1ST QUIZZ Flashcards
physiological process associated
with growth in which the tooth moves from its original
position either in the maxilla or mandible to its final
position in the oral cavity but this process can be
affected by multiple congenital or environmental
causes
DENTAL ERUPTION
What phenoms does the eruption considers:
- root development
- alveolar bone growth
- eruption secuence
Phases of tooth eruption
1) pre eruptive
2) pre functional
3) functional
It takes place inside the bone
and there is only a lateral
displacement from the point of origin of the dental lamina
towards the covering gum
Pre eruptive phase
1)Differentiated area in bone
tissue.
2)Calcification of the crown.
3)Fully outlined crown.
Tooth eruption phase
pre eruptive phase
- This cord has connective tissue and remains of
the dental lamina that cross the bone during
the eruption of the tooth - Many osteoclasts appear in the _________ ________that will enlarge this canal for the passage
of the tooth.
The reduced epithelia will join to the oral
epithelium and then the fused epithelia are
formed, an when the apoptosis occurs (due to
avascularization) it allows the tooth to emerge.
gubernacular cord
It begins when 50%/75% of the tooth root is
formed.
There is an intense vertical displacement
which allows the tooth to move towards the mucosa
pre functional phase
It begins at the moment the
tooth makes contact with the
antagonist and begins to
perform the chewing function
This lasts the entire life of the tooth
Functional phase
What factor can affect the tooth eruption process?
- craniofacial growth & development
- heredity
- Genetic control of the growth peak and sequence of dental development
Nolla’s table
(aprender o guardar foto)
Aprenderse cronología de la erupción temporal y permanente
constitute one of the local factors associated with the etiology of malocclusions can cause alterations in dental alignment and create more complex malocclusion problems.
anomalies of number (such as supernumerary or hyperdontia or hypodontia)
what are some of the consequences of dental anomalies when developing of occlusion:
- delat in the normal eruption of the teeth
-ectopic eruption
-Changes in the midline
-Transpositions
-rotation
-abnormal spacing
Mention all the dental anomalies seen in class
- supernumerary
- agenesia
- microdontia
- macrodontia
It is the absence of one or more dental organs and is a common developmental anomaly in both dentitions (deciduous and permanent) it is the result of a disorder of the dental lamina
which prevents the formation of the tooth germ. The absence isoften bilateral
AGENESIA
what are the most frequently absent dental
- third molar
- upper lateral incisors
- Ldl
is an alteration in the eruptive trajectory of the dental organ leading to its impaction against the adjacent tooth. Ectopic teeth are found in unusual positions or displaced from their normal anatomical location. The presence of an ectopic tooth can lead to malocclusion.
Ectopic eruption
is the change in the position of two adjacent teeth in relation to
their roots in the same quadrant of the dental arch which can lead
and inverted eruption position and alter the normal sequence of
eruption. They are generally unilateral, more frequent in the upper
arch.
transposition
despite of having been fully formed they have not emerged in the mouth during the usual period, and they can remain partially or completely inside the jaw bone
impacted teeth
Klinefelter syndrome and Down syndrome what can occur in these syndromes
taurodontism
Mention the factors that can cause the dental anomalies
- Systemic factors
- Genetic factors
- Environmental factors
Any alteration in the bone growth of the maxilla or mandible and
in the dental positions that impede the correct function of the
chewing system with the subsequent consequences that this
dysfunction has on the teeth themselves the gums and the bones
that support them the temporomandibular joint and facial
aesthetics
Malocclusion
What are the general factors of the malocclusion?
- hereditary
- congenital defects
- oral habits
- trauma and accidents
local factors of the malocclusion
- anomalies in the number of teeth
- ’ tooth size
3 ‘ dental shape - premature loss of decidious teeth
- late eruption of permanent teeth
- prolonged retention of decidious teeth
- Cavities
It is the anteroposterior relationship between the upper and
lower permanent canines.
Canine classification
A normal molar relationship but there’s other alignment irregularities
Angle’s Class I
Mesibucal cuspid of the 1st permanent upper molar occludes in front of the buccal grove
Angle’s Class II
Mesiobuccal cuspid of the 1st upper molar ocludes behind of the buccal groove
Angle’s Class III
The cusp of the upper canine occludes between the canine embrasure and the lower first premolar
Class I (Canine classification)
The cusp of the upper canine occludes IN FRONT the embrasure of the canine and the lower first premolar
Class II (Canine classification)
The cusp of the upper canine occludes BEHIND the embrasure of the canine and lower first premolar
Class III (Canine classification)
Area occupied by the dental papilla.
