TYPES OF ORTHODONTIC APPLIANCES
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Transcript of TYPES OF ORTHODONTIC APPLIANCES
TYPES OF ORTHODONTIC APPLIANCES
Dr . Fitri Octavianti12th June 2013
Orthodontic Appliances
• Removable appliances• Functional appliances• Fixed appliances
REMOVABLE APPLIANCES• Appliances can be inserted and removed from the mouth by the patient
Component of removable appliance
• Active component• Retentive component• Anchorage• Baseplate
Active components
Active component of Removable Appliances
• Springs, bows• Screws• Elastics
Active component of Removable Appliances
Z-Spring• 0.5 mm diameter SS• Function: proclination of 1 or 2 incisors
Active component of Removable Appliances
T-Spring • 0.5 mm diameter SS= incisors• 0.6 mm diameter SS=premolars• Function: proclination of incisors, premolars
Active component of Removable Appliances
Finger /palatal spring
• 0.5 mm diameter SS= incisors• 0.6 mm diameter SS= canine and premolars• Function: mesial or distal movement
Active component of Removable Appliances
Labial Bow • 0.7 mm diameter SS• Function: retraction of anterior teeth
Active component of Removable Appliances
Split Labial Bow • 0.7 mm diameter SS• Function: Retraction of anterior teeth and close midline diastema
Active component of Removable Appliances
Robert Retractor • 0.5 mm diameter SS + sleeve• Function: retraction of anterior teeth
Active component of Removable Appliances
Buccal canine retractor• 0.7 mm diameter SS• Function: Palatal and distal movement of mesially angulated canines
Active component of Removable Appliances
Coffin spring • 1.25 mm diameter SS• Function: transverse expansion, buccal crossbite correction
Active component of Removable Appliances
Screw
Function: Expansion and distalization
Activation: 1 turn / week = 0.25mm (1/4 turn)
ELASTICS
Rubber or Latex rings
Used in:– Extra oral traction– Inter-intramaxillary traction
Patient cooperation
Retentive components
Types of Clasps
1. Adams Clasps
2. Southend Clasps
5. Delta Clasps
4. Ball-ended Clasps
3. Labial bow
Retentive component of Removable Appliances
• 0.7 mm diameter SS on molars• 0.6 mm SS on premolars, canine and
deciduous molar
Adams clasps
Retentive component of Removable Appliances
• 0.7 mm diameter SSSouthend clasps
Function: Useful when distal movement of canines required
Retentive component of Removable Appliances
• 0.7 mm diameter SSLabial bow
Function:- Retention- important when mesial / distal
movement is planned
Retentive component of Removable Appliances
Labial bowShort labial bow
Long labial bow
Ball- ended Clasps
• Undercut interproximally
• minimal retention
• 0.7 mm diameter SS
Delta Clasps
• 0.7 mm diameter SS• Difficult to adjust
Anchorage
Definition: the resistance to unwanted tooth movement
• equal in magnitude and opposite in direction
Types of intra oral Anchorage
• Simple
• Reciprocal
• Stationary
• Intermaxillary
Types of INTRA ORAL Anchorage
Simple Anchorage
Active movement of few teeth versus several anchor teeth
Types of intra oral Anchorage
Resiprocal Anchorage
When two teeth or two sets of teeth move to an equal extent in an opposite direction
Types of intra oral Anchorage
Stationary Anchorage
Bodily movement of one group of teeth against tipping of another
Types of intra oral Anchorage
Intermaxillary Anchorage
When the anchorage units situated in one jaw used to provide the force required to move teeth in the opposing jaw
Baseplate
1. Hold components2. Clear acrylic : - heat cure - cold cure - autoresin3. Comfortable4. Good fit5. Can be active - biteplanes
Baseplate
Posterior biteplanes Anterior biteplanes
REMOVABLE OR FIXED ORTHODONTIC APPLIANCES WHICH USE FORCES GENERATED BY THE STRETCHING OF MUSCLES, FASCIA, AND /OR PERIODONTIUM TO ALTER SKELETAL AND DENTAL RELATIONSHIPS
FUNCTIONAL APPLIANCES
TYPE OF CASE• For correction of moderate to severe Class II div I and Class II div 2• Less for correction of Class III due to much lower success
INDICATIONS
PATIENT1. Growing patient2. Motivated patientDENTAL3. Classic case: uncrowded, well aligned 4. Functional appliance have non-mechanism for treating
irregularities of alignment of teethSKELETAL5. Moderate to severe Class II skeletal base 6. Normal to low MMPA
CONTRA INDICATIONS• Non-growing• Non compliance• Labial tipping of lower incisors• Care needed with: High angle cases with backward mandibular growth rotation Cases with proclined lower incisors
TYPES OF FUNCTIONAL APPLIANCE• TWIN BLOCK• THE ANDRESEN ACTIVATOR• THE HARVOLD ACTIVATOR• HERBST APPLIANCE• MEDIUM OPENING ACTIVATOR• BIONATOR• FRANKEL APPLIANCE• Others
Twin block appliance• The upper and lower parts fit together using posterior bite
blocks with interlocking biteplanes which posture the mandible forward
The Andresen Activator
Herbst Appliance
• A fix-functional appliance.
Bionator
• Minimal bulk
The Frankle Appliance
• Is a functional regulator and uses shield.
• Complex, uncomfortable, rapid changes if worn properly.
• Three main variants:• FR1: Class II div 1• FR2: Class II div2• FR3: Class III
WEAR• 12-14 hrs-Andresen, Harvold, Bionator• Full-time- twin block, Herbst, Frankel (except for eating and sports)
APPLIANCE WHICH IS FIXED TO TEETH AND CANNOT BE REMOVED BY THE PATIENT
FIXED APPLIANCES
2. Axillaries (attach arch wire to brackets and bands to move teeth such as tubes, hooks and elastics
3. Arch wires are attached to the brackets by bending the wire, it will give force and pressure that cause teeth to move in the desired direction .
1. Attachments include bands (especially on 1st and 2nd
molars) & brackets bonded directly to the teeth (especially on anterior & premolar teeth) .
COMPONANTS OF FIXED APPLIANCE
A
B
C
D
E
F
G
A. Bracket
B. Arch wire
C. Elastomeric modules
D. Elastic
E. Hook
F. Tube
G. Band
Full banding braces
Metal bracket
Plastic brackets Plastic brackets with metal slot
Ceramic brackets
Self ligating bracket
Self ligating clear bracket
Lingual appliances
Clear plastic appliances
Fixed Appliances Removable appliances - Precise three dimensional control of tooth movement
- Less precise control of tooth movement
- Bodily tooth movement - Tipping movement - High anchorage requirement - Smaller anchorage
requirement - Controlled space closure possible
- Controlled space closure difficult
- Simple to correct rotations - More difficult to correct rotations.
- Long chairside time - Short chairside time - Not dependent on compliance to wear
- Dependent on compliance to wear
- Require extensive training to manage
- Require less training to manage
- Multiple tooth movement - Fewer tooth movement