Modifications of the Teuscher activator

 
 

a) Torque springs on the central incisors

The Teuscher activator allows the design of torque
  springs on the central incisors in combination with  
protrusion springs for labial movement on the lateral
incisors.

b) Sheet springs and labial bow

The same effect can be achieved with sheet springs and
   
a labial bow that should contact the most prominent
teeth.

c) Labial pads
On the Teuscher activator, lip pads for the development
  of the lower jaw can be attached as in the function  
regulator according to Fränkel. Therefore the limit of the
vestibule has to be erased before making the appliance.

 
 
 d) Lip bumper
Also, a lip bumper can be attached directly to the
appliance in order to support a protrusion of the lower
   
incisors. It has to be positioned in height of the gingival
margin in front of the lower incisors in a distance of
approximately 1 mm.

e) Expansion screw
  Another variation for the expansion of both jaws: an  
expansion screw between the upper and lower jaw.

f) Combination with fixed appliances

If the Teuscher activator is used in combination with a
  transpalatal arch and upper molar bands, the activator  
has to be liberated in the area of the molar tubes and the
palate.

The Harvold-Woodside activator for class II-1

 
Elements: Labial bow 0.9 mm spring hard, distalizing springs 0.9 mm spring hard
Function: Functional change of the occlusal plane in a malocclusion class II-1
Description: A vertical opening of up to 20 mm is necessary for this activator; the smooth
lateral bite plane maintains the upper incisors and the lower are grinded
 
 In this class II-1 activator the labial bow is bent
contacting up to the canines, from there it is bent similar
as the buccinator loop to shield the cheek and is then
bent through a U-loop again towards the front; the
   
retention finishes in the area of the interocclusal
opening. The distalizing springs consist of a big loop in
the molar region and have a distal cantilever mesial of
the first molars and its retention in the incisal area.

The coverage with wax should be done carefully. The

characterizing feature of this appliance is the large
vertical opening in the buccal sections which is
determined by a construction bite. In order to guide the
  anterior movement in the posterior region, a thin wax  
plane is added in the upper jaw and a high wax plane,
higher than half of the vertical opening, is added in the
lower jaw; the main purpose is to create plane surfaces
for the acrylic platforms.

If the fixator is closed the separation between both wax

planes in the buccal area should be of approximately one
   
millimeter, so that the lateral bite plane presents enough
stability.

 
 

On the models the extension of the acrylic shield over

the whole incisal area in the upper and lower jaw should
be limited with a wax frame. The retention of the labial
  bow lies in the interocclusal acrylic right behind the  
upper incisors. The models prepared this way can be
covered with acrylic and put into the pressure vessel for
its polymerization.

 
 In the finished appliance, for their proper activation, only
the retention of the distalizing springs is covered with
   
acrylic. The labial bow only contacts the upper incisors.
The distal limitation of the appliance is the A-line.

The labial shield covers the incisors over one third of

their clinical crown. The lateral bite planes have no
   
contact at all with the posterior teeth in order to achieve
the desired vertical eruption.

 
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The Harvold-Woodside activator for class III
 
Elements: Labial bow 0.9 mm spring hard, distalizing spring 0.9 mm spring hard
Function: Therapy of a class III malocclusion
Description: The class III activator should not hinder the buccal segments in their vertical
eruption
 

In this class III activator, the labial bow in the lower jaw
is bent as an intermaxillary bow; its task in the upper
jaw is to shield off the lips through loops bent as labial
pads. The retention lies as in the class II appliance, in
  the anterior area of the vertical opening. Also, the  
distalizing spring is bent with a big loop in the molar
region. Although in this appliance the distal cantilevers
are located behind the first molars, the retention ends in
the anterior palatal area.

 
 As before, the wax coverage is very important. The big
vertical opening corresponds to the one in type-II. In this
case, a wax plane that reaches over the half of the
vertical opening is added onto the upper jaw. In the
  lower jaw, the posterior teeth are slightly covered with  
wax and in the incisal area, from canine to canine, the
wax is concavely shaped; the loop and the distal
cantilever of the distalizing spring are also covered with
wax.

For its proper stability, the acrylic in the interocclusal

   
area should show a thickness of one millimeter.

 
 

The acrylic shield of this appliance only covers the lower

incisal area and is correspondingly framed with a wax
limitation. Despite its location, a sufficient anchorage has
   
to be guaranteed for the retention of the labial bow.
Before adding the acrylic both models have to be
hydrated.

