This document discusses facial masks and chin cups used in orthodontic treatment. It provides historical background on facial masks, describing their development over 100 years ago. It outlines the key components of orthopedic facial mask therapy, including the facial mask itself with forehead and chin caps connected by a metal frame, as well as intraoral appliances and elastic forces. The document discusses different types of facial masks and their indications, effects, and guidelines for use in treating Class III malocclusions and maxillary deficiencies. It also briefly covers chin cups and their effects of downward and backward rotation of the mandible.
Maxillary protraction /certified fixed orthodontic courses by Indian dental ...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
0091-9248678078
This document discusses natural head position (NHP) in cephalometric radiography. It outlines limitations of traditional reference planes like sella-nasion and discusses how NHP provides a more reproducible and clinically relevant orientation. NHP is defined as the small range of positions where the subject looks at a distant eye-level point with relaxed posture. Several methods are described for standardizing and measuring NHP, including the use of mirrors, fluid levels, and inclinometers. Maintaining NHP is important because variations can influence the appearance and measurements of craniofacial structures.
This document discusses the management of open bite malocclusions. It begins by defining open bite and classifying it as either skeletal or dental in nature. Skeletal open bite is caused by excessive vertical growth of the jaws while dental open bite is due to reduced incisor height. Common etiologies of open bite include thumb sucking habits, tongue thrusting, and abnormal skeletal growth patterns. The document outlines various treatment approaches for different open bite classifications and etiologies.
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.for more details please visit
www.indiandentalacademy.com
The Frankel functional regulator is a removable orthodontic appliance developed by Dr. Rolf Frankel to effect changes in the jaw relationship during mixed and early permanent dentition. It consists of upper buccal shields, lower lip pads, and wires. The shields and pads act to change muscle function and guide jaw growth. Indications include Class II malocclusions with a retruded mandible. Contraindications include severe crowding. The appliance aims to correct jaw positions through muscle adaptation and differential tooth eruption guidance between the arches.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Maxillary protraction /certified fixed orthodontic courses by Indian dental ...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
0091-9248678078
This document discusses natural head position (NHP) in cephalometric radiography. It outlines limitations of traditional reference planes like sella-nasion and discusses how NHP provides a more reproducible and clinically relevant orientation. NHP is defined as the small range of positions where the subject looks at a distant eye-level point with relaxed posture. Several methods are described for standardizing and measuring NHP, including the use of mirrors, fluid levels, and inclinometers. Maintaining NHP is important because variations can influence the appearance and measurements of craniofacial structures.
This document discusses the management of open bite malocclusions. It begins by defining open bite and classifying it as either skeletal or dental in nature. Skeletal open bite is caused by excessive vertical growth of the jaws while dental open bite is due to reduced incisor height. Common etiologies of open bite include thumb sucking habits, tongue thrusting, and abnormal skeletal growth patterns. The document outlines various treatment approaches for different open bite classifications and etiologies.
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.for more details please visit
www.indiandentalacademy.com
The Frankel functional regulator is a removable orthodontic appliance developed by Dr. Rolf Frankel to effect changes in the jaw relationship during mixed and early permanent dentition. It consists of upper buccal shields, lower lip pads, and wires. The shields and pads act to change muscle function and guide jaw growth. Indications include Class II malocclusions with a retruded mandible. Contraindications include severe crowding. The appliance aims to correct jaw positions through muscle adaptation and differential tooth eruption guidance between the arches.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Modification of twin block functional applianceMaher Fouda
This document discusses the Twin Block appliance, which was originally developed by Clarke. It remains a widely used functional appliance for treating Class II malocclusions. The Twin Block consists of separate upper and lower acrylic appliances connected by occlusal blocks. It works by forcing the mandible into a protrusive position during jaw closure. The document describes the standard Twin Block design and various modifications that have been made, including the addition of expansion screws, torquing springs, and bite jumping screws to allow for gradual advancement. Advantages include comfort, aesthetics, and improved patient compliance compared to fixed appliances. The Twin Block is effective at correcting Class II malocclusions in a rapid manner.
This document discusses various methods and appliances for distalizing maxillary molars, including removable and fixed options. Removable appliances discussed include extraoral traction using headgear as well as removable appliances with finger springs or sliding jigs. Fixed appliances discussed include intramaxillary devices like Wilson's 3D appliance as well as intermaxillary appliances like Herbst or Jasper Jumper. Factors like the presence of second molars, skeletal pattern, and growth prognosis must be considered when determining whether molar distalization is indicated.
This document provides information on various non-patient compliant fixed functional appliances used to treat Class II malocclusions, including the Herbst appliance, MARA, Advansync, and fixed twin block. It discusses the history, design, advantages, disadvantages, and effects of each appliance. In general, these fixed functional appliances can eliminate patient compliance issues compared to removable appliances, have continuous effects, and shorter treatment times, but may have higher breakage and mechanical dislodgement risks.
