodontic treatment
Functional Regulator
Appliances

5. Classification of FR
❄ FR 1 – a, b, c
❄ FR 2
❄ FR 3
❄ FR 4

6. FR 1
Buccal shield
Lip pads Lingual shield
Acrylic components of FR 1

7. Labial bow
Canine loop
Palatal bow
Cross over
wire
Wire components of FR 1

8. Wire components of FR 1
Lower lingual
wires
Cross over
wires
Labial bow
Palatal bow Canine loop

9. FR1a and FR1 b
Lower lingual
loops
Overjet 5mm
Lower lingual
shield
Overjet 7mm

10. FR 1C
Step by step opening
in the anterior and
vertical direction
Overjet > 7mm

12. FR 2
Canine loop
and labial bow
Upper lingual wire

13. FR 3
Lower
labial wire
Upper
lingual
wire
Upper lip pads
Occlusal
rests

14. FR 4
4 occlusal rests
Palatal bow
Lower labial pads and
buccal shields
upper labial bow

15. Construction of the FR appliance

16. Impression technique
•Reproduce whole
alveolar process and
depth of the sulcus
•Tray selection
•Adequate base

17. Construction Bite
• Differs from other
functional appliances
• Advancement only by 2-
3mm in first step

18. Preparation of the casts
seating grooves:

19. Preparation of the casts
seating grooves

20. Preparation of the casts
wax relief:
Maximum thickness of
wax padding under
buccal shield
Wax padding under the buccal
shield to allow for dentoalveolar
expansion

21. Wire fabrication
• Correct position of wires on the maxillary work model
Labial bow 0.9mm ,
canine loop 0.8mm and
palatal bow 1mm

22. Wire fabrication
• Palatal bow
• Canine loop

23. Wire fabrication
• Correct position of lip pads and lingual shields and wires

24. Wire fabrication
• Correct position b/w wires
and wax up -0.75mm

25. Wire fabrication
• Future splitting of buccal shield with use of metal sheet

26. Timing of treatment
⏱ 7-8 ½ years
⏱ Best therapeutic effect when mandibular lateral incisors erupt
⏱ Class 2 div I with mandibular retrusion- males till a 15-16
years

27. Treatment phases with FR
⚙ Initial phase
⚙ Active phase
⚙ Retention phase

28. SKELETAL AND DENTAL CHANGES
FOLLOWING THE USE OF FFR II
Maxillary changes
mean movement of the maxilla of - -0·2mm - a slight increase of
forward growth, the range being from –7·1 to 5·8 mm

29. Mandibular changes
• 12·8 mm of advancement to –1·4 mm of relative backward
movement..

30. Molar Changes
U6- mesial direction -1·1 mm
The relative contributions to total upper molar movement were a
mean –0·4 mm of tip and –0·7 mm of bodily movement,
L6- (mean 0·9 mm)
The net correction of the position of the lower molar in the FR
group was due to the bodily movement(1·6 mm), the mean tip (–0·7
mm) opposing the Class II correction.
In the FR group a mean total molar correction of 3·8 mm

31. Incisor change
� 4·1 mm of retroclination in the upper incisors
� 2·2 mm of proclination in the lower.
� Bodily movement of the upper incisors- –4·9 to 3·7 mm with a
mean movement of –0·9 mm (forward direction).

32. SKELETAL AND DENTAL CHANGES
FOLLOWING THE USE OF FFR III
The skeletal effects on the maxilla - forward (point A, 1.3 mm.) and
downward (point A, 1.4 mm)
skeletal effects on the mandible - backward (point B- 0.8mm) and
downward (point B, 3.4 mm)
The increase in the mandibular plane angle and the decrease in SNB
ANB (1.9)
Wits - 2.4mm

35. ✅ Neither appliance has any appreciable effect on maxillary skeletal
structures
✅ The FR-2 affects the size - FR-3 the position of the mandible
✅ Increase in the vertical dimension, encountered with both appliances
✅ Changes in incisor inclination contributed to the favourable change
in overjet in both groups.

39. Modifications of FR appliance

40. Modifications of FR appliance
1. Capped frankel appliance-OTTON et al 1992
2. Modified functional regulator for VME -Owen1985
3. Hybrid appliance –activator –FR combination -1986
4. KINGSTON modified buccal shields
5. Fr with continuous buccolabial shield and palatal acrylic
support – Haynes 1986

41. CAPPED FR
• controls tipping
• Indicated in deep bite cases

42. Modified FR for VME
• Posterior part of maxilla –important for vertical growth
control
• ½ -1/3 mm posterior eruption increases AFH by 1mm.
• Molars intruded chin translated forward improving profile

43. Modified FR for VME
• Modified FR for VME by
adding posterior bite blocks
• Added head gear tubes

44. HYBRID FUNCTIONAL APPLIANCE
(fr and activator combination)

45. Modified Fr with continuous buccolabial shield and
palatal acrylic support- haynes ajo 1986
•To eliminate lip
trap
•No pressure on the
gingival
dentoalveolar
tissues

46. COMPARISION OF FR with OTHER
FUNCTIONAL APPLIANCES

52. CONCLUSION
• Frankel's Fr is an activator particularly suitable in
malocclusions of II/1 Class in the age of growth.
• Such device can be also utilized in combination with the
fixed multibands therapy.

53. REFERENCES
1. Rushforth, C. D. J., Gordon, P. H., & Aird, J. C. (1999). Skeletal
and Dental Changes Following the Use of the Frankel Functional
Regulator. British Journal of Orthodontics
2. Baik, H. S., Jee, S. H., Lee, K. J., & Oh, T. K. (2004). Treatment
effects of Fränkel functional regulator III in children with class III
malocclusions. American Journal of Orthodontics and Dentofacial
Orthopedics, 125(3), 294–301.
3. Graber TM, Rakosi T, Petrovic AG. Dentofacial orthopedics
with functional appliances. St Louis: Mosby; 1997

54. 4. Kerr, W. J. S., TenHave, T. R., & McNamara, J. A. (1989). A
comparison of skeletal and dental changes produced by Function
Regulators (FR-2 and FR-3). European Journal of Orthodontics,
11(3), 235–242.
5. Loh, M. K., & Kerr, W. J. S. (1985). The Function Regulator III:
Effects and Indications for Use. British Journal of Orthodontics,
12(3), 153–157.
6. Erbay, E., Ugur, T., & Ülgen, M. (1995). The effects of Frankel’s
function regulator (FR-4) therapy on the treatment of Angle Class I
skeletal anterior open bite malocclusion. American Journal of
Orthodontics and Dentofacial Orthopedics, 108(1), 9–21.

55. 7. HAYDAR, B., & ENACAR, A. (1992). Functional Regulator Therapy
in Treatment of Skeletal Open-bite. The Journal of Nihon University
School of Dentistry, 34(4), 278–287.
8. McNamara, J. A., Howe, R. P., & Dischinger, T. G. (1990). A
comparison of the Herbst and Fränkel appliances in the treatment of
Class II malocclusion. American Journal of Orthodontics and
Dentofacial Orthopedics, 98(2), 134–144.
9. Battagel, J. M. (1989). Profile changes in Class II, division 1
malocclusions: a comparison of the effects of Edgewise and Frankel
appliance therapy. European Journal of Orthodontics,