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At least 19 recordsLinked to original sources
PubMed2000

How orthodontic functional appliances work.

Orthodontic functional appliances are an essential part of an orthodontist's armamentarium. The amount of their use varies greatly, some feeling they have limited use with minor effects, others claiming dramatic changes in facial growth and appearance, without significant genetic constraints. The evidence on clinical use is not equivocal, the general results however not showing an unlimited amount of skeletal change, but rather a balance of change in the growth of the facial bones and dentition with clinically significant changes in the facial soft tissues. This article examines the current evidence.

Adolescent↗
PubMed1993

Early surgical correction of unilateral TMJ ankylosis and improvement in mandibular symmetry with use of an orthodontic functional appliance--a case report.

Early ankylosis of the temporomandibular joint (TMJ) can be a deterrent to normal mandibular growth. The frequency of occurrence is rare in the population of young patients who undergo orthodontic treatment. Early diagnosis of TMJ ankylosis is important and early surgical intervention is now an accepted mode of treatment. Ankylosis infers minimal, if any joint function. Caldwell argues that restoration of joint function at an early age is necessary to activate as much growth potential as possible. Laboratory and clinical studies have supported the theory that the mandibular condyle is adaptable under function and perhaps even the most deformed condylar head may exhibit growth when released and placed in function. The purpose of this article is to present a case report of surgical release of TMJ ankylosis followed by radiographic and clinical evidence of unilateral condylar growth. The surgical procedure involved maintenance of the condyle, the disk and majority of fibrocartilage covering the mandibular condyle. Aggressive postoperative physical therapy and the employment of a functional orthodontic appliance appeared to have assisted in a more symmetric growth pattern and maintenance of appropriate function.

Ankylosis↗
PubMed1995

Guiding occlusal development with functional appliances.

Orthodontic treatment with functional appliances has been available since the beginning of this century. One of the first known functional appliances, 'the Monobloc', was introduced at a conference in Paris in 1926 by Pierre Robin. This appliance had been developed at the beginning of the century for the treatment of patients with Pierre Robin syndrome. Patients with this syndrome have extreme retrognathia of the mandible at birth and, as a result, the tongue is so far back in the pharynx that there is a risk of suffocation. Several years later, the same appliance was modified by Pierre Robin himself for the treatment of patients with Class II malocclusions which are in combination with extreme overjet.

Activator Appliances↗
PubMed1989

Place of functional appliances in orthodontics.

Functional orthodontic appliances have recently captured the interest of a significant portion of the dental profession. In numerous articles and short courses, functional appliances have been portrayed as a new, low cost, easily managed and completely safe treatment modality. Claims have been made that they can make mandibles grow, can align the dentition without the need for extractions, and that because such treatment effects are achieved 'physiologically' they are thus inherently stable. Do functional appliances really work? The historical background to the development of functional appliances is described and the results of a number of clinical investigations are compared and discussed. Comment on the implications of functional appliance therapy is given and finally, a statement as to the rational use of functional appliances in practice is suggested.

Activator Appliances↗
PubMed2006

Effects of functional orthodontic appliances in the correction of a primary anterior crossbite--changes in craniofacial morphology and tongue position.

Chin caps have been used for the correction of primary anterior crossbites, but previous studies of the treatment effects have highlighted problems such as pressure on the temporomandibular joint (TMJ). Therefore, to reduce pressure on the TMJ, a functional orthodontic appliance, the Yanagisawa Class III (YC3) shield was developed to improve the overjet in the primary dentition. The aim of this study was to determine the treatment effects of the YC3 in correcting a primary anterior crossbite compared with a chin cap. The pre- and post-treatment lateral cephalograms of 10 patients (5 male, 5 females) and 10 treated with a YC3 (5 males, 5 females) were compared in relation to craniofacial morphology and tongue position [the YC3 was used from 51 months of age +/- 7 months to 74 months of age +/- 12 months (i.e. for 23 +/- 9 months) and the chin cap from 53 months of age +/- 2 months to 75 months of age +/- 1 month (i.e. for 22 +/- 5 months)]. A Mann-Whitney U-test was used to determine any statistical differences. The YC3 group showed significantly higher values for gonial angle and U1 to SN (P < 0.05), and significantly lower values for interincisal and tongue position (P < 0.05), compared with the chin cap group. The results indicate that the use of the YC3 not only improves overjet, but also changes the tongue position. The findings also suggest that the YC3 results in functional effects on the skeletal system during the mid-growth period.

