Myofunctional appliances

MYOFUNCTIONAL APPLIANCES
www.indiandentalacademy.com

“Who dares nothing ,
should hope for nothing”

HISTORY
KINGSLEY – Introduced the term” jumping the bite” for
patients with mandibular retrusion. -1880
He used a vulcanite palatal plate with an anterior inclined
plane which guided the mandible to a forward position when
the patient closed on it.
KINGLEY’S –idea influenced the development of functional
jaw orthopedics.

Robin’s monobloc- developed in early 1900’s
is the forerunner of all the functional appliances.
But the activator developed by ANDRESEN in Norway
in the 1920’s was the first functional appliance to be
widely accepted
Functional appliances were introduced into American
Orthodontics in the 1950’s.

BIMLER’S Labio-lingual appliances- -1949
VESTIBULAR APPLIANCES-(FRANKEL)- 1967
TWIN BLOCK APPLIANCES--1977

Functional appliance:-by definition is one
that
changes the posture of the mandible,holding
it open (or) open and forward (Proffit).
Stretch of the muscles and soft
tissues creates
pressures transmitted to the dental
and skeletal structures,moving teeth
and modifying growth.
DEFINITION

Definition:
Functional appliances are passive
appliances which harness natural
forces of the oro-facial musculature
that are transmitted to the
teeth and alveolar bone in a
predetermined direction.

All functional appliances are intraoral
devices,and nearly all of them are tooth borne
or supported by teeth.
These appliances are removable,primarily
consisting of acrylic with wire components for
retention &support.
Most of the functional appliances are used to
correct early class-2 malocclusions and some
cases of class –3 malocclusions.

CLASSIFICATION
According to “Tom Graber”:-
1.Group- A- Teeth supported appliances,
-catlan’s appliance,Inclined planes.
2.Group –B-Teeth/tissue supported appliances.
-Activator,Bionator etc
3.Group-C- Vestibular positioned appliances
with isolated support from tooth /tissue,
-Frankel appliance, Lip bumpers.

ACCORDING TO PROFITT
1.Tooth borne passive-
-Andersen activator
-Woodside and Harvold activator
-Bionator
2.Tooth borne active-
-Modified activator
-Expansion activator
-Orthopaedic Corrector
-Stockli headgear activator
3.Tissue borne appliances(Passive)s
-Frankel appliance.www.indiandentalacademy.com

Other classifications
1.MYOTONIC APPLIANCES:-
Depend muscle mass for their
action.
2.MYODYNAMIC APPLIANCES:-2.MYODYNAMIC APPLIANCES:-
Depend on muscle activity for
for their function.
.

1.REMOVABLE FUNCTIONAL APPLIANCES
-Activator
-Bionator
-Frankel
-Twin Block
2.Fixed functional appliances
-Herbst
-Jasper jumper
-Forsus
(Fatigue resistant device)www.indiandentalacademy.com

ADVANTAGES OF FUNCTIONAL APPLIANCES
1.To eliminate abnormal perioral muscle functions which
interfere with normal bone growth
.
2.Treatment can be started in early mixed dentition stage.
3.Easier to maintain oral hygiene.
4.Do not have any side effects of mechanotherapy
Such as---enamel decalcification,root resorption,
--gingivitis.

WHY_MEN_DIE_BEFORE_WOMEN

Lip pads hold the lips away from
teeth and force the lips to stretch
to obtain an oral seal.www.indiandentalacademy.com

The buccal shield holds the soft tissue
away from the dentition and facilitates
posterior dental expansion by disrupting
the tongue –cheek equilibrium.

LIMITATIONS OF FUNCTIONAL APPLIANCES
1. Individual tooth movements cannot be
achieved .
2. Cannot be used in adult patients.
3. Patient cooperation is essential for the
success of the treatment.
4. Cases treated with functional appliance may
require fixed appliance therapy for final
detailing of occlusion.-2phase Rx.

BIONATOR
Developed by-Balter-1950
HORSE SHOE SHAPED-acrylic lingual plate

VESTIBULAR SCREEN (OR) ORAL SCREEN
Introduced by Newell
-1912

MODIFICATIONS OF ORAL SCREEN
KRAUS - -WITH HOLES
HOTZ -- LINGUAL SIDE
PROJECTION OF ACRYLIC TO
KEEP TOUNGE AWAY.

