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TYPES OF ORTHODONTIC APPLIANCES Dr. Fitri Octavianti 12 th June 2013 Slide 2 Orthodontic Appliances Removable appliances Functional appliances Fixed appliances Slide 3 REMOVABLE APPLIANCES Appliances can be inserted and removed from the mouth by the patient Slide 4 Component of removable appliance Active component Retentive component Anchorage Baseplate Slide 5 Active components Slide 6 Active component of Removable Appliances Springs, bows Screws Elastics Slide 7 Active component of Removable Appliances Z-Spring 0.5 mm diameter SS Function: proclination of 1 or 2 incisors Slide 8 Active component of Removable Appliances T-Spring 0.5 mm diameter SS= incisors 0.6 mm diameter SS=premolars Function: proclination of incisors, premolars Slide 9 Active component of Removable Appliances Finger /palatal spring 0.5 mm diameter SS= incisors 0.6 mm diameter SS= canine and premolars Function: mesial or distal movement Slide 10 Active component of Removable Appliances Labial Bow 0.7 mm diameter SS Function: retraction of anterior teeth Slide 11 Active component of Removable Appliances Split Labial Bow 0.7 mm diameter SS Function: Retraction of anterior teeth and close midline diastema Slide 12 Active component of Removable Appliances Robert Retractor 0.5 mm diameter SS + sleeve Function: retraction of anterior teeth Slide 13 Active component of Removable Appliances Buccal canine retractor 0.7 mm diameter SS Function: Palatal and distal movement of mesially angulated canines Slide 14 Active component of Removable Appliances Coffin spring 1.25 mm diameter SS Function: transverse expansion, buccal crossbite correction Slide 15 Active component of Removable Appliances Screw Function: Expansion and distalization Activation: 1 turn / week = 0.25mm (1/4 turn) Slide 16 ELASTICS Rubber or Latex rings Used in: Extra oral traction Inter-intramaxillary traction Patient cooperation Slide 17 Retentive components Slide 18 Types of Clasps 1. Adams Clasps 2. Southend Clasps 5. Delta Clasps 4. Ball-ended Clasps 3. Labial bow Slide 19 Retentive component of Removable Appliances 0.7 mm diameter SS on molars 0.6 mm SS on premolars, canine and deciduous molar Adams clasps Slide 20 Retentive component of Removable Appliances 0.7 mm diameter SS Southend clasps Function: Useful when distal movement of canines required Slide 21 Retentive component of Removable Appliances 0.7 mm diameter SS Labial bow Function: - Retention - important when mesial / distal movement is planned Slide 22 Retentive component of Removable Appliances Labial bow Short labial bow Long labial bow Slide 23 Ball- ended Clasps Undercut interproximally minimal retention 0.7 mm diameter SS Slide 24 Delta Clasps 0.7 mm diameter SS Difficult to adjust Slide 25 Anchorage Definition: the resistance to unwanted tooth movement equal in magnitude and opposite in direction Slide 26 Types of intra oral Anchorage Simple Reciprocal Stationary Intermaxillary Slide 27 Types of INTRA ORAL Anchorage Simple Anchorage Active movement of few teeth versus several anchor teeth Slide 28 Types of intra oral Anchorage Resiprocal Anchorage When two teeth or two sets of teeth move to an equal extent in an opposite direction Slide 29 Types of intra oral Anchorage Stationary Anchorage Bodily movement of one group of teeth against tipping of another Slide 30 Types of intra oral Anchorage Intermaxillary Anchorage When the anchorage units situated in one jaw used to provide the force required to move teeth in the opposing jaw Slide 31 Baseplate 1. Hold components 2. Clear acrylic : - heat cure - cold cure - autoresin 3. Comfortable 4. Good fit 5. Can be active - biteplanes Slide 32 Baseplate Posterior biteplanesAnterior biteplanes Slide 33 REMOVABLE OR FIXED ORTHODONTIC APPLIANCES WHICH USE FORCES GENERATED BY THE STRETCHING OF MUSCLES, FASCIA, AND /OR PERIODONTIUM TO ALTER SKELETAL AND DENTAL RELATIONSHIPS FUNCTIONAL APPLIANCES Slide 34 TYPE OF CASE For correction of moderate to severe Class II div I and Class II div 2 Less for correction of Class III due to much lower success Slide 35 INDICATIONS PATIENT 1.Growing patient 2.Motivated patient DENTAL 1.Classic case: uncrowded, well aligned 2.Functional appliance have non-mechanism for treating irregularities of alignment of teeth SKELETAL 1.Moderate to severe Class II skeletal base 2.Normal to low MMPA Slide 36 CONTRA INDICATIONS Non-growing Non compliance Labial tipping of lower incisors Care needed with: High angle cases with backward mandibular growth rotation Cases with proclined lower incisors Slide 37 TYPES OF FUNCTIONAL APPLIANCE TWIN BLOCK THE ANDRESEN ACTIVATOR THE HARVOLD ACTIVATOR HERBST APPLIANCE MEDIUM OPENING ACTIVATOR BIONATOR FRANKEL APPLIANCE Others Slide 38 Twin block appliance The upper and lower parts fit together using posterior bite blocks with interlocking biteplanes which posture the mandible forward Slide 39 The Andresen Activator Slide 40 Herbst Appliance A fix-functional appliance. Slide 41 Bionator Minimal bulk Slide 42 The Frankle Appliance Is a functional regulator and uses shield. Complex, uncomfortable, rapid changes if worn properly. Three main variants: FR1: Class II div 1 FR2: Class II div2 FR3: Class III Slide 43 WEAR 12-14 hrs-Andresen, Harvold, Bionator Full-time- twin block, Herbst, Frankel (except for eating and sports) Slide 44 APPLIANCE WHICH IS FIXED TO TEETH AND CANNOT BE REMOVED BY THE PATIENT FIXED APPLIANCES Slide 45 2. Axillaries (attach arch wire to brackets and bands to move teeth such as tubes, hooks and elastics 3. Arch wires are attached to the brackets by bending the wire, it will give force and pressure that cause teeth to move in the desired direction. 1. Attachments include bands (especially on 1 st and 2 nd molars) & brackets bonded directly to the teeth (especially on anterior & premolar teeth). COMPONANTS OF FIXED APPLIANCE Slide 46 A B C D E F G A. Bracket B. Arch wire C. Elastomeric modules D. Elastic E. Hook F. Tube G. Band Slide 47 Full banding braces Slide 48 Metal bracket Slide 49 Plastic bracketsPlastic brackets with metal slot Slide 50 Ceramic brackets Slide 51 Self ligating bracket Slide 52 Self ligating clear bracket Slide 53 Lingual appliances Slide 54 Slide 55 Clear plastic appliances Slide 56 Fixed AppliancesRemovable appliances - Precise three dimensional control of tooth movement - Less precise control of tooth movement - Bodily tooth movement - Tipping movement - High anchorage requirement - Smaller anchorage requirement - Controlled space closure possible - Controlled space closure difficult - Simple to correct rotations - More difficult to correct rotations. - Long chairside time - Short chairside time - Not dependent on compliance to wear - Dependent on compliance to wear - Require extensive training to manage - Require less training to manage - Multiple tooth movement - Fewer tooth movement