Combined activator and headgear orthopedics /certified fixed orthodontic courses by Indian dental academy

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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

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Combined activator and headgear orthopedics /certified fixed orthodontic courses by Indian dental academy

  1. 1. Combined activator and headgear orthopedics www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3.    Activator therapy Biodynamics of growth and development Biomechanics of head gear www.indiandentalacademy.com
  4. 4. Growth of counterparts   In average growth pattern mandibular symphysis moves along y axis Balance is maintained www.indiandentalacademy.com
  5. 5. Effect of vertical components of growth on A-P position of symphesis www.indiandentalacademy.com
  6. 6. Division of growth vector into horizontal & vertical components www.indiandentalacademy.com
  7. 7. Head gears www.indiandentalacademy.com
  8. 8. Biomechanics of head gear  Center of resistance     Tooth Dentition Maxilla Rotations   Clock wise-posteriorcaudal Counter clock wiseanterior-cranial www.indiandentalacademy.com
  9. 9. Cervical pull force inferior to both the centers of resistance www.indiandentalacademy.com
  10. 10. Cervical pull force passing between centers of resistance www.indiandentalacademy.com
  11. 11. Occipital pull force inferior to both centers of resistance www.indiandentalacademy.com
  12. 12. Occipital pull force passing between centers of resistance www.indiandentalacademy.com
  13. 13. Mandibular forward positioners    Myotatic reflex activity and isometric contractions Viscoelastic property of muscle and stretching of soft tissues Transitional www.indiandentalacademy.com
  14. 14. Force vector with activator www.indiandentalacademy.com
  15. 15. Treatment concept of Combined activator & headgear orthopedics  Holding the maxilla in vertical as well as sagital direction Forward positioning of the mandible www.indiandentalacademy.com
  16. 16. Appliance design  Stocklie and Teuscher  Pfeiffer and Grobety  Hickham www.indiandentalacademy.com
  17. 17. Stocklie and Teuscher Appliance design       1968 – cervical traction with head gear Similear to work of Pfeiffer and Grobety Thurow –removable acrylic splint Bass –J hook head gear to incisal torquing mechanism Restrict developmental contributors that tend to class II Enhance developmental contributors that tend to harmonize the same www.indiandentalacademy.com
  18. 18. Stocklie and Teuscher Appliance design    Activator with 2 mm of incisal capping A transpalatal bar Headgear tube between molar and premolars www.indiandentalacademy.com
  19. 19. Stocklie and Teuscher Appliance design     A force of 400 gm per side is used Ideally force should pass through both the centers of resistance. Tips the incisors Torquing springs www.indiandentalacademy.com
  20. 20. Torquing springs    Used to stabilize the upper arch Palatal root tipping force is applied Made from 0.5/0.6 mm ss wire www.indiandentalacademy.com
  21. 21. Mandibular component of Stocklie and Teuscher Appliance design     Forward positioning is essential because the head gear force might be transmitted to the mandible via intercuspation –Edler Construction bite –transitional approach Anchorage from lower lingual cortical plate 2-3 mm of incisal capping www.indiandentalacademy.com
  22. 22. Modifications given by Stocklie and Teuscher      Upper labial and lingual wires Lower labial and lingual wires Springs for individual tooth movement Combination with TPA Combination with fixed appliance  Fixed appliance after activator   diastema, 2*4, utility Activator for cl II correction after fixed appliance www.indiandentalacademy.com
  23. 23. Modifications given by Stocklie and Teuscher  Lip bumper and lip pads www.indiandentalacademy.com
  24. 24. Modifications given by Stocklie and Teuscher   Grinding procedures Relining     Once in 8weeks for expansion Done when fit is lost Once in 6 months Expansion screws www.indiandentalacademy.com
  25. 25. Pfeiffer and Grobety combination therapy        Activator Prevents ,intercepts and corrects habits Acts as space maintainer Expands if necessary Starts to correct individual tooth position Starts to correct beep bite Helps to correct skeletal class II as it    Corrects habits Promotes mesial movement of lower teeth Inhibits maxillary growth www.indiandentalacademy.com
  26. 26. Pfeiffer and Grobety combination therapy       Cervical extra oral force Slowed or interrupted maxillary growth Distal movement of anchor molars Tipping of anterior teeth Extrusion of upper molar–opening of biterotating the mandible downward & back ward Tipping downward of the anterior part of the palate www.indiandentalacademy.com
  27. 27. Cervical pull force inferior to both the centers of resistance www.indiandentalacademy.com
  28. 28. Pfeiffer and Grobety combination therapy-1972 & 1975   Bands on first molar ,Extended lingual flanges & Spur on the labial bow Bite 2-3 mm short of most protrusive position & 3-4 mm beyond freeway space www.indiandentalacademy.com
  29. 29. Pfeiffer and Grobety combination therapy-1982    70 % cervical traction Teuscher approach in hyper divergent cases Bass design of looped torquing device in cl II div II cases www.indiandentalacademy.com
  30. 30. Pfeiffer and Grobety combination therapy-1982  Use of reverse head gear www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32. Pfeiffer and Grobety combination therapy-1982 www.indiandentalacademy.com
  33. 33. Pfeiffer and Grobety combination therapy1982 -Treatment time Do not wait till pre pubertal growth spurt      Soft tissue adaptation Psychological problems Permanent teeth cannot be guided hence extraction becomes necessary Long term stabality -tissue adaptation 12-18 orthopedic & 12-18 orthodontic www.indiandentalacademy.com
  34. 34. Hickham 1980   Advocated hooks soldered on labial bow to apply extra oral force of 16+ ounces Type of discrepancy decides the direction of force www.indiandentalacademy.com
  35. 35. Hickham 1980    High angle cases with anterior open bite Increase thickness of the bite Vertical pull head Cap with mandibular trough. www.indiandentalacademy.com
  36. 36. Activator and its modifications “Before disregarding my recommendations and making changes, first ask me why it failed when I first tried it. After all ,I have spent a lifetime trying and discarding alternate methods,selecting the best the easiest, the most efficient ways to do things.” -P R Begg www.indiandentalacademy.com
  37. 37. References       Orthodontics- current principles & technique-Graber & Swain Dentofacial orthopedics with functional appliances- Graber,Rakosi & Petrovic Pfeiffer, J.-P., and Grobéty, D.: Simultaneous use of cervical appliance and activator: An orthopedic approach to fixed appliance therapy, AM. J. ORTHOD. 61: 353-373, 1972. Pfeiffer, J.-P., and Grobéty, D.: The Class II malocclusion: Differential diagnosis and clinical application of activators, extraoral tractions and fixed appliances, AM. J. ORTHOD. 68: 499-544, 1975. Hickham,JH: Activators for the Fixed Appliance Orthodontist, J Clin Orthod 14;529,1980 Pfeiffer, J.-P., and Grobéty, D.: Combined orthopedic-orthodontic treatment, AM. J. ORTHOD. 81: 185, 1982 www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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