In this class III appliance, the distal limitation is also

marked by the A-line. Once again, only the retention of
  the distalizing springs is grasped in acrylic. In the upper  
jaw, the labial bow does not contact but shields off the
lip.

 
 The upper teeth only contact the acrylic shield. The
acrylic can be trimmed and shaped individually by the
   
orthodontist. The lateral bite plane allows more vertical
eruption for the upper posterior teeth.

 
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The Teuscher activator
 
Elements: Headgear tubes, torque springs 0.5 mm spring hard, Coffin spring 1.2 mm
spring hard
Function: Inhibition of the development of the upper jaw with simultaneous mandibular
advancement
Description: This headgear activator hinders the development of the upper jaw with
simultaneous advancement of the mandible
 

Base appliance with four torque springs

The torque springs only contact the upper incisors in one
  point shortly underneath the gingival margin. It is bent  
away slightly to avoid contact with the rest of the clinical
crown. The retention is in the interocclusal area.

The headgear tubes lie between both tooth rows in the

area of the deciduous molars. The interocclusal area
should be high enough to allow a good anchorage of the
  retentions of the headgear tubes in the acrylic. It should  
also be checked from the occlusal point of view if they lie
parallel to be able to insert the inner bow without any
problems.

 
 The acrylic base has to cover one third of the lower
incisors, and the upper incisors should be covered on the
   
palatal side up to one half and on the labial side, only to
the incisal edge.

 
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The Herren activator
 
Elements: Labial bow 0.8 mm spring hard, retention thorns 0.8 mm spring
hardLabialbogen 0,8 mm fh,Haltedorne 0,8 mm fh
Function: Modification of the muscular effect through an over dimensional opening of
the occlusion
Description: The over dimensional vertical opening of the occlusion, which is intended to
alter the muscular activity, is characteristic for this appliance
 

The Herren activator differs from the classic activator

only in the high vertical opening. The elements are bent
   
as in the traditional activator and a wax collar is fixed for
the limitation of the acrylic.

The vertical opening for the Herren activator is 8 to 10

  mm, determined by the construction bite and then set in  
the fixator.

 
 The design of the appliance of the finished activator does
   
not differ from the classic activator.

 
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The propulsor according to Mühlemann/Hotz
 
Elements: None
Function: Treatment of maxillary dentoalveolar protrusions in the mixed dentition
Description: Bimaxillar appliance without wire elements
 

The models are located in the fixator according to the

  construction bite. It is important to observe that the  
fixator does not hinder the application of the acrylic.

When the retentive parts are blocked out, the models are
covered with wax for the acrylic base. In the upper jaw
the complete labial surface is covered with acrylic, in the
lower jaw the lingual surface. The connection of the
   
upper buccal shield to the lower lingual shield serves also
as occlusal support and stabilizer for the appliance. The
lower incisal edges are also mounted into acrylic in order
to prevent the lower incisors from tipping.

 
 In the posterior area the interocclusal acrylic is removed
   
in order to allow the premolars to erupt.

 
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The headgear activator according to van Beek
 
Elements: Headgear 1.2 mm spring hard
Function: Treatment of malocclusions class II-1
Description: This headgear activator achieves the mandibular position through the lingual
wings of its lower base
 

The models are set into the fixator by a construction bite

with a vertical opening of approximately 10 mm.
Between the central and lateral incisors the short and
strong outer bows are set into the acrylic of the
  activator. The lower incisors are grasped labially 2 mm in  
acrylic in order to avoid their protrusion. The lingual
surfaces remain free. The upper incisors are also grasped
in acrylic. The position of the mandible is achieved
through the long lingual wings of the lower base.

The upper base plate is kept small. The palatal area of

the upper anterior teeth is blocked out with wax in order
  to allow a retrusion. The lateral bite plane reaches to the  
centre of the occlusal surfaces. In the premolar region,
the lower base is extended as far as possible downwards.

 
 In combination with a high pull headgear, this appliance
   
with bite block can be used to intrude the upper teeth.

 
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The activator according to Pfeiffer and Grobety
 
Elements: Modified labial bow with soldered triangular clasp 0.8 mm spring hard
Function: Retraction of the upper jaw with simultaneous distal movement of the upper
teeth
Description: Retraction of the upper jaw, and under influence of the masticatory muscles,
mesial movement of the lower teeth with simultaneous distal movement of
the upper teeth; the headgear is only used combined with the fixator
 

The impressions are filled with the bands in order to be

able to adapt the finished appliance better. In the
   
original appliance only a modified labial bow with a
soldered triangular clasp is bent.

