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.
Frankles appliance Is a myofunctional appliance
Functional appliance are removable or fixed appliances that aim to utilize eliminate or guide the forces arising from muscle function,tooth eruption and growth inorder to alter skeletal and dental relationship
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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self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
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
Dr. Barry Raphael gives an overview of a new subspecialty in orthodontics call Airway Orthodontics. This segment provides the rationale for this paradigm shift. (Animations and movies not included).
Frankles appliance Is a myofunctional appliance
Functional appliance are removable or fixed appliances that aim to utilize eliminate or guide the forces arising from muscle function,tooth eruption and growth inorder to alter skeletal and dental relationship
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
self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
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
Dr. Barry Raphael gives an overview of a new subspecialty in orthodontics call Airway Orthodontics. This segment provides the rationale for this paradigm shift. (Animations and movies not included).
Myofunctional Research Company presents Myobrace Beginner Course by Dr. Barry Raphael at the Raphael Center for Integrative Education, Clifton, New Jersey, January 2014: Part 1
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
Oral habits 1 /certified fixed orthodontic courses by Indian dental academy 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
History of orthodontics /certified fixed orthodontic courses by Indian denta...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
Activators and its modifications /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.
Activator- A Functional Appliance. pptxAfaf Mohammed
An activator is a removable functional appliance used to correct skeletal problems in young individuals. It is an orthopedic appliance when used at the right age can prevent skeletal malformations and prevents surgery in the future.
Contents:
Introduction
History of activator
Classification of views
Effect of activator on dentofacial structures
Advantages & Disadvantages
Indications & Contraindications
Principles of activator
Types of forces employed in activator
Effectiveness of activator during sleep
Muscle activity with activator
Case Selection for the treatment with the functional appliance.
Treatment timing
Clinical and laboratory steps in fabrication and treatment of activator
Construction bite
Modifications of Activator
Case report
Conclusion
Bibliography
Twin block are simple bite blocks that effectively modify the occlusal inclined plane with the help of upper and lower bite blocks that engage occlusal inclined plane.
The main objective of Twin-block is to induce supplementary lengthening of the mandible by stimulating increased growth at the condylar cartilage.
Hybrid appliances are specifically and individually tailored to exploit the natural processes of growth and development. Such an approach represents a departure from the practice of adopting a "named" appliance for the treatment of a class of malocclusion
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
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).
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
fixed functional appliances types and its description.
it includes all the varieties of appliances and its modifications , advantages and disadvantages, along with the skeletal and dental effects that are obtained by the appliances. varieties of herbst appliances.....etc
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
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STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. CONTENTS
• INTRODUCTION
-DEFINITION
-HISTORY
• BASIS FOR FUNCTIONAL
APPLIANCE
• CLASSIFICATION
• FORCES
• TREATMENT
PRINCIPLES
• INDICATIONS
• ACTION OF FUNCTIONAL
APPLLIANCES
• CASE SELECTION
• VISUAL TREATMENT
OBJECTIVE
• COMMON APPLIANCES
IN USE
• WHEN TO TREAT WITH
FUNCTIONAL
APPLIANCE?
• LIMITATIONS &
COMPLICATIONS OF FAs
• CONCLUSION
• REFERENCES
3. DEFINITION
• “ A removable or fixed appliance which favorably
changes the soft tissue environment”
-Frankel,1974
• “ A removable or fixed appliance which changes the
position of mandible so as to transmit forces
generated by the stretching of the muscles,fascia
&/or periosteum,through the acrylic and wirework
to the dentition and the underlying skeletal
structures.
-Mills,1991
4. “Loose fitting or passive appliance which harness
natural forces of the oro-facial musculature
that are transmitted to the teeth & alveolar
bone through the medium of the appliance.”
5. HISTORY
• 1879-Norman Kingsley-Forward positioning
of mandible in orthodontics-Bite plane/Bite-
jumping appliance(vulcanite).
Drawback-tendency to relapse even with bite
guide.
