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TYPES OF ORTHODONTIC APPLIANCES
Dr . Fitri Octavianti 12th June 2013
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Orthodontic Appliances
Removable appliances Functional appliances Fixed appliances
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REMOVABLE APPLIANCES Appliances can be inserted and removed
from the mouth by the patient
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Component of removable appliance
Active component Retentive component Anchorage Baseplate
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Active components
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Active component of Removable Appliances
Springs, bows Screws Elastics
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Active component of Removable Appliances
Z-Spring 0.5 mm diameter SS Function: proclination of 1 or 2 incisors
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Active component of Removable Appliances
T-Spring 0.5 mm diameter SS= incisors 0.6 mm diameter SS=premolars Function: proclination of incisors, premolars
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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
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Active component of Removable Appliances
Labial Bow 0.7 mm diameter SS Function: retraction of anterior teeth
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Active component of Removable Appliances
Split Labial Bow 0.7 mm diameter SS Function: Retraction of anterior teeth and close midline diastema
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Active component of Removable Appliances
Robert Retractor 0.5 mm diameter SS + sleeve Function: retraction of anterior teeth
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Active component of Removable Appliances
Buccal canine retractor 0.7 mm diameter SS Function: Palatal and distal movement of mesially angulated canines
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Active component of Removable Appliances
Coffin spring 1.25 mm diameter SS Function: transverse expansion, buccal crossbite correction
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Active component of Removable Appliances
Screw Function: Expansion and distalization Activation: 1 turn / week = 0.25mm (1/4 turn)
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ELASTICS Rubber or Latex rings Used in: Extra oral traction
Inter-intramaxillary traction Patient cooperation
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Retentive components
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Types of Clasps 1. Adams Clasps 2. Southend Clasps 3. Labial bow
4. Ball-ended Clasps 5. Delta Clasps
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Retentive component of Removable Appliances
Adams clasps 0.7 mm diameter SS on molars 0.6 mm SS on premolars, canine and deciduous molar
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Retentive component of Removable Appliances
Southend clasps 0.7 mm diameter SS Function: Useful when distal movement of canines required
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Retentive component of Removable Appliances
Labial bow 0.7 mm diameter SS Function: Retention important when mesial / distal movement is planned
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Retentive component of Removable Appliances
Labial bow Short labial bow Long labial bow
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Ball- ended Clasps 0.7 mm diameter SS Undercut interproximally
minimal retention
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Delta Clasps 0.7 mm diameter SS Difficult to adjust
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Anchorage Definition: the resistance to unwanted tooth movement
equal in magnitude and opposite in direction
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Types of intra oral Anchorage
Simple Reciprocal Stationary Intermaxillary
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Types of INTRA ORAL Anchorage
Simple Anchorage Active movement of few teeth versus several anchor teeth
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Types of intra oral Anchorage
Resiprocal Anchorage When two teeth or two sets of teeth move to an equal extent in an opposite direction
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Types of intra oral Anchorage
Stationary Anchorage Bodily movement of one group of teeth against tipping of another
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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
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Baseplate 1. Hold components 2. Clear acrylic : - heat cure - cold cure - autoresin 3. Comfortable 4. Good fit 5. Can be active - biteplanes
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Baseplate Posterior biteplanes Anterior biteplanes
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FUNCTIONAL APPLIANCES
Removable or fixed orthodontic appliances which use forces generated by the stretching of muscles, fascia, and /or periodontium to alter skeletal and dental relationships
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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
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INDICATIONS PATIENT Growing patient Motivated patient DENTAL
Classic case: uncrowded, well aligned Functional appliance have non-mechanism for treating irregularities of alignment of teeth SKELETAL Moderate to severe Class II skeletal base Normal to low MMPA
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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
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TYPES OF FUNCTIONAL APPLIANCE
TWIN BLOCK THE ANDRESEN ACTIVATOR THE HARVOLD ACTIVATOR HERBST APPLIANCE MEDIUM OPENING ACTIVATOR BIONATOR FRANKEL APPLIANCE Others
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Twin block appliance The upper and lower parts fit together using posterior bite blocks with interlocking biteplanes which posture the mandible forward
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The Andresen Activator
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Herbst Appliance A fix-functional appliance.
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Bionator Minimal bulk
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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
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WEAR 12-14 hrs-Andresen, Harvold, Bionator
Full-time- twin block, Herbst, Frankel (except for eating and sports)
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appliance which is fixed to teeth and cannot be removed by the patient
FIXED APPLIANCES appliance which is fixed to teeth and cannot be removed by the patient
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COMPONANTS OF FIXED APPLIANCE
1. Attachments include bands (especially on 1st and 2nd molars) & brackets bonded directly to the teeth (especially on anterior & premolar teeth) . 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 .
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E G A C D F B A. Bracket E. Hook B. Arch wire F. Tube C. Elastomeric modules G. Band D. Elastic
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Full banding braces
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Metal bracket
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Plastic brackets Plastic brackets with metal slot
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Ceramic brackets
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Self ligating bracket
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Self ligating clear bracket
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Lingual appliances
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Clear plastic appliances
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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 - Multiple tooth movement - Fewer tooth movement
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