The canine loops of the labial arch are placed as usual in

the canine area. Then the wire is bent distally and
  between the first and second premolar it is bent into the  
retention. The screw is fixed in the upper jaw and the
base plate is limited with wax stripes.

 
 The activator additionally consists of lateral bite blocks
   
and an incisal cap in the lower anterior region.

 
 

The lower impression has to depict the lingual area very

  well in order to extend the lower lingual wings as far as  
possible into the sublingual area.

The lower wings of the activator should be very

  pronounced on the lingual side favoring the activity of  
the masticatory muscles.

This is a lateral view of the activator with its pronounced

   
lower wings.

 
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 The Functionator according to Eschler
 
Elements: Labial wire 0.8 mm spring hard, triangular clasp 0.7 mm spring hard, Adams
clasp 0.7 mm hard
Function: Treatment of class II-1 or class III
Description: Depending on the position of the labial wire, the upper front can be retruded
(class II treatment) or the lower front can be moved lingually (class III
treatment)
 

Class II-1 treatment: When the labial wire adapts on the

upper front teeth, from the mesial third of 13 to the
mesial third of 23, then it is bent with distance to the
   
lower incisor area. This way, the upper front teeth which
are blocked out with wax can be moved orally and the
lower lip can be maintained off the lower incisors.

Class III Treatment: When the labial wire adapts on the

lower front teeth, from the mesial third of 33 to the
mesial third of 43, then it is bent with distance to the
   
upper incisor area. This way, the lower front teeth which
are blocked out with wax can be retruded and the upper
lip can be maintained off the upper incisors.

A screw can be added to the appliance. For a desired

  anterior-posterior correction an inclined anterior plane can  
be integrated in addition to the bite block.

The activator with spring bows

according to Schwarz
 
Elements: Labial bow 0.8 mm spring hard, spring bow 1.2 mm spring hard
Function: Activation through muscle function
Description: Through the spring bows, which can be activated horizontally or vertically,
 the muscle activity is stimulated
 

The base appliance only contains few elements, but can

be replenished in any way. A labial bow is bent for each
   
upper and lower jaw and the single plates are finished
with plane lateral bite blocks.

The polished and finished plates are set onto the models
which were articulated according to the construction bite.
  Now the unifying spring bows can be bent and be added  
into the acrylic of the single plates of the activator. These
spring bows are supposed to enhance muscle activity.

The spring bows reach distally over the base plate for a
  proper activation. Different directions for their activation  
are possible (horizontal, vertical).

 
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The open bite activator with tongue crib
 
Elements: Labial bow 0.8 mm spring hard, Coffin spring 1.2 mm spring hard, tongue crib
1.0 mm spring hard, mandibular connection bow 1.0 mm spring hard
Function: Intrusion of the posterior teeth, extrusion of the incisors and simultaneous
protection of the tongue
Description: The tongue is kept from the teeth because of the tongue loop which follows
the curve of the dental arch
 
 The models are set into the fixator with the construction
bite and the vertical opening is determined. The labial
bows are bent as usual. The connecting bow in the lower
   
jaw and the Coffin spring in the upper jaw are fixed each
1 mm from the gingival tissue. The divided tongue crib is
fixed parallel to the lingual or palatal area of the incisors.

The tongue crib consists of two divided loops. For the

first half, the wire is bent back 180° in the middle. The
separation of the parallel wires corresponds to half of the
area to be closed off. The loop is bent according to the
   
curvature of the anterior segment. Both wire ends are
bent over for retention and are anchored in the lateral
part of the activator. The second half is bent like a mirror
image and is set on the other side.

The acrylic body of the open activator is designed quite

delicately. The anterior open base and the adapted
   
tongue crib make this a well accepted appliance by
patients.

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The rigid open activator (SOA)

 
Elements: Connecting bow 1.5 mm hard, labial bow 0.9 mm hard, supporting thorns 0.8
mm spring hard, protrusion spring 0.7 mm spring hard
Function: Alignment of the anterior teeth
Description: Delicate activator with wide space for the tongue
 
 For the SOA the elements are bent according to the
planned design and are fixed with wax. The rigid
connecting bow is underlaid with tin foil before its
   
fixation in the area of the first molars of the upper jaw to
guarantee an even distance from the palatal gingival
tissue.

The acrylic base is designed as in the EOA, as delicate as

  possible with interocclusal acrylic. The rigid connecting  
bow gives the body of the appliance certain stability.

Because of the rigid connecting bow, with this appliance

   
expansion of the jaws is not possible.

