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MYOFUNCTIONAL APPLIANCES




      INDIAN DENTAL ACADEMY
   Leader in Continuing Dental Education
     www.indiandentalacademy.com


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HISTORY
       KINGSLEY – Introduced the term” jumping the bite” for
       patients with mandibular retrusion. -1880
He used a vulcanite palatal plate with an anterior inclined
plane which guided the mandible to a forward position when
the patient closed on it.

KINGLEY’S –idea influenced the development of functional
jaw orthopedics.

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Robin’s monobloc- developed in early 1900’s
is the forerunner of all the functional appliances.


But the activator developed by ANDRESEN in Norway
in the 1920’s was the first functional appliance to be
widely accepted

Functional appliances were introduced into American
Orthodontics in the 1950’s.


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BIMLER’S Labio-lingual appliances- -1949

VESTIBULAR APPLIANCES-(FRANKEL)-           1967



 TWIN BLOCK APPLIANCES--1977




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DEFINITION

Functional appliance:-by definition is one
that
changes the posture of the mandible,holding
it open (or) open and forward (Proffit).

Stretch of the muscles and soft
tissues creates
pressures transmitted to the dental
and skeletal structures,moving teeth
and modifying growth.
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Definition:

Functional appliances are passive
appliances which harness natural
forces of the oro-facial musculature
that are transmitted to the
teeth and alveolar bone in a
predetermined direction.



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All functional appliances are intraoral
devices,and nearly all of them are tooth borne
or supported by teeth.

These appliances are removable,primarily
consisting of acrylic with wire components for
retention &support.

Most of the functional appliances are used to
correct early class-2 malocclusions and some
cases of class –3 malocclusions.
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CLASSIFICATION
According to “Tom Graber”:-

1.Group- A- Teeth supported appliances,
     -catlan’s appliance,Inclined planes.
2.Group –B-Teeth/tissue supported appliances.
     -Activator,Bionator etc
3.Group-C- Vestibular positioned appliances
  with isolated support from tooth /tissue,
     -Frankel appliance, Lip bumpers.
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ACCORDING TO PROFITT

 1.Tooth borne passive-
          -Andersen activator
          -Woodside and Harvold activator
          -Bionator
 2.Tooth borne active-
          -Modified activator
          -Expansion activator
          -Orthopaedic Corrector
          -Stockli headgear activator
 3.Tissue borne appliances(Passive)s
          -Frankel appliance.
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Other classifications

     1.MYOTONIC APPLIANCES:-
         Depend muscle mass for their
           action.
     2.MYODYNAMIC APPLIANCES:-
         Depend on muscle activity for
           for their function.
                               .


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1.REMOVABLE FUNCTIONAL APPLIANCES

                       -Activator
                       -Bionator
                       -Frankel
                       -Twin Block

2.Fixed functional appliances

                       -Herbst
                       -Jasper jumper
                       -Forsus
                        (Fatigue resistant device)
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ADVANTAGES OF FUNCTIONAL APPLIANCES

1.To eliminate abnormal perioral muscle functions which
  interfere with normal bone growth
.
2.Treatment can be started in early mixed dentition stage.

3.Easier to maintain oral hygiene.

4.Do not have any side effects of mechanotherapy
       Such as---enamel decalcification,root resorption,
                --gingivitis.


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Lip pads hold the lips away from
teeth and force the lips to stretch
to obtain an oral seal.
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The buccal shield holds the soft tissue
away from the dentition and facilitates
posterior dental expansion by disrupting
the tongue –cheek equilibrium.
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LIMITATIONS OF FUNCTIONAL APPLIANCES


1. Individual tooth movements cannot be
   achieved .
2. Cannot be used in adult patients.
3. Patient cooperation is essential for the
   success of the treatment.
4. Cases treated with functional appliance may
   require fixed appliance therapy for final
   detailing of occlusion.-2phase Rx.


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BIONATOR
        Developed by-Balter-1950

HORSE SHOE SHAPED-acrylic lingual plate




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VESTIBULAR SCREEN (OR) ORAL SCREEN


 Introduced by Newell
 -1912




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MODIFICATIONS OF ORAL SCREEN

KRAUS - -WITH HOLES

HOTZ -- LINGUAL SIDE
PROJECTION OF ACRYLIC TO
KEEP TOUNGE AWAY.




