1. Face masks apply heavy orthopedic forces over 400g to effect changes in skeletal structures.
2. They derive anchorage from both the chin and forehead to distribute forces over a large area and prevent excessive force on growth centers.
3. Forces of around 450g per side for 12-14 hours per day are recommended to protract the maxilla forward and downward around 15-20 degrees to the occlusal plane.
This document discusses the Hawley retainer, which is commonly used to retain teeth after orthodontic treatment. It consists of an acrylic baseplate with Adam clasps and a labial bow. The Hawley retainer is simple to construct and can be easily modified. It offers good anchorage and maintains expansion. However, it depends on patient compliance and may impair speech. The document provides details on how to fabricate a Hawley retainer, including making the Adam clasps, labial bow, acrylic base, and finishing and polishing.
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.
There are 3 main types of orthopedic appliances used to modify maxillary or mandibular growth: headgear, face masks, and chin cups. Headgears apply distal force to the maxilla via hooks on a facebow attached to maxillary molars. Proper force magnitude, direction (through the center of resistance), and duration are important to achieve skeletal changes. Face masks apply anterior force to the maxilla using elastic bands from a chin cup and/or forehead band. They are used to correct retrognathic maxillas. Chin cups provide anchorage for elastic traction from a reverse-pull face mask to protract the maxilla.
O Double Cantilever Spring/Z-Spring é um aparelho ortodôntico removível construído de aço inoxidável em forma de duas hélices. Ele é usado para corrigir pequenos deslocamentos de um ou mais incisivos, como movimentos lingual-palatino ou correção de mordida cruzada anterior. Sua ativação envolve abrir as hélices para aumentar a distância entre os braços ativo e passivo.
The document discusses using bite ramps or bite turbos in orthodontic treatment to correct deep overbites and curves of Spee. It provides instructions on how to make and place bite ramps using light cure material. Bite ramps are bonded to the palatal surfaces of maxillary central incisors. The ramps can be extended lingually if needed. Bite ramps are a useful orthodontic device to correct deep overbites and allow bonding of lower anterior brackets which may otherwise not be possible.
Lip bumper, quad helix, tongue crib,Tpa,Nance by Dr.Saurav Mishrasaurav mishra
This document discusses the lip bumper, quad helix, and tongue crib appliances. It provides details on the design, indications, and mechanisms of these appliances. The quad helix appliance is described as having anterior and posterior helical loops to provide a wide range of continuous, controlled force during maxillary expansion. Its fan-like sweeping action can buccally expand and distally rotate the maxillary molars. Indications for the quad helix include correcting crossbites through upper arch expansion and mild class II malocclusions requiring upper arch widening and molar rotation. Complications and clinical management are also briefly covered.
This document discusses removable orthodontic appliances. It describes the advantages as being able to be removed for cleaning, being less conspicuous, and allowing for treatment by general practitioners. Disadvantages include only being able to correct simple malocclusions. Indications include growth modifications and limited tooth movement needs. Components include retentive components like clasps and active components like springs. Different types of clasps and their uses are outlined, along with various spring designs and their applications.
This document discusses the Hawley retainer, which is commonly used to retain teeth after orthodontic treatment. It consists of an acrylic baseplate with Adam clasps and a labial bow. The Hawley retainer is simple to construct and can be easily modified. It offers good anchorage and maintains expansion. However, it depends on patient compliance and may impair speech. The document provides details on how to fabricate a Hawley retainer, including making the Adam clasps, labial bow, acrylic base, and finishing and polishing.
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.
There are 3 main types of orthopedic appliances used to modify maxillary or mandibular growth: headgear, face masks, and chin cups. Headgears apply distal force to the maxilla via hooks on a facebow attached to maxillary molars. Proper force magnitude, direction (through the center of resistance), and duration are important to achieve skeletal changes. Face masks apply anterior force to the maxilla using elastic bands from a chin cup and/or forehead band. They are used to correct retrognathic maxillas. Chin cups provide anchorage for elastic traction from a reverse-pull face mask to protract the maxilla.
O Double Cantilever Spring/Z-Spring é um aparelho ortodôntico removível construído de aço inoxidável em forma de duas hélices. Ele é usado para corrigir pequenos deslocamentos de um ou mais incisivos, como movimentos lingual-palatino ou correção de mordida cruzada anterior. Sua ativação envolve abrir as hélices para aumentar a distância entre os braços ativo e passivo.
The document discusses using bite ramps or bite turbos in orthodontic treatment to correct deep overbites and curves of Spee. It provides instructions on how to make and place bite ramps using light cure material. Bite ramps are bonded to the palatal surfaces of maxillary central incisors. The ramps can be extended lingually if needed. Bite ramps are a useful orthodontic device to correct deep overbites and allow bonding of lower anterior brackets which may otherwise not be possible.
Lip bumper, quad helix, tongue crib,Tpa,Nance by Dr.Saurav Mishrasaurav mishra
This document discusses the lip bumper, quad helix, and tongue crib appliances. It provides details on the design, indications, and mechanisms of these appliances. The quad helix appliance is described as having anterior and posterior helical loops to provide a wide range of continuous, controlled force during maxillary expansion. Its fan-like sweeping action can buccally expand and distally rotate the maxillary molars. Indications for the quad helix include correcting crossbites through upper arch expansion and mild class II malocclusions requiring upper arch widening and molar rotation. Complications and clinical management are also briefly covered.
This document discusses removable orthodontic appliances. It describes the advantages as being able to be removed for cleaning, being less conspicuous, and allowing for treatment by general practitioners. Disadvantages include only being able to correct simple malocclusions. Indications include growth modifications and limited tooth movement needs. Components include retentive components like clasps and active components like springs. Different types of clasps and their uses are outlined, along with various spring designs and their applications.
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.
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 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
This document discusses various methods of mixed dentition analysis used to predict the size of unerupted permanent teeth during childhood. It describes Moyer's, Tanaka Johnston, Hixon-Oldfather, Nance, Ballard and Wylie, and Huckaba methods. Each method uses dental casts and sometimes radiographs to measure erupted teeth and predict unerupted tooth sizes using regression equations or charts. The most accurate methods are Hixon-Oldfather and refinements like Staley-Kerber, but other methods may be more practical or applicable to different populations.
Essential diagnostic aids in orthodonticsHariprasadL3
1. Orthodontic diagnosis involves collecting data through various diagnostic aids like case history, clinical examination, study models, and radiographs to identify the nature and cause of a malocclusion.
2. Essential diagnostic aids include case history, clinical examination, study models, periapical radiographs, and bitewing radiographs which provide information on the patient's medical history, dentition, occlusion, and underlying bone and tissue.
3. Additional diagnostic aids like cephalometric radiographs, photographs, and specialized radiographic views provide supplementary information to develop a comprehensive orthodontic diagnosis.
