Functional Appliances Flashcards by Leanne Hughes

What is the definition of a functional appliance?

To treat:
• Muscle functional Imbalance
•Skeletal Discrepancies

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What is the Functional Matrix Theory?

70% Dento -Alveolar
30 % Bone/skeletal

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What are the three points of the Functional Matrix Theory?

Muscles linked to the jaw
More tooth movement
Forward posture of mandible= stretched facial soft tissues

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What cases are Functional appliances used on?

• Class IIi
• Class IIii
• Rarely III

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What is the growing/ pubertal age for Girls to wear a functional appliance?

11-13

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What is the growing/ pubertal age for Boys to wear a functional appliance?

12 -14

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Indications for Functional Appliances:

•II mild/moderate
•Actively growing
•Increased overjet
•Buccal crossbites
• Potential competent lips
• Minimal crowding
•average/reduced LAFH

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What Dento Alveolar changes does a functional achieve?

•Retrocline the maxillary incisors
• Procline the mandible incisors
• Distal movement of the upper dentition
• Mesial movement of the lower dentition

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What skeletal changes does a functional achieve?

• passive molar eruption:
- Backward growth of the mandible
- Increased LAFH
•Glenoid Fossa is remodelled forward
• Condyle= down and forwards

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Advantages of Functional Appliances?

• can be removed for OH
• Easy to adjust
• Easy Anchorage= Base plate (Heat cure)

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Disadvantages of a Functional Appliance?

• Pt compliance
• Only tipping movements
• good Lab Technician needed
• Pt tolerance
• gingival trauma
• aching jaw/muscles

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Treatment for II i

• worn for 6-8 months
• functional postures mandible forwards
• overjet= 0mm
• incisors,canines, molars = III
• fixed appliance

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Treatment for IIii

• Procline upper incisors :
- URA + z spring/ anterior screw
- sectional upper 2-2
• Functional and z spring to keep incisors proclined
• Trt as IIi with functional
- reduce OJ ➡️ III

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Treatment for III

• Rare
• Mandible retracted
• Reverse TB
•Frankel -elimainates soft tissues =
Arch expansion and corrects buccal crossbites

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At the end of treatment whats relationship is achieved?

III
- over correction to allow for relapse

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What are the 4 types of functional appliances?

Tissuebourne
Toothbourne
Removable
Fixed

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Name the 6 functional appliances?

Clarks Twin Block
Herbst
Medium Open Activator MOA
Bionator
Frankel
COFF - Clip on fixed functional

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How long should a Clarks TB be worn for?

22 hours FT

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What type of appliance is a Clarks TB?

• Removable
• Toothbourne

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What are the measurements of a Clarks TB?

• Blocks = 7-8 mm + 70 angle

What planes are corrected with the Clarks TB?

• AP
• Transverse

Components of a Clarks TB?

• Blocks
•Baseplate
•Cribs
• Ball ended clasps
• Can add expansion screws and springs

What side effects does a Clarks TB have?

• Lateral Open bites
• posterior teeth stopped from over erupting due to capping from blocks

Disadvantages of a Clarks TB?

• not used on increased LAFH AND MMPA as increases.

What type of functional Appliance is a Herbst?

• Fixed • Tooth Bourne

What is the function of a Herbst applaince?

•Fixed • Rigid arms that posture the mandible forwards • Reduces the OJ

What are the disadvantages of a Herbst appliance?

• Cost • Breakages

What type of functional is a Medium Opening Activator?

• Removable • Toothbourne

Components of a Medium Opening Activator?

• Baseplate • lower incisor capping - postures lower mandible forwards • Anterior breathing hole

Advantage of MOA. Medium Opening Activator?

• No capping posterior so the molars can erupt - good for DEEP BITES

Disadvantage of Medium Opening Activator?

• Pt cant eat or speak • Difficult to tolerate

What type of functional is a Bionator?

• Removable • Tissue and Tooth bourne

Components of a Bionator?

• Labial bow extends posteriorly - holds cheeks away from buccal segments - Allows arch expansion • grooves in the lower part of the acrylic posture the mandible forwards • posterior capping- stops molars erupting

Disadvantages of a Bionator?

• Pt is unable to speak/ eat

What type of Functional is a Frankel?

• Removable • Tissue Bourne

List the types of Frankel appliances?

• FR1 • FR2 • FR3

What planes of space does a Frankel treat?

• AP • Transverse

What case would a FR1 trt?

IIi

What case would a FR2 trt?

II ii

What case would a FR3 trt?

III

What dentition and lip case would a Frankel be used on?

• mixed dentition • lip traps

What are the components of a Frankel?

• one piece • wire and acrylic that remove lips and soft tissues

Disadvantages of a Frankel?

• Expensive • one piece • pt cant eat/drink/ speak

What does COFF stand for?

Clip On Fixed Functional

What type of functional is a COFF?

• Fixed • Toothbourne

Components of a COFF?

• Acrylic Blocks attached to molar bands similar to TB • seps/ bands needed

What is a COFF similar too?

• Clarks TB • Blocks interlock at 70%

Advantage of a COFF

• Fixed • Fast • No Baseplate

Disadvantage of a COFF?

• Expensive • No baseplate- no screws- no expansion- cant fix crossbites • OH and cleaning