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MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

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MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI
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Page 1: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

MANAGEMENT OF FUNCTIONAL APPLIANCE

SAKINAHMASYITAHAISHAH

FAIS ZULKHAIRI

Page 2: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

Pre-functional StageO a short period of treatment prior to fitting the

appliance optimize the benefits of a functional appliance. Eg:

1. Removable appliance with a midline expansion screw

Maxillary arch expansion prevent a posterior maxillary lingual crossbite in

saggital correction Not necessary in twin block

2. a removable appliance or a sectional fixed appliance prior to or parallel with the functional appliance class II division 2 incisor relationship Proclination

and alignment of the labial segments if they are retroclined or crowded

Page 3: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

Impression and Bite

Detailed impressions in alginate

both dental arches

Adequate extension into the lingual and labial vestibules• Particularly important in Fränkel functional

regulator as buccal shields and labial pads are made to actively stretch the mucosa.

Page 4: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

O Articulation in simple articulatorO working models mounted to a postured bite taken in

the mouth.O usually done in wax, with the mandible as far

forwards as is comfortable

Page 5: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

If the overjet is 10-mm or less• postured bite can be taken with the

incisors in an edge-to-edge relationship.

If greater than 10-mm• unlikely that full overjet reduction can be

achieved with a single appliance• appliance may need reactivating; either

by adjusting it so the mandible is postured further forwards,

• or by fabricating a second appliance once the overjet has been partially reduced

Page 6: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

O Vertically there should be approximately 2-mm of separation between the incisors.O But Harvold-type activators and twin -

block are acception• Constructed to open the bite

beyond the freeway spaceHarvold-type

activators

• which require at least 5-mm of vertical separation in the buccal segments to allow for the inclined occlusal planes

Twin-Block

Page 7: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

Appliance Fitting And Review

O Appliance should be fitted within 2weeks

O Show to the patient before fittingO Once fitted, full instructions be given

– min wear required per dayO Allow pt to practice insert and

removing appO The use of calendar in record hours

wornO Review 1/12, if no problem then

bimonthly

Page 8: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

Appliance Fitting And Review

Each review visit:O Record OJ and buccal segment r/shipO OJ in max protrusionO If no change within 6 months, tx plan should be

reviewedO Signs of poor wear: no change, continued problem

with speech, a pristine app with no signs of wear and numerous breakage d/t repeated removal by pt

Page 9: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

End of Treatment of Appliance and Retention

O Once OJ corrected, cont using appliance on part-time basis

O Further records (lat ceph) will aid in planning subsequent tx i.e. fixed appliance

O Unless early tx was done in mixed dentition. Pt will be directly transfer for fixed app

O Further tx should be planned to address any undeisrable effect

Page 10: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

End of Treatment of Appliance and Retention

O Retention should be continued until the end of adolescent skeletal growth

O Incorporate a postural component to maintain the class II correction

O This include: Parttime wear of cut down app or Removable app with inclined

anterior bite plane

Page 11: MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI.

ReferenceO Handbook of orthodontic

O Martyn T. Cobourne BDS(Hons) FDSRCS(Eng) FDSRCS(Edin) MSc MOrth RCS(Eng) FDSOrth RCS PhD (Author), Andrew T. DiBiase BDS(Hons) FDSRCS(Eng) MSc MOrth RCS(Eng) FDSOrth RCS (Author)


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