The document discusses the mechanics of orthodontic tooth movement. It covers topics such as the nature of orthodontic tooth movement, forces, center of resistance, moments, couples, types of tooth movement including tipping, translation, rotation, intrusion and extrusion. It also discusses force duration types including continuous, interrupted and intermittent forces. Threshold force values and moment to force ratios for different tooth movements are provided.
This document discusses orthopedic appliances used for growth modification. It describes three main types of orthopedic appliances: headgears, protraction face masks, and chin cups. Headgears are the most widely used and can be cervical, occipital, or a combination to modify maxillary growth. Protraction face masks apply an anterior protractory force on the maxilla through facial anchorage from the chin and/or forehead. Chin cups provide anchorage from the chin area. The key principles of orthopedic appliance therapy are applying heavy intermittent forces through teeth to modify bone growth at sutures and growth sites.
This seminar discusses the classification and management of deep bites. It defines deep bites as having excessive overbite and classifies them as incomplete, complete, dental, or skeletal. Diagnosis involves clinical exams, study models, and cephalograms. Treatment depends on the type but generally involves intrusion or extrusion of teeth using removable appliances like bite planes, myofunctional appliances, or fixed appliances like utility arches to correct the overbite. Light forces are used to intrude incisors while heavier forces extrude posterior teeth. The goal is to reduce overbite through controlled tooth movement.
The document summarizes theories of orthodontic tooth movement including the pressure-tension theory and bone-bending theory. It discusses how application of orthodontic forces leads to remodeling changes in the periodontal ligament and alveolar bone through pressure and tension sites. Key signaling molecules that mediate the biological response to orthodontic forces are also summarized, including prostaglandins, cytokines, and growth factors that regulate bone resorption and formation during tooth movement.
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.
This document discusses the management of cross bites in dentistry. It defines cross bites as abnormal occlusions where one or more teeth are positioned lingually or labially in relation to opposing teeth. Cross bites can be classified as anterior, posterior, skeletal, dental or functional. Management depends on the dentition stage and includes techniques like occlusal grinding, arch expansion appliances, and orthodontic tools like elastics or springs. Expansion appliances discussed include quad helix, rapid palatal expander, and hybrid designs. Surgical correction may be used for severe cross bites. The goal is to properly diagnose the cross bite type and address it at early detection for best treatment outcomes.
The document discusses the properties and characteristics of orthodontic archwires. It describes the mechanical properties such as stress, strain, stiffness, strength and load deflection rate. It discusses different types of archwire materials including gold, stainless steel, nickel-titanium alloys, beta titanium, and cobalt chromium alloys. It also covers characteristics such as formability, resilience, biocompatibility and friction for orthodontic archwires. The document provides details on various generations of nickel-titanium alloys and their properties like shape memory effect and super elasticity.
This document summarizes the prenatal development and postnatal growth of the mandible. It begins with an overview of the formation of pharyngeal arches during embryonic development, including the mandibular arch which gives rise to the lower jaw. Meckel's cartilage provides a template for mandibular growth. Ossification begins in the mandible through intramembranous and endochondral bone formation. After birth, various regions such as the ramus, body, angle, and condyle continue growing through bone deposition and resorption to accommodate the erupting teeth and enlarging muscles. Growth generally ceases around age 20.
Orthodontic tooth movements and biomechanics.Sk Aziz Ikbal
The document discusses biomechanics principles related to orthodontic tooth movement. It covers topics such as:
- Forces applied to teeth can cause movement through bone remodeling.
- Biomechanics refers to mechanics applied to biological systems. Knowledge of forces is needed to control orthodontic treatment.
- Teeth can move through light forces during normal function but heavier sustained forces over 1 second are needed for orthodontic tooth movement.
- Forces have magnitude and direction, while scalars only have magnitude. Resultant forces and moments from multiple applied forces are calculated.
- Different force systems and moment-to-force ratios produce different types of tooth movement such as tipping, translation, rotation, and torque.
This document discusses anchorage in orthodontics. It defines anchorage as the resistance to unwanted tooth movement. It classifies anchorage according to site (intraoral vs extraoral), number of units (simple vs compound), and arch form (Moyers and Burstone classifications). Biological factors like tooth morphology and muscles affect anchorage. Mechanically, friction influences anchorage. The document reviews anchorage considerations for removable and fixed appliances historically used like edgewise and Begg appliances. It also discusses anchorage preparation and loss.
This document summarizes the construction of various types of removable orthodontic appliances including Hawley retainers, Begg retainers, and appliances used for tooth movement. It describes the components, construction steps, and principles of each appliance. Key steps in the construction include bending labial bows and Adams clasps, adding acrylic to make the base plate, and finishing and delivery. Removable appliances are useful for retention, minor tooth movement, and settling of the occlusion. Patient compliance is important for their effectiveness.
Study models are essential records in orthodontics that provide a 3D representation of the teeth and occlusion. A study model has two parts - the anatomic portion showing the teeth and soft tissues, and the artistic portion which is the stone base. Models need to be trimmed accurately to reproduce the dental anatomy and occlusion. Various analyses like Carey's, Ashley Howe's and Bolton's can be done on study models to assess discrepancies and plan treatment. Mixed dentition analysis using Moyer's or Tanaka-Johnston method helps predict the size of unerupted teeth.
This document discusses self-correcting anomalies that arise during development from the predentate period to the permanent dentition period. It classifies anomalies based on the developmental period and describes several types including retrognathic mandible, anterior open bite, deep bite, flush terminal plane, primate and physiological spacing, anterior deep bite, end on molar relation, mandibular anterior crowding, and the ugly duckling stage. Many of these anomalies correct on their own through continued growth, eruption of teeth, attrition, and movement of jaws without requiring dental treatment.
This document discusses removable orthodontic appliances used for tooth movement. It defines key terminology like removable appliance and classifications active and passive appliances. It describes how removable appliances can be used to expand arches, reposition teeth, and intrude or extrude teeth. Specific active plate designs are outlined for anterior expansion, transverse expansion, and simultaneous anterior and posterior expansion. Removable appliances can also be used to position individual teeth using springs or screws. The document discusses various retentive components like Adams clasps and ways to improve retention. It concludes by noting other uses of removable appliances like as bite planes, to treat habits, as space maintainers, or to retain treatment results.
This document provides an overview of orthodontic archwire materials. It discusses the history of archwire materials including precious metals, stainless steel, cobalt chromium alloys, and nickel titanium alloys. The basic elastic properties of archwires like stress, strain, modulus of elasticity, and stiffness are explained. Clinical implications of archwire selection including size, shape and fabrication are covered. Recent advancements in braided, twisted, triangular, and non-metallic wires are also summarized.
