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MYOFUNCTIONAL

APPLIANCES
ACTIVATOR
HISTORY:
Kingsley 1879 vulcanite plate for patients with retruded
mandible
Hotz devised a vorbissplatte
Pierre robin modified kingsley plate - monobloc
Viggo andersen 1908 (denmark) loose fitting appliance
biomechanical working retainer.
Karl haupl worked with andersen- functional jaw
orthopaedics & norwegian appliance or the activator.
Activators induces musculoskeletal adaptation by
introducing a new pattern of mandibular closure

The appliance loosely fits in the mouth

The patient has to move the mandible forward to engage


the appliance reflex
1. Prevention of further forward growth of the
maxillary dento alveolar process
2. Movement of maxillary dento alveolar process
distally
3. Reciprocal forward force on the mandible

Force is generated while sleeping and swallowing


Indications:
In actively growing individuals with favorable growth
patterns.

1. CLASS 2 division 1&2

2. Class 3 malocclusion

3. Class 1 open bite

4. Class1 deep bite

5. Before major fixed appliance therapy


6. For post treatment retention

7. Children with lack of vertical height


Contraindications
1. Correction of class I cases with crowded teeth caused
by disharmony b/w tooth size & jaw size.

2. In children with excess lower facial height.

3. In children whose lower incisors are severely


procumbent.

4. In children with nasal stenosis caused by structural


problems within the nose or chronic untreated allergy.

5. In non-growing individuals.
Advantages

1. Uses existing growth of the jaws


2. Minimal oral hygiene problems
3. Intervals b/w appointments is long
4. Appoinments are short
5. Minimal adjustments required
6. More economical
Disadvantages

1. Requires very good patient cooperation

2. Cannot produce a precise detailing & finishing of


occlusion.

3. May produce moderate mandibular rotation(hence


contraindicated in excess lower facial height cases)
Modifications

BOW ACTIVATOR By A.M.Schwarz

WUNDERERS MODIFICAITON FOR


CLASS III
BIONATOR
Developed by Balters during 1950
Modified activator less bulky & more
elastic

3 types-
Standard type-class II div I having narrow dental arches
Class III Appliance
Open bite appliance
TYPES OF BIONATOR

Standard type

Class III Appliance Open Bite Appliance


TWIN BLOCK APPLIANCE
The Twin Block appliance is a removable, orthodontic
functional appliance that is used to help correct jaw
alignment, particularly an underdeveloped lower jaw.

Effectively combines inclined planes with


intermaxillary & extraoral traction.
The removable twin block is a tooth-born functional appliance that is
worn fulltime.
It helps in the advancement of the mandible.
It is a two-piece appliance composed of an upper and lower bite block.
Orthopedic traction can be added in cases of severe skeletal
discrepancies.
This includes the use of a Concord Facebow (or headgear) at
0
nighttime. Upper & lower bite blocks interlock at 70 angle.
The fixed twin block is similar to the removable twin block,
but can be used in non-compliant patients.
Advantages

Very good patient acceptance.

Bite planes offer greater freedom of movement &


lateral excursion.
Less interference with normal function.

Significant changes in patients appearance within 2-3


months.
FRANKEL FUNCTIONAL APPLIANCE
Developed by Rolf Frankel
Also called oral gymnastic appliance

It has two main treatment effects


It serves as a template against which the cranio facial
muscle function
The appliance removes muscle forces in labial and
buccal areas that restricts skeletal growth thereby
providing an environment which enables skeletal
growth
MODE OF ACTION

The following are effects of frankel appliance

1. Increase in sagittal and transverse intra oral space


2. Increase in vertical space where appliance is kept free
from posterior teeth
3. Mandibular protraction
4. Muscle function adaptation the pads and shield
massage the blood vessels increase circulation
5. Shields loosen up the tight muscles and improve muscle
tone
Frankels exercises or oral gymnastics
1. lips closed at all times
2. swallowing speaking etc becomes exercise
while using the appliance
TYPES OF FRANKEL APPLIANCE

FR 1 : Class 1, class2 division 1 malocclusion


FR2 : Class2 division 1&2
FR3 : Class3
FR4 : Open bite and bimaxillary protrusion
FR5 : They are functional regulator which
incorporate head gear indicated in long face
patients having a high mandibular plane angle and
vertical maxillary excess
HERBST APPLIANCE
Fixed functional appliance developed by Emil Herbst in
early 1900s.

Indications:
-correction of class II MO due to retrognathic
mandible.
-can be used as anterior repositioning splint in
patients having TMJ disorders.
Specific indications

-Post adolescent patients: Treatment completed within 6-8 months,


hence possible to use the residual growth in these patient

-Mouth breathers

-Uncooperative patients

2 types:
-Banded Herbst
-Bonded Herbst
BANDED HERBST APPLIANCE

BONDED HERBST APPLIANCE


Advantages

Continuous action
Treatment duration is short
Less patient cooperation needed
Can be used in pts who are at the end of their growth
Can be used in pts with mouth breathing habit.
Disadvantages:

Cause minor functional disturbances.


Increased risk of development of dual bite,with tmj
dysfunction symptoms as a possible consequence.
Repeated breakage & loosening of appliance occurs,esp.
In lower premolar area.
Plaque accumulation & enamel decalcification can occur
Tendency for posterior open bite.
JASPER JUMPER
A relatively new flexible,fixed ,tooth borne FA.
Introduced by J.J.Jasper ,1980
Actions similar to Herbst appliance but lack rigidity.
Basically indicated in skeletal class II mo with max.
excess & mandibular deficiency.
Advantages
Produce continuous force

Does not require patient compliance

Allows greater degree of mandibular freedom than


herbst appliance

Oral hygiene is easier to manage.


Thank you.