This document provides an overview of myofunctional appliances used in orthodontics. It discusses how they work to modify skeletal discrepancies by harnessing natural muscle forces. Different types of appliances are described, including activators, Frankel regulators, and Twin Blocks. Key factors in case selection and successful treatment outcomes with these appliances are highlighted, such as patient age and cooperation. The document also reviews concepts like Moss's functional matrix theory and how appliances can guide dental changes and bone growth. Contraindications and factors maximizing success are outlined.
This document provides an overview of functional appliances used in orthodontic treatment. It begins with definitions of functional appliances and a brief history of their development. It then discusses the basis, classification, forces, treatment principles, indications, actions, case selection, and common appliances like the activator, frankel regulator, bionator, twin block, and Herbst appliance. It provides details on their design, indications, mode of action, and advantages. In summary, the document serves as a comprehensive guide to functional appliances, their development and use in orthodontic treatment.
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 document discusses different methods of maxillary arch expansion in orthodontics, including slow expansion and rapid maxillary expansion. Slow expansion uses lighter forces over a longer period and can involve dental or skeletal changes. Rapid expansion applies greater force to separate the mid-palatal suture more quickly, but risks relapse. A variety of fixed and removable appliances are described for delivering expansion forces, including quad helix, W-arch, nickel-titanium wires, and expansion screws. The effects, indications, contraindications, and risks of both rapid and slow expansion techniques are compared.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
The lingual arch space maintainer is a passive bilateral mandibular appliance used to control tooth movement and arch perimeter after the loss of lower primary molars. It consists of bands on the first molars connected by a stainless steel wire. The wire is positioned to contact the lower incisors and rest on the gingiva of the molared and molar bands. It maintains the arch shape and leeway space until the permanent teeth erupt. Advantages include allowing eruption of permanents without interference and maintaining oral hygiene, while disadvantages include not preventing opposing tooth extrusion and potential for distortion.
This document provides information on headgear, including its components, principles of use, types, and applications in orthodontic treatment. Headgear delivers extraoral force from a cranial support to intraoral appliances. It consists of a facebow, force element, and head cap. Forces from headgear can distalize teeth and maxilla through different anchorage points. Types include cervical, occipital, and high pull headgear. Headgear is useful for orthopedic effects, anchorage reinforcement, molar distalization, and space maintenance.
Functional appliances are either active or passive devices that harness the natural forces of muscles in the mouth and face to guide growth of the jaws and teeth. They work based on Moss's functional matrix theory, which proposes that muscles and other soft tissues influence bone growth. Common functional appliances include the activator, bionator, frankel appliance, and twin block. They can modify jaw growth, alter tooth positions, and improve muscle tone. Functional appliance therapy is most effective when started before puberty to influence jaw growth.
The document discusses the history and use of expansion screws in removable orthodontic appliances. It describes how expansion screws work to move teeth and skeletal structures as needed. Guidelines are provided for properly positioning expansion screws. Various types of expansion screw appliances are outlined, including the Schwarz expander, transverse expander, fan expander, Nord expander, and lower Schwarz appliance. Advantages and disadvantages of expansion screw appliances are also summarized.
This document provides an overview of functional appliances used in orthodontic treatment. It begins with definitions of functional appliances and a brief history of their development. It then discusses the basis, classification, forces, treatment principles, indications, actions, case selection, and common appliances like the activator, frankel regulator, bionator, twin block, and Herbst appliance. It provides details on their design, indications, mode of action, and advantages. In summary, the document serves as a comprehensive guide to functional appliances, their development and use in orthodontic treatment.
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 document discusses different methods of maxillary arch expansion in orthodontics, including slow expansion and rapid maxillary expansion. Slow expansion uses lighter forces over a longer period and can involve dental or skeletal changes. Rapid expansion applies greater force to separate the mid-palatal suture more quickly, but risks relapse. A variety of fixed and removable appliances are described for delivering expansion forces, including quad helix, W-arch, nickel-titanium wires, and expansion screws. The effects, indications, contraindications, and risks of both rapid and slow expansion techniques are compared.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
The lingual arch space maintainer is a passive bilateral mandibular appliance used to control tooth movement and arch perimeter after the loss of lower primary molars. It consists of bands on the first molars connected by a stainless steel wire. The wire is positioned to contact the lower incisors and rest on the gingiva of the molared and molar bands. It maintains the arch shape and leeway space until the permanent teeth erupt. Advantages include allowing eruption of permanents without interference and maintaining oral hygiene, while disadvantages include not preventing opposing tooth extrusion and potential for distortion.
This document provides information on headgear, including its components, principles of use, types, and applications in orthodontic treatment. Headgear delivers extraoral force from a cranial support to intraoral appliances. It consists of a facebow, force element, and head cap. Forces from headgear can distalize teeth and maxilla through different anchorage points. Types include cervical, occipital, and high pull headgear. Headgear is useful for orthopedic effects, anchorage reinforcement, molar distalization, and space maintenance.
Functional appliances are either active or passive devices that harness the natural forces of muscles in the mouth and face to guide growth of the jaws and teeth. They work based on Moss's functional matrix theory, which proposes that muscles and other soft tissues influence bone growth. Common functional appliances include the activator, bionator, frankel appliance, and twin block. They can modify jaw growth, alter tooth positions, and improve muscle tone. Functional appliance therapy is most effective when started before puberty to influence jaw growth.
The document discusses the history and use of expansion screws in removable orthodontic appliances. It describes how expansion screws work to move teeth and skeletal structures as needed. Guidelines are provided for properly positioning expansion screws. Various types of expansion screw appliances are outlined, including the Schwarz expander, transverse expander, fan expander, Nord expander, and lower Schwarz appliance. Advantages and disadvantages of expansion screw appliances are also summarized.