Embrasure
which are the anomalies in the number of teeth?
agenesis
supernumerary
Characteristic of the agenesis
- absence can be seen in both arches
- absence usually bilateral
- more common in permanent teeth
Mention the 2 types of agenesis
Hypodontia
Anodontia
Is the absence of formation of three or more dental
organs
The most common one:
Third molars.
Upper lateral incisors
Hypodontia
Disorder in which there are no temporary or permanent teeth because of the congenital absence of tooth germs. This alteration is classified according to the number of missing teeth and can be partial or total
Anodontia
characterized by
having more teeth than the regular number of teeth
hyperdontia
a is due to the hyperactivity of the
dental lamina with the consequent formation of additional tooth germs
hyperdontia
They appear more frequently in the maxilla.
* When the affected region is located in the midline
of the palate between the two upper central
incisors it is called mesiodens.
*Heredity seems to play a more significant role in cases of
missing teeth and also in supernumerary teeth.
Supernumerary teeth
which are the three types of supernumerary teeth?
- Supplementary teeth
- Conical teeth
- Mesiodens
It has a normal morphology and size.
They appear in permanent dentition as
extra upper lateral incisor or as
lower incisor.
Supplementary teeth
They present a conical crown and smaller root than a normal tooth
Conical teeth
Type of conical teeth that is located in the premaxilla near the midline between the upper
central incisors is known as
MESIODENS.
Which are the 2 types of Anomalies in the tooth size
- microdontia
- macrodontia
The term microdontia is applied to teeth that are smaller than the limits of variation considered normal.
Microdontia
which are the 3 types of microdontia?
- True generalized microdontia
- Relative generalized microdontia
- Localized microdontia
It is the most common type of microdontia and it usually affects the upper lateral incisors and third molars.
Localized microdontia
The term _______ is applied to
teeth that are bigger than the limits
of variation considered normal.
Macrodontia
which are the 3 types of macrodontia
- true generalized macrodontia
- Relative generalized macrodontia
- Localized macrodontia
It is a very rare condition and has been observed in some cases of pituitary gigantism and hemifacial hypertrophy
True generalized macrodontia
It is the result of a bonedental discrepancy where
the size of the teeth is bigger related to the jaws.
Relative generalized macrodontia
It is not common and its etiology is unknown;
it mainly affects the upper central incisors.
The macrodontic tooth is a normal tooth in all
respects except its size.
Localized macrodontia
Characteritics of the anomalies in the dental shape
Dental morphology is determined by
genetics.
Alterations in the shape of the teeth
can be present in any dental group.
Classification in the dental form
- fusion
- gemination
- dilaceration
- dens in dente
Is the union of two developing
teeth into a single structure.These teeth may have two independent pulp canals
Fusion
From a single enamel organ two teeth form or attempt to form and normally there is only one pulp canal.
Germination
Its an excessive root angulation
and may be the result of a trauma
in the deciduous dentition
Dilaceration
Also called an invaginated tooth.
This developmental anomaly is a lingual invagination of the enamel and can occur in primary and permanent teeth
Dens in Dente
Refers to the early loss of primary teeth that can compromise the natural maintenance of the perimeter or arch length and therefore the eruption of the substitute tooth.
Premature loss
The deciduous teeth not only serve as
dental organs for chewing they also
serve as “____ ______” for the
permanent teeth.
space maintainers
what are some of the problems premature loss can lead to:
- loss of dental balance
- shortening of the arch lenght
- extrusion of the opposing tooth
- Problems in the ATM (TMJ)
- Early prosthetic tx
what are some of the possible causes for premature loss on primary teeth?
- diseases (dental such as caries, periodontitis, etc)
- involuntary causes (trauma)
- bad oral habits (causing mobility and tooth loss before than expected)
also constitutes a disorder in the development of the dentition.
Mechanical interference can cause the permanent teeth and cause a bad position and leading a malocclusion.
Prolonged retention of deciduous teeth
if a delay of more than six months of the eruption of a permanent teeth we may be facing a case of ________________
Prolonged retention of deciduous teeth
This may be due to physical barriers such as: dense tissues, bone crypts at the line of eruption of the permanent tooth, supernumerary teeth that prevent the eruption.
Delayed eruption of
permanente teeth
what are the barriers (3) that doesn’t allow the permanent teeth to erupt and so the delay the whole process
Supernumerary teeth.
Deciduous roots.
Bone barriers.
