Fixed functional appliance

FIXED FUNCTIONALFIXED FUNCTIONAL
APPLIANCEAPPLIANCE
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INTRODUCTION
Functional orthopedic treatment seeks to correct
malocclusions and harmonize the shape of the dental arch
and orofacial function. Functional appliance intended to
alter mandibular growth play a major role in growth
modification treatment. Unfortunately due to the bulk and
inconvenience, removable functional appliance fails to
attract the patient’s cooperation. In addition,their
intermittent wear does not elicit continuous muscle activity,a
factor that is very essential for promoting skeletal
change.Patient cooperation has longbeen recognised as an
important factor in the outcome of orthodontic treatment.
Failure to adhere to prescribed schedules of removable
appliance wear will result in slow treatment response or no
response at all. To reduce these factors the fixed functional
appliances were developed.www.indiandentalacademy.comwww.indiandentalacademy.com

HISTORICAL PERSPECTIVE
NORMAN KINGSLEY Bite plate
He introduced the bite plate for jumping the bite. He
was the first to use the forward positioning of the mandible in
orthodontic therapy. The bite plate was the forerunner of the
modern functional appliances.
Fixed functional appliances first appeared in 1910
when Emil Herbst presented his system at the Berlin
international dental congress. Since then and up to the
seventies, very little was published on this appliance. It was at
that time that Hans Pancherz brought the subject back into the
discussion with the publication of several articles on the
Herbst in 1979.

Name of the Appliance Introduced by Year
Herbst Emil Herbst
Popularised by Pancherz
1905
1979
Herbst with high head gear Schiavoni 1992
Flip Lock Herbst Robert Miller 1996
Mars Ralph M. Clements and Alex
Jacobson
1982
Jasper Jumper J.J. Jasper 1987
Saif Spring Armstrong 1957
Adjustable Bite Corrector Richard P. West 1995
Mandibular Protraction
Appliance
Coelho Filho 1997
Eureka Spring John Devincenzo 1997
Universal Bite Jumper Xavier Calvex 1998
Churro Jumper Ricardo Castanan 1998
Twin Block William Clark 1977
Biopedic Jay Collin 1997

CLASSIFICATIONCLASSIFICATION
According to the forces producedAccording to the forces produced
I.Appliances producing pushing forceI.Appliances producing pushing force
a.Temporarily fixed functional appliances – eg.Twin blocka.Temporarily fixed functional appliances – eg.Twin block
b.Permanently fixed functional appliancesb.Permanently fixed functional appliances
1.Rigid1.Rigid
i. Herbst & its familyi. Herbst & its family
ii. MARSii. MARS
iii. Active vertical correctoriii. Active vertical corrector
iv. Rick - A - Natoriv. Rick - A - Nator
v. MPAv. MPA
vi. Universal bite jumpervi. Universal bite jumper

2. Flexible
i. Adjustable bite corrector
ii. Jasper jumper
iii. Churro jumper
iv. Eureka spring
v. Forsus
- Fatigue Resistant Device
- Forsus Nitinol Flat Spring
II. Appliances producing pulling force.
eg. SAIF springs

RIGID FIXED FUNCTIONAL APPLIANCESRIGID FIXED FUNCTIONAL APPLIANCES
AdvantagesAdvantages
• RFFA do not easily fracture but neither do they haveRFFA do not easily fracture but neither do they have
elasticity or flexibility.elasticity or flexibility.
• After fitting and activation they do not allow the patientAfter fitting and activation they do not allow the patient
to close in centric relation.to close in centric relation.
• This means that the mandible is in a forward position 24This means that the mandible is in a forward position 24
hrs a day creating greater stimulus for mandibularhrs a day creating greater stimulus for mandibular
growth than with FFFA.growth than with FFFA.
• The skeletal effects produced with this type of applianceThe skeletal effects produced with this type of appliance
are greater than with FFFAs.are greater than with FFFAs.
• when comparing with FFFAs these appliances does notwhen comparing with FFFAs these appliances does not
produce much dental effects.produce much dental effects.
• Patient cannot close the mandible in centric relation.Patient cannot close the mandible in centric relation.

