Functional Applicances colloquim Flashcards
(49 cards)
1
Q
Monoblock characteristics
A
- Tooth borne appliance(can be combined)
2
Q
Monoblock elements
A
- Bi maxillary acrylic base
- Labial bow(0.8-0.9mm)
- Retention claps(0.7mm)
- Active springs and or expansion screws
3
Q
Monoblock uses
A
- Maxillary prognathism-II
- Mandibular prognathism- III
- Symetrical bimaxillary compression
- Lateral deviation of mandible
- Deep and open bite
4
Q
Monoblock working bite registration
A
- Sagittal plane-Mesial and distal/Class II/Class III
- Vertical plane
- Sagittal plane
- Mesial and distal occlusion recorded in class I/ In class II mandible protruded forward, in class III mandible retracted until edge to edge
- 1-2 mm bite opening between incisal edges of max and man teeth
- Midlines aligned
5
Q
Monoblock acrylic base borders in maxilla
A
- Incisal egde of incisors and canines buccally
- Middle of occlusal surfaces of premolars and molars
- Distally-distal surface of molars
6
Q
Monoblock acrylic base borders in mandible
A
- Lingual surfaces of mandibular anteriors-2-3 mm under cervices
- 5-6mm below mylohoid line in molars and premolars
7
Q
Monoblock advantages
A
- Treats occlusal problems
- Changes muscle function
- Eliminates bad habits
- Acceptable wear time-14-16 hours
8
Q
Monoblock therapeutic principle
A
- Mandibular protraction to class I=>
- Moved mesially and condyle position changed
- Anterior interocclusal acrylic intrudes mandibular front teeth
- Posterior interocclusal acrylic discludes bite-corrects deep overbite(vertical discrepancies)
- Acrylic grinded distally in maxilla and mesially in mandibe-> posterior teeth eruption guidance and bite opening
9
Q
Monoblock therapeutic principle when expansion screw added
A
- Interocclusal acrylic transfers active force to posterior teeth
- Moved buccally
10
Q
Monoblock time of use
A
At night and 2-3 hours during the day
11
Q
Activator characteristics
A
- Tooth borne passive myotonic appliance
- Effective for class II=>
- Correction of muscle function
- Growth spurt utilisation
- Eruption guidance
12
Q
Activator fabrication requirements
A
- Precise impression taking
- Lower impression tray extended manually to reach mylohoid line=>
- Where lower border of activator lies
13
Q
Activator elements
A
- Labial bow (0.8-0.9mm)-Anterior area for retention and/or tooth movement
- Retention clasps (0.7-0.8mm)-Adams, circumferential clasps
- Supplemental elements-Active springs, coil springs for headgear, expansion screws
- Acrylic base
circumferential clasp where molar tubes for headgear are present
14
Q
Acrylic base of activator
A
- Extends to palate, interocclusal space between posterior teeth and then to lingual surfaces of mandiular anteriors
- In mandibular posterior area- extends 12 mm apically to first molar gingival margin
- Mandibular anterior teeth area relieved with wax
Wax seperation to avoid acrylic lodging in area of mylohyoid line
Wax relief to present mandibular anterior teeth proclination
15
Q
Activator construction bite
A
- Sagittal plane=>maximal mandible protrusion then 3mm distally
- Vertical plane-=>bite opened between incisal edges of maxillary and mandibular anterior teeth- 4,8,10
- Sagittal plane-=>midlines aligned
16
Q
Activator indications
A
- Class II division 1 and 2
- Class I open bite/deep bite
- Class III
- Laterognathia
- Post treatment retention
-Laterognathia-Central midline not aligned w/ facial midline at rest or in occlusion=>True cross bite
17
Q
Activator time use
A
- Optimal time is during second premolar eruption phase-peak of pubertal growth
- Worn at night(12-14 hours)
- Can be used with facebow headgear
18
Q
Activator contra-indications
A
- Class I problems w/ crowding
- Nasal stenosis
Nasal stenosis-narrowing of nasal cavity
19
Q
Activator advantages
A
Little routine adjustments
20
Q
Activator disadvantages
A
- Bulky
- Requires good patient co-operation
- No precise detailing of occlusion
21
Q
Difference between activator and monoblock
A
- Working wax bite
- Increased vertical opening
- Midlines aligned
- Greater length of lingual wings
22
Q
Frankel functional regulator characteristics
A
- Tissue borne passive functional appliance
- Myodynamic and myotonic action
23
Q
Frankel regulator indications
A
- Class I w/ mandibular anterior teeth retroclination
- Class II div 1 w/ severe overjet
- Class II div 2 w/ maxillary constriction
- Class III w/ mandibular anterior teeth proclination
- Open bite
24
Q
Frankel working bite registration
A
- Sagittal plane- mandible advanced to Class I
- Vertical plane- Enough vertical opening(2.5-3mm) for cross over wires to pass through interocclusal area
- Sagittal plane- midlines aligned
25
Frankel regulator parts of appliance
* Acrylic base-Buccal shield, lingual shield, acrylic pads
* Labial bow
* Lingual support wire
* Palatal support wire