The document discusses orthopedic appliances used to correct skeletal imbalances. It focuses on headgears and facemasks. Headgears apply force to distalize the maxilla and correct Class II malocclusions, with cervical headgears extruding molars and occipital headgears intruding molars. Forces of 400+ grams for 12+ hours per day are needed to induce skeletal effects. Facemasks apply forward force on the maxilla to correct Class III malocclusions, advancing the maxilla 2-4mm over 8-12 months with 300-500 grams of force per side.
This document provides information about the ESC3180 Field Mapping course to be held from July 4-20, 2016 in Broken Hill, Australia. The course is worth 6 credits and will involve students completing geological mapping assignments of increasing difficulty over 3 weeks. Students will map the Eldee structure, create cross-sections, and participate in an elective. The course will be held at Eldee Station and involve travel, accommodations in shared quarters and tents, and catered meals. The document highlights positive feedback and awards the course has received for its teaching excellence in preparing students for careers in geology.
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.
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 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
This document discusses various methods of mixed dentition analysis used to predict the size of unerupted permanent teeth during childhood. It describes Moyer's, Tanaka Johnston, Hixon-Oldfather, Nance, Ballard and Wylie, and Huckaba methods. Each method uses dental casts and sometimes radiographs to measure erupted teeth and predict unerupted tooth sizes using regression equations or charts. The most accurate methods are Hixon-Oldfather and refinements like Staley-Kerber, but other methods may be more practical or applicable to different populations.
Essential diagnostic aids in orthodonticsHariprasadL3
1. Orthodontic diagnosis involves collecting data through various diagnostic aids like case history, clinical examination, study models, and radiographs to identify the nature and cause of a malocclusion.
2. Essential diagnostic aids include case history, clinical examination, study models, periapical radiographs, and bitewing radiographs which provide information on the patient's medical history, dentition, occlusion, and underlying bone and tissue.
3. Additional diagnostic aids like cephalometric radiographs, photographs, and specialized radiographic views provide supplementary information to develop a comprehensive orthodontic diagnosis.
The document discusses the mechanics of orthodontic tooth movement. It covers topics such as the nature of orthodontic tooth movement, forces, center of resistance, moments, couples, types of tooth movement including tipping, translation, rotation, intrusion and extrusion. It also discusses force duration types including continuous, interrupted and intermittent forces. Threshold force values and moment to force ratios for different tooth movements are provided.
This document discusses orthopedic appliances used for growth modification. It describes three main types of orthopedic appliances: headgears, protraction face masks, and chin cups. Headgears are the most widely used and can be cervical, occipital, or a combination to modify maxillary growth. Protraction face masks apply an anterior protractory force on the maxilla through facial anchorage from the chin and/or forehead. Chin cups provide anchorage from the chin area. The key principles of orthopedic appliance therapy are applying heavy intermittent forces through teeth to modify bone growth at sutures and growth sites.
This seminar discusses the classification and management of deep bites. It defines deep bites as having excessive overbite and classifies them as incomplete, complete, dental, or skeletal. Diagnosis involves clinical exams, study models, and cephalograms. Treatment depends on the type but generally involves intrusion or extrusion of teeth using removable appliances like bite planes, myofunctional appliances, or fixed appliances like utility arches to correct the overbite. Light forces are used to intrude incisors while heavier forces extrude posterior teeth. The goal is to reduce overbite through controlled tooth movement.
The document summarizes theories of orthodontic tooth movement including the pressure-tension theory and bone-bending theory. It discusses how application of orthodontic forces leads to remodeling changes in the periodontal ligament and alveolar bone through pressure and tension sites. Key signaling molecules that mediate the biological response to orthodontic forces are also summarized, including prostaglandins, cytokines, and growth factors that regulate bone resorption and formation during tooth movement.
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.
This document discusses the management of cross bites in dentistry. It defines cross bites as abnormal occlusions where one or more teeth are positioned lingually or labially in relation to opposing teeth. Cross bites can be classified as anterior, posterior, skeletal, dental or functional. Management depends on the dentition stage and includes techniques like occlusal grinding, arch expansion appliances, and orthodontic tools like elastics or springs. Expansion appliances discussed include quad helix, rapid palatal expander, and hybrid designs. Surgical correction may be used for severe cross bites. The goal is to properly diagnose the cross bite type and address it at early detection for best treatment outcomes.
The document discusses the properties and characteristics of orthodontic archwires. It describes the mechanical properties such as stress, strain, stiffness, strength and load deflection rate. It discusses different types of archwire materials including gold, stainless steel, nickel-titanium alloys, beta titanium, and cobalt chromium alloys. It also covers characteristics such as formability, resilience, biocompatibility and friction for orthodontic archwires. The document provides details on various generations of nickel-titanium alloys and their properties like shape memory effect and super elasticity.
This document summarizes the prenatal development and postnatal growth of the mandible. It begins with an overview of the formation of pharyngeal arches during embryonic development, including the mandibular arch which gives rise to the lower jaw. Meckel's cartilage provides a template for mandibular growth. Ossification begins in the mandible through intramembranous and endochondral bone formation. After birth, various regions such as the ramus, body, angle, and condyle continue growing through bone deposition and resorption to accommodate the erupting teeth and enlarging muscles. Growth generally ceases around age 20.
Orthodontic tooth movements and biomechanics.Sk Aziz Ikbal
The document discusses biomechanics principles related to orthodontic tooth movement. It covers topics such as:
- Forces applied to teeth can cause movement through bone remodeling.
- Biomechanics refers to mechanics applied to biological systems. Knowledge of forces is needed to control orthodontic treatment.
- Teeth can move through light forces during normal function but heavier sustained forces over 1 second are needed for orthodontic tooth movement.
- Forces have magnitude and direction, while scalars only have magnitude. Resultant forces and moments from multiple applied forces are calculated.
- Different force systems and moment-to-force ratios produce different types of tooth movement such as tipping, translation, rotation, and torque.
This document discusses anchorage in orthodontics. It defines anchorage as the resistance to unwanted tooth movement. It classifies anchorage according to site (intraoral vs extraoral), number of units (simple vs compound), and arch form (Moyers and Burstone classifications). Biological factors like tooth morphology and muscles affect anchorage. Mechanically, friction influences anchorage. The document reviews anchorage considerations for removable and fixed appliances historically used like edgewise and Begg appliances. It also discusses anchorage preparation and loss.
This document summarizes the construction of various types of removable orthodontic appliances including Hawley retainers, Begg retainers, and appliances used for tooth movement. It describes the components, construction steps, and principles of each appliance. Key steps in the construction include bending labial bows and Adams clasps, adding acrylic to make the base plate, and finishing and delivery. Removable appliances are useful for retention, minor tooth movement, and settling of the occlusion. Patient compliance is important for their effectiveness.