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.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...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
0091-9248678078
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
00919248678078
This document discusses utility arches, which are orthodontic appliances used to apply light forces in the dental arch. It provides details on:
- The historical background and development of utility arches based on biomechanical principles.
- Common wire dimensions and materials used, including stainless steel, nickel titanium, and beta titanium alloys.
- The standard design components of utility arches, including molar, vertical, and incisal segments.
- Different types of utility arches like passive arches, intrusion arches, and retraction/protrusion arches and how they are activated to apply specific orthodontic forces.
This document provides information about molar distalization, including:
- Molar distalization involves moving molars backwards to correct malocclusions.
- Various appliances can be used for molar distalization, including headgear, K-loops, and pendulum appliances.
- Treatment planning for molar distalization generally involves two phases - a space gaining phase followed by a consolidation phase to achieve ideal occlusion.
This document discusses open bite, including definitions, classifications, anterior open bite (AOB), and posterior open bite (POB). It defines open bite as a malocclusion where there is no vertical overlap between the maxillary and mandibular anterior or posterior teeth. AOB is more common than POB and can be caused by factors like thumb sucking, increased vertical facial proportions, tongue posture, mouth breathing, and neurological issues. Diagnosis involves assessing medical history and performing tests like the Overbite Depth Indicator. Treatment aims to correct the underlying causes and close the open bite.
- The ForsusTM FRD is a flexible fixed functional appliance developed by Bill Vogt in 2001 that can be used with a fixed pre-adjusted Edgewise appliance.
- It consists of spring modules, push rods of varying lengths, split crimps, and a measurement gauge.
- The ForsusTM is recommended for Class II cases where patients did not cooperate with class II elastics, and is planned from the beginning of treatment.
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.for more details please visit
www.indiandentalacademy.com
Biomechanics of fixed functional appliances /certified fixed orthodontic cour...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
0091-9248678078
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.for more details please visit
www.indiandentalacademy.com
TMA is an archwire material that is intermediate in stiffness between stainless steel and nickel titanium. It has good flexibility and springback along with predictable moderate forces that provide consistent tooth movement. TMA can be used in all stages of treatment but is especially useful as a main working archwire due to its properties. It is formable, weldable, and delivers approximately half the force of stainless steel.
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.for more details please visit
www.indiandentalacademy.com
Maxillary protraction /certified fixed orthodontic courses by Indian dental a...Indian dental academy
This document discusses maxillary protraction, which is a common treatment for Class III malocclusions involving a deficient midface. It involves using headgear to apply forward force on the maxilla to correct the skeletal discrepancy. The document covers the history and development of maxillary protraction appliances, treatment effects, optimal timing, benefits of combining with rapid maxillary expansion, and different appliance designs.
This document discusses various types of dental retention appliances. It begins by defining retention and explaining why it is necessary after orthodontic treatment. It then covers theories of retention, keys to eliminating lower retention, and classifications of retainers. The main types of retainers discussed are removable retainers like Hawley retainers, wrap-around retainers, and Essix retainers. Fixed retainers and principles of different retention times are also summarized.
Dr. Percival Raymond Begg developed the Begg technique for orthodontic treatment over many years, beginning in the 1920s. He studied under Dr. Angle and was an early user of the Edgewise appliance. Through his own practice, Begg realized some limitations of Angle's methods and made modifications like removing teeth or stripping tooth width to improve outcomes. This evolved into the Begg technique using light wires and brackets to minimize forces and reduce relapse. The technique gained popularity after visits by American orthodontists to Begg's practice and demonstrations of its effectiveness.
Orthodontic adhesives have progressed through five generations, moving from unfilled acrylic resins to modern light-cured resin composites. First generation adhesives were unfilled poly(methyl methacrylate) that caused enamel damage. Second generation used UV light activation but had radiation hazards. Third generation introduced two-paste filler systems like Concise. Fourth generation were "no-mix" but had inhomogeneous curing. Current fifth generation utilize visible light curing for safer, deeper curing without diminishing over time.
Functional appliances utilize the natural forces of the orofacial musculature to produce skeletal and dental changes. They are based on Moss's functional matrix theory which proposes that muscles and glands influence bone growth. Functional appliances can be active or passive and produce orthopedic, dentoalveolar, and muscular changes through forces of compression, elimination of restrictive influences, and mandibular repositioning. Common functional appliances discussed in the document include Bionators, Twin-Blocks, Herbst, Frankel Regulator, and Jasper Jumper. They vary in their mode of action, indications, advantages, and disadvantages.
Orthopedic protraction of the maxilla part 1MaherFouda1
1. The document discusses treatment of Class III malocclusion through maxillary protraction using face masks connected to various intraoral appliances.
2. Common intraoral appliances used include rapid palatal expanders, removable plates, and splints to stabilize the maxilla.
3. Face masks like the Delaire or Petit masks can be used to apply approximately 350-450g of forward force over 12-14 hours per day to correct maxillary deficiency.
