Functional Appliances

Question 1

What are the 2 functional matrices?

Answer 1

Capsular

Periosteum

Question 2

What is in the capsular matrix? (2)

Answer 2

Neurocranial capsular matrix

Orofacial capsular matrix

Question 3

Whats in the periosteum matrix? (2)

Answer 3

Periosteum

Muscle insertions

Question 4

Capsular matrix is responsible for…?

Answer 4

translation/sliding growth

Question 5

The capsular matrix produces growth due to …

Answer 5

Growth of surrounding structures

Question 6

The periosteum matric is responisble for …

Answer 6

growth mediated by bone remodelling

Question 7

5 periosteum growth centres in mandible?

Answer 7

• condyle
• coronoid process
• gonial angle
• basal bone
• alveolar bone

Question 8

Growth center + muscle: Condyle?

Answer 8

Pterygoid muscle

Question 9

Growth center + muscle: coronoid process?

Answer 9

temporalis muscle

Question 10

Growth center + muscle: gonial angle?

Answer 10

masseter muscle

Question 11

Growth center + muscle: alveolar and basal bone?

Answer 11

neuro-vascular bundle

Question 12

Functional appliances act on the _____ muscle stimulating growth and development especially on the …..

Answer 12

Pterygoid & condyle unit

Question 13

Muscle groups altered when using a functional appliance? (3)

Answer 13

• Masticatory muscles
• Facial muscles
• Suprahyoid muscles

Question 14

What are the masticatory msucles? (4)

Answer 14

• temporallis
• masseter
• internal/external pterygoid

Question 15

What are the facial muscles?

Answer 15

• Orbicular

- Buccinator

Question 16

What do the suprahyoid muscles do? (3)

Answer 16

• Maintain airway patency thru lower farinx
• control tongue position and function
• maintain equilibrium between masticatory and neck musculature

Question 17

Suprahyoid muscles and class II malocclusions?

Answer 17

Disequilibrium between suprahyoid musculature due to retrognathic and lower position of the mandible

Question 18

What 4 elements control craniofacial growth?

Answer 18

Anterior: maxilla and mandible
Posterior: mandibular condyle & ramus

Question 19

If disequilibrium occurs in craneofacial growth…

Answer 19

Bone dysplasia and disharmony takes place

Question 20

Craneofacial growth: equilibrium between anterior and posterior elements?

Answer 20

Growth vector is down and forward

- parallel direction to facial axis

Question 21

Craneofacial growth: tendency for anterior element vertical growth?

Answer 21

Dolichocephalic growth pattern

Question 22

Craneofacial growth: tendency for saggital anterior element growth?

Answer 22

Class II develops due to tenddency for anterior maxillary growth and decreased condylar growth

Question 23

Craneofacial growth: tendency for posterior element growth?

Answer 23

Growth has a horizontal vector

Class III osseous dysplasia may occur

Question 24

Functional appliances effect on mandibular growth: Condylar cell division?

Answer 24

Increased condylar CARTILAGE cell division

Question 25

Functional appliances effect on mandibular growth: Condylar growth?

Answer 25

Changes in condylar growth. | possibly posteriorly?

Question 26

Functional appliances effect on mandibular growth: Gonial angle changes?

Answer 26

- Mandibular lower posterior bone remodelling | - Mandibular advancement growth

Question 27

Functional appliances effect on mandibular growth: mandibular growth?

Answer 27

Horizontal mandibular growth

Question 28

Functional appliances effect on mandibular growth: Anatomy and neuromuscular function?

Answer 28

Has changes

Question 29

Functional appliances effect on mandibular growth: dentoalveolar changes? (3)

Answer 29

 Upper incisor retroclination  Lower incisor proclination  Mesial eruption of lower posterior teeth

Question 30

Functional appliances effect on mandibular growth: Anterior maxillary growth?

Answer 30

Anterior maxillary growth restriction

Question 31

Functional appliances effect on mandibular growth: glenoid fossa?

Answer 31

- Adaptive changes | - Anterior position of glenoid fossa

Question 32

Functional appliance indications? (6)

Answer 32

 Growing patients with high sagittal growth potential (Braquicephalic)  Class II patients with maxillary prognathism and mandibular retrognathism  Interceptive treatment  Distocclusion wit upper incisor procliantion and lower anterior retroclination (dento-alveolar class II)  As a retention appliance  Compliance patients

Question 33

Functional appliance contraindications? (5)

Answer 33

```  Cannot treat severe bone discrepancies  Bad prognosis in Dolicocephalic patients  Does not treat crowding or volumetric malocclusion  Normally needs a second stage (Fixed Orthododntics) treatment  Class II, division 2, class II with lower incisor proclination ```

Question 34

Functional appliances are always ... (2)

Answer 34

- bimaxillary appliances. | - They need a constructive bite registration

Question 35

The constructive bite will determine

Answer 35

The new maxillary –mandibular relationship

Question 36

Bite registration: With the anterior mandibular position we achieve? (2)

Answer 36

 Forward condyle movement in the glenoid fossa |  Stimulate muscle contraction

Question 37

There are 2 components to constructive bite. What do they depend on?

Answer 37

- Anterior-posterior - Vertical facial growth pattern, growth development, age, and type of appliance.

Question 38

Bite registration horizontal component: (5)

Answer 38

Mandibular sagittal position can be obtained in 3 ways  Maintain neutrocclusion  Mandibular advancement: around 3 mm less than maximum advancement possible by the patient  If overjet is accentuated, advancement is done in different stages  We can do unilateral mandibular advancement in structural deviations

Question 39

Bite registration vertical component: (6)

Answer 39

2 to 3 mm. more than rest height, although it will depend on  Facial growth pattern  Growth development and age  Type of appliance  If advancement is considerable, vertical opening should be small, so that we limit muscle stretching  Degree of vertical opening must be individualised in each.