RIGID FIXED FUNCTIONAL APPLIANCESRIGID FIXED FUNCTIONAL APPLIANCES
DisadvantagesDisadvantages
• Patient discomfort.Patient discomfort.
• Does not allow lateral excursion of the mandible.Does not allow lateral excursion of the mandible.
• Difficult to maintain oral hygiene when compared toDifficult to maintain oral hygiene when compared to
FFFAs.FFFAs.

HERBST
When patient is still growing it is
possible to accentuate growth of lower
jaw to catch up with upper face by
Herbst.
Indications
• Dental class-II malocclusion
• Skeletal class-II mandibular deficiency
• Upper molar distalization
• Lower incisor advancementwww.indiandentalacademy.comwww.indiandentalacademy.com

Contra Indications
• Case Prone to root resorption
• Dental and skeletal open bites
• Vertical growers
• Procumbent mandibular incisors
• Protrusive maxillary and normal mandibular positions
Mechanics
• Bilateral telescoping mechanism advancing
• Mandible into new positionwww.indiandentalacademy.comwww.indiandentalacademy.com

The appliance can be compared to an artificial joint
working between the maxilla and the mandible.A bilateral
telescope mechanism attached to orthodontic bands keeps the
mandible mechanically in continuous anterior jump
position.Each telescope device consists of
• A tube
• A plunger
• Two pivots
• Two screws
(one on each side)
The pivot for the tube is usually soldered to the
maxillary first molar band and 1 pivot for the plunger to the
mandibular first premolar band.The screws prevent the
telescopic parts from slipping of the pivots. The length of the
tube determines the amount of bite jumping.www.indiandentalacademy.comwww.indiandentalacademy.com

ANCHORAGE
In the maxillary arch, I premolar and the permanent I
molar are banded and are interconnected on each side with
the half round (1.5 x 0.75 mm) lingual sectional arch wire.In
the mandibular dental arch the I premolars are banded and
connected with a half round lingual sectional arch wire
touching the lingual surface of the front teeth.This form of
anchorage is called as partial anchorage. When the lingual
sectional arch wire is extended to the permanent I molar
band, called as total anchorage. Herbst often used crowns
instead of bands on anchor teeth. Langford(1982) was the
first orthodontist to suggest using preformed stainless steel
crowns. Dischinger(1989) expanded on the idea of using
crowns on the upper I molars and lower bicuspids.www.indiandentalacademy.comwww.indiandentalacademy.com

Advantages
• Dislodgement never happens
• Used with any age patients
Disadvantages
• Thick screw impinge on cheek.
• Little discomfort

FLIP LOCK HERBST
APPLIANCE
Robert miller(1996)
introduced this appliance which
reduces the number of moving
parts that can lead to breakage. It
is easy to use and more
comfortable for the patient than
the conventional Herbst. Instead
of the screw attachment , it has
the ball-joint connector and it
needs no retaining springs.

The appliance was
designed to prevnt accidental or
intentional removable by the
patient as often happens due to
loose or stripped screws. It is
reactivated every 6 – 8 weeks
using 1 -3 mm split bushing that
are crimped onto the rods as
needed.

MODIFIED EDGEWISE HERBST APPLIANCE (MALU)
The MALU consists of 2 tubes, 2 plungers, 2 upper
“Mobee ” hinges with ball pins and 2 lower key hinges with
brass pins. In the upper arch of the Edgewise – Herbst MALU
appliance , only the I molars are banded, with 0.051” headgear
tubes. A palatal arch can be used in cases of over-expansion.
In the lower arch, the 1st
molar are banded and the anterior
segment is bonded from cuspid to cuspid with 0.22" brackets.