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TWIN BLOCK APPLIANCE



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Introduced by william J.Clark in--1982




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Advantages of delta            clasp:
1.Does not open with repeated insertion & removal.

2.Maintains its shape better and requires less adjustment.

3.Subjected to less breakage.




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MODIFICATIONS OF TWIN BLOCK


BROADBENT
CLARK
MAHONY-TO OPEN & TO CLOSE
MODIFIED McNamara




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MODIFIED
                       McNamara
                       TWIN BLOCK




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ACTIVATOR
DEVELOPED BY VIGGO ANDRESEN-1908

LATER WAS CALLED “NORWEGIAN APPLIANCE”

Modifications were done in Norway teaming up with HAUPL

They later called it ACTIVATOR- due to its ability to
activate the muscles.

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INDICATIONS OF ACTIVATOR

1.   CLASS 2 DIV-1 MALOCCLUSION
2.   CLASS 2 DIV-2 MALOCCLUSION
3.   CLASS 3 MALOCCLUSION
4.   CLASS 1 OPENBITE
5.   CLASS 1 DEEP BITE
6.   FOR POST TREATMENT RETENTION




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CONTRANDICATIONS
1. In children with excess LFH-and extreme
    vertical mandibular growth .
2. In class –1 crowding.
3. Has limited application in non-growing children.
4. In severely proclined lower incisors.




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ACTIVATOR-
                       AND ITS
                       MODIFICATIONS




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FUNCTION REGULATOR
         OR
  FRANKEL APPLIANCE



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FRANKEL APPLIANCE

 Developed by Prof. ROLF FRANKEL of GERMANY

Also called –Vestibular   Appliance and

            Oral –Gymnastic appliance
            (FRANKEL –recommended
             certain oral excercises called
             oral gymnastics-hence the name)
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FRANKEL APPLIANCE( OR)
FUNCTIONAL REGULATOR




 www.indiandentalacademy.co
TYPES OF
                         FRANKEL


                             1.   FR1a
                             2.   FR1b
                             3.   FR1c
                             4.   FR2
                             5.   FR3
                             6.   FR4


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Parts of frankel:-
1.Buccal shields
2.Lip pads- upper and lower
3.lingual shield
4.Palatal bow
5.Labial bow—upper or lower
6.Lingual stabilizing bow
7.Canine clasp
8.protrusion bow
9.Lower lingual spring
10.Lower labial wires
11.Occlusal rest.
            www.indiandentalacademy.co
Parts of FR-2-Class 2-div-1&2
        The acrylic components include:-
            A.Buccal shields
            B.Lip pads
            C.Lower lingual pad
        The wire components include:-
          A. Palatal bow
          B.Labial bow
          C.Canine Extensions
          D.Upper Lingual wire
          E.Lingual crossover wire
          F.Support wire for lip pads
          G.Lower lingual springs.
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DIFFERENCES
                         BETWEEN
                         ACTIVATOR &
                         FRANKEL




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LATERAL & MEDIAL PTERYGOID
     LATERAL PTERYGOID:
     It is a short & conical muscle.
     Has upper & lower head.


     MEDIAL PTERYGOID:
     Quadrilateral muscle
     Has superficial & deep head
                    www.indiandentalacademy.co
Dr VINEETH V T
MODE OF
                             ACTION OF
                             FUNCTIONAL
                             APPLIANCE




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Commonly used fixed functional appliances:-


        1.   Herbst Appliance
        2.   Jasper jumper
        3.   Forsus (Fatigue resistant device.)
        4.   MARA –Appliance (Mandibular anterior
        5.   repositioning device)
        6.   Eureka Spring




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FIXED
                       MYOFUNCTIONAL
                       APLIANCES




www.indiandentalacademy.co
THANK YOU




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orthodontic Myofunctional appliances /certified fixed orthodontic courses by Indian dental academy