Is the union/fusion between a tooth and the alveolar
bone.
This is due to some type of injury, which causes
perforation of the periodontal ligament and the
formation of a “bone bridge” joining the cement and the hard sheet.
Ankylosis
Relationshionship between cavities and maloclusions
(Interproximal cavities)
represent one of the most common causes of space loss
Which are the three types of Anomalies in the dental structure
- Imperfect amelogenesis
- Imperfect dentogesisis
- Dentin dysplasia
Its a hereditary disorder of enamel formation affecting primary and permanent dentition.
Imperfect amelogenesis
There are 3 types of imperfect amelogenesis
- Hypoplasic
- Hypocalcified
- Hypomaduration
is the type of imperfect amelogenesis in which he enamel does not have normal thickness in certain areas or in its entirety.
Hypoplasic
is the type of imperfect amelogenesis in which he enamel has a normal thickness but is fragile and can be easily
removed.
Hypocalcified:
is the type of imperfecte amelogenesis in which the thickness of the enamel is normal but it doesn’t have a
normal hardness and transparency and opaque spots appear on the incisal edges of
the teeth.
Hypomaturation
It consists on opalescent teeth made up of
irregularly formed and hypomineralized
dentin that obliterates the coronal root
and pulp chambers. The teeth range in
color from bluish gray to yellowish.
The dentin is abnormally soft, despite to
the exposure of dentin the teeth are not
especially prone to dental caries
Imperfect dentogenes
It is an inherited disorder characterized by abnormal
dentin formation and abnormal pulp morphology
Dentin dysplasia
Which are the two types of dentin dysplasia?
Type I: root dentin dysplasia
Type II: Coronal dentin dysplasia
Type of dysplasia in which Teeth are affected in both
dentitions. The teeth have a normal color and in some cases may present a bluish or brown transparency in the cervical region. The roots of the teeth
are short, blunt, bulging, conical, or absent.
Type I Root dentin
Type of dysplasia in which Both the primary and permanent dentition are affected in this type of dysplasia, however the appearance of the temporary teeth is different from the permanent
teeth. Primary teeth clinically show a bluish gray, brown or yellowish color and have a translucent or opalescent appearance, the permanent teeth appear clinically normal and the roots in both dentitions are normal.
Type II
‘Straight’ ‘dentition’
Orthos Odontos= orthodontia
He was a major contributor in the early
development of orthodontic treatments
Normal W. Kingsley
Father of the modern orthodontics
E. Angle
specific area of dental practice that has as its responsability the study and supervision of the growth and thedevelopment of the dentition and its related
anatomical structures from birth to dental maturity, including all preventive and corrective procedures of dental irregularities requiring the repositioning of teeth by functional or mechanical forces
Orthodontics
Study Field of orthodontics
- prevention & correction of malocclusions
-tx and dento-facial abnormalities - growth of the cranio-facial complex
- development of malocclusion
The objective is to act before the appearance of malocclusions when the diagnosis indicates that they are going to occur and will alter the normal development of the dental and maxillary/mandible organs. It is usually applied at young ages to avoid possible malocclusion.
Preventive orthodontics
Types of space mantainers
- nance bottom
- lingual arch
- band and loop
The aimed is to correct bad dental positions or habits that are occurring but they can still be treated to change their evolution.
Interceptive orthodontics
Interceptive orthodontics methods
- serial extractions
- correction of developing crossbite
- control of oral habits
- removal of supernumerary and akylosed teeth
Mention all the bad oral habits
- thumb sucking
- Onychophagy
-Tongue thrusting
-Mouth breather - Lip biting
It is applied when the malocclusion has already been
established and has altered the normal course of the
dentofacial complex.
Corrective orthodontics
Mention the orthodontic’s goals
- facial aesthetics
- dental aesthetics
- functional oclussion
- periodontal health & stability
Teeth have a strong tendency to move mesially even
before they erupt into the mouth; this phenomenon
has been called the
mesial thrust tendency
Appliances used to maintain space or regain the mayor amount of space so that they can guide the eruption of the permanent teeth into a proper position.
Space Maintainers
The most important function of space
maintenance is to maintain the ________ relationship
mesiodental
what’s important to mantain in the primary and early permanent dentition is important for the normal development of the occlusion.
the arch length
Functions of space mantainers
- Maintain arch length and perimeter.
- Prevent space loss.
- Prevent the development of a malocclusion or reduce it’s severity
Requirements that a space
maintainer must have
- Maintain the desired proximal space.
