Myofunctional Appliances Question And Answers

Myofunctional Appliances Important Notes

• Definition of myofunctional applications
  • Myofunctional appliances are defined as loose fitting or passive appliances which harness natural forces of the oro-facial musculature that are transmitted to the teeth and alveolar bone through the medium of appliance
• Visual treatment objective [VTO]
  • Helps in realizing the therapeutic goals
  • Helps to motivate the patient to cooperate by making the patient realize the esthetic improvement
• Types of bionator
  • Standard appliance
  • Class 3 appliance
  • Open bite appliance
• Classification of myofunctional appliances
  • According to Tom Graber
    • Group A – Teeth supported Ex. Catlan’s appliance
    • Group B – Teeth/tissue supported
      Example. Activation
    • Group C – Vestibular positioned Ex. Lip bumper
  • Removable – Activator
    • Semifixed – Bass appliance
    • Fixed – Herbst
  • Classical – Activator
    • Hybrid – Bass
  • Teeth borne passive – Activator
    • Tooth borne active – Elastic open activator
    • Tissue-borne passive-oral screen
    • Tissue borne active – FR
    • Functional orthopaedic magnetic appliance
• Frankel regulator

Myofunctional Appliances Long Essays

Question 1. Classify myofunctional appliances. Name components of FR – 2 and describe its mode of action.
Answer.

Classification Of Myofunctional Appliances:

• According to Tom Graber
  • Group A – Teeth supported Ex. Catlan’s appliance
  • Group B – Teeth/tissue supported
    Example. Activation
  • Group C – Vestibular positioned Ex. Lip bumper
• Removable – Activator
  • Semifixed – Bass appliance
  • Fixed – Herbst
• Classical – Activator
  • Hybrid – Bass
• Teeth borne passive – Activator
  • Tooth borne active – Elastic open activator
  • Tissue-borne passive-oral screen
  • Tissue borne active – FR
  • Functional orthopaedic magnetic appliance

Frankel Appliance

• It is myofunctional appliance developed by Professor Rolf Frankel of Germany

Components Of Myofunctional Appliances:

Acrylic component:

• Buccal shields
  • Extends deep into the vestibule
  • Helps in unrestricted dentoalveolar development
  • Also causes periosteal bone deposition
• Lips pads
  • Helps in the elimination of abnormal perioral muscle activity
  • Eliminates lower lip trap
  • Causes periosteal pull resulting in bone growth
• Lower lingual pad
  • Stimulates protractor muscles of the mandible by activating proprioceptors

Wire component:

• Labial bow
  • Adapted on labial surfaces of the lower anteriors
• Canine extensions
  • Eliminates restrictive muscle function
  • Helps in transverse development in the canine region
• Palatal bow
  • Prevents supra eruption of first permanent molars

Read And Learn More: Orthodontics Short And Long Essay Question And Answers 

• Upper lingual wire
  • Runs between the upper canines and first deciduous molars
• Lower lingual springs
  • Prevents supra eruption of the lower incisors
  • Screens the tongue pressure from lower incisors
  • For proclaiming the lower incisors actively
  • Causes bite opening by the relative intrusion

Lingual Cross Over Wire:

• Runs between mandibular first and second premolar

Mode Of Action Of Frankel Appliance:

Increase in transverse and Sagittal intra-oral space:

• Buccal shields and lip pads:
  • Eliminates abnormal muscular forces
  • Favours forces from tongue
  • Exerts outward pull on connective tissue and muscles
  • This transmits force on the bone
  • Results in bone formation
  • Leads to lateral movement of dental alveolar region
• Increase in vertical space:
  • Frankel appliance does not contact posterior teeth
  • Thus, they are free to erupt
  • This leads to an increase in vertical intra-oral space
• Mandibular protraction:
  • By lingual pads
  • These apply pressure on the lingual alveolar process
  • Causes activation of protractor muscles
  • Position the mandible mesially
• Muscle function adaptation:
  • Overcomes abnormal muscular forces
  • Rehabilitates muscles
  • Causes muscle pull
  • This leads to bone formation
  • Massages soft tissues
  • Improves blood circulation
  • Improves muscle tone
  • Prevent hyperactivity of mentalis
  • Eliminates lip trap
  • Establishes lip seal

 

Question 2. Define and classify myofunctional appliances. Discuss indications and mode of action of the activator.
Answer.