Cephalometry↗
PubMed1993

[A critical evaluation of Class-II anomalies treated with functional orthodontic appliances].

In the course of a clinical and radiological follow-up study of 55 patients with class II malocclusions, who had been treated with functional appliances, the dental and skeletal changes were critically studies and statistically analyzed in relation to long term aesthetic, dental, and skeletal changes. Differences between class II, division 1 cases and class II, division 2 cases were also compared. The study revealed that at the end of the treatment period 80% of the functionally treated patients displayed much better nose to upper lip relations than at treatment begin. Aesthetically the best treatment results were in the class II, first group patients with an average 4.2 degree reduction of the soft tissue H-angle in the course of functional therapy. It was shown that both dental and skeletal changes were responsible fo the in most cases good treatment results, whereas the changes in patients in the two subgroups with class II malocclusions showed significant differentiations. This paper describes these changes in detail. Viewed in its entirety this study clearly supports the efficacy of functional therapy in adolescents. In relation to long-term stability the results of functional balanced occlusion and the stability of the maxillo-mandibular relationship should be especially emphasized, whereas the therapeutically induced protrusion of the mandibular incisors and their relapse should be critically viewed.

Adolescent↗
PubMed1990

[The modification of growth with the jumping-the-bite plate compared to other functional orthodontic appliances].

The bite-jumping-appliance BJA is a special functional appliance which affects the upper jaw comparably to activator headgear combinations (SNA angle). Concerning its influence on the lower jaw (SNB angle) the BJA can be compared with the Teuscher activator and the Klammt activator. The change in the inclination of the upper jaw (ANS-PNS to nasion-sella) proved to be negligible because the vector of the force passed through the center of resistance of the upper jaw. The extend of the dental influence was the largest with the activator, the smallest with the Fränkel II appliance. The inclination of the lower incisors (1 to gonion-menton) was hardly affected. The upper incisors were retruded however not be the same extend as with the Teuscher activator which even has torque springs (to avoid the retrusion). The treatment of all the patients ended in all cases excepting those that were treated with an activator in a nearly ideal IIW angle. Our findings encourage us to say that the BJA is an appliance with a far better working mechanism than the working mechanism of other functional appliances.

Activator Appliances↗
PubMed2006

Treating Class II patients with removable plates and functional orthopedic appliances-the importance of anterior tooth inclination and direction of growth on treatment outcome.

OBJECTIVE: To determine the influence of physiological growth pattern and anterior tooth inclination on the outcome in Class II patients treated with removable orthodontic plates and functional orthodontic appliances. PATIENTS AND METHODS: After recruiting 50 patients with an upper anterior proclination of 1-SN >or= 107 degrees for this retrospective study, another 50 patients with a retroclination of 1-SN <or= 95 degrees were also included. All patients initially presented a skeletal Class II relationship with a distoclusion of at least one premolar width in the region of the first molars. All patients were evaluated separately by gender and additionally subdivided into three subgroups with a horizontal, neutral, or vertical craniofacial configuration. Treatment with removable orthodontic plates (pretreatment) and functional orthodontic appliances was initiated in mixed dentition. Pre- and post-treatment lateral cephalograms were evaluated for each patient. RESULTS: Dento-alveolar analysis showed that the inclination of the upper incisors changed in the direction of the clinical standard value independent of the craniofacial configuration, although full correction using removable orthodontic plates and functional orthodontic appliances was not always achieved. Similarly good treatment outcomes were achieved with regard to overjet and overbite. The lower incisors of all patients were in proclination after treatment. The ANB angle was reduced in both groups. Nevertheless, on average a skeletal Class II persisted in the Class II, Division 2 patients, while Class II, Division 1 patients with horizontal craniofacial configurations attained skeletal Class I. CONCLUSIONS: Treatment of Class II patients with removable appliances resulted in differences depending on anterior tooth inclination (Class II, Division 1 and II, Division 2) and craniofacial configuration. These differences must be taken into account during treatment planning. Complete treatment success with regard to sagittal jaw balance is very difficult to achieve with removable orthodontic plates (pre-treatment) and functional orthodontic appliances alone in Class II, Division 1 cases with a vertical craniofacial configuration and generally in Class II, Division 2 cases. A particularly favorable constellation for removable treatment is a Class II, Division 1 situation with a horizontal craniofacial configuration and retroclined or orthognathic mandibular anteriors.

Bone Development↗