Fixed functional appliances

Fixed functional appliances

There are plenty of fixed functional appliances. They are an evolution of removable functional appliances, such as bionator, Fränkel and Twin Block.

The following is a list of a few of them and we will dedicate a page for those that are mostly used.

SUS² correctors

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Forsus™ Class II correctors

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Twin Force^® Bite Corrector (TFBC) devices

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Xbow^® (crossbow) appliance

The Xbow^® appliance is composed of an Hyrax expansion device in the maxilla, lower labial and lingual arches with occlusal rests onto the lower premolars and Forsus™ Class II correctors. The Xbow^® appliance is used early in the treatment before the fixed appliances (braces) are installed.

This appliance efficiently corrects Class II malocclusions, but it offers a poor control of the lower teeth during the corrective phase with Forsus™ Class II correctors.

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Cantilever Bite Jumper

The Cantilever Bite Jumper (CBJ) is an evolution of the Herbst appliance. It is composed of stainless steel crowns (SS crowns) cemented onto molars. In the maxilla, the SS crowns can be incorporated to an Hyrax expansion device as seen on this picture.

In the mandibular arch, the SS crowns are joined by a rigid lingual arch with occlusal rest on the first premolars and a long cantilever armspring soldered to the buccal side of the lower SS crown and extending up to the first premolar. The end of this cantilever armspring is augmented by a rectangular tube in which a segmented orthodontic archwire can be inserted to consolidate the anterior lower teeth from canine to canine.

Rigid devices with adjustable length depending on the correction required for each case maintain the lower jaw in an advanced position.

This mechanism is spring free and it is harder to adapt to.

The Cantilever Bite Jumper is now obsolete with spring devices (Forsus™, TFBC and SUS²) now available on the market.

 

Removable functional appliances

The bionator, Fränkel and Twin Block appliances are examples of removable functional appliances. They are less and less used since they are voluminous and bulky in the mouth. They require a great cooperation from the patient.

Twin Block

Example of a Twin Block appliance. It is composed of 2 acrylic parts: a maxillary and a mandibular one, from where the name Twin Block was given.

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Bionator

Bionator is a removable functional appliance with the acrylic components on the tongue side. A labial arch and an acrylic index guide the teeth in edge to edge. The patient must maintain this appliance between the teeth 22 hours per day.

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Fränkel

The Fränkel appliance was designed by Rolf Fränkel and popularized in the United States in the 1970s by Dr John McNamara.

It is characterized by acrylic shields between the cheeks and the teeth that do not take over the space for the tongue. It allows the expansion of the dental arches.

 

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