Study models are essential records in orthodontics that provide a 3D representation of the teeth and occlusion. A study model has two parts - the anatomic portion showing the teeth and soft tissues, and the artistic portion which is the stone base. Models need to be trimmed accurately to reproduce the dental anatomy and occlusion. Various analyses like Carey's, Ashley Howe's and Bolton's can be done on study models to assess discrepancies and plan treatment. Mixed dentition analysis using Moyer's or Tanaka-Johnston method helps predict the size of unerupted teeth.
This document discusses self-correcting anomalies that arise during development from the predentate period to the permanent dentition period. It classifies anomalies based on the developmental period and describes several types including retrognathic mandible, anterior open bite, deep bite, flush terminal plane, primate and physiological spacing, anterior deep bite, end on molar relation, mandibular anterior crowding, and the ugly duckling stage. Many of these anomalies correct on their own through continued growth, eruption of teeth, attrition, and movement of jaws without requiring dental treatment.
This document discusses removable orthodontic appliances used for tooth movement. It defines key terminology like removable appliance and classifications active and passive appliances. It describes how removable appliances can be used to expand arches, reposition teeth, and intrude or extrude teeth. Specific active plate designs are outlined for anterior expansion, transverse expansion, and simultaneous anterior and posterior expansion. Removable appliances can also be used to position individual teeth using springs or screws. The document discusses various retentive components like Adams clasps and ways to improve retention. It concludes by noting other uses of removable appliances like as bite planes, to treat habits, as space maintainers, or to retain treatment results.
This document provides an overview of orthodontic archwire materials. It discusses the history of archwire materials including precious metals, stainless steel, cobalt chromium alloys, and nickel titanium alloys. The basic elastic properties of archwires like stress, strain, modulus of elasticity, and stiffness are explained. Clinical implications of archwire selection including size, shape and fabrication are covered. Recent advancements in braided, twisted, triangular, and non-metallic wires are also summarized.
The document discusses orthopedic appliances used to correct skeletal imbalances. It focuses on headgears and facemasks. Headgears apply force to distalize the maxilla and correct Class II malocclusions, with cervical headgears extruding molars and occipital headgears intruding molars. Forces of 400+ grams for 12+ hours per day are needed to induce skeletal effects. Facemasks apply forward force on the maxilla to correct Class III malocclusions, advancing the maxilla 2-4mm over 8-12 months with 300-500 grams of force per side.
This document provides information about the ESC3180 Field Mapping course to be held from July 4-20, 2016 in Broken Hill, Australia. The course is worth 6 credits and will involve students completing geological mapping assignments of increasing difficulty over 3 weeks. Students will map the Eldee structure, create cross-sections, and participate in an elective. The course will be held at Eldee Station and involve travel, accommodations in shared quarters and tents, and catered meals. The document highlights positive feedback and awards the course has received for its teaching excellence in preparing students for careers in geology.
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
Obstructive sleep disorder /certified fixed orthodontic courses by Indian de...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
Biomechanical principles of orthodontics /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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document discusses different approaches to combined activator and headgear orthopedics. It describes the biomechanics of headgear and how forces applied in different locations can result in different rotations and movements of the maxilla. Several appliance designs are summarized, including those developed by Stocklie and Teuscher, Pfeiffer and Grobety, and Hickham. The Stocklie and Teuscher design uses an activator, transpalatal bar, and headgear to hold the maxilla vertically and sagitally while positioning the mandible forward. Pfeiffer and Grobety advocated using an activator along with cervical extraoral force to correct Class II malocclusions.
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).
Surgical procedures for the treatment ofBhagwat Kapse
Apnea” is the Greek word for “without breath.”
Obstructive sleep apnea (OSA) was
( 1837) First Charles Dickens term “Pickwickian syndrome”
described a similar presentation of a typical OSA patient; obese, somnolent, and with an excessive appetite.
Orthodontic study casts are accurate plaster models of the teeth and soft tissues that are used for various diagnostic purposes in orthodontic treatment planning and evaluation. Study casts can be used to assess dental anatomy, occlusion, arch form, tooth alignment and spacing, total arch length and tooth size discrepancies through various analyses such as Pont's analysis, Carey's analysis, Bolton analysis, and mixed dentition analysis. These analyses provide important diagnostic information to orthodontists for determining appropriate treatment plans.
Functional examination /certified fixed orthodontic courses by Indian dental...Indian dental academy
This document discusses functional examination in orthodontics. It outlines the key aspects of functional examination including examination of the postural rest position and maximum intercuspation, examination of the temporomandibular joint, and examination of orofacial dysfunctions.
It describes in detail the examination of the postural rest position and its relationship to maximum intercuspation. Various methods for determining and registering the postural rest position are provided. The document examines the path of closure in the sagittal, vertical, and transverse planes and how to evaluate different malocclusion types based on the path of closure. It distinguishes between true and pseudo deep bites, class II and III malocclusions, as well as
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 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.
Postero anterior cephalometry/certified fixed orthodontic courses by Indian d...Indian dental academy
1. The document discusses posteroanterior cephalometry, which is used to evaluate facial asymmetry and transverse discrepancies. It describes landmarks and techniques for tracing structures on posteroanterior radiographs.
2. Two main analysis methods are described: Grayson's multiplane analysis and Grummons analysis. Grayson's method involves tracing structures on three different coronal planes and constructing midlines to evaluate three-dimensional asymmetry. Grummons analysis uses horizontal reference planes and assesses asymmetries through linear measurements, volumetric comparisons, and ratios.
3. Both methods aim to quantify and characterize asymmetries seen on posteroanterior cephalograms through identification of landmarks, construction of reference structures, and linear
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...Indian dental academy
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This document provides information on headgear used in orthodontic treatment. It discusses the mechanism of action, classification, components, uses, factors influencing effectiveness, and problems associated with headgear use. It also outlines instructions that should be provided to patients wearing headgear for orthodontic treatment.
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ORTHOPEDIC APPLIANCES:
The appliance that produces skeletal changes by applying orthopaedic forces are known as “Orthopaedic appliance”.
‘Orthopaedic therapy' is aimed at the correction of skeletal imbalance with the correction of any dentoalveolar malocclusion being of less importance, in which little or no tooth movement is desired. Therefore, orthopedic forces are heavier (= 400 gm) when compared to orthodontic forces (50-100 gm).
This document discusses orthopedic appliances used for growth modification. It describes three main types of orthopedic appliances: headgears, protraction face masks, and chin cups. Headgears are the most widely used and can be cervical, occipital, or a combination to modify maxillary growth. Protraction face masks apply an anterior protractory force on the maxilla through facial anchorage from the chin and/or forehead. Chin cups provide anchorage from the chin. Orthopedic appliances use heavy intermittent forces through teeth to modify skeletal growth at sutures and growth sites rather than cause tooth movement.