It should not interfere with the eruption of the
permanent successor tooth.
It should not interfere with the opposite tooth.
It must provide enough mesiodistal space for
permanent teeth.
It should not interfere with phonation, chewing or
functional jaw movement.
They should be simple in design.
They should be easy to clean and maintain.
IDEAL CHARACTERS OF THE
SPACE MAINTAINERS
- Simple
- Strong and stable
- Passive (not cause teeth movement)
- Do not increase the risk of caries development
General considerations for the placement of space mantainer
a) time elapsed after loss
b) px’s dental age
c) amount of space loss
d) tooth eruption sequence
e) late eruption of permanent teeth
Consequences of premature loss
- Decrease in the perimeter and length of
the arch with the consequent deviation
from the midline.
Causing malocclusions such as crowding,
ectopic eruption or impaction of
permanent teeth.
Alteration of the molar and canine
relationship.
Changes in the vertical plane such as
deep bites, and in the transverse plane
such as crossbites
Planning for the space maintainance: we need
- Clinic exam
- X-rays
- Dental Casts
Type of space mantainer
a) unilateral (band & loop)
b) bilateral (lower lingual arch, transpalatal arch, nance appliance, removable acrylic appliance)
The indication for placement of a
band and loop space maintainer is for
loss of the
first primary molar
The band & loop is indicated to maintain the space for a missing second primary molar, only if we have
the presence of
the first permanent molar
Advantages of band & loop
Allows the eruption of permanent
teeth.
Easy to construct and adjust.
Not expensive.
Non-invasive or painful
The indications for a lingual arch
space maintainer are:
Bilateral loss of the mandibular
primary molars after eruption of the
permanent incisors.
* Unilateral loss of more than one tooth
in the mandibular arch
Its design is of bilateral bands on
molars that are connected by a
heavy wire that rests on the
cingulum of the anterior incisors
LOWER LINGUAL ARCH
Its design is made of bilateral bands
on the first molars that are connected
by a heavy wire, and the arch wire is
directed toward the palatal surface
and is embedded in an acrylic button
resting on the soft tissue.
nance appliance
The indications for a Nance appliance
are:
Bilateral loss of the maxillary primary
molars.
Unilateral loss of more than one tooth in
the maxillary arch
Its design is made of bilateral bands on the first
molars that are connected by a heavy wire that
transverse the hard palate without touching soft
tissue. Although it is easier to clean than the
Nance appliance but it is not as stable,
especially when bilateral second primary
molars are missing
TRANSPALATAL ARCH
indications for a Transpalatal Arch
appliance:
Bilateral loss of the maxillary primary molars.
Unilateral loss of more than one tooth in the
maxillary arch.
In the mandibular primary dentition, a
loss of the second primary molars along
with the both first primary molars, will
indicate the placement _______ ________.
of an acrylic
appliance
Removable acrylic appliance is
indicated:
There has been a loss of more than
one tooth in a quadrant, and the
permanent molars have’nt
erupted yet
It is a procedure within the field of
Interceptive Orthodontics that can
be applied in cases of bone-dental
discrepancy where the supporting
bone is less than the sum of the
size of the dental materia
SERIAL EXTRACTION
was the first to propose in one of his dental
treatises, the extraction of deciduous teeth to achieve
greater alignment of the permanent dentition.
Pierre Fauchard
It’s a timed planned
sequential extraction of certain
deciduous teeth followed by the
removal of specific permanent
teeth in order to guide the
eruption permanent teeth into a
favorable position.
SERIAL EXTRACTION
SERIAL EXTRACTION is based on 2 principles
a) Arch Length /tooth size discrepancy.
B) Physiologic tooth movement
Indication for serial extractions
a) Premature loss of primary teeth.
b) Arch length deficiency and tooth size discrepancy
.
c) Crowded maxillary and mandibular incisors.
d) Class I malocclusion.
CONTRAINDICATIONS of serial extractions
- Severe Class II or Class III malocclusion.
- Cleft palate cases.
- Extensive caries of first permanent
molar
Methods of serial extractions
a) DEWEL METHOD
b) TWEED METHOD
c) METHOD NANCE
Extraction of deciduous canines, followed by
deciduous first molars an finally first premolars
Dewel Method
Extraction of deciduos first molar, followed by first
premolars and then deciduos canines.