  • 1. MYOFUNCTIONAL APPLIANCES INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com www.indiandentalacademy.co
  • 4. HISTORY KINGSLEY – Introduced the term” jumping the bite” for patients with mandibular retrusion. -1880 He used a vulcanite palatal plate with an anterior inclined plane which guided the mandible to a forward position when the patient closed on it. KINGLEY’S –idea influenced the development of functional jaw orthopedics. www.indiandentalacademy.co
  • 5. Robin’s monobloc- developed in early 1900’s is the forerunner of all the functional appliances. But the activator developed by ANDRESEN in Norway in the 1920’s was the first functional appliance to be widely accepted Functional appliances were introduced into American Orthodontics in the 1950’s. www.indiandentalacademy.co
  • 6. BIMLER’S Labio-lingual appliances- -1949 VESTIBULAR APPLIANCES-(FRANKEL)- 1967 TWIN BLOCK APPLIANCES--1977 www.indiandentalacademy.co
  • 7. DEFINITION Functional appliance:-by definition is one that changes the posture of the mandible,holding it open (or) open and forward (Proffit). Stretch of the muscles and soft tissues creates pressures transmitted to the dental and skeletal structures,moving teeth and modifying growth. www.indiandentalacademy.co
  • 8. Definition: Functional appliances are passive appliances which harness natural forces of the oro-facial musculature that are transmitted to the teeth and alveolar bone in a predetermined direction. www.indiandentalacademy.co
  • 9. All functional appliances are intraoral devices,and nearly all of them are tooth borne or supported by teeth. These appliances are removable,primarily consisting of acrylic with wire components for retention &support. Most of the functional appliances are used to correct early class-2 malocclusions and some cases of class –3 malocclusions. www.indiandentalacademy.co
  • 10. CLASSIFICATION According to “Tom Graber”:- 1.Group- A- Teeth supported appliances, -catlan’s appliance,Inclined planes. 2.Group –B-Teeth/tissue supported appliances. -Activator,Bionator etc 3.Group-C- Vestibular positioned appliances with isolated support from tooth /tissue, -Frankel appliance, Lip bumpers. www.indiandentalacademy.co
  • 11. ACCORDING TO PROFITT 1.Tooth borne passive- -Andersen activator -Woodside and Harvold activator -Bionator 2.Tooth borne active- -Modified activator -Expansion activator -Orthopaedic Corrector -Stockli headgear activator 3.Tissue borne appliances(Passive)s -Frankel appliance. www.indiandentalacademy.co
  • 12. Other classifications 1.MYOTONIC APPLIANCES:- Depend muscle mass for their action. 2.MYODYNAMIC APPLIANCES:- Depend on muscle activity for for their function. . www.indiandentalacademy.co
  • 13. 1.REMOVABLE FUNCTIONAL APPLIANCES -Activator -Bionator -Frankel -Twin Block 2.Fixed functional appliances -Herbst -Jasper jumper -Forsus (Fatigue resistant device) www.indiandentalacademy.co
  • 14. ADVANTAGES OF FUNCTIONAL APPLIANCES 1.To eliminate abnormal perioral muscle functions which interfere with normal bone growth . 2.Treatment can be started in early mixed dentition stage. 3.Easier to maintain oral hygiene. 4.Do not have any side effects of mechanotherapy Such as---enamel decalcification,root resorption, --gingivitis. www.indiandentalacademy.co
  • 15. Lip pads hold the lips away from teeth and force the lips to stretch to obtain an oral seal. www.indiandentalacademy.co
  • 16. The buccal shield holds the soft tissue away from the dentition and facilitates posterior dental expansion by disrupting the tongue –cheek equilibrium. www.indiandentalacademy.co
