Frankel functional appliance /certified fixed orthodontic courses by Indian dental academy

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Frankel functional appliance /certified fixed orthodontic courses by Indian dental academy

  1. 1. FRANKEL FUNCTION REGULATOR www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2.  Prof Dr Rolf Frankel born in Leipzig on March 29.  He has been an outstanding contributor to functional appliance thought & the creator of the Function regulator (Frankel) system of appliances. www.indiandentalacademy.com
  3. 3. Buccinator mechanism  The laws of muscle action.  The integrity of dental arches and the relationship of teeth to each other.  Of-setting of the tongue pressure by buccal and labial muscles during mastication.  Hence aberrations of muscle function can and do produce marked mal relationships of the dental arches. www.indiandentalacademy.com
  4. 4. Guiding effect of Buccinator mechanism www.indiandentalacademy.com
  5. 5. THE FRANKEL PHILOSOPHY  The major part of the Frankel appliance is confined to the oral vestibule.  The concept of shielding the perioral musculature.  The Function regulator of Frankel differs from other functional appliances in the Sense: The Frankel appliance is largely confined to the oral vestibule. Stresses the influence of the functional matrix, the buccinator mechanism and the Orbicularis Oris complex. The dynamic barriers to optimal growth of the cranio facial complex in three dimensions of space. www.indiandentalacademy.com
  6. 6. The vestibular arena of operations The classic concept of “Pushing the dental arches out from within”. vestibular constructions act as an artificial “Ought –to –be” matrix. Appliance as an exercise device for oral gymnastics. The primary role of the lip and check musculature in arch form development as opposed to the tongue. www.indiandentalacademy.com
  7. 7. Sagittal correction The major draw backs in the past. The appliance is anchored to the maxillary dentition. The role of acrylic pad. www.indiandentalacademy.com
  8. 8. Differential Eruption Guidance  As the mandibular dentition is free .  Rules out the demanding and precise grinding, so often needed in other functional appliances. www.indiandentalacademy.com
  9. 9. Minimal Maxillary Basal effect  Newton`s third law of motion.  According the Mc. Namara this effect is very little on the maxilla. www.indiandentalacademy.com
  10. 10. Periosteal pull by Buccal shields & lip pads.  Periosteal pull hypothesis.  This working hypothesis, which was under research at the American Dental Association Research institute by Graber et al ( unpublished study, 1988), clearly shown that the buccal shields due stimulate bodily buccal movement of posterior teeth and buccal plate activity far beyond the activity observed in controls. www.indiandentalacademy.com
  11. 11. Visual Treatment objective – As an Diagnostic Test  Gives a clue to the operator regarding the importance in facial appearance and profile when subjected to any type of functional appliance. www.indiandentalacademy.com
  12. 12. Indications for the Function Regulator www.indiandentalacademy.com
  13. 13. Type I  Class I Early treatment Late treatment  Class II div I Early treatment Late treatment www.indiandentalacademy.com
  14. 14. Type II  Class I Early treatment Late treatment  Class II div I Early treatment Late treatment Class II div II Early treatment Late treatment www.indiandentalacademy.com
  15. 15. Type III Early treatment Late treatment Type IV Early treatment www.indiandentalacademy.com
  16. 16. CONSTRUCTION OF FUNCTION REGULATOR www.indiandentalacademy.com
  17. 17. Separation of Teeth  Recommendation for early separation of teeth.  Slicing of teeth. www.indiandentalacademy.com
  18. 18. Impression Taking  Actual reproduction of the resting vestibular sulcus depth.  Consistency of the impression material.  Use of thermal- sensitive tray in clinical procedures.  Reduces the cost effective chair side trimming. www.indiandentalacademy.com
  19. 19. Trimming of working Model  Failure to reproduce adequate sulcus depth.  Trimming is done to produce the necessary tissue tension.  Carved back about 5mm from the greatest curvature of the alveolar base with a pear shaped carbide bur and office knife. www.indiandentalacademy.com
  20. 20. Wax Relief  Outlining the area with pencil.  Subsequent covering with layers of pink base plate wax. www.indiandentalacademy.com
