‏‏THE TREATMENT OF CLASS II, DIVISION 1 MALOCCLUSION WITH FUNCTIONAL CORRECTORS.pptx

THE TREATMETHE TREATMENT OF CLASS II, DIVISION 1 MALOCCLUSION WITH FUNCTIONAL CORRECTORS
According to Hotz, the adjustment of teeth basically involves a modification of that "natural interplay of forces" which is responsible for the shape of the dentoalveolar arches.

In this article certain problems of Class II, Division 1 cases which arise in connection with the use of skeletal vestibular screens are discussed.
The figure illustrates the Frankel functional appliance that is used in the treatment of Class II cases. The mandible is repositioned in a forward direction to produce the so-called "construction bite," in which the incisors are in an end-to-end relation. The degree to which the buccal shields and the lip pads extend beyond the upper and lower arches corresponds to that of the normal dentition.

This illustrates an occlusal view of a Class II malocclusion. The degree of expansion of the dental arches and of the palatal vault was achieved in this case with the functional appliance in 1 year and 7 months. These casts illustrate not only that good morphologic results can be obtained with functional correctors, but also the manner in which these results are obtained.


The aim at bringing about a new equilibrium between the mechanical forces of the tongue and the cheeks with the aid of oral-seal exercises and a reorientation of the tongue position against the palate. This therapeutic principle corresponds to that applied in general orthopedics.
The first objective is to modify the soft-tissue structures by physiotherapy, and the second is to reeducate motor functions and muscle tone by exercises.

1. THE TREATMETHE TREATMENT OF CLASS II, DIVISION 1 MALOCCLUSION WITH FUNCTIONAL CORRECTORS ACHIEVED BY: Dr.Maen Dawodi

2. According to Hotz , the adjustment of teeth basically involves a modification of that "natural interplay of forces" which is responsible for the shape of the dentoalveolar arches. In this article certain problems of Class II, Division 1 cases which arise in connection with the use of skeletal vestibular screens are discussed.

3. The figure illustrates the Frankel functional appliance that is used in the treatment of Class II cases. The mandible is repositioned in a forward direction to produce the so-called "construction bite," in which the incisors are in an end-to-end relation. The degree to which the buccal shields and the lip pads extend beyond the upper and lower arches corresponds to that of the normal dentition.

4. This illustrates an occlusal view of a Class II malocclusion. The degree of expansion of the dental arches and of the palatal vault was achieved in this case with the functional appliance in 1 year and 7 months. These casts illustrate not only that good morphologic results can be obtained with functional correctors, but also the manner in which these results are obtained.

5. The aim at bringing about a new equilibrium between the mechanical forces of the tongue and the cheeks with the aid of oral-seal exercises and a reorientation of the tongue position against the palate. This therapeutic principle corresponds to that applied in general orthopedics. The first objective is to modify the soft-tissue structures by physiotherapy, and the second is to reeducate motor functions and muscle tone by exercises.

6. Figure shows anterior and lateral views of the plaster casts. The black arrows at the level of the root tips and at the alveololabial sulcus indicate the expansion of the deeper supporting structures. As the arrows show, a marked expansion of 5 mm. is also demonstrable in the alveolar process, in the premolar region. A comparison was made of 150 upper plaster casts, of which half had been treated with palatal plates and the other half with functional correctors. The results confirm the view that stretching of the soft tissues in the alveololabial sulcus by means of the projecting buccal shields stimulates bone apposition in the apical base area.

7. Figure illustrates a functional appliance placed on a lower plaster cast. It shows that bite shift with the functional corrector is not achieved by the functional corrector resting on the mandibular molars or premolars, or on the incisors, either, since the center part of the lingual arch has been annealed.

8. Experiments have shown that, for the first 3 months at least, the bite correction is mainly effected by the U-shaped loops. If the mandible tries to fall back into its habitual distal position, these U-shaped loops produce a reaction by making contact with the mucosa at the lingual surfaces of the alveolar process. The appliance must not be worn longer than 1 or 2 hours daily during the initial treatment period. There is no mesial movement of the lower molars and premolars.

9. Shows the facial photographs of the patient shown. These photographs were taken before treatment began and after a treatment period of 2½ years. In the upper photograph, note the marked mentolabial fold and the high position of the soft tissues of the chin which is caused by mentalis muscle actvity . The lower photographs show the effect of the lower lip pads. The over-all profile correction is seen.

10. CONCLUSION Form and function are interrelated in that there is mutual influence and reciprocal action between the two. This discussion with functional correctors indicates that by eliminating abnormal perioral pressure, these appliances enable us to effect significant changes in the eruption of the teeth and hence in the development of the alveolar process, probably right up to the apical base. The traction exerted on the buccal fold by the lateral shields also seems to play an important part in this process.

11. The practical procedures discussed are based on the concept that abnormal mechanical factors prevailing in the functional matrix, or in the interplay of forces, must be located and eliminated. This should not be delayed until the permanent teeth have erupted. The only measures deserving the name of orthopedic treatment are those taken during the first stage of development of the permanent dentition and its supporting bone structure. In this respect, the vestibule constitutes a new base of operation for the practical application of mechanical devices.

12. AJODO Volume 1969 March (265 - 275) THANK YOU