The oral screen is a removable orthodontic appliance introduced in 1912 used to correct conditions like thumb sucking and mouth breathing. It works by concentrating pressure from the lips and cheeks on proclined front teeth near the incisal edges. It also prevents forces from the perioral muscles from acting on the back teeth, allowing for arch expansion. Variations include the vestibular screen, which extends into the vestibule without touching teeth, and the double oral screen for eliminating multiple issues. Small holes may be added initially if needed for breathing and gradually reduced in size.
This document discusses various methods for gaining space in orthodontic treatment, including proximal stripping, arch expansion, extraction, distalization of molars, uprighting tilted molars, derotation of posterior teeth, and proclination/flaring of anterior teeth. It provides details on techniques such as rapid maxillary expansion using devices like Hyrax or bonded expanders, extraction of first premolars, and distalization of molars using appliances like pendulum or Jones Jig. The document also covers indications, advantages, and disadvantages of different space gaining methods.
This document discusses the correction of Class 3 skeletal problems using reverse pull headgear or facemasks. It begins by describing Class 3 malocclusions that are due to maxillary deficiency or mandibular excess. It then discusses the types and etiology of Class 3 malocclusions. Reasons for treating Class 3 issues are provided. The document focuses on describing reverse pull headgear and facemasks, including their definition, indications, components, types, force parameters, biomechanics, treatment completion indications, advantages, and effects.
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
Tongue thrusting is defined as the forward movement of the tongue between the teeth during swallowing or speech instead of the mature swallow pattern. It can be classified based on its effects and may cause malocclusions like an open bite. Diagnosis involves examining swallow patterns and tongue posture. Treatment depends on the age of the patient and involves myofunctional exercises, appliances to reposition the tongue, and orthodontics or surgery if malocclusion is present. Speech therapy may also be used if a speech defect is associated with the tongue thrusting.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
Transient malocclusions are self-correcting developmental variations that occur during dental development. In the pre-dentate period, infants have a retrognathic mandible that corrects over time. In the primary dentition, children commonly have an anterior open bite, deep anterior bite, spacing between teeth, and an edge-to-edge anterior bite that self-correct. In the mixed dentition, a deep bite and crowding are common but resolve with time. The permanent dentition may show increased overjet and overbite during transition that lessen without treatment.
The document discusses various oral habits and their effects on dentition and facial growth. It defines habits like thumb sucking, tongue thrusting, and mouth breathing. It describes William James' definition of habit formation in the brain and classifies habits as useful/harmful, pressure/non-pressure, and intraoral/extraoral. Specific sections provide details on the etiology, clinical effects, diagnosis and management of thumb sucking and tongue thrusting habits.
This document provides an overview of mixed dentition and orthodontic appliances used during this period. Mixed dentition refers to the stage when primary teeth are being replaced by permanent teeth, between ages 6-13 years. Common orthodontic problems in mixed dentition include increased overjet and open bite. Functional appliances discussed include oral screens, lip bumpers, activators, and Frankel's regulator. Other appliances mentioned are space maintainers, tongue blades for crossbite correction, and space regainers. The document outlines the principles, advantages, limitations and indications for different appliances used in intercepting and correcting malocclusions during mixed dentition.
indications and contraindications of rapid maxillary arch expansion,appliances used and effects of rapid maxillary arch expansion/ comparison between rapid and slow expansion
Myofunctional appliances in orthodonticbilal falahi
This document discusses different types of removable functional appliances used in orthodontic treatment, including activators, bionators, and Frankel function regulators. Activators are loose-fitting appliances that guide muscle forces to correct skeletal discrepancies like retrognathic mandibles. Bionators are less bulky than activators and can be worn full-time, using tongue posture modification to guide growth. Frankel function regulators aim to re-educate muscle balance through controlled orthopedic exercises.
This document provides an overview of Class II malocclusions, including:
- Classification systems for Class II malocclusions described by Angle and Moyers.
- Common etiological factors like heredity and habits.
- Clinical features both intraorally and extraorally.
- Diagnostic tools and assessments including study models, photographs, and cephalometrics.
- Treatment modalities for Class II malocclusions in growing and non-growing patients, including functional appliances, headgear, fixed appliances, and orthognathic surgery.
The document summarizes the functional matrix theory of bone growth proposed by Melvin Moss. The theory states that bone growth occurs as a response to functional needs mediated by soft tissues, rather than bones growing independently. Growth involves periosteal matrices altering bone size in response to soft tissue demands, and capsular matrices passively translating bones during expansion. Experiments on rats supported the theory by showing bones altered in size and shape following muscle resection. Clinical implications include functional appliances altering bone growth by changing soft tissue pressures.
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
1. Space maintainers are appliances used to maintain space created by premature tooth loss. They prevent crowding, impaction, and other issues by holding space open.
2. Common space maintainers include band and loop, crown and loop, lingual arch, Nance palatal arch, and removable appliances. The best option depends on factors like time since tooth loss and dental age.
3. Space maintainers are generally indicated when space is closing, future orthodontics may be simplified, or to prevent issues like supraeruption. They are contraindicated if space isn't closing or the succedaneous tooth is absent.
The document discusses orthodontic diagnosis and the essential and supplemental diagnostic aids used. It describes the key components of clinical examination including case history, medical history, dental history, and physical examination of the head, face, lips, nose, and chin. Clinical examination aims to evaluate oral health and function, identify the nature of malocclusions, and determine which diagnostic records are needed for diagnosis and treatment planning.
The document provides information on Twin Block appliances. It begins with describing the history, design, and mechanism of Twin Block appliances. Twin Blocks consist of separate upper and lower bite blocks with inclined planes. They were developed in 1977 to treat a class II malocclusion. The inclined planes guide the mandible forward into a class I occlusion. The document further describes the skeletal and dental changes caused by Twin Block therapy, as well as the standard construction and stages of treatment. It covers indications, contraindications and modifications of Twin Block appliances.
The document discusses headgear, including:
- A brief history of headgear from the late 1800s to present day.