Modification of twin block functional applianceMaher Fouda
This document discusses the Twin Block appliance, which was originally developed by Clarke. It remains a widely used functional appliance for treating Class II malocclusions. The Twin Block consists of separate upper and lower acrylic appliances connected by occlusal blocks. It works by forcing the mandible into a protrusive position during jaw closure. The document describes the standard Twin Block design and various modifications that have been made, including the addition of expansion screws, torquing springs, and bite jumping screws to allow for gradual advancement. Advantages include comfort, aesthetics, and improved patient compliance compared to fixed appliances. The Twin Block is effective at correcting Class II malocclusions in a rapid manner.
This document discusses various methods and appliances for distalizing maxillary molars, including removable and fixed options. Removable appliances discussed include extraoral traction using headgear as well as removable appliances with finger springs or sliding jigs. Fixed appliances discussed include intramaxillary devices like Wilson's 3D appliance as well as intermaxillary appliances like Herbst or Jasper Jumper. Factors like the presence of second molars, skeletal pattern, and growth prognosis must be considered when determining whether molar distalization is indicated.
This document provides information on various non-patient compliant fixed functional appliances used to treat Class II malocclusions, including the Herbst appliance, MARA, Advansync, and fixed twin block. It discusses the history, design, advantages, disadvantages, and effects of each appliance. In general, these fixed functional appliances can eliminate patient compliance issues compared to removable appliances, have continuous effects, and shorter treatment times, but may have higher breakage and mechanical dislodgement risks.
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.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...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
0091-9248678078
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
00919248678078
This document discusses utility arches, which are orthodontic appliances used to apply light forces in the dental arch. It provides details on:
- The historical background and development of utility arches based on biomechanical principles.
- Common wire dimensions and materials used, including stainless steel, nickel titanium, and beta titanium alloys.
- The standard design components of utility arches, including molar, vertical, and incisal segments.
- Different types of utility arches like passive arches, intrusion arches, and retraction/protrusion arches and how they are activated to apply specific orthodontic forces.
This document provides information about molar distalization, including:
- Molar distalization involves moving molars backwards to correct malocclusions.
- Various appliances can be used for molar distalization, including headgear, K-loops, and pendulum appliances.
- Treatment planning for molar distalization generally involves two phases - a space gaining phase followed by a consolidation phase to achieve ideal occlusion.
This document discusses open bite, including definitions, classifications, anterior open bite (AOB), and posterior open bite (POB). It defines open bite as a malocclusion where there is no vertical overlap between the maxillary and mandibular anterior or posterior teeth. AOB is more common than POB and can be caused by factors like thumb sucking, increased vertical facial proportions, tongue posture, mouth breathing, and neurological issues. Diagnosis involves assessing medical history and performing tests like the Overbite Depth Indicator. Treatment aims to correct the underlying causes and close the open bite.
- The ForsusTM FRD is a flexible fixed functional appliance developed by Bill Vogt in 2001 that can be used with a fixed pre-adjusted Edgewise appliance.
- It consists of spring modules, push rods of varying lengths, split crimps, and a measurement gauge.
- The ForsusTM is recommended for Class II cases where patients did not cooperate with class II elastics, and is planned from the beginning of treatment.
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.for more details please visit
www.indiandentalacademy.com
Biomechanics of fixed functional appliances /certified fixed orthodontic cour...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
0091-9248678078
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.for more details please visit
www.indiandentalacademy.com
TMA is an archwire material that is intermediate in stiffness between stainless steel and nickel titanium. It has good flexibility and springback along with predictable moderate forces that provide consistent tooth movement. TMA can be used in all stages of treatment but is especially useful as a main working archwire due to its properties. It is formable, weldable, and delivers approximately half the force of stainless steel.
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.for more details please visit
www.indiandentalacademy.com
Maxillary protraction /certified fixed orthodontic courses by Indian dental a...Indian dental academy
This document discusses maxillary protraction, which is a common treatment for Class III malocclusions involving a deficient midface. It involves using headgear to apply forward force on the maxilla to correct the skeletal discrepancy. The document covers the history and development of maxillary protraction appliances, treatment effects, optimal timing, benefits of combining with rapid maxillary expansion, and different appliance designs.
This document discusses various types of dental retention appliances. It begins by defining retention and explaining why it is necessary after orthodontic treatment. It then covers theories of retention, keys to eliminating lower retention, and classifications of retainers. The main types of retainers discussed are removable retainers like Hawley retainers, wrap-around retainers, and Essix retainers. Fixed retainers and principles of different retention times are also summarized.
Dr. Percival Raymond Begg developed the Begg technique for orthodontic treatment over many years, beginning in the 1920s. He studied under Dr. Angle and was an early user of the Edgewise appliance. Through his own practice, Begg realized some limitations of Angle's methods and made modifications like removing teeth or stripping tooth width to improve outcomes. This evolved into the Begg technique using light wires and brackets to minimize forces and reduce relapse. The technique gained popularity after visits by American orthodontists to Begg's practice and demonstrations of its effectiveness.
