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MANAGEMENT OF FUNCTIONAL APPLIANCE

MANAGEMENT OF FUNCTIONAL APPLIANCE. SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI. Pre-functional Stage. a short period of treatment prior to fitting the appliance optimize the benefits of a functional appliance. Eg : Removable appliance with a midline expansion screw

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MANAGEMENT OF FUNCTIONAL APPLIANCE

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  1. MANAGEMENT OF FUNCTIONAL APPLIANCE SAKINAH MASYITAH AISHAH FAIS ZULKHAIRI

  2. Pre-functional Stage • a short period of treatment prior to fitting the appliance optimize the benefits of a functional appliance. Eg: • Removable appliance with a midline expansion screw • Maxillary arch expansion • prevent a posterior maxillary lingual crossbite in saggital correction • Not necessary in twin block • 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

  3. Impression and Bite

  4. Articulation in simple articulator • working models mounted to a postured bite taken in the mouth. • usually done in wax, with the mandible as far forwards as is comfortable

  5. Vertically there should be approximately 2-mm of separation between the incisors. • But Harvold-type activators and twin -block are acception

  6. Appliance Fitting And Review • Appliance should be fitted within 2weeks • Show to the patient before fitting • Once fitted, full instructions be given – min wear required per day • Allow pt to practice insert and removing app • The use of calendar in record hours worn • Review 1/12, if no problem then bimonthly

  7. Appliance Fitting And Review Each review visit: • Record OJ and buccal segment r/ship • OJ in max protrusion • If no change within 6 months, tx plan should be reviewed • 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

  8. End of Treatment of Appliance and Retention • Once OJ corrected, cont using appliance on part-time basis • Further records (lat ceph) will aid in planning subsequent tx i.e. fixed appliance • Unless early tx was done in mixed dentition. Pt will be directly transfer for fixed app • Further tx should be planned to address any undeisrable effect

  9. End of Treatment of Appliance and Retention • Retention should be continued until the end of adolescent skeletal growth • Incorporate a postural component to maintain the class II correction • This include: • Parttime wear of cut down app or • Removable app with inclined anterior bite plane

  10. Reference • Handbook of orthodontic • 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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