Conference Insight: Orthodontics
Karachi, Pakistan, 2007
Functional therapy: By utilizing genetics to modify jaw growth.
Functional appliances: Removable or Fixed appliances that alters growth by muscles or neurovascular bundle. Changes include: Endochrondrial cartilage modification, Tempromandibular joint modification proliferation.
Condlye and Glenoid fossa both change with respect to direction.
Drawbacks of functional appliances:
Effects: Pushes mandible, accelerates its growth but restricts Maxillary growth, differential eruption of posterior teeth, effect on neuromuscular bundle, adaptive changes in Glenoid fossa.
Treatment: Limit incisor eruption. Differential eruption of posterior teeth.
Twin block therapy: Protrusive maxillary incisors and retrusive mandibular incisior. Increased overjet and deep overbite, minimal crowding.
If maxillary teeth width less than 30 mm, donít twin block it, first expand it.
Drawback of twin block: Open bites appear later.
Never extract decidius molars coz cortical labial and buccal plates will collapse and retard bone growth.
Lingual arch good for bringing posterior tooth ahead if congenitally missing teeth.
Effective in preventing anterior open bite. If fixed appliance added, still use supportive appliance till both arches leveled and stainless steel wires added/
Effects: Distilization of maxillary molars. Twin blocks reduce overjet by skeletal effect (20%), majority is dental effect.
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