Various functional appliances & its components /certified fixed orthodontic courses by Indian dental academy

FUNCTIONAL APPLIANCES
• Also called Myofunctional
appliance.
• These appliance are used
for growth modification
procedure that are aimed
at intercepting & treating
jaw discrepancies.

Myofunctional appliances
Removable

Fixed

Activator, Bionator

Herbst appliance
Jasper jumper

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• Activator: By Anderson in 1908.
 Also called Norwegian
appliances.

Components-Labial bow
-Jack screw(Optinal in maxillary
arch)
-Acrylic portion

Indication1)Class II Div 1 malocclusion
2)Class II Div 2 malocclusion
3)Class III malocclusion
4)Class I openbite malocclusion
5)Class I deep bite malocclusion

Contraindication :1)Not used in correction of Class I problems.
2)In children with excess lower facial height.
3)Children with procumbent incisors.
4) Children with nasal stenosis.

Advantage :1)It uses existing growth of jaws.
2)Minimum oral hygiene problem.
3)Interval between appointment is more.
4) Appointments are usually short.
5) More economical.

Disadvantage:1)Require patient cooperation.
2)Can’t produce precise detailing & finishing of occlusion.
3)May produce moderate mandibular rotation.

Mode of activation :The activator induces musculoskeletal adaptation by a new
pattern of mandibular closure. This appliances fits
loosely in the mouth. The patient has to move the
mandible forward to engage the appliance. This results
in stretching of elevator muscles of mastication which
starts contracting thereby setting up a myotactic reflex.
In addition to this myotactic reflex, a condylar adaptation
by backward & upward growth occurs.

• Bionator:-By Balters in 1950s.
-Less bulky & elastic than
activator.
-3 types:
 Standard bionator
 Class III appliance
 The open bite appliance

1. Standard Bionator
-Used in treatment of
Class II Div 1 & Class I
malocclusion having narrow
dental arch.

2)Class III appliances:Used in mandibular prognathism. The
palatal arch is placed in opposite
direction. The vestibular wire runs over
the lower incisors instead of
terminating at lower canines.

3)The open bite appliances:Used in open bite cases. The palatal &
the vestibular arch wires same as
standard appliance. The maxillary
acrylic portion is modified so that even
the anterior area is covered.


• Indication:-Class II Div 1 malocclusion in the mixed dentition using
standard bionator under following condition
 Well aligned dental arches.
 Function retrusion.
 Mild to moderate dental discrepancy.
 Evidence of labial tipping is seen.

• Contraindication: Class II relation caused by maxillary prognathism.
 Vertical growth pattern.
 Labially tipped lower incisors.

• Advantage: Less bulky.
 Can be worn full time except during meals.
 Appliance exert a constant influence on
tongue & perioral muscle.

Disadvantage: Difficulty in correctly managing it.

•

Frankel Appliance:-

-Developed by Prof. Rolf Frankel.
-Also known as Functional regulator, Functional corrector,
Oral gymnastic appliance.

Principles1.
2.
3.
4.
5.

Vestibular arena of operation.
Sagittal correction via tooth borne maxillary anchorage.
Differential eruption guidance.
Minimal maxillary basal effect.
Periosteal pull by buccal shields & pads.

Types of functional regulators:FR 1- For treatment of Class I & Class II Div
1.
1a-Class I malocclusion where minor to moderate crowding is
present.
-Class I deep bite.
1b-Class II Div 1 malocclusion where overjet does not exceed
5mm.
1c-Class II Div1 malocclusion where overjet is more than
7mm.

FR 2-ClassII Div 1 & 2.
FR 3- Treatment of Class III.
FR 4- treatment of open bite & bimaxillary
protrusion.

• Herbst appliance:-Fixed functional appliance.
-Popularized by Pancherz(1979).
Indication-Dental Class II malocclusion.
-Skeletal Class II mandibular deficiency.
Contraindication-Dental & skeletal open bite.
-Vertical growth with high
maxillomandibular plane angle.
-Excess lower facial height.
-Case prone to root resorption.
Disadvantage-Prone to breakage.
-Lateral movement restricted.

• Jasper jumper:Consists of two vinyl coated auxillary
spring which are fitted to fully
banded upper & lower fixed
appliances.

Indication –
- ClassII malocclusion.
- Deep bite with retroclined lower
incisors.

Contraindication :-Dental & skeletal open bite.
-Minimum buccal vestibule space.
-Vertical growth pattern with increased
lower facial height.

Disadvantage:www.indiandentalacademy.com
Oral hygiene compromised.

Orthopaedic Appliances
•
•
•
1)

Head gear
Face mask
Chin cup
Head gear:-

-Most commonly used.
-Ideally indicated in patient with excessive horizontal
growth of maxilla with or without vertical change along
with some protrusion of maxillary teeth.
-Most effective in prepubertal period.
-Used for distalization of molars.

Components1)Face bow
2)Force element
3)Head cap /Cervical strap

 Face bow:
i)Outer bow- made up of 1.5mm round
stainless steel wire.This can be short,
medium or long.
ii)Inner bow- made up of 1.25mm round
stainless steel wire & contoured
around the dental arch and fixed in
buccal tube which is fixed on maxillary
first molar.Stop are placed to prevent
sliding from tube.

iii)The junction:It is a rigid joint of inner & outer bow. It is placed at the
midline of bows.
 Force element:It is the assembly which provide the force to bring about the
desired effect. This may comprises of spring, elastics & any
other stretchable material.
 Head cap:Used for anchorage purpose.

Principles of head gear: Centre of resistanceThe centre of resistance for a molar is usually at the midroot
region. Force applied through centre of resistance cause
bodily movement.
-if force pass below it- distal tipping of crown.
- if force pass above it- distal tipping of root.

 Centre of resistance of maxilla:It is located above the roots of premolar teeth.
Force passing through it – translation of maxilla in distal
direction.
Force passing above and below it- rotation of maxilla.
 Point of origin of force:i) Cervical
ii) Occipital
iii) Combination


•

Types-

i)Cervical:
-Take anchorage from nape of neck.
-Causes extrusion of molars.
-Can move maxilla & maxillary dentition
in distal direction.
-Indicated in low madibular angle cases.
ii)Occipital:
-Take anchorage from back of head.
-produce distal & superiorly directed
force on maxillary dentition &
maxilla.


iii) Combination:Force exerted by both are equal &
distal & slight upward force is
exerted on maxillary dentition &
maxilla.

2)Face mask:-Also called Reverse pull head gear
or Protraction head gear.
-By Hickham in 1972.
-Parts
i)Forehead cap
ii)Metal frame
iii)Chin cup
-Used primarily for protraction of
upper teeth or arch. www.indiandentalacademy.com

Types of face mask:i)Delaire type of face mask

ii)Tubinger type of face
mask

iii)Petit type mask


• Chin cup:It is sometimes referred to is an
extraoral orthopaedic device that
covers the chin & is connected to a
head gear.
It is used to restrict the forward &
downward growth of mandible.
-Types :
 Occipital pull chin cup
 Vertical pull chin cup


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Various functional appliances & its components /certified fixed orthodontic courses by Indian dental academy

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Various functional appliances & its components /certified fixed orthodontic courses by Indian dental academy