Professional Documents
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Functional Appliances
Functional Appliances
1. growth modification,
2.dental camouflage,
3. and orthognathic surgery.
The first two options are used in growing patients, and the latter two can be used in adults.
These appliance are used for growth modification
procedure that are aimed in intercepting & treating jaw
discrepancies.
Orthodontic force vs orthopedic force
A. Removable
appliances:
B. Fixed
appliances:
Functional Orthodontic Appliances
These are appliances which engage both arches
and act principally by holding the mandible
away from its resting position, they transmit the
natural forces of the circum-oral musculature to
the teeth and/ or alveolar bone.
Functional Orthodontic Appliances
can also be classified in to
Activator
Forcus appliance
Bionator Herpst appliance
Jusper jumper
Twin block
Frankel appliances
These appliances generally
cause a change in the
surrounding soft tissue
envelope of the teeth
thereby leading to a more
harmonious relationship of
the jaws to each other and
to the other bones of the
facial skeleton, e.g. the
Frankel appliance. They can
be either
Functional appliance are different varieties
of appliances fabricated mainly to correct
skeletal class II by enhancing mandibular
growth and also altering the mandibular
position (forward and downward) .
• Patient and family cooperation
• Mild \ moderate skeletal problems
• Actively growing patient : boys (12 – 14y )
girls ( 11-13y )
Can functional appliance be used in
earlier than pubertal growth spurt?
If there is a psychosocial concerns relating to the
aesthetic
Habit braker
AGE OF THE PATIENT
It is advisable to start with
patients in the mixed dentition
period, to make most of the
active growth occurring during
prepubertal growth spurt.
Treatment may have to be
continued until the completion
of adolescent growth, so as to
prevent relapse caused by the
re-expression of patient’s
fundamental (essential) growth
pattern after the cessation of
orthopedic therapy.
Optimum timing of extraoral force application is considered to be during evening and night. This is because an increased
release of growth hormone and other growth-promoting endocrine factors
Orthopedic appliances are worn intermittently for only about 10–14 hours a day.
Mode of action of functional appliances
The activator was originally described by Andresen and Häuplthe early 1900s.
It was based upon the hypothesis of stimulating increased muscle activity in the mandibular elevator and retractor
muscles to act directly on the dentition through the appliance and stimulate the mandibular condyle to allow
remodelling and growth.
Dr.FaHaD
Mode of Action: Forward Positioning of the Dr.FaHaD
Mandible with lingual flanges (acrylic guide ) which will stretch 5 mm
the muscles, reposition and accelerate the mandibular Growth. Dr.FaHaD
Dr.FaHaD
Dr.FaHaD
Dr.FaHaD
Dr.FaHaD
Dr.FaHaD
Dr.FaHaD
5 mm
Dr.FaHaD
Dental Changes Produced by
Activator
Incisor Changes
Mode Of Action: It is made up of two components an upper and a lower plate which work
together to posture the lower jaw forward. This frees up the "locked-in lower jaw and
encourages it to grow to its fullest potential The upper plate may also have an expansion screw
to widen the upper arch to avoid developing a posterior crossbite when the lower jaw is
Advanced
Advantage of Twin-block
Disadvantage of Twin-block
Components: There is a section attached (banded or bonded) to the upper buccal molar teeth
and another section attached to the lower premolar teeth. These sections are joined by a rigid
arm that postures the mandible forwards.
Advantage
As it is a fixed appliance, it removes some (but not all) patient`s compliance factors and better
tolerated than the other bulkier functional appliances
Disadvantage
• Increased breakages
• Higher cost
• Not easy repairable
4-Jasper jumper
The bionator was originally designed to modify tongue behavior, using a heavy wire loop in the
palate. The lack of acrylic in the palate makes it easy to wear. A buccal extension of the labial bow
holds the cheeks out of contact with the buccal segment teeth, allowing some arch expansion.
6. Fränkel appliance
Uses:
•in patients exhibit lower lip sucking
•in patients with hyperactive mentalis
•to support anchorage
•distalization of molars
•as a space regainer
8-Oral screen
It is a curved shield of acrylic centered in the vestibule between the labial/buccal aspects of the teeth from
behind and lips and cheeks from the front
Types
•Active: It transfers the force of circumoral musculature to the most proclined teeth
•Passive: eliminate the force exerted by circumoral musculature allowing the teeth to move labially by action
of tongue
Advantages
1.Act as habit breaker in patients suffering from mouth breathing, tongue thrusting, lip and cheeks biting
2.Muscle trainer for hypotonic lip and cheek muscles
3.To retrocline mild proclined anterior teeth
Extra Oral Traction
(EOT) Appliances
1-Headgear
a.Cervical attachment/neck
strap
b. Occipital attachment/head
cap
c. High pull headgear
d. Combination pull headgear
Amount, Duration and Timing of Force
Dr.FaHaD
A forward maxillary pull is applied with the help of heavy
elastics that are attached to hooks on the rigid framework.
Dr.FaHaD
3-Chin cap
Types of Chin Cup
Chin cups are available in the following types:
1. Occipital pull chin cup: indicated in
patients with:
i. A mild skeletal prognathism of the mandible.
ii. A decreased facial height.
iii.A well-aligned or protrusive, but not
retroclined mandibular incisors.