HEADGEAR and FACE MASK ORTHOPEDIC FORCE .pptxMaen Dawodi
There are 2 types of forces used in orthodontics-
1) orthodontic force
when applied brings about dental change.
They are light forces ( 50- 100 gm) bringing about
tooth movement.
2) orthopedic force
when applied brings about the skeletal changes.
They are heavy forces ( 300-500gm) that bring about
changes in the magnitude & direction of bone growth.
The following are the commonly used orthopedic appliances
a) Headgears
b) Protraction Face Mask
c) Chin Cup Appliance.
Headgears are the most widely used extra oral orthopedic appliances.
They are mainly used in the management of skeletal class II malocclusion by growth modification.
They are also used for distalization of maxillary molars
1) Force delivering unit
a) Face bow b) ‘J’ hook
2) Force generating unit
3) Anchor unit
a) Head cap or b) Neck strap
Extra-oral forces
And
Appliances
Prepared by:
Dr. Mohammed Alruby
Definition
Philosophy
History and development
Classification of extra-oral forces
Advantages of extra-oral forces
Disadvantages of extra-oral forces
Uses of extra-oral forces
Headgear
Appliance enhanced the action of headgear
Protraction appliances
Types of reversed headgear
Chin cup appliance
Orthopedic correction of class III
Orthopedic correction of open bite
Orthopedic correction of class II
Retention after orthopedic correction
Definition
It is a force derived from an extra-oral appliance that uses the forehead, the top of the head or the back of the neck as anchorage to apply forces to the dental or basal arch. It may be orthodontic force or orthopedic force to move the dentition, or restrict or redirect the growth respectively.
Philosophy:
The philosophy beyond the use of extra-oral force is based upon the old concept that, (the application of appreciable amount of force against the growing bone con modify or alter the direction of bone growth and consequently alter the shape and position of the bone
= the well-known best examples are the induced skull deformation in Colombia –India and feet deformation in Chinese girls
History and development:
Appliances resembling chin cups have been in use since the early 1800's. According to Graber, the early attempts with the chin cup were not successful because of incomplete knowledge of mandibular and facial growth, its use on non-growing patients, and an inadequate understanding of the forces generated by the chin cup.
1802: Cellier and Josef Fox in 1803, utilized chin caps in combination with bite blocks to correct the “underslung chin”
1866: Norman Kingsley introduced extra-oral head cap anchorage or force for maxillary distal movement
1880: Kingsley described an appliance that could influence the position of the dentition in upper jaw with the aid of extra-oral forces
1887: E.H.Angle recommended the use of occipital bandage in treatment of maxillary protrusion
1904: Jackson was first describing the facial mask
1892: headgear appliance was originally designed by Kingsley
1920: Angle and his followers were convinced that class II and class III elastics not only moved teeth but cause a significant skeletal changes: stimulate growth of one and restrain growth for the other so we not need to use any extra-oral force just wait until permanent dentition is completed
1923: Case recommend the use of extra-oral force against maxilla in treatment of class II and class I maxillary protrusion
1947: Kleohn, presented his treatment results with cervical neck strap, subsequent to this report, many other variation of the headgear appliance were presented
1960: Delaire facemask
Classification of extra-oral force appliances according to uses
The extra-oral pull is generally applied bilaterally, for three main purposes:
(1) as a restraining force
(2)
Headgears are commonly used extraoral appliances with three main components: a face bow to transmit forces, a force element like elastic bands, and a head cap or cervical strap for anchorage. They work by applying forces at points below or above the centers of resistance of the maxilla and teeth to cause rotations. The five main types are cervical, occipital, combination, vertical pull, and asymmetrical headgears. Headgears are used orthopedically to restrict maxillary growth and distally displace teeth, helping to correct malocclusions through effects like molar distalization and rotation.
Effects of extra-oral appliances
And
Forces
Prepared by
Dr. Mohammed Alruby
Factors affect extra-oral force
Studies of maxillary protraction force
Results of extra-oral force
Effects of extra-oral appliances
The effects of extra-oral forces on dentofacial structure depend on the following factors:
- Direction of force
- Magnitude of force
- Duration of force
- Growth
- Patient cooperation
1- Direction of force:
Kloehn 1953, Gould 1975, Greenspan 1970, Merrifield and Cross 1970, and Worms et al 1973, all give an adequate description for the direction of force application and their effect on maxillary molar position, tipping, bodily, extrusion, intrusion movement
The direction of force should be adjusted according to the patient needs and objective of treatment as:
- When bodily movement is required, the force should pass through the center of resistance of molars (at the tri-furcation of roots) and the extra-oral tube should be placed gingivally as possible
- When bodily displacement of maxilla is required, the force should pass through the center of maxillary resistance (zygomatic bone)
- When extrusion of molars is required, (in case of deep bite) the force should pass below the center of resistance (below the level of occlusal plane)- cervical headgear is the best choice
- When intrusion is required (open bite cases) the force should pass above the level of occlusal plane
- In occipital headgear, the vector of force may pass through the center of resistance of 1st molar and thus causes: -------------- distal translation of 1st molar
- If the vector of force passes above the center of resistance causing:
a- Distal root torque
b- Mesial crown tipping
c- Intrusion of maxillary 1st molar ---- that, ----- closing the bite and same can occurs in the vertical or high pull headgear
== the direction of force can be determined by adjusting the outer bow in relation to the occlusal plane or center of resistance
== the best method for recording the force direction is the lateral cephalometric radiograph with the appliance in place, then the outer bow is adjusted in relation to the occlusal plane and the center of resistance of tooth or jaw
= in Kloehn’s face bow, the direction of force is 25 – 30 degree below the occlusal plane so that, the vector of force is far away from the center of resistance of 1st molars, thus cervical headgear causes distal tipping and extrusion of 1st molars and open bite
The direction of force depends upon the following variables:
I- Vertical position of the outer bow relative to the center of resistance:
= force applied by oblique headgear passing through the center of resistance will cause translation of the tooth and make intrusion at the same time
= force applied by oblique headgear passing above the occlusal plane
but below the center of resistance will cause:
a- Distal crown tipping, mesial root torque
b- Extrusion of mesial marginal ri
This document discusses various aspects of orthodontic anchorage. It defines anchorage and provides classifications including according to the manner of force application, the jaws involved, and the site of anchorage. Biological aspects are covered such as factors affecting an individual tooth's anchorage value like the number, shape, and length of roots. Mechanical aspects include using force couples to restrict unwanted tooth movement. Different anchorage reinforcement techniques are presented such as extraoral appliances, implants, and temporary anchorage devices.