1883- Wilhelm Roux-first to study the
influences of natural forces and functional
stimulation on form-foundation of both
general orthopedic and functional dental
orthopedic principles (Wolff’s Law).
6. • Ottolengui-removable plate
• 1902-Pierre Robin-first practitioner to use
functional jaw orthopedics to treat a
malocclusion-Monoblockin children with
glossoptosis syndrome.
7. • 1909-Viggo Andresen(Denmark) -modified bite jumping
appliance-inspired from Benno Lisher’s theory.
Viggo Andresen Karl Häupl
1938-Karl Häupl(Germany)-saw the potential of Roux’s
hypothesis and explained how functional appliances work
through the activity of the orofacial muscles.
8. • Andresen-Häupl associationACTIVATOR
Biomechanical Orthodontics Functional Jaw
Orthopedics Norwegian System.
1936-collaborated on a textbook
Funktionskieferorthopädie (Function orthodontics).
• 1906-Alfred P. Rogers- Father Of Myofunctional therapy-
the first to implicate the facial muscles for the growth,
development,and form of the stomatognathic system.
9. The Original Herbst Appliance
Prof. Emil Herbst
1905/09- Emil Herbst -
okklussionsscharnier /
Retentionsscharnier Herbst
appliance
10. •1949-Hans Peter Bimler-during WWII-incorporated elastic
force to orthopedic appliance elastischer Gebissformer
(elastic bite former) /adapter Bimler appliance.
~1938 -developed, the
“roentgenphotogramm,” by
superimposing a photograph on a
head plate, to show the relationship
between the skull, the teeth, and the
soft tissues.
11. • 1956-Martin Schwarz- Double Plates
combine the advantages of the
activator and the active plate by
constructing separate mandibular and
maxillary acrylic plates that were
designed to occlude with the
mandible in a protrusive position.
Double Plates
1950-Wilhem Balters-Modified activator by reducing bulk from
palate & substituted with a coffin spring Bionator
Prof.Dr.Wilhem Balters
Dr.Martin Schwarz
12. • 1957-Rolf Fränkel-Function Regulator.
• 1977-Dr.William J. Clarks-Twin Block
• 1989Magnetic Appliances-Blechman et al.
Prof.Rolf Frankel
Dr.William J. Clark
13. BASIS FOR FUNCTIONALAPPLIANCE
• “The three M’s-Muscles,Malformation and
Malocclusion”-By Graber,1963-described
effects of function & malfunction.
• The Functional Matrix Hypothesis by Melvin
Moss
• Identification of certain cartilages(eg.
Condylar cartilage) as secondary cartilages.
15. CLASSIFICATION
I. Classification by Tom Graber,when
functional appliances were removable:
(i) Group I-Teeth supported -Eg: catlan’s
appliance,inclined planes.etc.
(ii) Group II-Teeth/Tissue supported-
Eg:activator,bionator,etc.
(iii) Group III-Vestibular positioned appliances with
isolated support from tooth/tissue-Eg:Frankel’s
appliance,lip bumpers,vestibular screen
16. II. With advent of fixed functional appliances:
(i) Removable Functionals-Eg: Activator, Bionator,
Frankel’s
(ii)Removable & Fixed-available in both removable &
fixed type-Eg: Twin Block,Herbst
(iii)Semi Fixed-Some components fixed,some detachable
Eg: Den Holtz, Bass Appliance
(iv) Fixed- Eg: Herbst,Jasper Jumper,Churro Jumper,Saif
springs,Mandibular Anterior Repositioning
Appliance(MARA),etc.
17. III. With concept of hybridization by Peter Vig:
(i) Classical Functional Appliance-Eg:
Activator,Frankel’s appliance
(ii)Hybrid Appliances-Eg: propulsor,double oral
screen,hybrid bionators,etc.