Orthodontic adhesives have progressed through five generations, moving from unfilled acrylic resins to modern light-cured resin composites. First generation adhesives were unfilled poly(methyl methacrylate) that caused enamel damage. Second generation used UV light activation but had radiation hazards. Third generation introduced two-paste filler systems like Concise. Fourth generation were "no-mix" but had inhomogeneous curing. Current fifth generation utilize visible light curing for safer, deeper curing without diminishing over time.
Functional appliances utilize the natural forces of the orofacial musculature to produce skeletal and dental changes. They are based on Moss's functional matrix theory which proposes that muscles and glands influence bone growth. Functional appliances can be active or passive and produce orthopedic, dentoalveolar, and muscular changes through forces of compression, elimination of restrictive influences, and mandibular repositioning. Common functional appliances discussed in the document include Bionators, Twin-Blocks, Herbst, Frankel Regulator, and Jasper Jumper. They vary in their mode of action, indications, advantages, and disadvantages.
Orthopedic protraction of the maxilla part 1MaherFouda1
1. The document discusses treatment of Class III malocclusion through maxillary protraction using face masks connected to various intraoral appliances.
2. Common intraoral appliances used include rapid palatal expanders, removable plates, and splints to stabilize the maxilla.
3. Face masks like the Delaire or Petit masks can be used to apply approximately 350-450g of forward force over 12-14 hours per day to correct maxillary deficiency.
The document discusses various types of face masks and headgear used in orthodontic treatment. It describes how face masks can be used to protract the maxilla in cases of Class III malocclusion by applying anteriorly-directed force. It provides details on different designs of face masks, including components, force levels, and indications. Headgears like high-pull and low-pull designs are explained in terms of their effects on tooth movement and anchorage control. Safety aspects of these appliances are also covered.
HEADGEAR and FACE MASK ORTHOPEDIC FORCE .pptxMaen Dawodi
There are 2 types of forces used in orthodontics-
1) orthodontic force
when applied brings about dental change.
They are light forces ( 50- 100 gm) bringing about
tooth movement.
2) orthopedic force
when applied brings about the skeletal changes.
They are heavy forces ( 300-500gm) that bring about
changes in the magnitude & direction of bone growth.
The following are the commonly used orthopedic appliances
a) Headgears
b) Protraction Face Mask
c) Chin Cup Appliance.
Headgears are the most widely used extra oral orthopedic appliances.
They are mainly used in the management of skeletal class II malocclusion by growth modification.
They are also used for distalization of maxillary molars
1) Force delivering unit
a) Face bow b) ‘J’ hook
2) Force generating unit
3) Anchor unit
a) Head cap or b) Neck strap
Chin cup for treatment of growing class III patientbilal falahi
Chin cups are a traditional orthopedic appliance used to treat Class III malocclusions. While some studies have found chin cups can temporarily retard mandibular growth and correct the malocclusion through backward rotation, the effects are not consistently maintained long-term. Meta-analyses found chin cups significantly reduced SNB angle and increased ANB and Wits appraisal in the short-term, but heterogeneity between studies was high. Chin cups also increased SN-ML angle and decreased gonial angle, indicating a tendency for increased vertical growth and posterior mandibular rotation. However, long-term stability and the effects of vertical chin cups require more research due to limited data.
This document discusses the treatment of class III malocclusions. It begins by defining class III malocclusions and describing the most common causes as either skeletal class III due to increased mandibular length or rare causes such as cleft palate or craniofacial syndromes. Treatment options discussed include functional appliances like FR-III, facemasks, and class III elastics attached to miniplates. Facemasks aim to protract the maxilla while functional appliances guide dental eruption. Class III elastics provide skeletal anchorage for correction. Factors like severity, growth remaining, and dentoalveolar compensation determine whether orthodontics alone or with orthognathic surgery is appropriate. Chin cups are discussed for treating
Protraction face mask /certified fixed orthodontic courses by Indian dental a...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
0091-9248678078
Protraction face mask /certified fixed orthodontic courses by Indian dental a...Indian dental academy
1. The document discusses protraction face mask therapy for correcting Class III malocclusions. It reviews previous literature on the use of face masks and summarizes various studies on the skeletal and dental effects of maxillary protraction.
2. Key findings from face mask therapy included forward movement of the maxilla and maxillary dentition, downward and backward redirection of mandibular growth, and lingual tipping of the lower anterior teeth.
3. The optimal timing of face mask therapy is in the early mixed dentition to induce more favorable skeletal changes, though it can still provide benefits in older children. Proper diagnosis, force levels, and retention are important for successful and stable outcomes.
Class III malocclusion, also known as mandibular prognathism, is characterized by the mandibular first molar occluding posterior to the maxillary first molar. It can be true skeletal Class III due to genetic factors or pseudo Class III caused by forward positioning of the mandible. Treatment depends on whether Class III is due to maxillary deficiency, mandibular excess, or both, and may involve myofunctional appliances, chin cups, face masks, fixed appliances, extractions, or orthognathic surgery. Interception during growth is important to improve the skeletal discrepancy and prevent worsening of the malocclusion.
