Orthodontic Seminer on

Myofunctional Appliances
Submitted To :
Dept. of Orthodontics
Dental Unit
Rajshahi Medical College





Prepared By :
Md. Tauhid Hossain
Batch: 21st BDS
Roll No : 32
Session: 2009-10

Definition
Funtional appliances are passive appliances
which harness natural forces of the oro-facial
musculature that are transmitted to the teeth
and alveolar bone in a predetermined
direction.

.? Function Muscular Action Effect on dentoalveolar development .What they do….

Function Muscular Action Effect on dentoalveolar development .

FORCE ELIMINATION • The principle involves the elimination of abnormal and restrictive environmental influences on the dentition thereby allowing optimum development thus function is rehabilitated with a secondary change in form. .TREATMENT PRINCIPLES FORCE APPLICATION • Compressive stress and strain act on the structures involved and result in a primary alteration in form with a secondary adaptation in function.

Action of functional appliance Appliance can produce following changes Orthopedic changes Dento-alveolar changes Muscular changes .

They can bring about changes in sagittal. 3. . They bring about remodelling of glenoid fossa. In vertical plane they allow selective eruption of teeth. 2. 3. Most of them allow upper anteriors to tip palatally and lowers to tip labially. 2. transverse and vertical directions. They can change the direction of growth of the jaws.Action of functional appliance • Orthopedic Changes 1. In tranverse direction they can bring about expansion of the dental arches by incorporating screws in them. 4. Myofunctional appliances are capable of accelerating growth in condylar region. • Dento-alveolar Changes 1. • Muscular Changes – Functional appliance can improve tonicity of the oro-facial musculature.

When??? Early treatment : 9-10 years. . These appliances should be worn at night-time as this is when growth takes place. This is the time when the mandible may exhibit increased growth which may be influenced. Definitive treatment : 12-13 years.Functional appliance treatment should be started before the pubertal growth spurt. Duration: 10-12 hours a day.

• Acceptable to many patients. • Easy to maintain oral hygiene. • Frequency of the patients visit is less. • No side effects of mechanotherapy. • Less chair side time.Advantages of Functional Appliances • Helps to eliminate abnormal perioral muscle function which interferes with muscle growth. . can be worn during night.

Bass appliance etc. Eg. Den holtz. Activator. Frankel etc. Fixed Functional Appliances. . Eg.Basic Classification Functional Appliances Removable Functional Appliances. Eg. Jasper jumper Semi-fixed Functional Appliances.

3. 2. Group B –Teeth or tissues supported appliances • Activator. Group C –Vestibular positioned appliances with isolated support from tooth/tissue • Frankel appliance. Group A – Teeth supported appliances • Catalans appliances. Bionator etc. Lip bumpers etc. Inclined planes etc. .Classification by Tom Graber 1.

Tissue borne appliance (passive)  Frankel appliance . Tooth borne active appliance     Modified activator Expansion activator Orthopaedic corrector Stockli headgear activator 3.Classification by Proffit 1. Tooth borne passive appliance  Andersen activator  Harvold activator  Bionator 2.

Oral Screen Consists of vestibular shields which holds the lip away from all teeth except upper incisors • aids patient with digit sucking . They can shield the lip away.Simple functional appliances Lip Bumper Used in patients exhibiting lip habits such as lip sucking.

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TMJ pain cases. Low(FMA) angle case . As a diagnostic splint. Uses • • • • • • Deep bite Cuspal interferences Pain associated with Temporo-mandibular joint disturbances.Upper Flat Bite Plane It is an extension of acrylic base plate covering the region behind the upper anterior teeth extending usually from canine. Decrease lower facial height.

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Upper Anterior Inclined Bite Plane Used in case where there is severe retroclination of lower anteriors. Uses • Guiding mandible forward • Proclination of retroclined lower anteriors • Reduction of overbite. .

Posterior Bite Plane Extension of acrylic base plate over the occlusal surface of posterior teeth • INDICATION – To give occlusal clearance for correction of cross bite – Diagnosis of occlusal prematurities – Cases with TMJ pain dysfunction .

3. Class II div-1 Class II div-2 Class III Class I openbite Class I deep bite . – Activator • Due to its ability to activate muscles. – Norwegian appliance • Indications 1.Andresen Activator • Other Names – Mono-block • As upper and lower plates appear joined together. 5. 4. 2.

 Expands dental arches.Frankel’s Functional Regulator  Passive functional appliance  Essentially tissue borne  Appliance of choice in class II due to mandibular retrusion.  Has direct effect on neuromuscular system. .  Used in early mix dentition.

A cross palatal stabilizing wire on the maxillary arch. .

Acrylic Bite Block Lingual flange extensions .

Class I b.FUNCTIONAL REGULATOR • FR I a. Class II div 1 >7mm • FR II Class II div 2 • FR III Class III • FR IV Open bite & mild bimax . Class II div 1 <5mm c.

3. 6. soreness etc report to Dentist If no pain also report the dentist after 2 weeks Pt advised to maintain lip seal by conscious effort Time charts should be given to record duration of wearing the appliance . 4.POST DELIVERY INSTRUCTION 1. 2. 7. Teach the patient to wear and remove the appliance in front of mirror Should be worn 2-3 hours daily initially When not in use keep in water Any pain. 5.

crowding etc • Tendency to increase lower facial height therefore contraindicated in patients with backward rotating mandible .Limitations of Functional Appliances • Not useful in adults where active growth completed • Patient cooperation and wearing appliance important • Not possible to correct rotation.

The art and science – by S.S Rani • Text book of orthodontics – by Graber .I Bhalajhi • Essentials of Orthodontics for Dental Students – by Mohammad Emadul Haq • Removable orthodontic appliances – by M.BIBLIOGRAPHY • Orthodontics .