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myofunctional

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Kezhan Salh
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16 views

myofunctional

Uploaded by

Kezhan Salh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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… Myofunctional Appliance …

Prepared by

Bafrin
Hero
Kizhan
Nma
Kizha Krim Mahmud

p.o.p Department

collage of dentistry

university of sulaimani

November 2024
Introduction

Myofunctional appliances are orthodontic devices designed to correct dentofacial


anomalies by influencing jaw growth and modifying muscle activity. These appliances
utilize the natural forces generated by oral and facial muscles to guide skeletal and dental
development. They are most effective during the mixed dentition or early permanent
dentition stages, where significant growth potential remains, making them ideal and
crucial for interceptive orthodontics.[1][2]

Myofunctional appliances are primarily intraoral devices supported by teeth (tooth-


borne), and they are typically removable and passive in nature. Constructed from acrylic
with wire components for retention and support, these appliances do not exert active
forces like traditional braces. Instead, they transmit, eliminate, or neutralize natural forces
of the orofacial musculature to correct abnormal growth patterns and function in
dentofacial structures.[3]

Unlike active orthodontic appliances, myofunctional appliances lack components like


springs or elastics. Instead, they rely entirely on forces generated by masticatory and
facial muscles. This unique mechanism is why they are often classified as “functional
appliances,” a subset of myofunctional appliances.

Functional appliances are particularly utilized to address Class II malocclusions and, in


some cases, Class III malocclusions. For Class II cases, these devices reposition the
mandible into a forward or postured position, promoting beneficial jaw development.
Although there are various designs, all functional appliances interact with both dental
arches and facilitate mandibular repositioning by moving the condyles within the glenoid
fossae.

The main purpose of functional appliances is to alter the anteroposterior relationship


between the upper and lower arches of teeth. Nevertheless, they are not effective for
solely addressing problems such as crowding or arch alignment. Generally, these
appliances are utilized in the first stage of a two-phase orthodontic treatment plan. The
initial stage aims to decrease overjet, while the second stage employs fixed appliances to
address alignment or crowding concerns.[4]
Optimal Timing of Treatment

These devices are most effective during periods of rapid growth, particularly the pubertal
growth spurt. However, dental and skeletal growth rates often differ. Some children may
transition into permanent dentition earlier than others, while some may remain in the
mixed dentition stage well into puberty.

For prognosis and improvement, it requires 12–18 hours of daily wear for 6 months to a
year. Evening and nighttime usage is especially beneficial due to increased growth
hormone release during sleep. A force magnitude of 400–600 grams per side ensures
skeletal rather than dental changes and intermittent forces are more effective for skeletal
adjustments, while continuous forces can lead to unwanted dental movements.

Therefore, success of functional appliances depends on appropriate case selection, patient


adherence, and heavily on the timing of their use.
Indication

1. patient must be in a phase of rapid growth, and well-motivated. Because these


appliances are bulky and must be worn (12–18h daily).
2. Class II Malocclusion:
• Division 1 with mandibular deficiency (e.g., prominent overjet).
• Division 2 after aligning the upper incisors.
3. Class III Malocclusion: With maxillary deficiency or retrognathic mandible.
4. For deep bite/open bite/crossbite correction
5. Oral habit correction
6. As retention appliance.
7. as space maintainer in mixed dentition by extending acrylic into the gap of a
missing tooth.
8. Used in snoring patients of Obstructive Sleep Apnea.

Contraindication

1. Sever crowding
2. Mandible that could not move forward or backward
3. Extreme Vertical mandible growers.
4. Patients with nasal stenosis/nasal insufficiency
5. In non-Growing/breathers/uncooperative patients.
References

1. Clark WJ. Twin Block Functional Therapy: Applications in Dentofacial


Orthopedics. 3rd ed. Elsevier; 2014.
2. Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 6th ed. St.
Louis: Elsevier; 2019.
3. Akhoon AB, Mushtaq M, Akhoon ZA. Myofunctional Appliances: An Overview.
Int J Contempt Med Res. 2021;8(9):[4]
4. Singh GD, McNamara JA. The Use of Functional Appliances in Contemporary
Orthodontics. Seminars in Orthodontics. 2001;7(1):25–33.

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