- The components and assembly of headgear including head caps, neck straps, face bows, molar bands and tubes.
- The types of headgear including high pull, low pull, and combinations.
- The uses of headgear such as for growth modification in class II malocclusions, anchorage reinforcement, molar distalization, and space maintenance.
- Guidelines for headgear force prescription, wear time, and expected tooth movements.
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 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 document discusses different types of functional appliances used in orthodontics including simple functional appliances like lip bumpers and oral screens, as well as more complex removable appliances like the Frankel regulator, Bionator, activator, and twin block. It describes the indications, contraindications, components, and mechanics of several commonly used functional appliances. The document emphasizes that functional appliances aim to alter the neuromuscular environment and utilize muscle forces to effect skeletal and dental changes.
The oral screen is a removable orthodontic appliance introduced in 1912 used to correct conditions like thumb sucking and mouth breathing. It works by concentrating pressure from the lips and cheeks on proclined front teeth near the incisal edges. It also prevents forces from the perioral muscles from acting on the back teeth, allowing for arch expansion. Variations include the vestibular screen, which extends into the vestibule without touching teeth, and the double oral screen for eliminating multiple issues. Small holes may be added initially if needed for breathing and gradually reduced in size.
This document discusses various methods for gaining space in orthodontic treatment, including proximal stripping, arch expansion, extraction, distalization of molars, uprighting tilted molars, derotation of posterior teeth, and proclination/flaring of anterior teeth. It provides details on techniques such as rapid maxillary expansion using devices like Hyrax or bonded expanders, extraction of first premolars, and distalization of molars using appliances like pendulum or Jones Jig. The document also covers indications, advantages, and disadvantages of different space gaining methods.
This document discusses the correction of Class 3 skeletal problems using reverse pull headgear or facemasks. It begins by describing Class 3 malocclusions that are due to maxillary deficiency or mandibular excess. It then discusses the types and etiology of Class 3 malocclusions. Reasons for treating Class 3 issues are provided. The document focuses on describing reverse pull headgear and facemasks, including their definition, indications, components, types, force parameters, biomechanics, treatment completion indications, advantages, and effects.
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
Tongue thrusting is defined as the forward movement of the tongue between the teeth during swallowing or speech instead of the mature swallow pattern. It can be classified based on its effects and may cause malocclusions like an open bite. Diagnosis involves examining swallow patterns and tongue posture. Treatment depends on the age of the patient and involves myofunctional exercises, appliances to reposition the tongue, and orthodontics or surgery if malocclusion is present. Speech therapy may also be used if a speech defect is associated with the tongue thrusting.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
Transient malocclusions are self-correcting developmental variations that occur during dental development. In the pre-dentate period, infants have a retrognathic mandible that corrects over time. In the primary dentition, children commonly have an anterior open bite, deep anterior bite, spacing between teeth, and an edge-to-edge anterior bite that self-correct. In the mixed dentition, a deep bite and crowding are common but resolve with time. The permanent dentition may show increased overjet and overbite during transition that lessen without treatment.
The document discusses various oral habits and their effects on dentition and facial growth. It defines habits like thumb sucking, tongue thrusting, and mouth breathing. It describes William James' definition of habit formation in the brain and classifies habits as useful/harmful, pressure/non-pressure, and intraoral/extraoral. Specific sections provide details on the etiology, clinical effects, diagnosis and management of thumb sucking and tongue thrusting habits.
This document provides an overview of mixed dentition and orthodontic appliances used during this period. Mixed dentition refers to the stage when primary teeth are being replaced by permanent teeth, between ages 6-13 years. Common orthodontic problems in mixed dentition include increased overjet and open bite. Functional appliances discussed include oral screens, lip bumpers, activators, and Frankel's regulator. Other appliances mentioned are space maintainers, tongue blades for crossbite correction, and space regainers. The document outlines the principles, advantages, limitations and indications for different appliances used in intercepting and correcting malocclusions during mixed dentition.
indications and contraindications of rapid maxillary arch expansion,appliances used and effects of rapid maxillary arch expansion/ comparison between rapid and slow expansion
Myofunctional appliances in orthodonticbilal falahi
This document discusses different types of removable functional appliances used in orthodontic treatment, including activators, bionators, and Frankel function regulators. Activators are loose-fitting appliances that guide muscle forces to correct skeletal discrepancies like retrognathic mandibles. Bionators are less bulky than activators and can be worn full-time, using tongue posture modification to guide growth. Frankel function regulators aim to re-educate muscle balance through controlled orthopedic exercises.
This document provides an overview of Class II malocclusions, including:
- Classification systems for Class II malocclusions described by Angle and Moyers.
- Common etiological factors like heredity and habits.
- Clinical features both intraorally and extraorally.
- Diagnostic tools and assessments including study models, photographs, and cephalometrics.
- Treatment modalities for Class II malocclusions in growing and non-growing patients, including functional appliances, headgear, fixed appliances, and orthognathic surgery.
The document summarizes the functional matrix theory of bone growth proposed by Melvin Moss. The theory states that bone growth occurs as a response to functional needs mediated by soft tissues, rather than bones growing independently. Growth involves periosteal matrices altering bone size in response to soft tissue demands, and capsular matrices passively translating bones during expansion. Experiments on rats supported the theory by showing bones altered in size and shape following muscle resection. Clinical implications include functional appliances altering bone growth by changing soft tissue pressures.
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
1. Space maintainers are appliances used to maintain space created by premature tooth loss. They prevent crowding, impaction, and other issues by holding space open.
2. Common space maintainers include band and loop, crown and loop, lingual arch, Nance palatal arch, and removable appliances. The best option depends on factors like time since tooth loss and dental age.
3. Space maintainers are generally indicated when space is closing, future orthodontics may be simplified, or to prevent issues like supraeruption. They are contraindicated if space isn't closing or the succedaneous tooth is absent.
