List of orthodontic functional appliances

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Upper and Lower Jaw Functional Expanders Upper and Lower Jaw Functional Expanders.jpg
Upper and Lower Jaw Functional Expanders

This is a comprehensive list of functional appliances that are used in the field of orthodontics. The functional appliances can be divided into fixed and removable. The fixed functional appliances have to be bonded to the teeth by an orthodontist. A removable functional appliance does not need to be bonded on the teeth and can be removed by the patient. A removable appliance is usually used by patients who have high degree of compliance with their orthodontic treatment. Fixed appliances are able to produce very accurate movement in the teeth [1]

Contents

Both fixed and removable functional appliances can be used to correct a malocclusion in three planes: Anterior-Posterior, Vertical and Transverse.

In the Anterior-Posterior dimension, appliances such as Class II and Class III are used. Appliances used in transverse dimension are utilized to expand either the maxillary or the mandibular arch. Appliances used in the vertical dimension are used to correct open or deep bite. [2] [3]

History

It is important to note that initially dento-facial Orthopaedics was mainly done in Europe. The United States was introduced to Fixed Orthodontics by Edward Angle. Norman William Kingsley was the first person to show "jumping the bite" by using an anterior bite plate. Hotz then developed the Vorbissplate which was a modification of Kingsley's plate. Wilhelm Roux is credited with being the first person who studied the effects of functional forces on Orthodontics in 1883. His workings were then used by other dentists studying dental orthopaedics. His teachings became known as Roux Hypothesis, which Karl Haupl later expanded upon. The Monobloc was developed by Pierre Robin (surgeon) in 1902 and is considered to be one of the first functional appliances in Orthodontics. The Monobloc was a modification of Ottolengui's removable plate. In 1908, Viggo Andersen developed the Activator appliance. This was the first functional appliance to be widely accepted, especially in Europe. This appliance became the "Norwegian" system of treatment in Orthodontics in the early 1900s.[ citation needed ]

In addition, in 1905 the Herbst Appliance was introduced by Emil Herbst. This appliance did not go through much evolution until the 1970s when Hans Pancherz revived interest in it. In the 1950s, Wilhem Balters modified Andersen's Activator appliance and gave the new appliance the name Bionator Appliance, which was designed to produce forward positioning of the mandible. The Positioner Appliance was developed by Harold Kesling in 1944 in order to aid the orthodontic treatment during the finishing stage. The Frankel appliance were developed by Rolf Frankel in 1957 for treatment of Class I, II, III Malocclusions . William Clark also developed Twin Block Appliance in 1978 which resembled Artur Martin Schwarz double plates that he developed in the 1950s.[ citation needed ]

Fixed appliances

Distalization appliances

Class II appliances

Class III appliances

Intrusion appliances

Mesialization appliances

Vertical Dimension appliances

Removable Appliances

Components

Some of the components of removal appliances are retentive in nature. They are usually connecting by an acrylic component known as baseplate. The majority of the appliances include components such as Labial Bow and Adams Clasp, both of these components are passive in nature. Labial bow is a wire attached to the baseplate which goes around the incisor teeth to provide retention of those teeth. Labial bow usually have U-Loops at the end to allow it to activate more. Adams clasps are used for retention of these removable appliances and are usually fabricated in the molar areas. They are usually manufactured from 0.7mm hard stainless steel wire (HSSW), or 0.6mm HSSW when planned for deciduous teeth. [4] Removal of the appliance is usually performed by holding the bridge of this clasp. Other clasps that are usually used are C clasps on canines, Southend Clasp (on anteriors), [5] Ball-ended clasp (primarily for use with the Twin Block system in the lower anteriors) [6] and Plint clasp.

Active components of removable appliances include springs which provides light forces on a tooth to move it orthodontically. Components such as Palatal Finger Springs, Buccal Canine Retractor, Z-Spring, T-Spring, Coffin Spring, Active Labial Bows (Mill's Bow or Roberts retractor), Screws and Elastics are all considered to be active components of the removable functional appliances. If a spring is moving one tooth it is made of 0.5mm thick stainless steel wire. The thickness increases to 0.6 or 0.7mm wire if it is to move more teeth or a larger/multi rooted tooth. [7]

Class II Appliances

Class III Appliances

Transverse Appliances

Distalization Appliances

Orthodontic/Deprogramming Splints

See also

Related Research Articles

<span class="mw-page-title-main">Orthodontics</span> Correctional branch of dentistry

Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, as well as misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial orthopedics.