Definition:

• Myofunctional appliances are defined as loose fitting or passive appliances which harness natural forces of the oro-facial musculature that are transmitted to the teeth and alveolar bone through the medium of appliance

Classification Of Myofunctional Appliances:

• According to Tom Graber
  • Group A – Teeth supported Ex. Catlan’s appliance
  • Group B – Teeth/tissue supported
    Example. Activation
  • Group C – Vestibular positioned Ex. Lip bumper
• Removable – Activator
  • Semifixed – Bass appliance
  • Fixed – Herbst
• Classical – Activator
  • Hybrid – Bass
• Teeth borne passive – Activator
  • Tooth borne active – Elastic open activator
  • Tissue-borne passive-oral screen
  • Tissue borne active – FR
  • Functional orthopaedic magnetic appliance

Activator Of Myofunctional Appliances:

• Activator is myofunctional appliance described by Andresen and Haupl

Indications Of Myofunctional Appliances:

• Class 1 open bite
• Class 1 deep bite
• Class 2 div. 1
• Class 2 DDiv 2
• Class 3
• Preliminary treatment
• Post-treatment retention
• Decreased facial height

Mode of Action Of Myofunctional Appliances:

• Prevents dentoalveolar growth of maxilla
• Moves it distally
• Move mandible forward
• Stretches elevator muscles
• Adaptation of condyle

Question 3. Classify myofunctional appliances. Describe indications, construction and trimming of the activator.
Answer.

Classification Of Myofunctional Appliances:

• According to Tom Graber
  • Group A – Teeth supported Ex. Catlan’s appliance
  • Group B – Teeth/tissue supported
    Example. Activation
  • Group C – Vestibular positioned Ex. Lip bumper
• Removable – Activator
  • Semifixed – Bass appliance
  • Fixed – Herbst
• Classical – Activator
  • Hybrid – Bass
• Teeth borne passive – Activator
  • Tooth borne active – Elastic open activator
  • Tissue-borne passive-oral screen
  • Tissue borne active – FR
  • Functional orthopaedic magnetic appliance

Activator Of Myofunctional Appliances:

• Activator is myofunctional appliance described by Andresen and Haupl

Indications Of Myofunctional Appliances:

• Class 1 open bite
• Class 1 deep bite
• Class 2 div. 1
• Class 2 Div 2
• Class 3
• Preliminary treatment
• Post-treatment retention
• Decreased facial height

Construction Of Myofunctional Appliances:

Trimming:

For Vertical control: 

• Intrusion:
  • Acrylic – Over incisal edge/cusp tips
  • Labial bow – Below the height of the contour initially
• Extrusion:
  • Acrylic – Lingual surface
  • Labial bow – Above the height of contour gingivally
    For Sagittal control:
  • Protrusion
  • Acrylic – lingual surface
  • Labial bow – Passive, away from teeth

Retrusion:

• Acrylic – Away from the lingual surface
• Labial bow – Active

Movement of posterior teeth in the sagittal plane:

• In class 2 – Acrylic over the mesial lingual surface of maxillary molars
• Distolingual surface of mandibular molars

Movement of teeth in the transverse plane:

 

Myofunctional Appliances Short Essays

Question 1. Jasper jumper.
Answer.

Jasper jumper is a flexible, fixed tooth-borne appliance introduced by Jasper in 1980

Jasper jumper Indications:

• Class 2 malocclusion with maxillary excess and mandibular deficiency

Effects Of Jasper jumper

• Skeletal effects:
  • Holds and displaces maxilla distally with a small shift of point A distally
  • Clockwise rotation of the mandible
  • Forwarded movement of condyles
• Dental changes:
  • Posterior tipping and intrusion of upper molars and palatal tipping of maxillary incisors
  • Anterior translation and tipping of mandibular teeth and intrusion of mandibular incisors

Jasper jumper Advantages:

• It produces continuous forces
• Allows a greater degree of mandibular freedom
• It is easier to maintain better oral hygiene

Question 2. Name components of FR2 and describe the uses of buccal shields.
Answer.

Components Of FR2:

Acrylic component:

• Buccal shields
• Lip pads
• Lower lingual pad

Wire component:

• Labial bow
• Canine extensions
• Palatal bow
• Upper lingual wire
• Lower lingual springs
• Lingual cross-over wire
• Support wire for lip pads

Use of Buccal Shields:

• Prevents abnormal muscular forces
• Creates forces on tissue
• This leads to bone formation
• Rehabilitates muscles
• As it stands away from posterior teeth, it allows their eruption

Question 3. Mode of action of functional appliance.
Answer.

Force Application:

Force Elimination by

• Bite planes – Effects:
  • Disocclude the posterior teeth
  • Differential eruption of posteriors
  • Intrusion of incisors
  • Downward and backward mandibular rotation
  • Reduces mandibular prognatism
• Shields/Screens – Effects:
  • Prevents muscular forces on dentoalveolar structures
  • Allows unrestricted growth of the jaw
• Construction bite – Effects:
  • Displaces mandible from its rest position
  • Stretches muscles
  • Displaces mandible in sagittal and transverse plane

Question 4. Case Selection for Functional Appliances.
Answer.