The document discusses orthodontic diagnosis and the essential and supplemental diagnostic aids used. It describes the key components of clinical examination including case history, medical history, dental history, and physical examination of the head, face, lips, nose, and chin. Clinical examination aims to evaluate oral health and function, identify the nature of malocclusions, and determine which diagnostic records are needed for diagnosis and treatment planning.
The document provides information on Twin Block appliances. It begins with describing the history, design, and mechanism of Twin Block appliances. Twin Blocks consist of separate upper and lower bite blocks with inclined planes. They were developed in 1977 to treat a class II malocclusion. The inclined planes guide the mandible forward into a class I occlusion. The document further describes the skeletal and dental changes caused by Twin Block therapy, as well as the standard construction and stages of treatment. It covers indications, contraindications and modifications of Twin Block appliances.
The document discusses headgear, including:
- A brief history of headgear from the late 1800s to present day.
- The components and assembly of headgear including head caps, neck straps, face bows, molar bands and tubes.
- The types of headgear including high pull, low pull, and combinations.
- The uses of headgear such as for growth modification in class II malocclusions, anchorage reinforcement, molar distalization, and space maintenance.
- Guidelines for headgear force prescription, wear time, and expected tooth movements.
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 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 document discusses different types of functional appliances used in orthodontics including simple functional appliances like lip bumpers and oral screens, as well as more complex removable appliances like the Frankel regulator, Bionator, activator, and twin block. It describes the indications, contraindications, components, and mechanics of several commonly used functional appliances. The document emphasizes that functional appliances aim to alter the neuromuscular environment and utilize muscle forces to effect skeletal and dental changes.
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
Distraction osteogenesis is a technique used to regenerate bone by gradually separating a bone in two pieces. It works by placing tension stresses across the bone gap which stimulates new bone growth. It has been used to treat various craniofacial abnormalities and avoid problems with conventional surgery. The history of distraction osteogenesis dates back to 1905 but it was pioneered and expanded upon by Ilizarov in the 1950s for limb lengthening. It has since been adapted for use in the craniofacial region including the mandible, maxilla and midface.
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
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
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.
Functional appliances
For general practitioners
Prepared by
Dr. M Alruby
Functional appliances are large category of orthodontic appliances that used primarily to reposition of the mandible in order to alter the muscular forces against the teeth and craniofacial skeleton.
Functional appliances are used for growth modification procedures that are aimed at intercepting and treating jaw discrepancies. They can bring about the following changes:
1- Change the relationship of the jaws.
2- Change the direction of the growth of the jaws.
3- Acceleration of desirable growth.
4- Provide more favorable environments foe developments of dentition through:
a- Modify the muscle function.
b- Relive abnormal muscle function.
c- Selectively alter the eruptive path o the teeth.
5- Selectively inhibit the skeletal growth.
Classification of functional appliances:
1- Myotonic appliances: they are functional appliances that depend on the muscle mass for their action.
2- Myodynamic appliances: they are functional appliances that depend on the muscle activity for their action.
3- Removable functional appliances: they are functional appliances that can remove and inserted into the mouth by the patient for example: activator and bionator.
Uses and indications of functional appliances:
1- When the muscle dysfunction play a role in etiology of malocclusion.
2- Where alteration of muscle function may provides an optimum condition for normal dentofacial development.
Functional appliances may be indicated in the following:
1- Anteroposterior discrepancies on mild disproportional bases as Class II, Class III.
2- Vertical discrepancies on mild disproportional skeletal bases (open bite or deep bite).
Timing of treatment:
All the functional appliances are probably most effective in the growing children to gain maximum benefits from pubertal growth spurt.
Treatment principle:
Functional appliances work on two broad principles:
1- Force application: comprehensive stress and strain act on the structures involved and result in a primary alteration in form with a secondary adaptation in function. Most of the fixed and removable appliances work on this principle.
2- Force elimination: this principle involves the elimination of abnormal and restrictive environmental influences on the dentition thereby allowing optimal development. Thus function is rehabilitated with secondary changes in form. All functional appliances are assemblies of a few simple components. Each component has a desired function and is generally incorporated for a specific purpose. The currently used appliances are made of combination from three basic functional components. They are bite planes, shields or screens and construction of working bites. These components produce skeletal and dentoalveolar changes by acting on the following:
1- Eruption (bite plane).
2- Linguofacial muscle balance (shields or screens).
3- Mandibular repositioning (construction of working bite).
Functional appliances utilize the natural forces of the orofacial and masticatory muscles to influence skeletal growth. They are based on Moss's functional matrix theory which proposes that tissues like muscles influence bone growth. Functional appliances can be removable or fixed, and active appliances reposition the mandible to stimulate condyle growth while passive appliances reposition the musculature to influence jaw bone growth to a new position. Examples of appliances discussed include the Bionator, Twin-Block, Herbst, and Jasper Jumper. Treatment should begin before puberty to take advantage of growth and last 10-12 hours per day.
Functional appliances are removable orthodontic devices that alter the posture and function of the mandible to influence craniofacial growth and correct malocclusions. They work by applying controlled forces to the teeth and jaws, establishing a new functional environment that leads to morphological changes through growth modification and dentoalveolar remodeling. Functional appliances are classified based on how they generate and transmit forces, and whether they are tooth-borne, myotonic/myodynamic, removable, or fixed. The key principles of their effects involve force application/elimination, selective tooth eruption, and muscular changes.
This document discusses the classification and management of Class II Division 1 malocclusions. It describes six main horizontal facial types (A through F) and five vertical types based on skeletal patterns. Treatment involves growth modification using functional appliances or headgear in growing patients, camouflage orthodontics using extractions or non-extraction approaches in non-growing patients, or orthognathic surgery for more severe skeletal discrepancies. The goal is to correct the Class II malocclusion through altering jaw positions and modifying facial growth.