  21. 21.  The wax covering is especially important in the region of the maxillary first deciduous molars, because this is the region of greatest arch narrowing in most class II Div I malocclusions. www.indiandentalacademy.com
  22. 22. Fabrication of wire components www.indiandentalacademy.com
  23. 23. General rule  All the wires should be bent with smooth curve.  The vestibular wires are placed 1.5 mm from the alveolar mucosa.  Wires should follow the natural tissue contours.  The distance between the wires and the wax padding should be approximately 0.75mm. www.indiandentalacademy.com
  24. 24. Maxillary wires www.indiandentalacademy.com
  25. 25. Mandibular wires www.indiandentalacademy.com
  26. 26. The FR – 2 www.indiandentalacademy.com
  27. 27. The FR- 3 www.indiandentalacademy.com
  28. 28. FR –IV www.indiandentalacademy.com
  29. 29. Construction bite  Procedures differ in both the degree of vertical opening and amount of forward posturing of the mandible.  One of the limitations of the Frankel appliance is the vertical opening.  In case of large overjet step by step advancement is emphasized.  Hence, for a clinician a good rule of thumb is that greater the sagittal component lesser the vertical component. www.indiandentalacademy.com
  30. 30. MODE OF ACTION OF THE FUNCTION REGULATOR  Interception of aberrations of muscle function.  Frankel appliance with holds muscle pressure acting on the developing jaws and the dento alveolar area.  Passive expansion achieved through relief of force from the neuromuscular capsule (the buccinator mechanism). www.indiandentalacademy.com
  31. 31. CHANGES BROUGHT BY FRANKEL APPLIANCE IN THE OROFACIAL COMPLEX. www.indiandentalacademy.com
  32. 32. Increase in Intra oral space (Sagittal and Transverse)  Achieved mainly through buccal shields and lip pads.  Favouring the forces acting from within the oral cavity (the tongue).  Movement of the teeth in the direction of least resistance.  Effect of stretch on the contiguous soft tissue. www.indiandentalacademy.com
  33. 33.  Supporting effect on the lower lip.  Establishment of a competent lip seal.  The physiological relevance of hermetic closure of the oral functioning space.  The concomitant action of the Buccal shields and labial pads. www.indiandentalacademy.com
  34. 34.  Enhancing basal bone development.  Frankel emphasizes maximal superior extension of the upper lip pad.  The transverse and sagittal development of the apical base is possible only as long as there is some natural growth potential remaining. www.indiandentalacademy.com
  35. 35. Vertical space increase  The Importance of construction bite.  According to Frankel, the disturbance in vertical development is more often caused by the cheeks, than the effect of the tongue.  screening effect of buccal shields www.indiandentalacademy.com
  36. 36. Mandibular protraction  “Sensory feed back mechanism” through lingual acrylic shield. www.indiandentalacademy.com
  37. 37. Muscle function adaptation  Development of new pattern of motor functions.  Preventing the deforming influence on the bony structures.  Creation of a new shell by the appliance.  Massaging effect of pads and shields.  The appliance loosens up the tight muscles and improves tonicity. www.indiandentalacademy.com
  38. 38. FR for vertical maxillary excess  Patients with excessive vertical growth or “long face” syndrome”.  The dominant morphological feature.  The original FR relies only on the inter proximal cross over wires and occlusal rests to control the vertical eruption of the maxillary dentition, while the mandibular dentition is permitted to erupt freely. www.indiandentalacademy.com
  39. 39. The schedule of appliance wear  The first couple of weeks 2-4 hrs.  The next period of 3 weeks 4-6 hrs.  Speech improvement.  The third appointment.  Treatment progress checked regularly at 4 Week intervals.  As treatment progresses there should be a gradual improvement in the facial appearance. www.indiandentalacademy.com
  40. 40. CONCLUSION  No universal or cook-book formula is available within the orthodontic literature.  A no of tools are available to the clinician to attempt correction of maxillo-mandibular malrelationships.  Regardless of the appliance used there is a large and similar amount of variation in individual patient response to treatment. www.indiandentalacademy.com
  41. 41. THANK YOU !! For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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