36. Klammt appliance

Question 1

Klammt elastic open activator characteristics

Answer 1

• Tooth borne passive myodynamic appliance
• Eliminates abnormal function and re-establishes balance between perioral muscles and tongue
• 24 hour wear

Question 2

Klammt appliance indications

Answer 2

• Class II w/ deep overbite
• Mixed dentition

Other indications include:
* Open bite
* Anterior teeth proclination and retroclincation
* Biprotrusion of anterior teeth

Question 3

Klammt appliance elements

Answer 3

• Acrylic base
• Maxillary and mandibular labial bow (0.9mm)
• Maxillary and mandibular protrusion springs (0.7mm)
• Palatal bow (1.2 mm)

Question 4

Labial bow for klammt appliance

Answer 4

• Maxillary and mandibular teeth=>parallel at most prominent buccal surface of anteriors
• Initially, retention inflections on left and right side bent
• Wire continues buccally from contact point of canines and first premolars(first primary molars) to midpoint of buccal surface of first molars distally=>
• formed into loop and guided back from where they are bent=>palatal or lingual into retention

Question 5

Protrusion springs for klammt appliance

Answer 5

• Extend from distal surface of left canine to distal surface of right canine in maxilla and mandible
• For incisor extrusion-springs in gingival third of incisor crown
• For incisor intrusion- springs in incisal third
• Protrusive force enhanced by tongue function
• Flexibility of springs increased when cut through middle

To protect tongue-cut ends inserted w/ plastic tube

Question 6

Palatal bow for Klammt appliance

Answer 6

• Bent similar to coffin spring
• Connects acrylic parts
• Adapted to shape of palate and located 1.5-2mm from soft tissue
• Functions to Support the appliance

Question 7

Acrylic base for klammt appliance

Answer 7

• Two lateral parts extending from mesial surface of canines to first molars in maxilla and mandible
• Occlusal surfaces of posterior teeth half covered with acrylic

• Occlusal acrylic surfaces are grinded gradually after a certain period of appliance wear(14 days), first trimmed distally to allow eruption of posterior teeth

Question 8

Modifications of klammt appliance with regards to wire elements

Answer 8

• Tongue barrier crib-instead of protrusion spring in open bite treatment
• Zig-zag shaped mandibular labial bow for lip sucking habit
• U-loop in canine area of labial bow-anterior teeth retraction
• Maxillary and mandibular acrylic pads-stimulation of apical base development