The document discusses different types of headgears used in orthodontic treatment including cervical headgear, high-pull headgear, combination headgear, and headgear attached to the lower jaw. It explains how the position of the outer bow relative to the center of resistance and line of force determines the direction of tooth movement and effects on the occlusal plane. Intrusive, extrusive, clockwise, and counterclockwise moments can be created by adjusting the outer bow position. The timing and indications for different headgear types are also covered.
This document discusses different types of anchorage used in orthodontics. Anchorage can be defined as the resistance to unwanted tooth movement during orthodontic treatment. The document describes minimal anchorage techniques like stops, tip backs, and tie backs that allow some anchorage loss. It also discusses moderate and maximum anchorage techniques and the importance of anchorage selection based on factors like dental crowding, facial profile, and tooth morphology. Absolute anchorage using implants is also mentioned.
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This document provides an overview of headgear appliances used in orthodontic treatment. It discusses the evolution of headgear from early designs in the 1800s to modern versions. Headgears are classified based on their use, attachment method, and direction of pull. The key components of facebow headgear are described, including the outer bow, inner bow, junction, and force elements like elastics that connect it to the head cap or cervical strap anchorage. Adjustments to the inner bow are outlined to position the appliance properly during treatment.
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Intrusion PEREPERD BY DR.ABDULGHANI ALMOHAYA ,ALHADDAD.pptxAbdulghaniAlmohaya
The document discusses intrusion, which refers to the apical movement of a tooth's geometric center in relation to the occlusal plane or the tooth's long axis. Intrusion can be used to correct deep overbites by moving anterior teeth vertically downward. True intrusion is achieved by applying a single intrusive force through the tooth's center of resistance. Several appliances can provide intrusive forces, including utility arches, tip-back springs, and segmented arches. Proper biomechanics must be followed, such as applying light, constant forces and positioning the force vector through the tooth's center of resistance and parallel to its long axis.
Techniques for anchorage control in lingual orthodonticsParag Deshmukh
various techniques used in lingual orthodontics for anchorage control are described here.. and various cases of lingual orthodontics in which different techniques were used for anchorage control are discussed here..
1. Biomechanics is the study of movement in biological systems and explains the mechanisms of orthodontic appliances and force systems used for tooth movement.
2. Understanding biomechanical principles allows orthodontists to design treatment plans, select appliances, and move teeth efficiently with minimal damage.
3. The three laws of motion described by Newton - inertia, acceleration, and action/reaction - are important biomechanical concepts for orthodontists to understand to improve treatment outcomes.
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This document discusses anchorage in orthodontics, including its definition, classification, sources, and applications. It describes different types of anchorage according to how forces are applied (simple, stationary, reciprocal) and which jaws are involved (intramaxillary, intermaxillary). Reinforced anchorage uses additional resistance units or adjuncts. Prepared anchorage sets teeth in a distoaxial inclination to increase resistance. Various intraoral and extraoral appliances can provide anchorage, including transpalatal arches, Nance arches, headgear, and face masks. Careful assessment of a case's anchorage needs is important for treatment planning.
1. Forces in orthodontics are vectors that have magnitude, direction, and sense. The center of resistance is the point where a force must pass through to produce pure translation of a tooth.
2. When a force does not pass through the center of resistance, it produces a moment that causes rotation. Different force systems and moments produce different types of tooth movement such as tipping, translation, root movement, and rotation.
3. The principle of action and reaction applies to orthodontic tooth movement. Applying a force to one tooth produces reactive forces on other teeth, so anchorage control is important. Document provides examples of how to determine forces from wire bends and correct different malocclusions using mechanics.
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TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
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2. Introduction
In orthodontic practice ,forces employed are basically of two types
-Orthodontic force (that moves the teeth efficiently ):applied using wires
and other active components of fixed and removable or fixed appliances
Force produced by this appliances are light and range from 50-100 grams
-Orthopaedic force (effect the deeper cranio-facial structures):
The orthopedic forces on the other hand are heavy forces of over 400 grams
that bring about a change in the skeletal tissue
3. -Forces applied to the teeth have the potential to radiate outwards and affect
the nearby skeletal structures.
-For such skeletal changes to occur, the forces employed should be over 400
grams.
-Thus the orthopedic appliances utilize the teeth as handles to transmit the
forces to the adjacent skeletal structures.
-In order to produce skeletal changes, consideration should be given to the
AMOUNT OF FORCE APPLIED and the DURATION OF FORCE.
BASIS FOR ORTHOPAEDIC APPLIANCES
4. AMOUNT OF FORCE
Heavy forces of over 400 grams totally compress the periodontal
ligament on the pressure side and cause hyalinization that prevents the
tooth movement.
These heavy forces are conducted to the skeletal structures to produce
an orthopedic effect.
DURATION OF FORCE
Intermittent forces ranges from 12-14 hours a day are believed to
bring about minimum tooth movement but maximum skeletal
change
5. The commonly used orthopedic appliances are
A . HEAD GEAR
B . FACE MASK
C . CHIN CUP
7. HEAD GEAR
Most commonly used extra oral orthopedic appliance
Used during the growth period to intercept or correct certain skeletal
malocclusions as well as to distalize the maxillary dentition or maxilla
itself.
Also form one of the important adjuncts to control or gain anchorage.
They derive anchorage from the cervical or the cranial regions.
The major 3 components
1. Face bow
2. The force element
3. The head cap or cervical strap
8. FACE BOW
Two types of face bow
1. Inner and outer bow type
2. J hook type
Inner-outer bow type
The face bow is a metallic component that helps in transmitting the
extraoral forces on to the posterior teeth. The face bow consist of :
A . Outer bow
B . Inner bow
C . Junction
9. Outer bow is made up of 1.5mm stiff round wire and is contoured to fit around
the face the outer bow can be short, medium or long
Short –outer bow is lesser in length than inner bow
Medium – outer bow length equal to inner bow
Long – outer bow is longer than inner bow
The distal end of the outer bow is curved to form a hook that gives
attachment to the force element .
Inner bow is made up of 1.25mm round stainless steel wire and contoured
around the dental arch and molars .The inner bow is inserted in to the buccal
tubes fixed on the maxillary first molars. Stops are placed on the inner bow from
sliding too far through the tubes
10. The junction is the rigid joint of inner and outer bow it can be
a. Simple soldered
b. Wrapped soldered or
c. Welded joint
It is placed at the midline of the bows in case of symmetric forces required
it can be shifted from midline when asymmetric forces are needed
Inner bow attached to the
tube on first molar
junction
11. The ‘J’ hook type of face bow
It consist of two 0.072 inch curved wire whose ends form hooks that are contoured
to fit over a small soldered stop on the maxillary arch wire their normal site of
attachment on the arch wire is between the lateral incisor and canine .the j hook type
of face bow is therefore used along with maxillary fixed appliance having a continuous
arch wire they are used for retraction of maxillary anteriors and have limited
orthopaedic indications
12. The force element
It is that part of the assembly which provides the force to bring about desired
effect .this may comprise of Springs, elastics and other stretchable materials. The
force element connects the face bow to the head cap or neck strap
13. The head cap or cervical strap
The appliance takes anchorage from the rigid bones of the skull or from the back of
the neck by means of a Head cap or a neck strap or a combination of the to the
selection of this depends upon the
individual patients needs
14. Principles in the use of headgears
Headgear have the ability to move the dentition and the maxilla in all the
three planes of space .
