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DENT 656 Orthodontics

Removable and myofunctional appliances

Sarandeep Huja

Removable Appliances
Including retainers

Myofunctional Appliances - Including Head Gear Removable-Fixed Appliance (aka Passive Fixed)

Development of Removable Appliances

US - Jackson, Crozat Europe Andresen, Haupl, Schwartz Dichoctomy existed till 1970s
Primary use
Growth modification Limited tooth movements, tipping no bodily control Retention

Removable appliances
Used to expand arches (usually maxilla, not mandible). Open jackscrew 0.25 mm (1/4 turn), not exceed 1mm/month Fingersprings more gentle movement than jackscrew
Retention of removable appliances is critical (anchorage)

Main use today is as retainers, biteplates for crossbite corrections Some functional appliances are used, but claims of early 70s not substantiated in randomized clincial trials

Removable Appliances


Retentive Active


C Clasp and Labial Bow

Active component


Bite Plate

Correction of deep bite

Removable Appliances

Lower arch expansion

Distalizing molars

Retainers used post-fixed appliances

They are usually removable Can be fixed

Hawley appliance *

Labial bow, Adams or C clasp

Spring retainer

Tooth positioner


Myofunctional appliances
History Theoretical Basis

Cl II malocclusions Developed in Europe Dental and skeletal effects

Activator/Headgear Combination
Hybrid appliance, add what you need Lip bumper Torquing wires

Frankel Appliance
Buccal shields Lip pads Lingual plate

Herbst Appliance
Commonly used Has dental and skeletal effects Patient compliance not required

Jasper Jumper and Lip Bumper

Active Vertical Corrector and Twin Block

Repelling magnets

Postures mandible forward

Myofunctional Anchorage for fixed appliances


Cervical pull

High pull

Headgear* Combi pull and J Hook

Usually HG facebow attached to molar tubes J hook directly to soldered hooks on archwire

Face Mask or Reverse Pull HG

Used in maxillary deficient cases Cl III due to retrognathic maxillas

Fixed Removable Appliances

Aka Fixed Passive

Upper Hyrax* and Lower Expansion*

Upper appliance used prior to age ~ 13, before the midpalatal suture gets interdigitated, get skeletal effects Lower arch only tipping movement of teeth

Palatal and Lingual Arch*

Very commonly used to reinforce anchorage with fixed appliance; 036 SS wire Connects the transverse dimension, and helps in expansion and root movements

Quad Helix* with Finger Springs and W arch

Expansion appliances Maxillary expansion more common than mandibular Increase in length of wire by forming helices, 040 wire

Pendulum appliance
Bonded to premolars Uses TMA wire with helices molar tubes Anchorage from palate Primarily molar movement, but Movement of anteriors

Habit appliance* Tongue or digit habit