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ORTHOPAEDIC APPLIANCES

ORTHOPAEDIC APPLIANCES. Dr. Praveena Shetty. INTRODUCTION.

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ORTHOPAEDIC APPLIANCES

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  1. ORTHOPAEDIC APPLIANCES Dr. PraveenaShetty

  2. INTRODUCTION In orthodontic practice forces employed are of 2 types:- Orthodontic force -50 to 100 gms.- Orthopaedic force-above 400 gms.BASIS FOR ORTHOPAEDIC APPLIANCES:- Orthopaedic appliances utilize teeth as handles to transmit the forces - To the adjacent skeletal structures.- Amount of force-above 400 gms.- Duration of force-12 to 14 hrs./day

  3. COMMONLY USED ORTHOPAEDIC APPLIANCES • Head gear • Face mask • Chin cup

  4. HEAD GEAR - Most commonly used extra-oral orthopaedic appliance. - Derives anchorage from cervical or cranial region. 3 COMPONENTS : • Face bow • The force element • The head cap or cervical strap. Components of a head gear assembly

  5. FACE BOW - Transmits extra-oral forces on to the posterior teeth. Parts: Outer bow Inner bow Junction FORCE ELEMENT - Provides force to bring about the desired effect. Parts: Springs Elastics and Other stretchable materials.

  6. HEAD CAP - Appliance takes anchorage from the rigid bones of the skull or from the back of the neck by means of a head cap or neck strap or combination.

  7. PRINCIPLES OF HEAD GEARS - Centre of resistance of the dentition. - Centre of resistance of maxilla. - The point of origin of the force. - Point of attachment of force.

  8. TYPES OF HEAD GEARS Based on site of anchorage , 3 types • Cervical head gears • Occipital head gears • Combination head gears

  9. A) Cervical Head Gear B) Occipital Head Gear C) Combination Head Gear

  10. Uses of head gear: - Orthopaedic effect - Anchorage augmentation - Distalization of molars - Molar rotation - Space maintenance

  11. FACE MASK Principle of pulling forceon the maxillary structures with reciprocal pushing force on the forehead or mandible through facial anchorage is simple and mechanically sound enough to be used as a therapeutic procedure for treatment of prognathic syndromes,maxillary retrusions,clefts and mandibular prognathism. Indications: • Growing patient with prognathic mandible and retrusive maxilla. • Bending condylar neck for stimulating TMJ adaptations to posterior displacement of chin. • Selective rearrangement of palatal shelves in cleft patients. • Correction of post-surgical relapse after osteotomies. • Treat problems associated with nose morphology e.g. lateral deviation

  12. SITES OF ANCHORAGE: -From Skull -From chin -From chin and forehead BIOMECHANICAL CONSIDERATION Amount of force-for skeletal changes is about 1 pound/side. Duration of force-time is proportional to the amount of force utilized. Low forces(250 gm/side) -13 months Very high forces(1600-3000gm)-4 to 21 days. Direction of force-15 to 20 degree downward pull to the occlusal plane for pure forward translatory motion of maxilla.If line of force is parallel to occlusal plane,a forward translation as well as an upward rotation takes place. Frequency of use -12 to 14 hrs. of wear a day.

  13. Parts of a reverse pull head gear: • Chin cup • Forehead cap • Intra oral appliance • Elastics • Metal frame Chin cup with head gear

  14. TYPES OF REVERSE PULL HEAD GEAR - Protraction head gear by Hickham - Face mask by Delaire - Tubinger model - Petit type of face mask

  15. CHIN CUP Extra oral orthopaedic device to restrict the forward and downward growth of the mandible. Parts: Chin cup-face bow assembly consists of : - Chin cup - Head cap - Adjustable elastic strap to connect the two

  16. Types of chin cups: - Occipital pull chin cup - Vertical pull chin cup

  17. Fabrication of chin cup: - Individually by taking impression of chin and fabrication by self cure acrylic on the cast poured. - Pre-fabricated commercially. Force of magnitude: - At the time of appliance delivery-150 to 300g/side - Next 2 months- force increased to 450 to 700g/side; - Duration of wear-12 to 14 hrs. a day

  18. Thank You

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