Factors to be considered when planning the use of headgears include
A . Centre of resistance of the dentition :The inner bow of the face bow
is generally attached to the maxillary first Permanent molars through buccal
tubes on these teeth .Thus the force acting on the molars tends to displace
them. A decision should be made whether bodily movement or tipping
movement of the teeth is required .
15. B . Centre of resistance of maxilla
The centre of resistance of maxilla as whole should also be considered when
planning for headgears .It is believed to exist at the posteriosuperior aspect of
zygomaticomaxillary suture . Under clinical Conditions the centre of resistance
of the dental arch , as a whole should be considered this is located between the
roots of the premolars
Forces passing through the centre of resistance of maxilla produce translation
of the maxilla in a distal direction . While forces passing above or below this point
causes rotation of the maxilla
16. The center of resistance for a molar is usually at the mid-root region.
-Force applied at center of resistance causes bodily movement
-Force applied below center of resistance causes distal crown tipping
-Force applied above center of resistance cause distal root tipping
C . The point of origin of force
Headgears derive anchorage from the occipital region of the cranium or the cervical
region(back of the neck) . Occipital headgears produce a superior and distal force on
the teeth and the maxilla , while cervical headgears inferior and distal force.
Based on this criteria type of anchorage(point of origin) is to be selected
17. D . Point of attachment of force
The point of attachment refers to the hook present on the distal end of the outer
bow to which the force element is attached . It is possible to alter the direction of
force to maxilla and the maxillary dentition by altering the point of attachment .
This can be done by varying
-the length of the outer bow or
-by varying the angle between the inner and outer bow
18. Types of headgears
Based on the site of anchorage headgears can be :
1 . Cervical headgears
2 . Occipital headgears
3 . Combination headgears
4 . Vertical pull headgears
5 . Asymmetrical headgear
19. Cervical headgears
These headgears obtain anchorage from nape of the neck . Cervical headgears
causes extrusion of the maxillary molars leading to an increase in the lower
facial height .They also move the maxillary dentition and the maxilla in a distal
direction .These headgears are generally indicated in low mandibular angle cases ,
as in increase in lower facial height would be beneficial in such patients
consideration
Relation of line of force to the centre of resistance is to be considered as if line
of force is passing below the centre of resistance we can expect a clockwise
rotation of maxilla
21. Occipital headgears
These headgears derive anchorage from the back of the head . This type of
headgear produces a distal and superiorly directed force on the maxillary teeth
and the maxilla . These high pull Headgears produce a more vertically directed
force and there for is used in individuals in whom an increase in vertical dimension
is to be avoided . They decrease the vertical development of maxilla and there
for indicated in long face class 2 patients and in patients with open bite tendencies
Combination headgears
In this type of headgear ,occipital and cervical anchorage is combined . When the
forces exerted by both are equal , a distal and slightly upward force is exerted on
the maxillary dentition and the maxilla . By varying the proportions of the total
force derived from the head cap and the neck strap the resultant force direction
can be altered
23. Vertical pull headgear
They are headgears that derive anchorage from the
parietal region of the cranium and there for Produce
a vertically directed force on maxilla and the
maxillary dentition these headgears can be used to
produce intrusive forces on the anterior region of
the maxilla and there by producing a Counter-
clockwise movement of maxilla . This is beneficial
in the treatment of vertical maxillary excess and
gummy smiles . Intrusive forces on the posterior
aspect of maxilla can be of benefit in anterior open
bite patients as it intrude the maxillary molars and
therefore produces a clockwise movement of
maxilla
24. Asymmetrical headgears
They are used when differential anchorage is required on both sides of the
maxillary arch. For Example a patient with class 2 molar relation on one
side and a class 1 molar relation on the other side can be given an asymmetric
headgear . The different force values are produced by Altering the length of
outer bow on each side and by variation of the angle between the outer And inner
bows
25. Uses of headgears
A . Orthopaedic effect : Forces applied onto the maxilla can be used to restrict
its downward and forward Growth . The distal force in such a case should be
applied through the centre of resistance of the maxilla . The suggested range
of force is 350-450 gms on each side for a minimum of 12-14 hrs /days are
required Orthopeadic effects from extraoral forces are best tapped in pre
adolescent years
B . Anchorage augmentation : Extra oral forces are used to reinforce
anchorage when those Obtained from intraoral sources are insufficient . The
headgear should be worn for approximately 10 hours/day for this purpose and
force values of 300 gms /side are usually sufficient . In the maxilla anchorage
reinforcement is achieved by restricting the mesial movement of molars
26. C . Distalization of molars : distal movement of upper molar may be
required for correction of molar relation or to gain space for correction of
crowding or retraction of anteriors this can achieved by using it for
14 hrs/ days . Unilateral distalization of molars is achieved using asymmetric
headgear of cervical or combination type (larger force on the side of longer
bow )
D . Molar rotation : in order to derotate a molar the molar has to be
banded with the buccal tube placed distally and then subsequently
repositioned . Correction is achieved by adjustment of the inner bow
so that it produces a rotational force on the molar . As soon as the
correction is achieved ,the Face bow should be readjusted to apply a
direct distal force
27. E . Space maintenance : a most effective method of maintaining arch length
is by the use of extraoral forces the mesial movement of molar is prevented
and the face bow does not interfere with erupting teeth . In this situation
daily wear of approx. 8 hrs is sufficient
29. Introduction
Headgears are generally used for the purpose of reinforcement of anchorage or for maxillary
Distalization . However, when an anterior protractory force is required , a protraction headgear is
used . Facial mask therapy has gained popularity. The principal of pulling force on the
maxillary structures with reciprocal pushing force on the forehead or mandible through facial
anchorage is simple and mechanically sound enough to be used as a therapeutic procedure for
treatment of prognathic syndromes, maxillary retrusions , clefts and mandibular prognathism
Hickham (1972) claims he was the first to use reverse headgear. However this modality
was made popular by Delaire around the same time .
