ORTHODONTIC APPLIANCES 214 DDA

DEFINITION
Orthodontic appliance is a device that is used to produce changes in the relationships of the teeth and the skeletal structures.

TYPES OF ORTHODONTIC APPLIANCES REMOVABLE .  FIXED . 

.REMOVABLE APPLIANCES They are designed to be placed & removed by the patient as directed by the orthodontist.

EXTRAORAL . . 2.TYPES OF REMOVABLE APPLIANCES 1. INTRAORAL .

OR II.1. 3. INTRAORAL APPLIANCES Types are Either I. . Functional appliances. Active retainers. Fixed : Space maintainers. Removable such as : 1. 2. positioners. Passive retainers & positioners.

before placement of fixed appliances . .FUNCTIONAL APPLIANCE Is a removable device that is frequently used during growth to correct skeletal imbalance and produce changes in the differential growth rate .

ACTIVE RETAINERS Are used to achieve minor tooth movement (tipping movement) . .

.RETAINERS & POSITIONERS Are removable appliances that are used to hold or retain alignment of the teeth after fixed appliance therapy.

.SPACE MAINTAINERS Are constructed to maintain the spaces for the permanent teeth after deciduous teeth loss .

EX: Headgear .2. EXTRAORAL APPLIANCES It is an appliance that is worn outside the mouth to gain force from the head & neck to change the differential growth rate.

 .it is used to control growth & tooth movement.HEADGEAR  Is an orthopedic device that can be used in conjunction with fixed or removable appliances . It is made of tow parts : Facebow & the traction device .

The outer part of the bow attaches to the traction device . * It has an intra & extra oral parts . Facebow : * It is used to stabilize or move the maxillary 1st molar distally to create more space in the arch. .the intra will fit into the buccal tube of the maxillary 1st molar .

combination & chin cap .Traction Device It applies the extraoral force used to achieve the desired Tx results .cervical .  .  It has four types : High pull .

It is used to stabilize or distalize the 1st maxillary molars . HIGH PULL : It is a caplike device that fits around the pt head &hooks perpendicular to the occlusal plane. It is used to control growth of the maxilla or retraction of anterior teeth. The exerted force is parallel to the occlusal plane.  Cervical pull : It fits around the pt s neck.

It controls mandibular growth in Cl III patients .  . Combination : It is a combination of high pull & cervical traction devices It exerts a force along the occlusal plane & upward . Chin cap : It is a combination of highhigh-pull strap & a chin cup that fits on the mandible.

distally . facially.as well as rotationally.  .  It can move teeth in six directions: Mesially. lingually. apically & occlusally .  It is called braces.FIXED APPLIANCES They are attached to the teeth which are removed by the orthodontist.

Arch wires are attached to the brackets by bending the wire it will give force & pressure that cause teeth to move in the desired direction . 3. hooks & elastics . Axillaries (attach arch wire to brackets & bands to move teeth such as tubes.COMPONANTS OF FIXED APPLIANCE: 1. . 2. Attachments include bands (esp on 1st & 2nd molars) & brackets bonded directly to the teeth (esp on anterior & premolar teeth) .

.After decision has been made that fixed appliance should be used Tx plan will be discussed & pt will be prepared to receive separators.

springs.steel separating .  .steel springs.SEPARATION OF TEETH  Separator is a device that force or wedge the teeth a part so bands can be fitted easily. It involves three separating methods : Brass wire separators . & elastomeric separators.

ORTHODONTIC ATTACHMENTS ARE : BANDS .1. BRACKETS . .

. . BANDS SELECTION: .They are divided into maxillary & mandibular (R & L).Bands are preformed stainless steal rings which has to be selected properly on diagnostic cast or by visual inspection of the size.

.CEMINTATION OF ORTHODONTIC BANDS  Cement has to have strength to aid in retention with enamel as (zinc phosphate). as well as a timetimereleased fluoride to prevent decay under the bands as (glass ionomer) .

BRACKETS The most common type is the edgewise brackets .lingual arch attachments .labial hooks .it has four wings to attach the arch wire to it after placing it horizontally .  .  It is made of stainless steal & attached to a backing pad .edgewise tubes .  It has auxiliary attachments such as headgear tubes .

PREPARATION OF TEETH  Teeth should be polished by pumice & rubber cup to remove pellicle & food debris . Acid etching will be placed on the tooth surface for 15 seconds then washed & dried .  .

 .  In addition to the agent the boding material will be placed on the bracket only .  The bracket pressed on the tooth surface & the excess will be removed .Monomer agent will be applied on the tooth surface as well as the bracket .

Stainless steal wires .  In addition it has different shapes & sizes (Round .2.Square & Rectangular).when it is tied to the brackets it provides sufficient force to move teeth . ARCH WIRES It is shaped like a horse shoe .  It has several types with each has different properties eg Nickel titanium .  .

AUXILARIES It has tow types : 1. Ligature wires are twisted around the bracket to hold the wire in place .3.  Kobyashi hooks has a hook for attachment of elastics . .

2. 3. elastomeric ties are made of plastic or rubberlike material & available in many colors . Power products it can move teeth & the tow commonly used types are elastic chain ties (to close spaces) & elastics (rubber bands) from one tooth to another in the same arch or teeth in opposing arches to move teeth in certain direction. .

.     Assistant should check the pt appliance for any Broken or missing arch wires Loose brackets & bands Loose or broken or missing ligatures Loose or broken or missing elastics .ASSISTANTS RESPONSIBILITIES : 1.

nuts & sticky foods should be avoided because they will cause band loosening . . Oral hygiene & dietary instruction: -Should be given to avoid food trapment & plaque accumulation because bad oral hygiene will lead to rampant caries & periodontal disease .2. -Also ice . bracket popping off & arch wire bending .popcorn .

COMLETED TREATMENT When Tx finished the appliance will be removed & teeth should be cleaned and polished .  All records will be retaken (Impression .  . radiographs and photographs ) .  As well as a removable or fixed retainer will be constructed .

RETENTION Is necessary to : Allow gingival & periodontal tissues reorganization .  Support unstable teeth to prevent relapse .  Control growth changes .  .

. HAWELY RETAINERS .TYPES OF RETENTIVE APPLIANCES 1. 2. LIGUAL RETAINERS . POSITIONERS . 3.

 .  It is designed to :  Retain teeth in desired position .  Allows alveolus rebuilding around the teeth before retainer is given .  Massage the gingiva .1. POSITIONERS Is a custom appliance made of rubber or pliable acrylic that fits over the dentition after orthodontic Tx completion .

HAWELY RETAINER It is constructed of clear .selfpolymerizing acrylic to hold wire clasps on molar teeth .2.while in the mandible it covers the anterior floor of the mouth .  .also it allows some tooth movement to close band spaces & control incisors .  In maxilla it covers the palate .self.  It passively hold the teeth after fixed appliance removal .

LINGUAL RETAINER It is a cuspid to cuspid fixed retainer which is fabricated from light stainless steal wire & bent to rest against the lingual surface of the teeth to maintain incisor position during late growth . .3.

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