 
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The elastic open activator according to Klammt (EOA)

 
Elements: Palatal bow 1.2 mm spring hard, labial bow 0.9 mm hard
Function: Alignment of the anterior teeth
Description: Open activator with wide space for the tongue
 
 The labial bows lie parallel to each other and are bent
buccally of the first molars into a loop. From there, they
are guided back mesially of the canines from where they
   
are bent palatal or lingual into the retention. The palatal
bow is bent similar to a Coffin spring and connects the
acrylic parts.

For an ergonomic finish and material saving, the models

are blocked out with wax. Under the palatal bow, a wax
   
spacer is placed to ensure adequate clearance for tissue
comfort.

The acrylic shares lay orally from the canines to the last
molars forming a small band contacting teeth and
  gingiva. The occlusal surfaces are not covered with  
acrylic and a vertical support by the acrylic is left only in
the canine area.

 
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Modifications of the EOA and the SOA

 

 
 Instead of the palatal bow, an expansion screw can be
  incorporated and in the anterior region paired guiding  
wires can be added.

If the canines should be influenced separately (in this

example an EOA), an additional M or U-loop can be bent
  into the labial wire. In order to distract the tongue from  
the incisors the Coffin spring can be replenished with a
small movable plastic pearl.

With corresponding carving of the models (in this

  example an EOA), labial shields or pads can be added for  
functional enhancement.

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The spring activator according to Sander

 
Elements: Labial bow 0.8 mm spring hard, protrusion loop 0.8 mm spring hard,
triangular clasps 0.7 mm spring hard, Adams clasps 0.7 mm hard, palatal bow
3.0 x 1.5 mm half round steel wire, a special spring system according to
Sander: 1.0-1.1 mm spring hard wire with simple or triple loop
Function: Treatment of skeletal open bites and rehabilitation after TMJ injuries
Description: Special springs of 1.0-1.1 mm spring hard wire are located lateral in this
appliance and therefore do not hinder the tongue
 
 For the making of the spring activator the models are set
in the fixator. As the acrylic base of the upper jaw is
reduced, the retentions have to be bent according to this
situation being anchored into this acrylic segment. The
  highest part of the palate is covered with a tin foil which  
is 1 - 1.5 mm thick to guarantee an even distance of the
palatal bow and to avoid pressure areas. The finished
elements are fixed onto the model, acrylic is added and
the plate is finished.

The base of the upper plate should extend palatally as

much as to guarantee sufficient retention and stability for
the special spring. The upper plate is finished and
polished completely in order to allow an even adjustment
   
of the upper and lower bite blocks. Isolated with a thick
wax layer, the upper bite block can be set onto the
polymerizing lower plate. Another option is to separate
both plates with a metal plate

Special attention should be paid to the fact that the labial

bow with its occlusal parts does not lie over the occlusal
plane. While occluding firmly with the spring activator
  there should not be any interfering contacts in the  
anterior area. The widths of the lateral bite blocks have
to be adapted orally so that the spring bow can glide
past the acrylic to connect the upper with the lower jaw.

 
 

Because of the extremely high load on the wire, the

springs should be made out of 1.1 mm wire. The decision
on whether to incorporate one or three loops into the
spring design depends on the oral space availability. The
  loops have to be bent in such a way that while closing  
the wire is pushed into the loop, which means it is
activated (safety pin principle). The length of the spring
can be calculated reaching from the last molar
approximately to the first premolar or canine.

 
 After polishing both individually made plates and the bite
blocks lay even on each other, the height has to be
checked in the fixator according to the construction bite.
  The retentions of the springs have to be anchored as far  
as possible into the distal area of the acrylic segments.
The springs should be incorporated into the plate without
strain.

Instead of the palatal bow, the spring activator can also

be fitted with a transversal expansion screw or headgear
  tubes. If the headgear tubes are incorporated in the area  
of the first premolars the triangular clasps cease to
apply.

 
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The divided activator with screw for the upper jaw

 

Elements: Labial bow and retention thorns 0.8 mm spring hard

Function: Separate expansion of the maxilla
Description: In this horizontally divided bimaxillar appliance, the upper expansion screw is
anchored in the lower jawin diesem horizontal geteilten bimaxillären Gerät ist
die Oberkiefer- Dehnschraube im Unterkiefer verankert
 

The elements are bent following the design, in this case,

additionally with two protrusion springs. The extension of
  the acrylic base is limited with wax. In this horizontally  
divided appliance, after bending the elements, the lower
jaw is finished separately and polished.