Myofunctional appliances are removable or fixed appliances that change the position of the mandible to transmit forces through muscle stretching to the dentition and underlying skeletal structures. They are used to intercept and treat jaw discrepancies through modifying growth patterns. Common myofunctional appliances discussed include the activator, bionator, frankel regulator, herbst appliance, and twin block. They work through establishing a new pattern of muscle function that leads to new morphological changes in the jaws through principles of applying and eliminating forces. Case selection focuses on growing patients with moderate to severe class II malocclusions.
Early treatment of class ii malocclusion /certified fixed orthodontic courses...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.
Activator/certified fixed orthodontic courses by Indian dental academyIndian 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
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removable functional appliances in orthodontics.pdfsafabasiouny1
This document provides information about removable functional appliances used to treat class II and class III malocclusions. It discusses several types of appliances including activators, bionators, twin blocks, and Frankel appliances. For each appliance, it describes the indications, contraindications, mode of action, advantages, limitations, and fabrication process. The document aims to classify and explain the effects and uses of different removable functional appliances in orthodontic treatment.
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.
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This document provides an overview of functional appliances used in orthodontic treatment. It begins with an introduction to functional appliances and their use in guiding natural forces to correct morphological abnormalities. It then covers classifications of functional appliances, how cephalometric analysis is used to assess patients, and descriptions of common appliances like the activator, bionator, and twin-block. The document discusses how functional appliances can correct Class II and III malocclusions by influencing facial growth. In under 3 sentences.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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2. INTRODUCTION
Functional appliances are used in orthodontics to modify or
camouflage an underlying skeletal discrepancy.
Passive appliances harness natural forces of the oro-facial
musculature that are transmitted to the teeth and alveolar bone
through the medium of the appliance.
Basis of functional treatment is based on principle that a ‘new
pattern of function’ dictated by the appliance , leads to the
development of corresponding ‘new morphologic pattern’
3. Functional appliances are conceptually based
on Moss’ functional matrix theory.
Functional matrix theory proposes that
functional matrices, tissues like muscles and
glands influence skeletal units such as jaw
bones and ultimately control their growth.
4. History
W.K. Bridgam -1859, causes of irregular teeth is unbalanced
muscle pressure.
Kingsley -1880, introduced the concept of ‘jumping the bite’ in
patients with mandibular retrusion.
Pierre robin-1902, introduced monobloc, used to position the
mandible forward in patients with mandibular retrognathism
Herbst-1909, invented the first fixed functional appliances that
subjected the mandible to constant forced protrusion.
5. Alfred Paul rogers-1918, concept of ‘ myofunctional therapy’ to
the American Society of orthodontist.
William clark -1977,Twin Block appliance’. Rapid functional
correction of malocclusion transmission of favorable occlusal
forces to occlusal inclined plane that cover the posterior teeth.
6. How do they work ..
Activation of the muscles of mastication
Dental changes-
Guided eruption of teeth
Changes in incisal inclination
Tonal balance of the buccal and lingual musculature
Modification of the soft tissue activity
Bone growth
7. Potential advantages
Enlarge transverse width of arches to relieve
crowding.
Diminsh adverse fixed appliances problems
Reduced or eliminate dysfunctional habits
Treatment of temporomandibular disorders
8. Indications
Well aligned dental arches
Posterior positioned mandible
Non severe skeletal discrepancy
Lingual tipping of mandibular incisors
Proper patient selection
9. Contraindications
Class II skeletal by maxillary prognathism
Vertically directed grower
Labial tipping of lower incisors
Severe crowding
10. MAXIMIZING THE SUCCESS
OF MYOFUNCTIONAL
APPLIANCES
mild/moderate skeletal problems
Patient and family cooporation
Patient actively growing
Growth spurt for boys(12-14)
for girls(11-13)
11. CASE SELECTION
Suited to treat Class II, division 1 malocclusion-
Age : growing patient (b/w 10 yrs & pubertal growth
phase).
Social considerations: Results with minimum
supervision. Patients who live far away from clinic may
benefit from these appliances.
Dental considerations: Only the case devoid of gross
local irregularities like rotations and crowding.
Low angle cases – respond well
12. High angle cases with Increased overbite are successfully
treated
High angle cases with an open bite pose special problems
Class II , div 2 is usually first modified to a div 1 and then
treated.
Mild class III malocclusions, which present with a reverse
overjet can also be considered.
13. CEPHALOMETRIC ANALYSIS
This includes three angular
measurements
Saddle angle
Articular angle
Gonial angle
And four linear measurements
-anterior and posterior facial height.
-anterior and posterior cranial base length.
14. Saddle Angle N-S-Ar
A large saddle angle signifies posterior
condylar position and a mandible which
is posteriorly placed with respect to
cranial base and maxilla.
Posterior positioning of the fossa is
some times compensated by the
articular angle and ramal length.
A non compensated posterior
positioning of mandible caused by a
large saddle angle is difficult to influence
with functional therapy.
15. Articular angle S-Ar-Go
A decrease in the articular angle
can be seen in
- Anterior positioning of the
mandible
-Mesial migration of posterior
segment
An increase in the articular angle is
seen in:
-Posterior relocation of mandible
-Distal driving of posterior teeth.
16. Gonial angle AR-Go-Me
An angle formed by tangents to the
body of the mandible and posterior
body of the ramus.
Acute or small angle ,signifies the
horizontal growth direction.
condition favorable for functional
appliance therapy/anterior positioning
of mandible
17. Anterior and Posterior facial
height
These are linear metric measurements
-Anterior facial
height—nasion to
menton
-Posterior facial height—
sella to gonion
18. Jarabak’s Ratio
It gives an idea about the growth direction of the patient.
Jarabak’s ratio = PFH
----- X 100
AFH
<62% indicates vertical growth pattern.
> 65% indicates more horizontal pattern of growth
19. Visual Treatment Objective
Important diagnostic test undertaken before making a decision
to use a functional appliances.