A reverse pull headgear basically consists of a rigid extraoral framework , which takes
Anchorage from chin or forehead or both for the anterior traction of the maxilla using extraoral
Elastics that generate large amount of force up to 1 kg or more
30. Indications
1 . In a growing patient having a prognathic mandible and a retrusive maxilla . It aids in
pulling the Maxillary structures forward and pushing mandibular structures backward
2 . It can be used for bending the condylar neck for stimulating temporo-mandibular joint
adaptation to posterior displacement of chin
3 . It can also be used for selective rearrangement of the palatal shelves in cleft patients
4 . It can be used in correction of postsurgical relapse osteotomies(or uncontrolled
postsurgical Adaptations )
5 . It can also be used to treat certain accessory problems associated with
nose morphology such as lateral deviations.
31. Sites of anchorage
Anchorage for the purpose of maxillary retraction can be obtained from
A . Forehead
B . Chin
C . Or both chin and forehead
Anchorage from chin :This type of protraction head gear is commonly used
in Britain ,chin cup with posts are employed . As the anchorage is obtained
solely from the chin ,the force is transmitted to the condylar cartilage and thereby
has a disadvantage of altering the growth of the mandible
33. Anchorage from skull :Certain form of reverse pull head gears obtain anchorage
only from forehead .The disadvantage include patient discomfort while sleeping , cost
and time required in fabrication and fixing
Anchorage from chin & forehead : This face mask makes use of anchorage from
both chin and forehead .Anchorage is spread over a larger area . Thus no excessive
force is exerted onto the growth cartilage . However the disadvantage with this
appliance are difficulty in speech and compromise in esthetics and Comfort due to
size
34. Biomechanical considerations
Amount of force : The amount of force required to bring about skeletal changes
is about 1 pound(or 450gms) per side
Direction of force : Most authors recommend a 15-20 degree downward pull
to the occlusal plane to produce a pure forward translatory motion of the maxilla .
If the line of force is parallel to the Occlusal plane, a forward translation as well
as an upward rotation take place .
35. Duration of force : The time taken to achieve desired result is
proportional to the amount of force utilized . Low forces (250 gm /side)
take 13 months to produce desired results. However ,very high
Force values like 1600-3000gms reduced treatment time to 4 -21 days
Frequency of use : Most authors recommend 12-14 hours of wear a day
36. Parts of a reverse pull headgear
The reverse pull headgear consists of the following parts :
Chin cup: Most protraction headgears obtain anchorage from chin as well as the
forehead . The chin cup is used to take anchorage from the chin area . It is usually
connected to the rest of the face mask assembly by means of metal rods . The chin
cup can the ready-made or can be fabricated from an impression from the patient’s
genial region .
Forehead cap : The forehead support or cap or strap is used to derive anchorage
from the forehead
38. Elastics : Elastic force is used to apply a forward traction on the upper arch .
Vertical posts of chin cup are used to attach the elastics on to the molars or
hooks soldered on the arch wire . This sort of traction is purely for tooth
movement
Intraoral appliance : The most common type of protraction device is a
multibanded appliance with ridge Wire. Traction hooks are placed either in
the molar or premolar region McNamara advocates a banded R.M.E. along
with the protraction device that more or less resembles the banded Herbst
appliance
39. Metal frame : The main component of a face mask assembly is the metal frame .
It connects the various components such as the chin cup and the fore head cap .
It also has provision to receive elastics from the intraoral appliance . The design
of the metal frame differs based on the type of face mask
Metal frame
Elastics
Intraoral appliance
40. Types of reverse pull head gears
Protraction headgears by Hickham: developed in the early 60’s, this appliance
uses the chin and top of the head for anchorage . The force distribution is as
follows – 15% head ,85%chin . It consists of two short arms in front of the
mouth to engage maxillary protraction elastics .It also has a chin cup from which
originate two long arms . The two long arms run parallel to the lower border of
the mandible and go vertically up from the angle of mandible and end behind the
ears . An elastic strap is attached to the end of the long arms to encircle the head
the advantage of the appliance include relatively better esthetics and comfort than
others with the option of unilateral force applicability . By adding a rubber
cushion under one arm , Force to that side can be altered
41. Two short arms
Chin cup
Long arm
The elastic strap
Parts of hickem’s chincup
42. Face mask of Delaire :this was popularized by Delaire in the 60’s and also
uses the chin and Forehead for support . The appliance is made up of a rigid
wire framework which is squarish and kept away from the face . It has a
forehead cap and a chin cup with a wire running in front of the mouth used
for elastic attachment
Tubinger model: this is a modified type of delaire face mask . It consist of a
chin cup from which originates two rods that runs in the midline and is shaped
to avoid the interference of the nose . The superior ends of the two rods
house a forehead cap from which elastics encircle the head .In addition, a
crossbar extends in front of the mouth which can be used to engage the
elastics .The forehead cap and crossbar can be adjusted by sliding along the rod
framework to suit the individual patient.
44. Petit type of face mask : this is also a modified
type of Delaire face mask. It consist of a chin
Cup and a forehead cap with a single rod
running in the midline from forehead cap to
chin cup . A cross bar at the level of the mouth
is used to engage elastics . The advantage of this
model is that the forehead cap ,chin cup and the
cross bar can be adjusted to suit the patient
46. Introduction
The chin cup or thin cap as it is sometimes referred to is an extraoral
orthopaedic device that covers The chin and is connected to a headgear .
It is used to restrict the forward and downward growth of the mandible .
The chin cup – face bow assembly consist of a chin cup that covers the
chin , a head cap and an adjustable elastic strap that connects the chin cup
with the head cap
47. Types of chin cups
Chin cups are of two types . They are the occipital pull chin cup and the vertical
pull chin cup
Occipital pull chin cup: This type of chin cup derives anchorage from the
occipital region of the head . This is the most commonly used type of chin
cup . It is used in class 3 malocclusions associated with mild to moderate
mandibular prognathism .they are very successful in patients who can bring
their incisors close to a edge-to-edge position at centric relation . They are
also indicated in patients with slightly protrusive lower incisors as they
invariably produce lingual tipping of the lower incisors
48. Vertical pull chin cup : this type of chin cup derives anchorage from the parietal
region of the head . It is indicated In patients with steep mandibular plane angle and
excessive anterior facial height . These Patients usually exhibit an anterior open bite
.
Occipital pull chin cup Vertical pull chin cup
49. Fabrication of chin cup
Chin cups are either fabricated individually for the patient or pre-fabricated
commercially available chin cups can be used . The fabrication of chin cup
requires an impression to be taken of the chin area. The cast is poured and the
chin cup fabricated using self-cure acrylic resins
Force magnitude and duration of wear
At the time of appliance delivery a force of 150-300 grams per side is used .
Over the next two months the force is gradually increased to 450-700grams
per side . The patient is asked to wear the appliance for 12-14 hours a day to
achieve the desired results