Nance Method
- Extraction of deciduos first molar, followed by the
first premolars then the decidiuos canines and
laterals
Tweed method
Mention 3 clinical findings in the
Thumb sucking habit:
Proclined upper incisors.
b) Retroclined lower incisors.
c) Finger involved( dry chapped skin) and
calloused digits
Mention 3 clinical findings in the
Lip biting habit
a) Proclined upper incisors.
b) Retroclined lower incisors.
c) Enlarged, red lower lip.
Mention 3 clinical findings in the
Tongue thrusting habit
a) Proclined upper incisors.
b) Proclined lower incisors.
c) Anterior spacing
Mention clinical findings in the
Nail biting habit
a) Anterior spacing and misalignment.
b) Exposed nail beds.
Mention 4 clinical findings in the
Mouth breather habit:
a) Narrow upper arch.
b)Posterior crossbite and anterior open bite.
c) Incompetent dry pale lips.
d)Swollen dry gingiva.
Mention 3 clinical findings in the
Bruxism habit
a) Tooth fractures.
b)Prominent masseter muscles.
c)Jaw’s pai
t is a routine behavior that is repeated
regularly and tends to occur unconsciously.
a habit
are the most frequent causes of these badformations mostly seen in the early childhood and mixed dentition
stages.
habits
a oral habit depends on:
a) intensity
b) duration
c) frequency
Which bad oral habit plays the most
critical role in the tooth movement
duration
Clinical and experimental evidence suggests that ___to ___ hours of force per day are enough to cause tooth
movement
4 to 6
Is the placement of the thumb or more fingers in the
oral cavity with repeated and forceful sucking
movements associated with strong buccal and lip
contraction
Thumb sucking (active and passive)
Treatment approaches of sucking habit include:
Direct Interview.
II. Reward System.
III. Reminder therapy appliance and non-appliance
reminders.
IV. Appliance Reminder Therapy.
Mention the 2 types of appliance reminder therapy
1) removable palatal crib
2) fixed palatal crib
Abnormal tongue function and posture that cause
many malocclusions. The effects and management
at early stages may be helpful to prevent future
severe skeletal malocclusions.
Tongue thrusting
Types of tongue thrust
A) Anterior tongue thrusting.
B) Posterior tongue thrusting.
C) Both: anterior/posterior tongue thrusting.
D) Lateral tongue thrusting.
E) Unilateral tongue trusting.
treatment of tongue trusting
Myofunctional therapy.
II. Simple habit control.
III. Habit-breaking appliance.
types of appliance therapy for tongue trusting
a) Removable appliance it has an active component bow as a
remainder and the tongue crib has retentive components and
acrylic base plate.
b) Nance palatal arch appliances which has an acrylic button
that can be used to place the tongue in the correct position.
c) Using fixed appliances with fixed tongue cribs.
Is the habitual breathing through the mouth instead of
nose and it can be abnormal when the patient breathes
through the mouth even during rest.
In about 85% of cases mouth breathing represents an
involuntary subconscious adaptation to reduced patency of
the nasal airway and mouth breathing is a simply
requirement in order to get enough air.
Mouth breathing
Etiology of the motuh breathing
1) obstructuve ( a complete obstruction through the nassal passages)
2) habitual (continuous breathing)
3) anatomic ( a short upper lip)
Almost all mouth-breathing patients should be referred to the
specialist so
to the Otorhinolaryngology
One of the most effective ways to
reestablish the nasal breathing is
preventing the access of air
through the oral cavity by this we use a ____ ______.
which consist on a thin sheet of acrylic
extending deep into the vestibular sulcus and the labial & buccal breathing holes can be punch out
so that they can allow the
entrance of some amount of air
into the mouth
Oral screen
Involves manipulation of the lips and perioral
structures there will be a big overjet with the
protrusion of the upper anterior teeth and a lingual
inclination of the lower anterior teeth followed by a
skeletal discrepancy.
Lip biting
The treatment of lip biting should be direct towards the etiology of the habit.
Appliance fixed therapy: lip bumper
is made of stainless steel
wire . It is placed on the jaw from the right
molar to the left molar. The curve of this lip
bumper is located more to the gingival margin
direction, 3 mm from the labial teeth surface.
The anterior area can be covered by
plastic or acrylic which functions are to
help the adaptation of lip and cheeks
muscles, so the pressure of lip muscle on
teeth will decrease
lip bumper
Is a common oral habit noticed in children and
adults.
The etiology includes: anxiety, stress, loneliness,
imitation of other family member, inactivity,
transference from a thumb-sucking habit.
Onicofagia
tx for onicofagia
- application of chemical with hot flavor on the nail area
Adenioid long face, incompetent lip
posture and narrow external nares are
Extraoral features.
