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Lingual technique

Fixed appliances can be positioned lingually when the design of the lingual brackets is adapted to the oral conditions. The height of the brackets with adhesive base, bracket body, slots, and wings and the distance of the archwire from the tooth surface determine wearing comfort or can cause speech restriction or tongue irritation. The appliance must therefore have a very flat design.

Multiband appliances

The Begg technique is an orthodontic technique with fixed appliances that uses special wires and brackets.The special types of bracket for this technique are called Begg brackets.Tipping as well as single-point contact can be achieved with these brackets. Tooth movements are enforced with light elastics.The archwire is fixed in the slots with lock pins.

Edgewise technique

The edgewise arch (square arch) technique is described here as the typical method of fixed orthodontic treatment. The edgewise technique involves working a square, spring hard archwire that is adapted to the desired width and form of the dental arch with special arch formers and is connected to the teeth with fixing components.

Advantages of fixed appliances

  • Can be used universally.
  • Almost any correction aimed at an ideal arch form can be performed.
  • Treatment period is relatively short (even in severe cases) and clear and manageable for the patient.
  • All the auxiliaries are prefabricated and can be placed directly in the patient by the dentist.
  • Corrections can be made immediately and directly in follow-up appointments.
  • Patient cooperation is not required to ensure compliance.
  • No damage to the appliance due to improper handling by patients.
  • Treatment program is direct with straightforward planning.

Fixed Orthodontic Appliances

Tooth movements with active spring components, which contact the tooth in a punctiform or linear fashion, are basically achieved by single-point and two-point application of force. Bodily tooth movement by multipoint application of force cannot be performed with removable active plates. Bodily tooth movements are only possible if the tooth is rigidly contained and this rigid mounting is pushed in the desired direction parallel to an additional guide. Rigid mountings encompass the tooth to be moved with a broad steel band. A mounting is welded to this steel band. A guide splint can be incorporated into this mounting, with which the tooth is moved.

Myofunctional therapy

Myofunctional therapy involves appliances for orofacial muscle exercises to repattern the activity of the masticatory, tongue, lip, and cheek muscles and re-educate them in order to correct anomalies of tooth and occlusal position. Functional orthodontic appliances for this therapeutic approach include oral screens.

Frankel functional regulator

The functional regulator is designed to alter the muscular function of the oral vestibule as the two buccal shields and lip pads keep development-inhibiting influences of the cheek, lip, and chin muscles away from the jaw and the shaping force of the tongue is fully exploited.The function regulator is indicated for defects of alveolar development such as mandibular retrognathia, deep bite, and prognathism.

Balters bionator

This is a functional orthodontic appliance made of a greatly reduced double-plate to which a widened labial bow and a palatally displaced "tongue bar" are attached (Fig 10-81a). It preferentially activates the vestibular musculature (lip closure) and the tongue (correct position and contact with the palate), which is the purpose of the lip bar with two buccinator loops and the tongue bar. It is indicated for shifting and leveling the occlusion and for correcting forms of dysgnathia arising from malfunctioning due to anomalies of the tongue and lip posture.

Brief outline of different activators

Monobloc activator

The monobloc activator is an appliance developed as an exercise device that embraces both jaws at once for correcting occlusal anomalies. It comprises an acrylic block for the maxilla and the mandible that is joined interocclusally (Fig 10-78).

Activator designs

During the course of treatment with an activator, articular and periodontal tissue remodeling takes place slowly over the course of 2 or 3 years. The optimal activator effect happens during exfoliation; treatment should be finished after eruption of the maxillary second molars.
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