The twin block appliance was developed in 1977 to treat a young patient with a Class II malocclusion caused by luxation of an upper central incisor. It consists of simple bite blocks with inclined planes at 70 degrees to apply forward and downward force on the mandible. The twin block uses natural muscle forces to encourage favorable skeletal and dental changes. It can be used to treat a variety of malocclusions in both growing and adult patients. Advancements in design have improved function, retention, and patient comfort.
The Hybrid Hyrax Distalizer is a new all-in-one orthodontic appliance that uses mini-implants for skeletal anchorage. It allows for (1) rapid palatal expansion to correct maxillary deficiencies, (2) application of protraction forces via facemask therapy to advance the maxilla, and (3) distalization of the upper molars without dental anchorage loss. A case report describes using the Hybrid Hyrax Distalizer for a 10-year old boy with severe class III malocclusion. It resulted in significant maxillary skeletal and dental changes over 14 months of treatment.
Uses of head gears in growing skeletal class /certified fixed orthodontic c...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
00919248678078
Biomechanics of headgears in orthodontics /certified fixed orthodontic course...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
0091-9248678078
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Extra-oral forces
And
Appliances
Prepared by:
Dr. Mohammed Alruby
Definition
Philosophy
History and development
Classification of extra-oral forces
Advantages of extra-oral forces
Disadvantages of extra-oral forces
Uses of extra-oral forces
Headgear
Appliance enhanced the action of headgear
Protraction appliances
Types of reversed headgear
Chin cup appliance
Orthopedic correction of class III
Orthopedic correction of open bite
Orthopedic correction of class II
Retention after orthopedic correction
Definition
It is a force derived from an extra-oral appliance that uses the forehead, the top of the head or the back of the neck as anchorage to apply forces to the dental or basal arch. It may be orthodontic force or orthopedic force to move the dentition, or restrict or redirect the growth respectively.
Philosophy:
The philosophy beyond the use of extra-oral force is based upon the old concept that, (the application of appreciable amount of force against the growing bone con modify or alter the direction of bone growth and consequently alter the shape and position of the bone
= the well-known best examples are the induced skull deformation in Colombia –India and feet deformation in Chinese girls
History and development:
Appliances resembling chin cups have been in use since the early 1800's. According to Graber, the early attempts with the chin cup were not successful because of incomplete knowledge of mandibular and facial growth, its use on non-growing patients, and an inadequate understanding of the forces generated by the chin cup.
1802: Cellier and Josef Fox in 1803, utilized chin caps in combination with bite blocks to correct the “underslung chin”
1866: Norman Kingsley introduced extra-oral head cap anchorage or force for maxillary distal movement
1880: Kingsley described an appliance that could influence the position of the dentition in upper jaw with the aid of extra-oral forces
1887: E.H.Angle recommended the use of occipital bandage in treatment of maxillary protrusion
1904: Jackson was first describing the facial mask
1892: headgear appliance was originally designed by Kingsley
1920: Angle and his followers were convinced that class II and class III elastics not only moved teeth but cause a significant skeletal changes: stimulate growth of one and restrain growth for the other so we not need to use any extra-oral force just wait until permanent dentition is completed
1923: Case recommend the use of extra-oral force against maxilla in treatment of class II and class I maxillary protrusion
1947: Kleohn, presented his treatment results with cervical neck strap, subsequent to this report, many other variation of the headgear appliance were presented
1960: Delaire facemask
Classification of extra-oral force appliances according to uses
The extra-oral pull is generally applied bilaterally, for three main purposes:
(1) as a restraining force
(2)
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.for more details please visit
www.indiandentalacademy.com
Class III malocclusion occurs when the mandible is positioned forward in relation to the maxilla. It can be caused by maxillary deficiency, mandibular excess, or a combination. Diagnosis involves measuring angles like ANB and Wits appraisal. Treatment depends on the underlying skeletal discrepancy and may involve functional appliances to guide growth, facemasks to protract the maxilla, or chin cups to restrain mandibular growth. For older patients, camouflage options like extractions and orthodontic tooth movement are used. Early treatment is preferred to prevent adverse effects on facial growth and development.
The document discusses orthopedic appliances used to correct skeletal imbalances. It focuses on headgears and facemasks. Headgears apply force to distalize the maxilla and correct Class II malocclusions, with cervical headgears extruding molars and occipital headgears intruding molars. Forces of 400+ grams for 12+ hours per day are needed to induce skeletal effects. Facemasks apply forward force on the maxilla to correct Class III malocclusions, advancing the maxilla 2-4mm over 8-12 months with 300-500 grams of force per side.
Removable orthodontic appliances can be inserted and removed by the patient. They were first developed in the 1830s using plaster models. Key advantages are that they allow for oral hygiene and are less expensive than fixed appliances. However, they have less control over tooth movement and require patient cooperation. Removable appliances use components like clasps for retention and bows or springs for applying forces. Common clasps include Adams, Jackson's, and circumferential clasps which engage tooth undercuts. Guidelines for appliance activation include providing paths for tooth movement and minimizing tipping.