Performed by asking the patient to bring the mandible forward
An improvement in profile is considered a positive indication for
the use of functional appliances
20. Classification- Based on
transmission of force
Group I appliance - transmit muscle force directly to
the teeth. e.g. inclined plane, oral screen.
Group II appliance - reposition the mandible
downward and forward (except in class III
malocclusion), activating the attached and associated
vasculature. e.g. Activator.
Group III appliance - bring mandibular changes
through musculature only. Their major operating area
is in the vestibule outside the dental arches.
Supporting bone and teeth are influenced by
changing the muscle balance through cheek shields
and lip pads. e.g. Frankel FR.
21. By Proffit-
Tooth borne active appliances: modifications of activator and
bionator designs that include expansion screws or springs to
move teeth. e.g. Expansion activator, Orthopaedic corrector.
Tooth borne passive appliances. These appliances have no
intrinsic force generating capacity from springs or screws
and depend only on soft tissue stretch and usual activity to
produce treatment effects e.g. activator, bionater.
Tissue borne appliance. The appliance has minimal contact
with teeth and is located in vestibule. e.g. Functional
regulator.
22. Myotonic Appliance -These appliance depend on
muscle mass for their action.
Myodynamic appliances -These appliances depend
on muscle activity for their action.
Removable Functional Appliances - can be removed
and inserted into mouth by patient.
Fixed functional appliances - cannot be removed by
the patient
23. Treatment Principles
Force application : Primary alteration in form with a secondary
adaptation in function.
Force elimination : Elimination of abnormal and restrictive
environmental influences on the dentition.
24. Functional component
Bite Planes
Shields Or Screens
Construction Or Working Bite
BITE PLANES
Flat or Inclined
Anterior or Posterior
Contacting Single or Multiple Teeth
25. FLAT ANTERIOR BITE PLANE-
It should be of sufficient dimensions to disocclude the
posterior teeth .
Following effects are seen:-
Differential eruption of posterior teeth.
Non eruption, relative or absolute intrusion of incisors.
Incisor overbite reduction
Dis-occlusion with removal of intercuspation may will
be responsible for any additional increments of
mandibular growth.
Unimpeded posterior tooth eruption may result in a
downward and backward mandibular rotation that tends
to increase anterior vertical lower height and reduces
the prognathism of the mandible.
26. FUNCTIONAL APPLIANCES
ADVANTAGES:-
Elimination of abnormal
muscle function.
Treatment can be initiated at
early age.
Psychological disturbances
avoided.
Less chair side time.
Frequency of patient visit is
reduced.
Worn during night so good
patient acceptance .
LIMITATIONS-
Cannot be used in adult
patients.
Cannot be used to bring
about individual tooth
movement.
Patient cooperation is
required.
Pre-functional orthodontic
tooth movement is
required.
Fixed appliance therapy
may be required.
27. Vestibular Screen
Takes form of a curved shield of acrylic
placed in the labial vestibule.
Introduced by Newell in 1912.
Principle: Both force application and
elimination.
Indications :
Habits interception.
Mild distocclusions.
To perform muscle exercises.
To correct mild anterior proclination
28. MANAGEMENT AND MODIFICATIONS
To be worn during night and 2-3 hours
during daytime.
Patient is instructed to maintain lip seal.
Modifications include :
Hotz modification
Double oral screen
Kraus’s modification.
29.
30. Lip Bumper
MODE OF ACTION
Holding the muscles and soft tissue away
from the teeth
Shields are placed up to 3 mm away from
the teeth
EFFECTS
By reducing the pressure of the lips and
cheeks on the teeth, the tongue applies an
uncompensated lingual force on the teeth
resulting in distal molar crown tipping, slight
expansion of the buccal segments, and
incisor proclination.
31. Activator
INDICATIONS
Class II, div 1
Class II, div 2
Class III malocclusion
Class I open bite
Class I deep bite.
CONTRA INDICATIONS
Class I problems of crowded
teeth.
Excessive lower facial height
In non growing individuals.
32. MECHANISM OF ACTION
Stretching of
elevator muscles of
mastication which
starts contracting
Myotactic reflex
Kinetic energy
produced
Prevent maxillary
growth
Moves maxilla
distally
Reciprocal forward
force on mandible
33. CONSTRUCTION BITE
Bite opening - 2-3 mm
advancement - 4-5 mm.
Overjet is too large, forward
positioning is done - 2-3 stages
In case of forward positioning
of the mandible by 7-8 mm, the
vertical opening should be
slight to moderate i.e. 2-4 mm.
If the forward positioning is not
more than 3-5 mm then the
vertical opening can be 4-6
mm.
34. FABRICATION OF
ACTIVATOR
Impression making
Study & working models preparation
Bite registration
Articulation of the model
Preparation of wire elements
Fabrication of the acrylic portion
3 parts:
Maxillary part
Mandibular part
Inter occlusal part
35. Management
Wear time:
2-3 hours a day during first week.
Second week 3 hrs during day and during sleeping.
Trimming plan is developed on the basis of individual needs
of the patient.
In expansion treatment the jackscrew are normally activated
by the patients at 1-week interval. Check the screw
Recall every 6 weeks
36. Trimming
Vertical control
For dolichofacial patients: intrude molars, extrude
incisors
For brachifacial patients: intrude incisors, extrude
molars
38. BIONATOR
Developed by Balters in 1950’s.
Modified activator
less bulky & more Elastic
3 types-
Standard type-class II div I having narrow
dental arches
Class III Appliance
Open bite appliance
39.
40. FRANKEL FUNCTIONAL
REGULATOR
developed by Rolf Frankel
Frankel believed that the active
muscle and tissue mass i.e., the
buccinator mechanism and the
orbicularis oris complex have a
major role in the development of
skeletal and dentofacial
deformities.