  • 17. LIMITATIONS OF FUNCTIONAL APPLIANCES 1. Individual tooth movements cannot be achieved . 2. Cannot be used in adult patients. 3. Patient cooperation is essential for the success of the treatment. 4. Cases treated with functional appliance may require fixed appliance therapy for final detailing of occlusion.-2phase Rx. www.indiandentalacademy.co
  • 18. BIONATOR Developed by-Balter-1950 HORSE SHOE SHAPED-acrylic lingual plate www.indiandentalacademy.co
  • 19. VESTIBULAR SCREEN (OR) ORAL SCREEN Introduced by Newell -1912 www.indiandentalacademy.co
  • 20. MODIFICATIONS OF ORAL SCREEN KRAUS - -WITH HOLES HOTZ -- LINGUAL SIDE PROJECTION OF ACRYLIC TO KEEP TOUNGE AWAY. www.indiandentalacademy.co
  • 21. TWIN BLOCK APPLIANCE www.indiandentalacademy.co
  • 22. Introduced by william J.Clark in--1982 www.indiandentalacademy.co
  • 29. Advantages of delta clasp: 1.Does not open with repeated insertion & removal. 2.Maintains its shape better and requires less adjustment. 3.Subjected to less breakage. www.indiandentalacademy.co
  • 30. MODIFICATIONS OF TWIN BLOCK BROADBENT CLARK MAHONY-TO OPEN & TO CLOSE MODIFIED McNamara www.indiandentalacademy.co
  • 31. MODIFIED McNamara TWIN BLOCK www.indiandentalacademy.co
  • 36. ACTIVATOR DEVELOPED BY VIGGO ANDRESEN-1908 LATER WAS CALLED “NORWEGIAN APPLIANCE” Modifications were done in Norway teaming up with HAUPL They later called it ACTIVATOR- due to its ability to activate the muscles. www.indiandentalacademy.co
  • 37. INDICATIONS OF ACTIVATOR 1. CLASS 2 DIV-1 MALOCCLUSION 2. CLASS 2 DIV-2 MALOCCLUSION 3. CLASS 3 MALOCCLUSION 4. CLASS 1 OPENBITE 5. CLASS 1 DEEP BITE 6. FOR POST TREATMENT RETENTION www.indiandentalacademy.co
  • 38. CONTRANDICATIONS 1. In children with excess LFH-and extreme vertical mandibular growth . 2. In class –1 crowding. 3. Has limited application in non-growing children. 4. In severely proclined lower incisors. www.indiandentalacademy.co
  • 39. ACTIVATOR- AND ITS MODIFICATIONS www.indiandentalacademy.co
  • 40. FUNCTION REGULATOR OR FRANKEL APPLIANCE www.indiandentalacademy.co
  • 41. FRANKEL APPLIANCE Developed by Prof. ROLF FRANKEL of GERMANY Also called –Vestibular Appliance and Oral –Gymnastic appliance (FRANKEL –recommended certain oral excercises called oral gymnastics-hence the name) www.indiandentalacademy.co
  • 42. FRANKEL APPLIANCE( OR) FUNCTIONAL REGULATOR www.indiandentalacademy.co
  • 43. TYPES OF FRANKEL 1. FR1a 2. FR1b 3. FR1c 4. FR2 5. FR3 6. FR4 www.indiandentalacademy.co
  • 44. Parts of frankel:- 1.Buccal shields 2.Lip pads- upper and lower 3.lingual shield 4.Palatal bow 5.Labial bow—upper or lower 6.Lingual stabilizing bow 7.Canine clasp 8.protrusion bow 9.Lower lingual spring 10.Lower labial wires 11.Occlusal rest. www.indiandentalacademy.co
  • 45. Parts of FR-2-Class 2-div-1&2 The acrylic components include:- A.Buccal shields B.Lip pads C.Lower lingual pad The wire components include:- A. Palatal bow B.Labial bow C.Canine Extensions D.Upper Lingual wire E.Lingual crossover wire F.Support wire for lip pads G.Lower lingual springs. www.indiandentalacademy.co
  • 46. DIFFERENCES BETWEEN ACTIVATOR & FRANKEL www.indiandentalacademy.co
  • 47. LATERAL & MEDIAL PTERYGOID LATERAL PTERYGOID: It is a short & conical muscle. Has upper & lower head. MEDIAL PTERYGOID: Quadrilateral muscle Has superficial & deep head www.indiandentalacademy.co Dr VINEETH V T
  • 48. MODE OF ACTION OF FUNCTIONAL APPLIANCE www.indiandentalacademy.co
  • 52. Commonly used fixed functional appliances:- 1. Herbst Appliance 2. Jasper jumper 3. Forsus (Fatigue resistant device.) 4. MARA –Appliance (Mandibular anterior 5. repositioning device) 6. Eureka Spring www.indiandentalacademy.co
  • 53. FIXED MYOFUNCTIONAL APLIANCES www.indiandentalacademy.co