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Orthodontics > Functional Appliances in Orthodontics > Flashcards

Functional Appliances in Orthodontics Flashcards

1
Q

What do functional appliances do?

A

Change the position of the mandible - open and forwards
Stretch muscles: apply forces to bones and teeth - condyle out of the glenoid fossa
Use growth

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2
Q

When do you use functional appliances?

A

Use during active growth period

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3
Q

Who wears functional appliance?

A

Class II div 1 incisors with increased overjet
Class II molars
Actively growing patient

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4
Q

What is the class II aetiology?

A

86% Mandibular retrusion

14% Maxillary protrusion

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5
Q

What are the 2 ways of assessing skeletal pattern?

A

Clinical assessment - assess visually, posture test

Cephalometric analysis

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6
Q

What are the ceph analysis figures?

A

SNA 81 degrees
SNB 75 degrees
ANB 6 degrees
MxMnPA = 30

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7
Q

What does the clinical assessment involve?

A

Patient sitting upright
Look at the profile
Posture test - bring the mandible forwards - does the patient look better or worse?

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8
Q

What is the posture test?

A

Posture the mandible forwards - get an improvement in the profile
Lips relaxed, not forced together

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9
Q

Who should avoid functional appliances?

A

Non-motivated patients
Class I molar relationship - increase the length of treatment
High FMPA - Frankfort mandibular plane angle

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10
Q

What does the ideal time for functional appliance depend on?

A

Stage of development:
Dental - late/mixed permanent dentition - need 4’s
Emotional - motivation
Physical - height

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11
Q

What are the 2 measurements of standing height?

A

Height curve: Standing height - skeletal growth

Velocity curve: rate of growth per year - shows how quickly growing

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12
Q

When is the best age range for functional appliance

A

13-16

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13
Q

When are the rapid growth periods for boys? and girls?

A

Boys 11-13

Girls 10-12

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14
Q

What are the different functional applicances?

A

Twin block
Activators: Medium-opening activator, Andresen, Harvold, Bionator
Frankel

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15
Q

What is the twin block appliance?

A

Separate upper and lower appliance - blocks fit together which postures the mandible forwards
Removable functional appliance
Work 24 hours except sports and cleaning
Midline screw - widen mandible
Crib on lower 6 to increase stability

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16
Q

What are the advantages of twin block?

A 
Aesthetic 
Patient can move the mandible 
Full-time
Robust
Can expand the upper arch/reactivate 
Can integrate with fixed appliances if want to straighten them 
Posterior teeth still free to erupt
17
Q

What is a medium opening activator?

A

Capping over lower incisors
Leaves the posteriors to do what they want
Tend to erupt/ reduce the overbite
Cribs on the upper 4 and 6 - gives more stability

18
Q

What is the fixed (herbst) appliance?

A

Consists of a barreld
Add a collar
piston arrangement to allow chewing

19
Q

What is the Frankel appliance?

A

Soft tissue borne
Sheilds alter the soft tissue balance
Moves the tissue out of the way, allowing the teeth to find natural position
If distort it - difficult to repair
Not as robust, not as easy to wear as twin block
Crib on 3 and 2 to prevent fracture at the midline
Can add more acrylic to reacitvate
No 4’s then use labial bow

20
Q

What is the dental mode of action of functional appliances?

A

Mandible moves down and forwards
Retraction of upper incisors
Upper labial segment retroclines with or without labial bow
Lower labial segment proclines controlled eruption of lowers into class I

21
Q

What is the skeletal mode of action of funcional appliances?

A

Forward movement of the mandible
Condyle secondary or primary groth site
Inhibits normal growth of the maxila - can do this by fitting head gear
73% correction due to dento-alveolar 27% due to skeletal

22
Q

What are the dental effects of functional appliance

A
  1. Upper labial segment retroclines
  2. Lower labial segment proclines
  3. Controlled eruption of lowers into class I
23
Q

What are the skeletal effects of funcitonal appliance

A

Inhibits normal forward groth of maxilla

Forward movement of the mandible

24
Q

What is are the percentage effect of the funcitonal appliance on skeletal and dento-alveolar

A

Skeletal 30%

Dento-alveolar 70%

Orthodontics (16 decks)

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