<span class="mw-page-title-main">Retainer (orthodontics)</span> Device to hold teeth in position

Orthodontic retainers are custom-made devices, usually made of wires or clear plastic, that hold teeth in position after surgery or any method of realigning teeth. Once a phase of orthodontic treatment has been completed to straighten teeth, there remains a lifelong risk of relapse due to a number of factors: recoil of periodontal fibres, pressure from surrounding soft tissues, the occlusion and patient’s continued growth and development. By using retainers to hold the teeth in their new position for a length of time, the surrounding periodontal fibres adapt to changes in the bone which can help minimize any changes to the final tooth position after the completion of orthodontic treatment. Retainers may also be used to treat overjets.

<span class="mw-page-title-main">Dental braces</span> Form of orthodontics

Dental braces are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often used to correct underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces are often used in conjunction with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws.

<span class="mw-page-title-main">Premolar</span> Transitional teeth located between the canine and molar teeth

The premolars, also called premolar teeth, or bicuspids, are transitional teeth located between the canine and molar teeth. In humans, there are two premolars per quadrant in the permanent set of teeth, making eight premolars total in the mouth. They have at least two cusps. Premolars can be considered transitional teeth during chewing, or mastication. They have properties of both the canines, that lie anterior and molars that lie posterior, and so food can be transferred from the canines to the premolars and finally to the molars for grinding, instead of directly from the canines to the molars.

<span class="mw-page-title-main">Malocclusion</span> Medical condition

In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855–1930), the "father of modern orthodontics", popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet.

Orthodontic technology is a specialty of dental technology that is concerned with the design and fabrication of dental appliances for the treatment of malocclusions, which may be a result of tooth irregularity, disproportionate jaw relationships, or both.

<span class="mw-page-title-main">Overjet</span> Medical condition

Overjet is the extent of horizontal (anterior-posterior) overlap of the maxillary central incisors over the mandibular central incisors. In class II malocclusion the overjet is increased as the maxillary central incisors are protruded.

<span class="mw-page-title-main">Crossbite</span> Medical condition

Crossbite is a form of malocclusion where a tooth has a more buccal or lingual position than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches.

<span class="mw-page-title-main">Lingual arch</span>

A lingual arch is an orthodontic device which connects two molars in the upper or lower dental arch. The lower lingual arch (LLA) has an archwire adapted to the lingual side of the lower teeth. In the upper arch the archwire is usually connecting the two molars passing through the palatal vault, and is commonly referred as "Transpalatal Arch" (TPA). The TPA was originally described by Robert Goshgarian in 1972. TPAs could possibly be used for maintaining transverse arch widths, anchorage in extraction case, prevent buccal tipping of molars during Burstonian segmented arch mechanics, transverse anchorage and space maintenance.

Serial extraction is the planned extraction of certain deciduous teeth and specific permanent teeth in an orderly sequence and predetermined pattern to guide the erupting permanent teeth into a more favorable position.

Lingual braces are one of the many types of the fixed orthodontic treatment appliances available to patients needing orthodontics. They involve attaching the orthodontic brackets on the inner sides of the teeth. The main advantage of lingual braces is their near invisibility compared to the standard braces, which are attached on the buccal (cheek) sides of the tooth. Lingual braces were invented by Craven Kurz in 1976.

<span class="mw-page-title-main">Anchorage (orthodontics)</span> Way of resisting tooth movement in orthodontics

Anchorage in orthodontics is defined as a way of resisting movement of a tooth or number of teeth by using different techniques. Anchorage is an important consideration in the field of orthodontics as this is a concept that is used frequently when correcting malocclusions. Unplanned or unwanted tooth movement can have dire consequences in a treatment plan, and therefore using anchorage stop a certain tooth movement becomes important. Anchorage can be used from many different sources such as teeth, bone, implants or extra-orally.

Activator Appliance is an Orthodontics appliance that was developed by Viggo Andresen in 1908. This was one of the first functional appliances that was developed to correct functional jaw in the early 1900s. Activator appliance became the universal appliance that was used widely throughout Europe in the earlier part of the 20th century.