Factors Considered:

Age – Growing patient:

• Between 10 years of age and pubertal growth phase

Social considerations:

• Patients living far from the clinic
• Hostelites

Dental considerations:

• Uncrowded cases
• Local irregularities

Skeletal considerations:

• Moderate to severe skeletal class 2 malocclusions
• Low angle cases
• High-angle cases with deep bites
• Class 2 Division 2
• Mild class 3 malocclusions

Question 5. Oral Screen.
Answer.

Synonym – Vestibular Screen:

• Introduced by Newell in 1912

Principle Of Oral Screen:

• Application of muscular forces to teeth by applying forces of circumoral to teeth
• Elimination of forces to teeth and allow them to move due to forces exerted by the tongue

Oral Screen Indication:

• Interception of habits
• Treatment of mild malocclusions
• For muscular exercises
• Correction of mild anterior proclination

Management Of Oral Screen:

• Frequency of wear – During the night 2-3 hours during day time

Question 6. Frankel 2.
Answer.

Uses of Frankel 2 – For treatment of class 2 division 1 and division 2 malocclusion.

Components Of Frankel 2:

Acrylic:

• Buccal shields
• Lip pads
• Lower lingual pad

Wire:

• Palatal bow
• labial bow
• canine extension
• Upper lingual wire
• Lingual cross-over wire
• Support wire
• Lower lingual spring

Functions Of Frankel 2:

Acrylic components:

• Eliminate the muscle as well as lip function over the dentoalveolar segment

Wire component:

• Palatal bow – Prevent supra eruption of posteriors
• Canine loops – Help in transverse development in the canine region
• Labial bow – Passive
• Lingual stabilizing bow – Prevents lingual tipping of incisors
• Lower lingual springs – Screen tongue pressure
• Procline lower incisors
• Lingual cross-over wire
• Labial support wires – Support lip pads

Question 7. Explain the treatment procedure in a child of 8 years with a deficient maxilla, the appliance used and the mode of action.
Answer.

An 8 years old child is a growing child

• Thus my function appliance can be used to facilitate the change
• Among them, Frankel regulator 3 can be used

 

 

Mode of Action:

• In transverse and sagittal intraoral space
  • By acrylic component
• In vertical space
  • As the appliance is kept free from posterior teeth
• Muscle function adaptation
  • Overcomes abnormal perioral muscle activity

Question 8. Difference between Activator and Frankel Appliance.
Answer.

Question 9. Lip Bumper.
Answer.

Combined removable fixed appliance

Mode of Action:

• Force application/elimination

Uses Of Lip Bumper:

• Interception of lip biting habits
• Increases arch length
• Reduces crowding
• In the case of active mental activity
• For augmentation of anchorage
• For visualization of 1st molar
• Used as space regainer

Designs Of Lip Bumper:

• Stainless steel wire from one molar to the opposite molar passing away from the anterior
• Acrylic portion from canine to canine

Myofunctional Appliances Short Questions And Answers

Question 1. Herbst Appliance.
Answer.

By Emil Herbst in the early 1900’s.

Herbst Appliance Indications:

• Post-adolescent patient – treatment of Class 2
• TMJ disorders
• Interception of mouth breathing habit

Types Of Herbst Appliance:

• Banded Herbst
• Bonded Herbst

Effects Of Herbst Appliance:

• Class 1 molar correction
• Increase in mandibular growth
• Visualization of molar
• Reduction of over-jet
• Increase SNB and decrease SNA

 

 

 

Question 2. Twin Block.
Answer.

Design: Consist of inclined planes with intermaxillary and extraoral traction

Acrylic Components:

• Upper inclined plane – Covering lingual cusps of upper posterior till mesial ridge of upper 2nd PM [Premolar]
• Lower inclined plane – From lower anterior upto distal marginal ridge of 2nd premolar
  • The angle between them – 45

Wire components:

• Modified arrow head clasp – To retain the upper plate
• Molar tube – for attachment of face bow
• Jack screw – for maxillary expansion
• Interdental ball clasp – Retain lower plate

 

Myofuctional Appliances Viva Voce

• Reverse binator is used for Angle’s class 3 malocclusion
• Newell developed an oral screen
• Lip bumper should be worn for 24 hours a day
• Myofunctional appliances harness natural forces from perioral structures
• Oral screening works on both force application and force elimination principle
• Twin block is the most acceptable functional appliance