* Labial support wire
* Canine extension loop
26
Frankel regulator acrylic base components
* Two buccal shields
* One lingual shield
* Two labial pads
27
Acrylic pads position on Frankel
* On lateral sides of upper and lower labial frenuli
* 6mm apical of cervices of central incisors
* Deep in vestibular sulcus
* Oval shape and thickness of 2mm
* Stimulate apical base development
## Footnote
In mandible in Frankel I, II, IV and V, Maxilla in Frankel III
28
Frankel regulator types
* Type I- Functional regulator(Class I and mild Class II)
* Type II- Class II div 1 and 2
* Type III- Classs III
* Type IV- Anterior open bite and bimaxillary proclination
* Type V- W/ headgear
29
Fabrication technique for Frankel appliance
* Requires very precise impressions
* Well imprinted vestibular sulcus in labial and buccal area
* Frenula of lips and tongue
* Bucco-gingival frenula and sublingual area
30
Wire elements of frankel
* Maxillary labial bow
* Canine extension (canine loop)
* Lingual support wire
* Palatal support wire
* Support wires for labial pads
31
Acrylic base of frankel I and II
* Wax layer added->relief between acrylic parts and dentoalveolar region
* Thickness->3mm in area of teeth and 2.5mm in vestibular sulcus
## Footnote
Wax relief done with care to ensure correct adjustment of apppliance and expansion of ridge
32
Acrylic base in Frankel III
* In mandible-fits tightly on alveolar ridge buccally
* Wax relief only to upper model in ridge area
* Interocclusal acrylic
## Footnote
Design blocks unfavourable mandibular growth
33
Acrylic base of frankel IV
* Buccal shields acrylic base same as frankel I and II
* Interocclusal acrylic designed individually taking into account their form and location
* They should avoid interfering with distal translation of mandible and additional bite opening
## Footnote
Interdental embrassures and rests of buccal shields have to be avoided
34
Acrylic base of Frankel V
* Buccal shields have molar tubes in maxillary molar area=>
* Insertion of inner bow of headgear appliance
35
Labial bow of Frankel regulator
* 9mm round stainless steel wire
* In maxilla in Frankel I, II, IV and V, mandible in III
* Starts from buccal sheilds with rententive inflections, half loops and crosses incisors at midpoints
## Footnote
Loop portion must be 2mm away from tissue above canines-important when permanent canines erupting as may be hit if bends incorrect
36
Lingual shield of frankel
* Present in Frankel I and II
* In sublingual area and on lingual surfaces of mandibular teeth
* Extends from left to right second premolars(primary second molars)
* Holds mandible in mesial position
* Retentive inflections of lingual bow and springs connecting wires embedded in acrylic of shield
37
Frankel regulator buccal shields
* 2mm thickness
* Borders:- vertically-deep into vestibular sulcus of maxilla and mandible
* Anterior-to mesial surface of first permanent premolar or primary molar in maxilla or mandible
* Posterior-To distal surface of maxillary and mandibular first molar
38
Klammt elastic open activator characteristics
* Tooth borne passive myodynamic appliance
* Eliminates abnormal function and re-establishes balance between perioral muscles and tongue
* 24 hour wear
39
Klammt appliance elements
* Acrylic base
* Maxillary and mandibular labial bow (0.9mm)
* Maxillary and mandibular protrusion springs (0.7mm)
* Palatal bow (1.2 mm)
40
Labial bow for klammt appliance
* 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
41
Klammt appliance indications
* Class II w/ deep overbite
* Mixed dentition
## Footnote
Other indications include:
* Open bite
* Anterior teeth proclination and retroclincation
* Biprotrusion of anterior teeth
42
Protrusion springs for klammt appliance
* 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
## Footnote
To protect tongue-cut ends inserted w/ plastic tube
43
Palatal bow for Klammt appliance
* 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
44
Acrylic base for klammt appliance
* 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
## Footnote
* Occlusal acrylic surfaces are grinded gradually after a certain period of appliance wear(14 days), first trimmed distally to allow eruption of posterior teeth
45
Modifications of klammt appliance with regards to wire elements
* **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
46
Balters bionator Characteristics
* Removable myodynamic functional appliance
* Restores balance between muscles=>
* Tongue, lips and cheeks
47
Balters bionator indications
*Class II div 1 mixed dentition under following conditions=>
* Well aligned dental arches
* Functional retrusion
* Mild to moderate skeletal discrepancy
48
Balters bionator contraindications
* Class II caused by maxillary prognathism
* Labially tipped lower incisors
49
Balters bionator elements
* Labial bow
* Palatal bow
* Acrylic base