18. IV. Classification By Profitt
(i) Teeth borne passive-myotonic appliances-Eg:
Activator,Bionator
(ii) Teeth borne active-myodynamic applainces-Eg;
Bimler’s appliance, elastic open activator,Stockfish
appliance
(iii)Tissue borne passive-Eg: Oral screen,lip bumpers
(iv)Tissue borne active-Eg: Frankel’s appliances
(v) Functional orthopedic magnetic
appliances(FOMA)
19. FORCES
• Mostly use tensile forces-cause stress & strain-alter
stomatognathic muscle balance.
• Both external(primary) & internal(secondary)
forces observed in each force application.
• External Forces-occlusal & muscle forces from
tongue,lips & cheeks.
• Internal Forces-reactions of tissues to 10
force
20. •They strain the contiguous tissues formation of
osteogenetic guiding structure (deformation & bracing of the
alv. process).
This rxn important for 20 tissue remodelling,displacement
and all other alterations that can be achieved by therapy.
•Differences in force application :
-duration of force is interrupted (exceptions-Hamilton &
Clark full-time-wear appliances & bonded Herbst & Jasper
Jumper)
-Magnitude of force is small.If induced strain is too
great,difficulty in wearing the appliances.
21. TREATMENT PRINCIPLES
• Depending on the type of force applied,2
treatment principles can be differentiated:
I. Force Application
II. Force Elimination
22. • In force application,compressive stress & strain act on
the structures involved resulting in a 10
alteration in
form with 20 adaptation in function.
• In force elimination,abnormal & restrictive
environmental influences are eliminated,allowing
optimal development.Function is rehabilitated &
followed by 20 adaptation in form.
23. INDICATIONS
• Use of FA alone:
-cases with mild skeletal discrepancy
-proclined upper incisors
-no dental crowding
• Use of FA in combination with fixed appliance:
-used most commonly to improve the anteroposterior
relationship before starting the fixed appliance
treatment.
24. -extremely useful in class II cases
-reduce the amount of a comprehensive fixed therapy
required
-reduce need for orthognathic surgery
• Interceptive treatment
-early intervention indicated when one wishes to
utilize their growth enhancing effect.
-extremely effective in reducing the relative
prominence of the proclined upper incisors,which are
particularly susceptible to dentoalveolar trauma.
25. ACTION OF FUNCTIONALAPPLAINCES
• Skeletal,dento-alveolar & soft tissue effects of
FA’s reviewed by Dare & Nixon(1999).
• Functional appliances can bring about the
following changes:
(i) Orthopaedic Changes
(ii) Dento-aveolar changes
(iii) Muscular & Soft Tissue changes
26. -Capable of accelerating the growth in the
condylar region.
-Can bring about remodeling of the glenoid
fossa.
-Can be designed to have a restrictive
influence on the growth of jaws.
-Can change the direction of growth in jaws.
27. -can bring about changes in sagittal,transverse &
vertical directions.
-Inhibition of downward & forward eruption of the
maxillary teeth.
-Retroclination of the upper incisors.
-Proclination of the lower incisor.
-Lower labial segment intrusion.
-Levelling of the curve of Spee & tipping of the
occlusal plane.
28. -improve the tonicity of the orofacial
musculature.
-Removal of the lip trap & improved lip
competence.
-Removal of adaptive tongue activity.
-Lowering of the rest position of mandible.
-Removal of soft tissue pressures from the
cheeks & lips.
29. CASE SELECTION
• Age: only in growing patient. Opt. age for FA
therapy b/w 10 years & pubertal growth
phase
• Social Considerations:
• Dental Considerations: ideal caseone devoid of
gross local irregularities
• Skeletal Considerations: Moderate to sever Class
II mo cases are ideal
Mild Class III mo with a reverse overjet & an
average overbite
30. VISUAL TREATMENT OBJECTIVE
• An imp. diagnostic test undertaken before making a
decision to use a functional appliance.
• Enables us to visualize how the patient’s profile would be
after FA therapy.
• Performed by asking the patient to bring the mandible
forward.
An improvement in profile positive indication.
Profile worsensnegative-other Rx modalities
considered.
• Photographs taken with forward mandibular posture.
31.
32. VESTIBULAR SCREEN
• Introduced by Newell in 1912.
