Professional Documents
Culture Documents
APPLIANCES
CONTENTS
DEFINITION
HISTORY
CLASSIFICATION
MECHANISM OF CRANIO FACIAL GROWTH
ADVANTAGES AND DISADVANTAGES
CRITERIA FOR CASE SELECTION
PRINCIPLES OF MYOFUNCTIONAL APPLIANCE
ACCORDING TO TOM GRABERS
CLASSIFICATION
BITE PLANE
INCLINED PLANE
ORAL SCREEN
VESTIBULAR SCREEN
DEFINITION
HISTORYTHE PAST
HISTORY.The past
HISTORY.THE PAST
HISTORY..The past
Alfred p.rogers
Sometimes called father of
myofunctinal therapy
Viggo andresen1920-ACTIVATOR
Not initially well
received .
Karl haupl:- became
enthusiastic, and
they together called
this the norwegian
system.
VIGGO ANDRESEN
HISTORY-----THE PAST
KARL HAUPL
HAUPL Applied roux concepts to the correction of
jaw and dental arch deformities.
Explained how functional appliances worked through
the activity of orofacial muscles.
HISTORY.The past
HISTORY-----------THE PAST
A. MARTIN SCHWARZ
HISTORY OF DEVELOPMENT OF
FUNCTIONAL APPLIANCE
ROBIN 1902-MONOBLOC
ANDRESEN 1920-ACTIVATOR
HERBST 1934-HERBST
BALTERS 1960-BIONATOR
BIMLER 1964-BIMLER
FRANKEL 1967-FRANKEL
CLARK 1977-TWIN BLOCK
CLASSIFICATION
1.
Stockfish
MYOTONIC APPLIANCES
Muscle mass
Activator, oral screen
MYODYNAMIC APPLIANCES
Muscle activity
Bimlers appliance
TOM GRABER
GROUP A
TOOTH SUPPORTED
GROUP B
TOOTH/TISSUE SUPPORTED
GROUP C
TISSUE SUPPORTED
ORAL SCREEN
INCLINED PLANES
ACTIVATOR
BIONATOR
FRANKEL APPLIANCE
VESTIBULAR SCREEN
REMOVABLE
APPLIANCE
ACTIVATOR
BIONATOR
SEMI FIXED
APPLIANCE
DEN HOLTZ
BASS APPLIANCE
FIXED
APPLIANCE
HERBST JASPER
JUMBER
MARS
PETER VIGI
CLASSIC FUNCTIONAL
APPLIANCE
ACTIVATOR
CATLANS APPLIANCE
FRANKELS APPLIANCE
HYBRID APPLIANCES
PROPULSOR
DOUBLE ORAL
SCREEN
HYBRID BIONATORS
PROFITT
FORCE ANALYSIS
TYPES OF FORCE
Types of forces
compressive
tensile
shearing
eg
Force elimination
Tensile strain
Optimal development
changes
1 orthopedic changes
Accelerating growth in condylar
region.
Remodeling of glenoid fossa
Restrictive influences and changing
direction of growth of jaws
DENTAL CHANGES
sagittal direction
upper anterior tip palatally.
lower anterior tip labially
Transverse direction
Shielding the buccal muscles away from dental
arch.
Bring about expansion by screws
Vertical direction
Selective eruption of teeth
Muscular hypothesis
Andersen-Haupl
Petrovic
and
McNamara
Viscoelastic hypothesis
Selmer-oslen
Harold
Woodside
Herren
Growth zone
Skeletoblasts$prechondrobla
st
Secondary cartilage
Primary cartilage
Growth zone
Functional chondroblast
ADVANTAGES
DISADVANTAGES
AND
ADVANTAGES
Helps in elimination of abnormal muscle function
aiding in normal development.
Less chair side time with less frequent adjustments.
Treatment can be started as early as mixed dentition
period, avoid psychological disturbance associated
with malocclusion
Worn during night, patient acceptance is good.
Do not interfere with oral hygiene maintenance.
LIMITATIONS
1.
2.
3.
4.
5.
6.
7.
8.
9.
Growth utilization
Correct diagnosis
Ideal and responsive type of malocclusion
Construction bite
Eruptive bite platform
Linguo facial screening
Force delivery/elimination
Patient cooperation
Patience
APPLIANCES
According to Kraus
Vestibular screen Appliances that extent into the
vestibule in contact with alveolar process, but did
not contact tooth at all.
PRINCIPLE
Force application as well as elimination.
Anterior segment influenced directly by appliance
-through muscle pressure.
Posterior segment influenced by keeping away of
cheek muscle allowing tongue posture and function
to expand posterior areas.
INDICATION:1.
are open]
thumb sucking
tongue thrusting
lip and cheek biting
construction
3 Extension - Into the sulcus to the point where
mucosal tissue reflects outwards. Care not to
impinge on frenum and muscle attachment.
Posteriorly - up to distal margin of last erupted
molar.
4 , Models covered with 2-3mm wax over labial surface
of tooth and alveolar process.
construction
Ensure that screen contacts maxillary incisors only
and stands away 3mm on each side from buccal
segment.
Open bite case no need expansion appliance
allowed to rest on tissue.
KRAUS
BITE PLANES
BITE PLANE
Thesearesimplefunctionalappliancesthat
bringaboutminor correctionsofthe
anteroposteriorrelationshipofthejaws.
Bite Plate.flv
INDICATION
Class I deep bite with
low facial height
CONTRAINDICATION
High facial height
Skeletal deep bite
Class II div II
Severely protruded/
retruded lower
anteriors
POSTERIORBITEPLANE
Indications:
Togiveocclusalclearanceforthecorrectionof
thecross
biteofeithertheanteriororposteriorteeth.
Fordiagnosisofocclusalprematurities
CONSTRUCTION:
covertheocclusalsurfaceofposteriorteet
h,
extendinganteriorlyfromfirstpremolartot
helast erupted toothposteriorly.
The thickness should be kept as minimum as
possible.
It is constructed as an extension of the
CLINICALMANAGEMENT
Whentheapplianceisdelivered,careistake
ntosee
thatthebiteplaneshouldcontactthebuccal
and
lingualcuspsoftheposteriorteethoftheopp
osingarchuniformlyonboththesides.
Thebiteplaneshouldbesufficientlythicktor
elievetheocclusalinterference.
Ifananteriorcrossbiteisbeingcorrect
ed,the
biteplaneneedsonlytobesufficiently
thickto
disengageocclusiononanteriorteeth.
Oncethecrossbiteiscorrected,themo
INDICATION-
Where anterior cross bite(single tooth or a segment
of upper arch) is developing with a good degree of
overbite and there is sufficient space for the
erupting teeth.
DESIGN
Fabricated using self cure acrylic, designed to have
a 45 angulation, which forces teeth in crossbite to
more labial position
MANAGEMENT OF APPLIANCE
Must be worn continuously, If appliance is removed
during eating the tooth will be forced back towards
original malposition.
DISADVANTAGES
1- Speech problem during therapy.
2- Anterior open bite if used for more than 6
weeks.
3-May need frequent recementation.
Thank you !