Frankel appliance or Frankel Functional Regulator is an orthodontic functional appliance which was developed by Rolf Fränkel in 1950s for treatment to patients of all ages. This appliance primarily focused on the modulation of neuromuscular activity in order to produce changes in jaw and teeth. The appliance was opposite to the Bionator appliance and Activator appliance.

Pendulum is an orthodontic appliance, developed by James J. Hilgers in 1992, that use forces to distalize the upper 1st molars to create space for eruption of impacted teeth or allowing correction of Class 2 malocclusion. This appliance is a fixed type of distalizing appliance that does not depend on the compliance of each patient to work. Hilgers published an article in Journal of Clinical Orthodontics in 1992 describing the appliance.

ACCO or Acrylic Cervical Occipital Anchorage is an appliance in field of orthodontics which is used for distalization of maxillary molars. This appliance is a removable type of appliance which was developed by Herbert I. Margolis. This appliance is intended to be worn 24 hours a day except during meals. It is one of the few removable appliances made for distalization of molars and thus require patient compliance for the treatment to be successful.

Intrusion is a movement in the field of orthodontics where a tooth is moved partially into the bone. Intrusion is done in orthodontics to correct an anterior deep bite or in some cases intrusion of the over-erupted posterior teeth with no opposing tooth. Intrusion can be done in many ways and consists of many different types. Intrusion, in orthodontic history, was initially defined as problematic in early 1900s and was known to cause periodontal effects such as root resorption and recession. However, in mid 1950s successful intrusion with light continuous forces was demonstrated. Charles J. Burstone defined intrusion to be "the apical movement of the geometric center of the root (centroid) in respect to the occlusal plane or plane based on the long axis of tooth".

Open bite is a type of orthodontic malocclusion which has been estimated to occur in 0.6% of the people in the United States. This type of malocclusion has no vertical overlap or contact between the anterior incisors. The term "open bite" was coined by Carevelli in 1842 as a distinct classification of malocclusion. Different authors have described the open bite in a variety of ways. Some authors have suggested that open bite often arises when overbite is less than the usual amount. Additionally, others have contended that open bite is identified by end-on incisal relationships. Lastly, some researchers have stated that a lack of incisal contact must be present to diagnose an open bite.

Orthodontic indices are one of the tools that are available for orthodontists to grade and assess malocclusion. Orthodontic indices can be useful for an epidemiologist to analyse prevalence and severity of malocclusion in any population.

The Herbst appliance is an orthodontic appliance used by orthodontists to correct class 2 retrognathic mandible in a growing patient, meaning that the lower jaw is too far back. This is also called bitejumping. Herbst appliance parts include stainless steel surgical frameworks that are secured onto the teeth by bands or acrylic bites. These are connected by sets of telescoping mechanisms that apply gentle upward and backward force on the upper jaw, and forward force on the lower jaw. The original bite-jumping appliance was designed by Dr. Emil Herbst and reintroduced by Dr. Hans Pancherz using maxillary and mandibular first molars and first bicuspids. The bands were connected with heavy wire soldered to each band and carried a tube and piston assembly that allowed mandibular movement but permanently postured the mandible forward. The appliance not only corrected a dental Class II to a dental Class I but also offered a marked improvement of the classic Class II facial profile.

References

  1. "https://www.bos.org.uk/Public-Patients/Orthodontics-for-Children-Teens/Treatment-brace-types/Fixed-appliances/Conventional"
  2. Graber, T. M.; Swain, B. F., eds. (1984-12-01). Orthodontics: Current Principles and Techniques (2nd ed.). Mosby. ISBN   9780801619663.
  3. Contemporary Orthodontics, 5e (5 ed.). Mosby. 2012-04-16. ISBN   9780323083171.
  4. "Luther, F. A. & Nelson-Moon, Z. A. Removable orthodontic appliances and retainers : principles of design and use"
  5. "Luther, F. A. & Nelson-Moon, Z. A. Removable orthodontic appliances and retainers : principles of design and use"
  6. " Fleming, P. S. E. & Lee, R. C. T. E. Orthodontic Functional Appliances: Theory and Practice."
  7. "Luther, F. A. & Nelson-Moon, Z. A. Removable orthodontic appliances and retainers : principles of design and use"