Related Terms:
Functional Appliances
Dentofacial Orthopedics
Functional Jaw Orthopedics is a term used to describe appliances that orthodontists use to affect the jaw
and bone - not just the teeth. Orthodontics is a term associated with movement of individual teeth.
Properly combining both techniques helps us to achieve more natural facial contours with a full smile, i.e.,
more pleasing facial aesthetics. Proper treatment can also lead to healthier temporomandibular joints
(jaw joints).
UPPER FRONT TEETH DON'T STICK OUT!
It is a common misconception that protruding upper front teeth need to be pushed back. Twenty years ago,
many times bicuspid teeth were extracted and headgears were used to help push the teeth back. The real
problem was that the lower jaw needed to come forward. Even in the most severe overbite cases with protruding
upper front teeth, the lower jaw (recessive mandible) is the main problem. The upper front teeth may only
stick out 1 millimeter. The twin block is a great appliance to correct these problems.
NOTICE HOW FUNCTIONAL APPLIANCE BROUGHT LOWER JAW FORWARD IN THESE THREE PATIENTS
Patient #1 Before
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Patient #1 After
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Patient #2 Before
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Patient #2 After
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Patient #3 Before
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Patient #3 After
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RIGHT VIEW
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FRONT VIEW
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LEFT VIEW
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This functional appliance does several things at the same time. It can widen the upper and lower jaw,
which helps make room for the permanent teeth and prevent extraction of bicuspid teeth. It can help bring the
lower jaw forward if it is recessive (back too far). It helps correct the overbite in two directions:
anterior-posterior which orthodontists call overjet, and vertically which orthodontists call overbite. It is
also an eating appliance so it isn't accidentally thrown away on a lunch tray! It can be used in children,
teens, and some adult cases.
Before
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After
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Same patient before and after shows how widening the smile makes room for the teeth without extracting
bicuspids.
Notice as the screw opens, the appliance widens the jaw. This changes the bone, not just the teeth.
Same Patient Before
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Same Patient After
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Notice Full Natural Smile
Notice how we are able to make room for all the permanent teeth by combining an appliance (Functional Jaw Orthopedics) and braces. This type of treatment can also dramatically reduce the amount of time braces are needed. Many of our patients only need braces for one year or less.
The main fixed appliance we use is the mini-palatal expander. It can orthopedically widen the upper jaw and is
fixed (or glued into the mouth). Variations can also be used on the lower jaw in some cases. It also helps
prevent the extraction of permanent bicuspid teeth and contributes to a full, natural smile. There are many
different variations of the removable and fixed appliances Dr. May uses for specific cases.
Below is a modified version of the mini expander which can be used to help correct Class III malocclusions
(underbite - where lower front teeth are in front of upper front teeth). This appliance is fixed (cemented in
the mouth) and is used in conjunction with a reverse face mask (not a headgear). Underbites can be corrected
as early as four years old, which helps to prevent severe problems later.
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