Their mechanical properties result in simple tipping
movements of teeth, therefore multiple simultaneous tooth
movements with apical control are not possible. It is for these
and other reasons that removable appliances are usually
only indicated for specific interventions in the mixed dentition,
and the appliance choice in specific cases of permanent
dentition.
Removable Appliance
Active removable appliances
Mechanical appliances: Carry some active
components which are activated to exert active forces.
Functional appliances: Work by modifying muscle forces and
exerting intermaxillary action
Passive removable appliances
These appliances remain passive in the mouth and they
don’t exert active pressure.
Example:
Space maintainers.
Retainers.
these movements areproduced when a single
force is applied against the crown of the tooth
Tipping movements
Indications of RA
Provide a useful means of extra oral force to a
teeth segment or an entire arch to help
achieve intrusion or distal movement.
Also employed for arch expansion which is
another example of their usefulness in moving
blocks of teeth.
They are use in a passive role as a space
maintainers and also as retainers appliances.
Components of RA
a) Retentive components
b) Active components
c) Baseplate Anchorage
These components help to retain
the appliance in place and resist
displacement.
The effectiveness of the active
components depend on retention
of the appliance.
Good fixation will help patient
compliance, anchorage and tooth
movement.
retentive components
types of retentive components in RA
Labial arch
Clasps
Used for two retention
purposes:
As a component of the
Hawley retainer.
Can also bring a minor
overjet reduction.
Labial arch
Are placed between the
maximum circumference of
the neck of the tooth and
they provide excellent
retention should not apply
active force and no
interference with
occlusion.
Clasps
In the active components, they Apply forces to the teeth,
so that they can bring the
desired tooth movement.
SPRINGS
types of active components (springs)
Simple Spring
Compound Spring
consists of 2 helix of small
diameter can be made for 1 or more incisors.
The spring is placed perpendicular to the
palatal surface of the tooth with a long
retentive arm.
Indication:
To move one or more teeth in the same
direction, example: the pro-inclination of 2
or more upper incisors for the correction of
anterior tooth crossbite.
Z spring (simple spring)
Finger spring.- the helix is
placed opposite to the direction of the
intended tooth movement.
It should also be placed along the long
axis of the tooth to be moved,
perpendicular to the direction of tooth
movement.
Indication:
Mesio-distal movement of teeth.
Example: closure of anterior
diastemas.
Compound Spring
It forms the major part of
removable appliance.
It acts as a major connector
that connects the other
individual components and it
also distribute the reaction forces
to the anchorage areas
baseplate
Passive (used as a major connector)
Active ( by modifyng as the anterior or posterior bitplane)
several important points to be considered when using a
removable appliance
Oral hygiene maintenance, is less complicated for patients.
It shortens the fixed orthodontic treatment when is used in the
preliminary stage of the treatment plan.
As an interceptive method, the appliance may be recommended for
those with an increased overjet (protruded upper anterior teeth) in the
middle mixed dentition age.
It has a lower relapse rate during retention period compared to fixed
appliances.
In other cases the outcome of the treatment should be maintained with
subsequent fixed treatment.
Functional Appliances
Also called
Myofunctional
appliances.
They have no active components
such as springs or elastics but
instead they use harness forces
generated by the masticatory
and facial musculature.
This is achieved by constructing the
appliance such that it holds the
mandible in a better postured
position away from it’s rest position.
funcitonal appliances or myofunctional appliances
Thus they are mostly used in the treatment of Class
III and Class II malocclusions, particularly Class II
division I where the overjet is increased.
Functional appliances
Components of funcitonal appliances
Buccal shield.
2) Labial pad.
3) Lingual pad.
4) Palatal bow
Mode of action of fuctional appliances
The appliance holds the mandible in a
forward postured position and the facial
musculatures are stretched, this would
applied a posterior force to the upper
arch and an anterior force to the lower
arch. The lower incisors have acrylic
capping to prevent excessive labial
movement of the lower incisors.
Indications for Functional
Appliances
The patient must still be growing preferably approaching
a phase of faster growth.
The pattern and direction of facial growth should be
reasonably favorable.
The patient must be well motivated. These appliances
must be worn for a substantial amount of time. This
requires a considerable effort and commitment by the
patient and the family particularly in the early stages of
treatment.
Types of functional appliances
1) BIONATOR.
2) FRANKEL.
3) TWIN BLOCK.
4) ANDRESEN ACTIVATOR.
5) HEADGEAR
6) HARVOLD ACTIVATOR