TWIN BLOCK APPLIANCE

Introduced by william J.Clark in--1982

Advantages of delta clasp:
1.Does not open with repeated insertion & removal.
2.Maintains its shape better and requires less adjustment.
3.Subjected to less breakage.

MODIFICATIONS OF TWIN BLOCK
BROADBENT
CLARK
MAHONY-TO OPEN & TO CLOSE
MODIFIED McNamara

MODIFIED
McNamara
TWIN BLOCK

ACTIVATOR
DEVELOPED BY VIGGO ANDRESEN-1908
LATER WAS CALLED “NORWEGIAN APPLIANCE”
Modifications were done in Norway teaming up with HAUPL
They later called it ACTIVATOR- due to its ability to
activate the muscles.

INDICATIONS OF ACTIVATOR
1. CLASS 2 DIV-1 MALOCCLUSION
2. CLASS 2 DIV-2 MALOCCLUSION
3. CLASS 3 MALOCCLUSION
4. CLASS 1 OPENBITE
5. CLASS 1 DEEP BITE
6. FOR POST TREATMENT RETENTION

CONTRANDICATIONS
1. In children with excess LFH-and extreme
vertical mandibular growth .
2. In class –1 crowding.
3. Has limited application in non-growing children.
4. In severely proclined lower incisors.

ACTIVATOR-
AND ITS
MODIFICATIONS

STRANGE DENTIST

FUNCTION REGULATOR
OR
FRANKEL APPLIANCE

FRANKEL APPLIANCE
Developed by Prof. ROLF FRANKEL of GERMANY
Also called –Vestibular Appliance and
Oral –Gymnastic appliance
(FRANKEL –recommended
certain oral excercises called
oral gymnastics-hence the name)

FRANKEL APPLIANCE( OR)
FUNCTIONAL REGULATOR

TYPES OF
FRANKEL
1. FR1a
2. FR1b
3. FR1c
4. FR2
5. FR3
6. FR4

Parts of frankel:-
1.Buccal shields
2.Lip pads- upper and lower
3.lingual shield
4.Palatal bow
5.Labial bow—upper or lower
6.Lingual stabilizing bow
7.Canine clasp
8.protrusion bow
9.Lower lingual spring
10.Lower labial wires
11.Occlusal rest. www.indiandentalacademy.com

Parts of FR-2-Class 2-div-1&2
The acrylic components include:-
A.Buccal shields
B.Lip pads
C.Lower lingual pad
The wire components include:-
A. Palatal bow
B.Labial bow
C.Canine Extensions
D.Upper Lingual wire
E.Lingual crossover wire
F.Support wire for lip pads
G.Lower lingual springs.www.indiandentalacademy.com

DIFFERENCES
BETWEEN
ACTIVATOR &
FRANKEL

A STORY ABOUT EVERYBODY
This is a story about four people
named Everybody, Somebody,
Anybody, and Nobody. There was
an important job to be done and
Everybody was asked to do it.
Everybody was sure Somebody
would do it. Anybody could have
done it, but Nobody did it.
Somebody got angry about that,
because it was Everybody's job.
Everybody thought Anybody could
do it but Nobody realized that
Everybody wouldn't do it. It
ended up that Everybody blamed
Somebody when Nobody did what
Anybody could have done.
Rate this joke

Dr VINEETH V T
LATERAL & MEDIAL PTERYGOID
LATERAL PTERYGOID:
It is a short & conical muscle.
Has upper & lower head.
MEDIAL PTERYGOID:
Quadrilateral muscle
Has superficial & deep head

MODE OF
ACTION OF
FUNCTIONAL
APPLIANCE

Commonly used fixed functional appliances:-
1. Herbst Appliance
2. Jasper jumper
3. Forsus (Fatigue resistant device.)
4. MARA –Appliance (Mandibular anterior
5. repositioning device)
6. Eureka Spring

FIXED
MYOFUNCTIONAL
APLIANCES

“Inaction creates fear in one’s
mind,
and action removes fear.”

Myofunctional appliances

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Myofunctional appliances