functional appliances mode and action i & r
TRANSCRIPT
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Functional Appliance
and
The Mode of Action
By :
Islam Yehia
Raghed Michael
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Functional appliances
• They do not act primarily on teeth like
conventional appliances (springs, elastics)
• They transmits, eliminate or guide natural
Forces
• Natural forces that can be controlled by
functional appliances are: muscle activity
from the tongue and check, tooth eruption,
and growth and development
• The most favorable age for therapy
– 8-11 years for girls
– 10-13 years for boys
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Why treat malocclusion?
• Possible pre-disposition to disease
• May lead to jaw dysfunction
(TMD, Speech, Mastication)
• Facial esthetics with psychological effects
• Single or multiple tooth damage
Indications for functional
Appliances
• Well aligned dental arches
• Posterior positioned mandible
• Non severe skeletal discrepancy
• Lingual tipping of mand. incisors
• Proper patient selection
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History of development of
functional appliances
• Robin 1902- monobloc
• Andresen 1908- Activator
• Herbst 1934- Herbst
• Balters 1960- Bionator
• Bimler 1964 – Bimler
• Frankel 1967- Frankel
• Clark 1977-Twin Block
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Historical biases of Europe and
America on functional appliances
European
• Functional approach most
biocompatible
• Mechanical force deemed
unbiologic
American
• European social system
excluded extensive fixed
appliance therapy
• Question of precision of results
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Duration and timing of wear
• Functional appliance treatment
should be started before the
pubertal growth spurt.
• This is the time when the
mandible may exhibit increased
growth which may be influenced.
• Functional appliances should be
worn for at least 10-12 hours a
day.
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Night Time
VS
Day Time
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Growth
Theories
Scott’s
Cartilaginous
Growth Theory
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Sitcher’s
Sutural Growth
Theory
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Moss’s Functional Matrix Theory
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Form
follows
function
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Polyvinyle sialoxane bite registration material
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Polyvinyle sialoxane bite
registration material
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Wax bite material
preformed to arch shape
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Activator
Woodside & harvold
activator
Herbst
Bionator
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Activator facts
• Tooth borne passive appliance • Original design worn at night
• Large one piece of acrylic
• Teeth could be redirected during eruption
• Large vertical opening construction bite
• Could not speak or eat when worn
• Advances mandibular jaw
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• The original andersen activator was designed with
angled flutes to guide the eruption of the molars for the
upper molars distally and the lower molars mesially as
they erupt
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• New design
• Lingual flanges contribute to its action
• Upper cant erupt
• Lower free to erupt
• Rotation of occlusion and correction of class II cases
Displacement
springs
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Bionater
•
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Twin block
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Frankel
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Herbst Appliance ( a.k.a. the “shock absorber” or "Bite Jumper")
•correction of ant-post relationships of upper and lower jaws.
• encourages mandibular growth, eliminate extractions and surgical corrections with
headgears.
•The appliance is formed from a rod and tube (called the “shock absorber”) and actually
connects the upper and lower jaws.
• fully intraoraly and doesn’t interfere with function.
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Herbst facts • Fixed to teeth
• Patient compliance not required
• Works 24 hours
• Less airway blockage
• Most popular type at present time in U.S.
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Arms guide the lower jaw
forward to the ideal jaw
position
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Upper Molars : Distalization
/Intrusion / Expansion
Upper Incisors : Retrusion /
Uprighting / Extrusion
Lower Molars : Mesialization /
Extrusion
Lower Incisors : Protrusion /
Intsusion
Reposition the Mandible
Jasper Jumper
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MARA Appliance (mandibular anterior
repositioning appliance)
Correction of anteroposterior relationships of
upper and lower jaws.
Works by guiding the mandible forward with
occlusion.
Completely intraorally so
better compliance
and aesthetics.
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Indications for the MARA
Ø The upper jaw is in good position and you
want to advance the mandible.
Ø It is desirable to inhibit maxillary anterior
growth and produce an increase in
mandibular length.
Ø You want to recapture a prolapsed disc.
Ø Adult cases, when lower jaw surgery is not
an option, needing a good compromise
Class II correction. While the result is
mostly dental, some mesial migration of the
fossa may occur.
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THE END
Special thanks for
Assisst. Prof.
Amjad Al-Taki