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Combined Activator Headgear Orthopedics

The document discusses combining a functional appliance like a bionator or activator with headgear to provide both intraoral and extraoral forces for orthodontic treatment. It describes attaching headgear tubes to functional appliances to apply vertical and distal forces from a facebow. This combination is useful for patients with mandibular deficiency and vertical maxillary excess who have downward and backward mandibular growth patterns. Images show an activator appliance modified to include headgear attachments, a lingual extension, and torquing springs to provide three-dimensional control of tooth movement and skeletal correction.

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477 views7 pages

Combined Activator Headgear Orthopedics

The document discusses combining a functional appliance like a bionator or activator with headgear to provide both intraoral and extraoral forces for orthodontic treatment. It describes attaching headgear tubes to functional appliances to apply vertical and distal forces from a facebow. This combination is useful for patients with mandibular deficiency and vertical maxillary excess who have downward and backward mandibular growth patterns. Images show an activator appliance modified to include headgear attachments, a lingual extension, and torquing springs to provide three-dimensional control of tooth movement and skeletal correction.

Uploaded by

Meenu D Grt
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

Stockli PW, Teuscher UM. Combined activator headgear orthopedics. In: Graber TM, Vanarsdall RL, eds.

Orthodontics: Current Principles and Techniques. St. Louis: Mosby; 1994.

A bionator or an activator can include headgear Tubes if a headgear is considered an adjunct for treatment. If a vertical and/or distal extraoral force is desired, a facebow can be fitted into headgear tubes attached to almost any type of tooth-borne functional appliance (i.e., almost anything except a Frankel appliance) . This application of extraoral force may be useful for patients with a combination of mandibular deficiency and vertical maxillary excess who have a growth pattern in which the mandible tends to rotate downward and backward.

Stockli and Teuscher argue very persuasively that a combined assault against the maxilla using a functional appliance and extraoral force produces a more dramatic and stable correction skeletally, cosmetically, and functionally.

The activator-headgear appliance and extraoral attachments A, Vestibular extensions and torquing springs. B, Appliance placed on the lower cast. Note the anterior area with torquing springs, palatal extension of acrylic, and the transpalatal wire. C, Appliance on the upper cast with facebow inserted. Note the lingual flange extension for engaging the mandibular arch, similar to the Hamilton appliance.

D, Appliance view, again showing the transpalatal bar, torquing springs, and lingual extensions.
E, Activator-facebow in place. F, Activator in place on the lower arch, showing insertion of facebow. Note the tongue against the transpalatal Coffin spring. In this construction, labial and lingual wires are used instead of torquing springs.

Perhaps the best compromise, ensuring optimal stability of the functional appliance when the headgear is worn, is to place first molar bands and buccal tubes, insert the occipital pull extraoral force arms into the buccal tubes, and have the wire clasps of the functional appliance snap above the buccal tubes to give maximal retention for day and night wear of the functional appliance. Three-dimensional control of molar anchor teeth is a top priority, preventing unwanted opening of the bite. This two-jaw approach enhances anchorage and dentoalveolar compensation and provides optimal growth guidance. A variety of functional appliances can be used, either a twin block or monobloc appliance, but with reduced bulk to permit full-time wearing.

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