Functional Appliances Flashcards
What is the definition of a functional appliance?
To treat:
• Muscle functional Imbalance
•Skeletal Discrepancies
What is the Functional Matrix Theory?
70% Dento -Alveolar
30 % Bone/skeletal
What are the three points of the Functional Matrix Theory?
- Muscles linked to the jaw
- More tooth movement
- Forward posture of mandible= stretched facial soft tissues
What cases are Functional appliances used on?
• Class IIi
• Class IIii
• Rarely III
What is the growing/ pubertal age for Girls to wear a functional appliance?
11-13
What is the growing/ pubertal age for Boys to wear a functional appliance?
12 -14
Indications for Functional Appliances:
•II mild/moderate
•Actively growing
•Increased overjet
•Buccal crossbites
• Potential competent lips
• Minimal crowding
•average/reduced LAFH
What Dento Alveolar changes does a functional achieve?
•Retrocline the maxillary incisors
• Procline the mandible incisors
• Distal movement of the upper dentition
• Mesial movement of the lower dentition
What skeletal changes does a functional achieve?
• passive molar eruption:
- Backward growth of the mandible
- Increased LAFH
•Glenoid Fossa is remodelled forward
• Condyle= down and forwards
Advantages of Functional Appliances?
• can be removed for OH
• Easy to adjust
• Easy Anchorage= Base plate (Heat cure)
Disadvantages of a Functional Appliance?
• Pt compliance
• Only tipping movements
• good Lab Technician needed
• Pt tolerance
• gingival trauma
• aching jaw/muscles
Treatment for II i
• worn for 6-8 months
• functional postures mandible forwards
• overjet= 0mm
• incisors,canines, molars = III
• fixed appliance
Treatment for IIii
• Procline upper incisors :
- URA + z spring/ anterior screw
- sectional upper 2-2
• Functional and z spring to keep incisors proclined
• Trt as IIi with functional
- reduce OJ ➡️ III
Treatment for III
• Rare
• Mandible retracted
• Reverse TB
•Frankel -elimainates soft tissues =
Arch expansion and corrects buccal crossbites
At the end of treatment whats relationship is achieved?
III
- over correction to allow for relapse
What are the 4 types of functional appliances?
- Tissuebourne
- Toothbourne
- Removable
- Fixed
Name the 6 functional appliances?
- Clarks Twin Block
- Herbst
- Medium Open Activator MOA
- Bionator
- Frankel
- COFF - Clip on fixed functional
How long should a Clarks TB be worn for?
22 hours FT
What type of appliance is a Clarks TB?
• Removable
• Toothbourne
What are the measurements of a Clarks TB?
• Blocks = 7-8 mm + 70 angle
What planes are corrected with the Clarks TB?
• AP
• Transverse
Components of a Clarks TB?
• Blocks
•Baseplate
•Cribs
• Ball ended clasps
• Can add expansion screws and springs
What side effects does a Clarks TB have?
• Lateral Open bites
• posterior teeth stopped from over erupting due to capping from blocks
Disadvantages of a Clarks TB?
• not used on increased LAFH AND MMPA as increases.
What type of functional Appliance is a Herbst?
• Fixed
• Tooth Bourne
What is the function of a Herbst applaince?
•Fixed
• Rigid arms that posture the mandible forwards
• Reduces the OJ
What are the disadvantages of a Herbst appliance?
• Cost
• Breakages
What type of functional is a Medium Opening Activator?
• Removable
• Toothbourne
Components of a Medium Opening Activator?
• Baseplate
• lower incisor capping - postures lower mandible forwards
• Anterior breathing hole
Advantage of MOA. Medium Opening Activator?
• No capping posterior so the molars can erupt - good for DEEP BITES
Disadvantage of Medium Opening Activator?
• Pt cant eat or speak
• Difficult to tolerate
What type of functional is a Bionator?
• Removable
• Tissue and Tooth bourne
Components of a Bionator?
• Labial bow extends posteriorly - holds cheeks away from buccal segments - Allows arch expansion
• grooves in the lower part of the acrylic posture the mandible forwards
• posterior capping- stops molars erupting
Disadvantages of a Bionator?
• Pt is unable to speak/ eat
What type of Functional is a Frankel?
• Removable
• Tissue Bourne
List the types of Frankel appliances?
• FR1
• FR2
• FR3
What planes of space does a Frankel treat?
• AP
• Transverse
What case would a FR1 trt?
IIi
What case would a FR2 trt?
II ii
What case would a FR3 trt?
III
What dentition and lip case would a Frankel be used on?
• mixed dentition
• lip traps
What are the components of a Frankel?
• one piece
• wire and acrylic that remove lips and soft tissues
Disadvantages of a Frankel?
• Expensive
• one piece
• pt cant eat/drink/ speak
What does COFF stand for?
Clip On Fixed Functional
What type of functional is a COFF?
• Fixed
• Toothbourne
Components of a COFF?
• Acrylic Blocks attached to molar bands similar to TB
• seps/ bands needed
What is a COFF similar too?
• Clarks TB
• Blocks interlock at 70%
Advantage of a COFF
• Fixed
• Fast
• No Baseplate
Disadvantage of a COFF?
• Expensive
• No baseplate- no screws- no expansion- cant fix crossbites
• OH and cleaning