41. TYPES OF FUNCTIONAL
REGULATOR
1. FR l-used for Class I and
Class II, Division 1.
FR la -used for Class I ,moderate crowding and deep bite.
FR lB -used for Class II Division 1 overjet less than7mm.
FR lc -used for Class II Division 1 overjet more than7mm
2. FR Il-used for Class II Division 2 and Division 1
3. FR Ill-used for Class III
4. FR IV-used for cases with open bite and bimaxillary
protrusion.
5. FR V-FR with headgear.
42. FRANKEL REGULATOR-II
Promotes transverse and vertical
development of maxillary and
mandibular arches,
corrects Class II, Division 2 cases and
opens bite. Used after the maxillary
incisors have been slightly proclinated
by an upper removable appliances
43. TREATMENT TIMING
late mixed and transitional dentition period, when
both the soft and hard tissues are undergoing their
greatest transitional changes.
Treatment for Class III and open bite cases should
usually start sooner than for Class Il problems.
44. MODE OF ACTION OF FR-II
1. Increase in transverse sagittal direction by
use of buccal shields and lip pads.
2. Increase in vertical direction
by allowing the lower molar to erupt freely
because appliance is fixed to the upper
arch.
3. Muscle adaptation
The form and extension of the buccal shields
and lip pads along with the prescribed
excercises corrects the abnormal peri-oral
muscle activity.
45. ORAL EXERCISES WITH
FRANKEL
Frankel-full time wear appliance.
Lips to be closed at all times or keep a paper
between the lips.
Swallowing, speaking, etc. with the appliance in
mouth, itself serves as an exercise.
46. WEAR TIME
First few weeks: 2-4 hours/day (day time)
After 3 weeks : 4-6 hours/day (day time)
After 3rd visit (2 months) : full time wear.
The patient is asked to perform oral gymnastics i.e.
talking , reading, tightly grasping the appliance in the
vestibule
47. TWIN BLOCK
Used to help correct jaw alignment, particularly
an underdeveloped lower jaw.
Dr.William J. Clarks , 1977.
Consists of u/l plates having occlusally inclined
planes that induce favorably directed occlusal
forces by causing a functional mandibular
displacement.
48. MODE OF ACTION
Twin blocks are simple bite blocks
designed for full time wear.
Upper and lower bite blocks interlock at a
70 degree angle.
Twin blocks achieve rapid functional
correction of malocclusion by modifying
the occlusal inclined plane,guiding the
mandible forward into correct occlusion.
The forces of occlusion are used to correct
the malocclusion.
49. MUSCLE RESPONSE
Changes in the muscles activity (1-7
days)
Decreased in activity of
temporalis muscles increased
activity of masseter and
lateral pterygoid (3 weeks)
cycles of changes was
completed (3 months)
50. PHASES OF TREATMENT
Active phase -Average time of treatment 6-9 months to
achieve full reduction of overjet to a normal incisors
relationship and to correct the distal occlusion.
Support phase -3 to 6 months for molars to erupt into
occlusion and premolars to erupt after trimming the
blocks. The objective is to support the corrected
mandibular translation while buccal teeth settle into
occlusion .
Retention- 9 months , reducing appliance wear when
the position is stabilized. An average estimate of
treatment time is 18 months, including retention.
51. TWIN BLOCK SAGITTAL
APPLIANCE
Used to treat class II div 2
malocclusion.
Sagittal arch development is
necessary to increase arch length
and to advanced retroclined
incisors.
52. REVERSE TWIN BLOCK
Correction of class III malocclusion
By reversing the occlusal inclined
planes to apply a forward
component of force to the upper
arch and a downward and
backward force to lower arch.
53. MAGNETIC TWIN BLOCKS
Magnets are incorporated in
occlusal inclined plane.
Purpose of magnets is to
increased occlusal contacts on the
bite blocks to maximize the
favorable functional forces
applied to correct the
malooclusion.
55. Advantages
very good patient acceptance.
bite planes offer greater freedom of movement
& lateral excursion.
less interference with normal function.
significant changes in patient’s appearance within 2-3
months.
56. HERBEST APPLIANCES
JASPER JUMPER
THE MANDIBULAR
ANTERIOR
REPOSITIONING APPLIANCE
(MARA)
EUREKA SPRING
SABBAGH UNIVERSAL
SPRING
FIXED
FUNCTIONAL
APPLIANCES
57. HERBEST APPLIANCE
Indications
1- dental CII
2- skeletal CII due to mandibular
deficiency
3- deep bite with retroclined
mandibular incisors.
Contra indication
1-Open bite
2-vertical grower
Disadvantages
• Appliance is prone to breakage.
• Lateral movement is restricted
58. JASPER JUMPER
Indications
• Dental Class II malocclusion
• Deep bite with retroclined
mandibular incisors.
Contraindications
• Dental and skeletal open
bites.
• Minimum buccal vestibular
space.
• Vertical growth pattern with
increased lower facial height.
-Cases prone to root resorption
59. JASPER JUMPER
Advantages
- Ease of insertion and
activation
- Generation of intrusive forces
on molars and incisors.
Disadvantages
- Frequent breakages
- Compromised oral hygiene
- Externally bulge in the cheeks
60. MANDIBULAR ANTERIOR
POSITIONING APPLIANCES
(MARA)
Indication
-Skeletal Class II with
mandibular deficiency.
Contraindications
-Cases prone to root
resorption Dental and
skeletal open bite
-Vertical growth pattern.
61. EUREKA SPRING
Advantages
- Good patient acceptance
- Can be used for Class Il and
Class ill
- Components are available
separately
- Significantly less expensive
Disadvantages
-Technique sensitive insertion
procedure
- Frequent breakages of interval
spring
62. SABBAGH UNIVERSAL
SPRING
It is the latest inter arch compressive
spring to be introduced and has a
number of unique features .
• Available in one standard link.