The document discusses the appliance construction and treatment stages of the Refined Begg technique. Key points include:
1. The Refined Begg technique uses the basic Begg bracket design but with modifications to incorporate built-in torque and rotation controls. Round and rectangular archwires are used along with various pins and tubes.
2. Treatment involves 3 main stages to achieve objectives such as alignment, arch form correction, overbite/overjet reduction, and class I molar and canine relationships.
3. Stage 1 is divided into 2 substages - the first aims to align and level teeth while correcting rotations, and the second focuses on bite opening, anterior retraction, and interarch coordination.
Functional appliances
History
Basis for functional applainces
Functional appliance are loose removable appliances designed to alter the neuromuscular environment of the orofacial region to improve occlusal development and / or craniofacial skeletal growth
This document describes several techniques for modifying traditional Begg appliance treatment to overcome its shortcomings. It discusses the Kamedanized Begg (KB) technique, which uses angulated brackets and rectangular buccal tubes. It also describes the modular self-locking appliance system, which uses single or double insert brackets that snap onto a receptacle bonded to teeth to allow light wire movement with minimal friction. The goal is to enable faster and more efficient treatment through a progression of self-locking brackets and wires.
This document describes several techniques for modifying Begg orthodontic treatment, including the Kamedanized Begg Technique, Modular Self-Locking Appliance System, Combination Anchorage Technique, and BEDDTIOT. It discusses improvements made to address shortcomings of conventional Begg treatment, such as improving precision of control, torque application, and intrusion of incisors. New bracket and wire designs are introduced to better control tooth movement.
This document discusses basic terminology used to study tooth movement in orthodontics, including forces, moments, rotation, and translation. It explains that a force is a push or pull acting along a straight line, and a moment is the product of a force times the distance from the center of resistance of the tooth. Depending on where forces are applied in relation to the center of resistance, they can cause either translation of the tooth along the direction of the force, or rotation. Understanding these concepts is key to studying biomechanics and applying forces for desired tooth movement in orthodontic treatment.
The document discusses the history and principles of functional appliances, specifically the activator and bionator. It describes how the activator was developed in 1909 by Viggo Andresen to alter the neuromuscular environment and promote skeletal and dental development. The activator works through muscle contraction and stretching of soft tissues to apply forces in all three planes. There have been many modifications of the original activator design over the years. The bionator was developed by Wilhelm Balter in 1960 as a modified, less bulky version of the activator that can be worn both day and night for a faster adjustment of the musculature.
This document discusses the diagnosis and treatment planning for Class II malocclusions. It covers soft and hard tissue diagnosis including anteroposterior and vertical components. Treatment modalities described include non-extraction approaches like maxillary arch expansion and molar distalization, as well as functional appliances and orthopedic/orthodontic treatments to modify growth. For skeletal Class II malocclusions, options discussed are growth modification, dental camouflage, and orthognathic surgery. A brief history of approaches to Class II treatment is also provided.
tongue and its anatomical relationship with the dentition
• Development of tongue .
• Anatomy of Tongue
• Muscles of tongue.
• Nerve & Blood supply of Tongue.
• Tongue In Orthodontics.
• Examination of tongue.
• Tongue Thrust and Malocclusion.
• Abnormal tongue posture.
The document discusses prenatal development of the face, beginning with formation of the pharyngeal arches and facial prominences in the early embryo. It describes how the maxilla and mandible develop from the first pharyngeal arch. Ossification begins slightly earlier in the mandible. Prenatal growth involves remodeling and reshaping of structures. Postnatally, the mandible grows primarily through deposition at the condyle and ramus. The maxilla is attached to the cranial base and its position depends on cranial growth.
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3. Facial mask is effective in most developing Class III
patients, because the appliance system affects virtually
all areas contributing to Class III.
4. History
• A reverse pull head gear basically consists of a rigid extra-oral framework which takes
anchorage from the chin or forehead or both for the anterior traction of the maxilla using
extra-oral elastics which generate large amounts of force upto 1 kg or more
• .
• Although the facial mast was developed over 100 years ago. Hickham claims he was the first
to use a reverse headgear. However, this modality was made popular by Delairc around the
same time. This approach was used infrequently until reintroduced by Delaire in the late
1960s for the treatment of cleft patients. Interest in the facial mask in the United States later
was stimulated by Petit through his studies conducted at Baylor University
5. Components of Orthopedic Facial Mask Therapy
The component of facial mask appliance
1)Facial Mask
Chin cup
Forehead cap
Metal frame
2)Intra-oral appliance
Bonded maxillary splint
3)Heavy elastic
6. . Frontal view of the Petit facial mask. Note
that the elastics converge on and attach to the
crossbow immediately adjacent to the central
support bar. The positions of the forehead &
chin pads are adjustable
The lateral view of the orthopedic facial
mask. Note the downward direction of
pull of the elastics. The direction of the
pull can be adjusted by raising or
lowering the crossbar, however, the
elastics must not interfere with the
functional of the lips.