 
 In the interocclusal area, the upper and lower bite blocks
of the divided activator show a separation of almost one
   
millimeter. That is the reason why this area is covered
with wax to this height.

In the upper jaw, the screw is centered and fixed with

wax so that the retentions of the screw stick out into the
lower jaw. Therefore, in the anterior region, two notches
  have to be grinded into the lower base plate. The fixator  
should be able to open and close without interference.
The area of retention in the lower jaw is blocked out with
wax.

 
 

Now acrylic is added on the upper jaw. While the acrylic

is still malleable the fixator is closed. The wax layer in
  the retention area of the screw prevents the union of the  
upper and lower plate. This way the upper plate can be
sawed, finished and polished separately.

After this, both separately produced plates are unified to

one appliance. For this purpose, the division and the
interocclusal area close to the screw are covered with
   
wax. Now the retentions of the screw are polymerized
into the lower plate and therefore both plates are unified
to one bimaxillar appliance.

 
 The upper part of this activator can be expanded without
   
the lower jaw.

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The U-bow activator according to Karwetzky

 
Elements: U-bow 1.2 mm spring hard, labial bow 0.8 mm spring hard
Function: Movement of the mandible in different directions, according to the specific
type (type I-III)
Description: Through the addition of different U-bows into the elastic activator, different
directions of mandibular movement are possible
 

For the U-bow activator separate upper and lower plates

with even grinded bite blocks and other elements
  (depending on the planed design) are made. If screws  
are added into the plates, they only have effect on that
specific jaw.

Type I distal activator Through both U-loops, which are

anchored into the acrylic in the region of the first molars,
both plates are joined to a bimaxillar appliance. The long
   
arm of the U-bow is always fixed into the lower jaw, the
short arm into the upper jaw. In this type I distal
activator the arms of the U-bow point anteriorly.

 
 Type II prognathism activator In type II both anchored
  arms of the U-bow are directed posteriorly. The long  
arms are situated in the lower plate as seen here.

 
 

Type III-a
Pan activator In this type III-a two different bows are
built in. On the right side, the upper short arm shows
   
distally, on the left side, the short upper arm shows
mesially. When activating the U-loops a panning
movement to the right is produced.

Type III-b Pan activator

In the type III-b the U-bows are incorporated opposite as
in type III-a. On the right side, the short upper arm
   
shows mesially, on the left side the short upper arm
shows distally. This way, when activating, a panning
movement to the left is the result.

This draft shows a schematic representation of the U-

loops of the different activator types and the movement
   
which is produced by their activation (draft according to
the tooth scheme).

 
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The Prognathism activator according to Wunderer with screw

according to Weise
 

Elements: Labial bow 0.8 mm spring hard, retention thorns 0.8 mm spring hard
Function: Continuous retropositioning of the mandible with simultaneous advancement
of the upper jaw
Description: In this horizontally divided activator, through the effect of the screw
according to Weise a continuous retropositioning of the mandible and a
simultaneous advancement of the upper jaw are strived for
 

The body of the Weise screw unifies the upper plate with
the lower plate through a strong U-shaped bow. Only the
retention part of the screw is grasped in the acrylic. The
   
bow extends orally over the acrylic base. The sagittal
divided screw lets the upper plate glide over the lower
plate.

The labial bow for the upper jaw normally does not
contact the incisors while in the lower jaw it contacts the
incisors passively. The retention thorns are bent as
   
usual. The parts of the upper and lower jaw are finished
and polished separately. It is important that the occlusal
and interdental tooth surfaces are grasped with acrylic.

The prognathism screw according to Weise is

polymerized into the lower plate in such a way that it
does not hinder the upper jaw in its occlusion also
verifying that the body of the screw is parallel to the
occlusal plane. The retention part of the screw has to be
   
well covered with acrylic. The bite block of the lower
plate can be covered with an even layer of wax in order
to avoid a later division of the activator. After this
preparation of the lower base plate, acrylic can be added
on the upper part of the activator.

 
 
 The connecting bow from the upper to the lower part and
  the part of the body of the screw that extends orally are  
not covered with acrylic, only the retentions of the screw.

In the finished activator, in the upper part of the base

plate a small opening can be grinded from the palatal
  side in order to activate the screw. Nevertheless the  
screw can also be activated from the oral side with a
screwdriver.

The finished acrylic base has to be designed as delicately

as possible. Through the continuous activation of the
   
sagittal screw spindle a retropositioning of the lower jaw
and an advancement of the upper jaw are possible.

 
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