• Takes the form of a curved shield of acrylic placed in the labial
vestibule.
• Works on the principle of both force application & elimination.
• Vestibular screen does not contact teeth as compared to oral
screen.
35. LIP BUMPER
• “combined removal-fixed appliance”.
• Used in both maxilla & mandible to shield
the lips away from the teeth.
Maxillary appliance Denholtz appliance.
• Uses:
-in lip sucking patients.
-hyperactive mentalis activity.
-to augment anchorage
-distalization of first molars
36. ACTIVATOR
• Indicaitons: In actively growing individuals with
favorable growth patterns.
-class II div I mo
-class II div II mo
-class III
-class I open bite
-class I deep bite
-as a preliminary T/t before major fixed appliance therapy
to improve skeletal jaw relations.
-for post treatment retention
-children with lack of vertical development in lower facial
height.
37. • Contraindications:
-correction of class I cases with crowded teeth
caused by disharmony b/w tooth size & jaw
size.
-in children with excess lower facial height.
-in children whose lower incisors are severely
procumbent.
-in children with nasal stenosis caused by
structural problems w/in the nose or chronic
untreated allergy.
-in non-growing individuals.
38. • Advantages:
-uses existing growth of the jaws
-minimal oral hygiene problems
-intervals b/w appointments is long
-appoints are short,minimal
adjustments required
-hence,more economical
39. • Disadvantages:
-requires very good patient cooperation
-cannot produce a precise detailing &
finishing of occlusion.
-may produce moderate mandibular
rotation(hence contraindicated in excess
lower facial height cases)
40. • Mode Of Action: Acc. To Andresen & Haupl
-induce musculoskeletal adaptation by introducing a new
pattern of mandibular closure.
stretching of elevator muscles of
masticationcontractionmyotactic reflex set up kinetic
energy which causes:
-prevention of growth of max. dento-
alveolar process
-movement of max. dento alveolar process
distally
-reciprocal forward growth of mandible.
• In addition, a condylar adaptation by backward & upward
growth occurs.
45. • Wear Time:
1st week 2-3 hrs a day during day time
2nd week onwards 3 hrs during day & while
sleeping.
46. FRANKEL’S FUNCTION REGULATOR
• 2 main T/t effects:
1) serves as a template against which craniofacial
muscles function. Framework of the appliance
provide an artificial balancing of environment.
2) removes the muscle forces in the labial & buccal
areas thereby providing an environment which
enables skeletal growth.
47. • Types:
FR I-Class I & Class II Div I .
FR 1a-Class I with minor to moderate crowding.
FR 1b-Class II div I where overjet does not exceed
5mm
FR 1c-Class II div I ;overjet >7mm
49. • FR III-Class III
• FR IV-open bite & bimaxilliary protrusion
• FR V- incorporate head gear. Indicated in long face
patients having high mandibular plane angle&
vertical maxillary excess.
FR III FR IV
50. 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
52. TWIN BLOCK APPLIANCE
• The Twin Block appliance is a removable,
orthodontic functional appliance that is used
to help correct jaw alignment, particularly an
underdeveloped lower jaw.
• Developed by Dr.William J. Clarks , 1977.
• Effectively combines inclined planes with
intermaxillary & extraoral traction.
53. • The removable twin block is a tissue-born functional
appliance that is worn fulltime. It helps in the
advancement of the mandible. It is a two-piece appliance
composed of an upper and lower bite block. Orthopedic
traction can be added in cases of severe skeletal
discrepancies. This includes the use of a Concord
Facebow (or headgear) at nighttime. Upper & lower bite
blocks interlock at 70
0
angle.
54. • 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.
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. HERBST APPLIANCE
• Fixed functional appliance developed by Emil
Herbst in early 1900’s.
• Indications:
-correction of class II MO due to retrognathic
mandible.
-can be used as anterior repositioning splint in
patients having TMJ disorders.
57. • Specific indications
-Post adolescent patients: T/t completed w/in
6-8 months,hence possible to use the residual
growth in these patients.