9. New Maxillary Protractor: Developed by Dr. Conte. This reverse headgear exerts a selective
propulsive force on the maxilla with no deleterious effect on the T.M.J.
Because the appliance has got only one point of resistance, (i.e. from the patient frontal bone).
There wont be any compression force against the mandible. So it can be used in whom a retrusive
mandibular force could be harmful to the joint.
Indication: Appliance is comfortable to wear. In patient with Class III malocclusion with
maxillary deficiency. Not suitable for patient with ideal maxilla and excessive mandibular growth
10. Indications:
1. It can be used in a growing patient having a prognathic mandible and a retrusive
axilla. It aids in pulling the maxillary structures forward and pushing the mandibular
structures backward.
2. It can be used for bending the condylar neck for stimulating temporomandibular
joint adaptations to posterior displacement of the chin.
3. It can also be used for selective rearrangement of the palatal shelves in cleft patients.
4. I can be used in correction of post-surgical relapse after osteotomies (or
uncontrolled post-surgical adaptations).
5. It can be used to treat certain accessory problems associated with nose morphology
such as lateral deviations.
11. Treatment Effects Produced by Facial Mask Therapy:
1. Correction of CO-CR discrepancy. This correction is immediate and usually is
observed in pseudo Class III patients.
2. Maxillary skeletal protraction. Usually 1 – 3 mm of forward movement of the
maxillary is observed.
3. Forward movement of the maxillary dentition.
4. Lingual tipping of the lower incisors. This tipping often occurs as a pre-existing
anterior crossbite is being corrected.
5. Backward rotation of the mandible is relation to the cranial base. In instances in
which the patient begins treatment with a short or neutral lower anterior facial
height, this change obviously is advantageous. In instances in which a patient has a
long lower anterior facial height at the beginning of treatment, this treatment effect
may be undesirable.
6. Favorable changes in mandibular growth, at least over the short – term. Condylar
growth in a forward direction can be associated with reduced increments in
mandibular length.
12. According to Proffit:
Clinical Management of Facemask Treatment. Generally, it is better to defer
maxillary protraction until the permanent first molars have erupted and can be
incorporated into the anchorage unit. Following palatal expansion or in conjunction with it,
a facemask that obtains anchorage from the forehead and chin (Fig.24) is used to exert a
forward force on the maxilla via elastics that attach to a maxillary appliance. To resist
tooth movement as much as possible, the maxillary teeth should be splinted together as a
single unit. The maxillary appliance can be banded, bonded, or removable. A removable
plastic splint that covers the occlusal surfaces of the teeth often is satisfactory. Multiple
clasps combined with plastic that extends over the incisal edges usually provide adequate
retention.
13. 12 Forward traction against the maxilla typically has three effects: (1) some forward movement of the maxilla, the
amount depending to a large extent on the patients age; (2) forward movement of the maxillary teeth relative to the
maxilla; and (3) downward and backward rotation of the mandible because of the reciprocal force placed against the
chin.
14. The orthopedic facial mask system
component:
has 3 basic
1) Facial mask,
2) Bonded maxillary splint and
3) Elastics.
15. The facial mask is an extraoral device
It consists of 2 caps which contact the soft tissue in the
forehead and chin regions.
16. The pads are made up of acrylic and are lined with a
soft closed-cell foam that is non-absorbent, easily
cleaned and replaceable.
The pads are connected by a midline framework made
from a round, contoured length of 0.25” stainless steel
with nuts on each end.
17. The positions of the pads are adjustable through the
loosening and tightening of a set screw.
The midline framework also can be bent to conform
better to the outline of the face of the individual patient.
18. In the center of the midline framework is a crossbar
made from 0.075” stainless steel that is secured to the
main framework by a set screw.
It allows the position of the crossbar to be adjusted
vertically. The ends of the crossbar are contoured for
patient’s safety.
19.
20. The splint is activated once per day until the desired
increase in transverse width has been achieved.
In patients - no increase in transverse dimension is
desired - activated for 8-10 days
- To disrupt the maxillary sutural system
- To promote maxillary protraction.
21. the facial mask - full time basis for 4-6 months, and
then it can be worn on a night-time only basis for an
additional period of time.
Maintaine oral hygine .
Visite within 3-5 weeks .
22. The facial mask is secured to the face by stretching elastics
from the hooks on the maxillary splint to the crossbow of
the facial mask.
Heavy forces are generated, usually through the use of a
sequence of elastics, ultimately resulting in a 18oz force
being generated by 5/16” elastics.
Lighter forces may be used during the break-in period, but
forces should be increased as the patient adjusts to the
appliance
23.
24. At the time of the delivery- 3/8” - 8oz elastics first 2
weeks
After 2 weeks - ½”. 14oz e.
Maximum force is delivered through the use of 5/16”
elastics.
25.
26. ⦁ Developed in 1960 by
Delaire
⦁ Design was squarish and
with rigid metal
framework
27.