- No difference in appliance for
the right and left sides.
- Lateral mandibular movement
possible.
- More resistant to fatigue fracture
63. SABBAGH UNIVERSAL
SPRING
The SUS is a combination
between the Herbst appliance
(as a telescope) and the Jasper
Jumper (as a spring) aiming to
increase the efficacy of th
treatment and to minimize
their disadvantages.
INDICATIONS-
•Class II, late growth cases
(rapid class II correction )
•Non-compliant class II
patients
•TMD therapy
64. SABBAGH UNIVERSAL
SPRING
ADVANTAGES
Dentoalveolar changes:-
- distal movement of
the upper molars
- mesial movement of
the lower molars
- retrusion of the upper
incisors
- protrusion of the lower
incisors
DISADVANTAGES
- Unsuitability for Class Ill
treatment
- Limitations in patients
with maximum opening
of less than 48 mm.
- Increased force levels
- Considerably greater cost
65. CONCLUSION
The method chosen depends upon on a series of factors that
must be carefully evaluated before the therapy is instituted.
The developmental age of the patient
Location and etiology of malocclusion
The specific morphological characteristics in both skeletal and
dental arches
The motivation and likely continuing co-operation of both the
patient and the patient’s parents.
No universal appliance or formula is available for any
malocclusion.
Only a careful diagnosis, a continuing diagnostic monitoring
during treatment, a number of appliances in the armamentarium,
and a willingness to change appliances as changing situations
dictate will ensure the best possible treatment
Editor's Notes
-they can bring about dentoalveolar changes in the saggital, transverse-by shielding the buccal muscles force away from dental arch and vertical direction. They can be designed to allow the selective eruption of teeth
MFA are capable of accelerating the growth in the condylar region. Bring about the remodeling in the condylar region.
CA Should be done before selecting the case for the any functional therapy
If articular angle is large the mandible is retrognathic and small if mandible is prognathic
The measurement should be done with teeth in habitual position
Ratio of PFH/AFH was described by jarabak in 1972 and is known as Jarabak’s ratio.
FA- COMPRESSIVE stress and strain act on the structures involved and result in a
FE- all the functional appliances are assemblies of a few simple components
INCLINED PLANES: May be designed to provide labiolingual mechanical eruptive displacement of incisors or the buccolingual deflection of the erupting posterior teeth.
Hotz modification-oral screen can be fabricated with metal ring projecting b/w upper and lower lip .help in exercise.
Tongue thrust habit-a additional screen is placed on the lingual aspect of the teeth. In mouth breather – the vestibular screen should be fabricated with the no. of holes that are gradually closed in phased manner.
Lip bumpers gain intraarch space by removing the pressure of the buccal musculature permitting lateral and anterior dentoalveolar development.
Andresen121 inDenmark in 1908
Intermaxillary wax record used to relate the mandible to the maxilla
This is done to improve the skeletal inter-jaw relationship.
Selective trimming of the activator can be done to intrude and extrude the teeth
BOW activator-is a horizontally split activator having maxi and mandibular portion connected together by an elastic bow.this kind of modification allow the step wise saggital movement by the adjustment of bow. WUNDERER modification-that is mostly used in treatment of class3 malocclusion ..maxi and mandi portion connected by the screw,by opening the screw the maxi portion move anteriorly,reciprocal backward movement of the mandible.
bulkiness of the activator and it limitation to night-time wear was a major deterrent in its greater use by clinicians to obtain maximum potential functional growth guidance. Standard type-consist slender acrylic body fitted to the lingual aspect of mandi and portion of the maxi .anterior region may uncovered. Wire component- palatal arch and vestibular bow
Class iii – acrylic part similar to standard type .used in mandi prognathism .palatal arch is placed in opposite direction.
Open bite-wire component are same .the maxi acrylic portion is modified so that anterior area is covered .its purpose is prevent tongue thrusting b/w the teeth as tongue is responsible for most cases of open bite
Hence he developed function regulators as orthopedic exercise devices, to aid in the maturation, training and
reprogramming of the orofacial neuromuscular system.
Removable orthodontic functional appliance that is
Initial placement of appliance produced an increase in the over all activity of the muscle respone.
This level of activity persist for 4-weeks.
Design- the upper TB is modified by the incorporation of two screws set in the palate for anteroposterior arch development.
- In lower arch a screws may be used in canine and premolar region
This is the most effective appliance for arch development to treat more severe labial and lingual crowding.
Design is similar to saggital TB with reverse inclined plane.
Magnets should be used only ,where speed of the treatment is important consideration.
The fixed twin block is similar to the removable twin block, but can be used in non-compliant
patients. It is similar in design to the Herbst appliance, however the telescopic tubes of the
Herbst appliance are replaced with two bite blocks.
(non compliance) Success of orthodontic treatment often relies on the patient’s cooperation in the wearing of removable appliances .
Eliminating the need to use these places the treatment result more under the control of orthodontist. This lead to development of fixed appliances
(non compliance)
HA-MAKE A artificial joint working between the maxilla and mandible . Keeps the mandibular in continous anterior positioned the tube is fixed to the distal end of the maxillary molar while the rod is fixed to the lower ist premolar
Jasper module is similar to the tube and plunger of of herbest appliance .but is more flexible.the jasper module available in size 26mm to 38mm.the force module is selected by measuring the distance between mesial aspect of the upper face bow tube and distal to mandibular canine.when the teeth comes into occlusion ,the forced module becomes longer and producing mesial force on mandibular arch and distal force on maxi arch
One of the first inter arch appliances to utilize the compressive forces.
• - Slotted screw for partial adjustment of distal aspect of the plunger assembly (upto 4 mm) The second coil spring
inserted at the time of placement which in combination with the internal spring permits a greater active
extension of force than any other
appliance.
rotation of the occlusion plane in clockwise
direction.
A number of methods are available to attempt the correction of malocclusions.