-Mouth breathers
-Uncooperative patients
• 2 types:
-Banded Herbst
-Bonded Herbst
59. • Advantages:
-continuous action
-T/t duration is short
-less pt cooperation needed
-can be used in pts who are at the end of
their growth
-can be used in pts with mouth breathing
habit.
60. • Disadvantages:
-cause minor functional disturbances.
-increased risk of development of dual
bit,with TMJ dysfunction symptoms as a
possible consequence.
-repeated breakage & loosening of appliance
occurs,esp. in lower premolar area.
-plaque accumulation & enamel
decalcification can occur
-tendency for posterior open bite.
61. JASPER JUMPER
• A relatively new flexible,fixed ,tooth borne
FA.
• Introduced by J.J.Jasper ,1980
• Actions similar to Herbst appliance but
lack rigidity.
• Basically indicated in skeletal class II mo
with max. excess & mandibular deficiency.
62. • Advantages:
-produce continuous force
-does not require patient compliance
-allows greater degree of mandibular freedom
than Herbst appliance
-oral hygiene is easier to manage.
63. WHEN TO TREAT WITH FUNCTIONAL
APPLIANCE ???
• The best time to start functional appliance
therapy is the late mixed dentition.
• Advantage of the pubertal growth spurt
should be taken.
• Girls & boys along with early maturers should
be assessed individually.
64. LIMITATIONS & COMPLICATIONS
• Discomfort, as both upper & lower teeth
are joined together.
• Mainly depends on patient’s compliance
• Can be used only if a favorable horizontal
growth pattern is present in cases of Class
II correction.
• It has to be removed during
masticaiton,particularly when strongest
forces are applied.
• May interfere with speech.
• Treatment duration is often long
65. CONCLUSION
• The global demand for orthodontics without braces
continues to grow. It's an option that many parents
and patients would prefer.
• Myofunctional orthodontics offers a viable
alternative to traditional orthodontic methods.
• A functional appliance is an appliance that produces
all or part of its effect by altering the position of the
mandible/maxilla.
66. • These appliances utilize the muscle action of the patient
to produce orthodontic or orthopaedic forces to restore
facial balance.
• The question that must be addressed in diagnosis is :
“does the patient require orthodontic treatment or
functional orthopedic treatment or a combination of both
and to what degree?
whether the patient requires functional appliance alone or
need a orthognathic surgery or to what extend FA can
reduce need for surgery?”
67. “ The study of orthodontia is indissolubly connected with
that of art as related to the human face.The mouth is a
most potent factor in making the beauty and character of
the face and the form & beauty of the mouth largely
depends on the occlusal relations of the teeth.
Our duties as orthodontists force upon us great
responsibilities and there is nothing which the student of
orthodontia should be more keenly interested than in art
generally,and especially in its relation to the human
face,for each of his efforts,whether he realizes it or not
makes for beauty or ugliness,for harmony or
inharmony,for perfection or deformity of the face.Hence it
should be one of his life studies. ” - E.H.Angle,1907
68. REFERENCES
1) Dentofacial Orthopedics with Functional Appliances by
Thomas M. Graber,Thomas Rakosi & Alexandre
G.Petrovic;2/e,2009
2) Orthodontics Diagnosis & Management of Malocclusion
& Dentofacial Deformities by Om Prakash
Kharbanda;2/e,2013
3) Orthodontics Principles & Practice by Basavaraj
Subhashchandra Phulari;1/e,2011
4) Textbook Of Orthodontics By Gurkeerat Singh;2/e,2007
69. 5) Textbook Of Pedodontics by Shobha Tandon;2/e,2008
6) Orthodontics –The Art & Science by
S.I.Bhalajhi;3/e,2003
7) Contemporary Orthodontics by William
R.Proffit;4/e,2007
8) Norman Wahl,Special Article, “Orthodontics in 3
millennia. Chapter 9: Functional appliances to
midcentury”;(Am J Orthod Dentofacial Orthop
2006;129:829-33)
9) Various Internet Sources