28. of chin cup and
⦁ Consists
forehead
vertical
midline
cap with single
rod
from
running in
chin to
forehead cap
29. Facial mask especially when combined with a
maxillary anchorage unit can produce one or more of
the following treatment effects:
1) Correction of CO-CR discrepancy. This correction is
immediate and usually observed in pseudo class 3
patients.
2) Maxillary skeletal protraction. Usually 1-2mm of
forward movement of the maxilla is observed.
30. 3) Forward movement of the maxillary dentition.
4) Lingual tipping of the lower incisors. This tipping
often occurs as a pre-existing anterior crossbite is
being corrected.
5) Redirection of mandibular growth in a more vertical
direction.
31. The ideal stage of dental development in which to begin
facial mask therapy is at the time of eruption of the upper
permanent central incisor.
Usually ,the lower incisors have already erupted into the
occlusion.
32. The achievement of a positive horizontal and vertical
overlap of the incisors during treatment is essential in
providing an environment that will help maintain the
achieved anteroposterior correction of the original class
III malocclusion.
Optimally, the patient is instructed to wear the facial
mask on a full-time basis except during meals.
33. Young patients (5-9yr old) usually can follow this regimen.
In older pts, full-time wear may not be possible.
Particularly if the patient is told the full-time wear will last
only 4-6 months.
34. The facial mask should be discontinued immediately if
the pt complains of any symptoms of
temporomandibular disorders.
Immediate discontinuance of the appliance usually
results in a reversal of the symptomatology.
35. Demet Kaya, Ilken Kocadereli, Bahadir Kan, and Ferda
Tasar studied the effects of facemask treatment
anchored with miniplates after alternate rapid maxillary
expansions in July 2011 (Angle Orthod.)
36. It is a relatively old orthopedic appliance.
Introduced by Oppenheim.
37. ⦁ This is not analogous to the use of extraoral force
against the maxilla because there are no mandibular
sutures to influence.
⦁ Mandibular condyle - growth site
⦁ Condylar growth is largely a response to translation
as surrounding tissues grow,
38. ⦁ There are two major ways to direct force against the
mandible.
Heavy force aimed directly at the condylar area, or lighter force aimed below the
condyle to produce downward rotation of the mandible.
39. Diagrammatic representation of a typical response to chin cup therapy,
showing the downward and backward rotation of the mandible
accompanied by an increase in facial height.
40. ⦁ When extraoral force is applied against the chin, it is
difficult to avoid tipping the lower incisors lingually.
⦁ If the mandibular dentition was protrusive initially,
uprighting of the incisors is desirable
41. Chin cups are divided into 2 types:
1) Occipital-pull chin cup (used in mandibular
prognathism)
44. 2) Vertical-pull chin cup (used in cases of steep
mandibular plane angle and excessive anterior facial
height)
45. According to Samir E. Bishara :
Effect on Mandibular Growth. The orthopedic effects of a chin cup on
the mandibular include (1) redirection of mandibular growth vertically, (2) backward
repositioning (rotation) of the mandible, and (3) remodeling of the mandible with
closure of gonial angle. To date, there is no agreement in the literature as to whether chin
cup therapy may or may not inhibit the growth of the mandible. however, chin cup
theryapy has been shown to produce a change in the mandible associated with a
downward and backward rotation and a decrease in the angle of the mandible. In
addition, there is less incremental increase in mandibular length together with posterior
movement of B point and pogonion. Because of the backward mandibular rotation,
control of the vertical growth during chin cup treatment is difficult to manage.
46. Effects of Maxillary Growth. Some studies have indicated that a chin cup appliance has
no effect on the anteroposterior growth of the maxilla.
However, Uner, Yuksel, and Uncuncu showed that early correction of an anteriro
crossbite with a chin cup appliance prevents retardation of anteroposterior maxillary
growth
.
Sugawara et al compared the growth changes of patients after chin cup treatment with
control subjects and reported that, at age 17, the midface is more deficient in patients of
the control groups than in those of the treatment groups
47. At the time of appliance delivery, the force level of 150-
300 grams per side is used initially.
Over the next 2 months, the force level is increased to
450-700 grams per side (if the force is directed through the
condyles and slightly less if force is directed below the
condyle)
48. Patient is instructed to wear the chin cup 14hours per
day with an acceptable range of wear being 10-16 hours
per day.
After correction of a preexisting anterior crossbite has
been accomplished, the patient wears the appliance
during the night only as a retention appliance.
49. Both the occipital and vertical pull chin cups create
pressure on the temporo-mandibular joint region.
If any signs and symptoms of TM disorders are noted,
the use of the chin cup should be discontinued
immediately.
50. ⦁ Heavy intermittent force is less likely to produce
damage to roots of teeth, probably because the
stimulus for undermining resorption is diluted during
the times that the heavy force is removed.
51. Force is a potent weapon in the hands of an orthodontist.
How he makes use of that weapon determines the relative
success or failure of the orthodontist.