The bicuspids may be left un-bracketed to help in
settling the occlusion and locking in the mandible. A
0.021" x 0.025" stainless steel archwire with slight labial
torque in the anterior segment is bent back tightly at the
distal ends. Tip-back bends mesial to the lower 1st
molars
are helpful in controlling the incisors.
Each upper Mobee hinge is inserted into the hole at
the end of the MALU tube and secured to the 1st
molar
headgear tube with the ball pin. Each lower hinge is
inserted into the hole at the end of the plunger assembly is
adjusted according to the amount of mandibular
protrusion needed. The mandible can be progressively
advanced using 1-5mm spacers.

The MARS Appliance
The function of the MARS Appliance is similar to
that of the Herbst appliance in that the mandible is
maintained in the continuous protruded position via
compression struts. However, there are several important
differences between the two appliances. Unlike the Herbst
appliance the MARS Appliance :
• Appliance neither soldering nor extensive laboratory
procedures.
• Has minimal incidence of breakage.www.indiandentalacademy.comwww.indiandentalacademy.com

• Does not depress the canines, open spaces in the premolar
area, or flare mandibular incisors (provided the mandibular
rectangular archwire is tied back to the terminal molars).
• Is easily attached to or removed from the archwire of a
multi-banded orthodontic appliance, and
• Can be placed at an appropriate time during treatment.

Appliance Design
The MARS Appliance is composed of a pair of
telescope struts, the ends of which are attached to the upper
and lower archwires of a multibanded fixed appliance by
means of a locking device. Each strut is composed of two
separate parts : a piston of a plunger and a cylindrical or
hollow tube. These two components telescope together,
forming an individual strut. The free ends of the plunger
and the hollow tube (strut) are attached to the upper and
lower archwires by means of a slot and setscrew
arrangement, which looks them securely in position on the
archwire. Two struts are required for each patient, one on
each side.

ACTIVE VERTICAL CORRECTOR
Indication
• Skeletal class-II
Contra indication
• Vertical growers, high angle
Mechanics
• Inclined plane mechanical determine cuspal relation of
teeth, as erupt into occlusion.
• Occlusal forces transmitted through dentition provides
stimulus to influence growth and trabecular structure of
bone.
• Muscle modify bone growth via feed back mechanical.

The AVC consists 2 posterior occlusal splints, one for
the upper and one for the lower jaw. Samarium cobalt
magnets are incorporated into the occlusal splints over the
occlusal region of the teeth to be intruded. One magnet per
distal quadrant is used. The magnets in the upper splints
are incorporated in a mode to repel the magnets in the
lower splints. Therefore the appliance is a combination of
acrylic posterior bite blocks and repelling magnetic forces of
repelling magnets angled buccal flanges are added to the
lower occlusal splints to stabilize the appliance during
lateral jaw movements. A heavy gauge stainless steel wire
connects the occlusal splint of each arch. The magnets are
cylindrical in shape with a diameter of 10mm. The magnets
along with bite blocks measures 12mm in height.

Because SmCo is a highly reactive rare earth material
they are best kept isolated from the oral environment.
Hence, they are hermetically sealed in stainless steel
capsules. The magnet generates a force of 700 gm per unit
at zero air gap in repulsion. If the anterior open-bite is of
skeletal origin than dental origin, it is preferred to elicit
maximum skeletal response.
While registering the bite, 5mm clearance is given at
the posteriors, 1mm more than the actual measurement of
4mm required by the magnet for safety. When the
posteriors are intruded auto rotation of the mandible takes
place and the mandible moves anteriorly to close the open-
bite. The AVC can be cemented or bonded. At the end of
12 weeks the appliance can be removed and be used as a
removable appliance.www.indiandentalacademy.comwww.indiandentalacademy.com

RICK - A - NATOR
The Rick-A-Nator is a very simple appliance, which
consists of two maxillary 1st
molar bands attached to an
anterior biteplate via two 0.040" connector wires. This
incisal ramp encourages the mandible to come forward
which corrects the Class II molar relationship to Class I and
eliminates the overjet.
Part of Rick - A - Nator
1. Two molar bands lingual attachments
a. Fixed (soldered)
b. Mia attachment (Mesial direction)
c. Mershon attachment (vertical direction)
2. 0.036" connector wire from molar bands to incisal ramp
3. Incisal ramp (clear acrylic)www.indiandentalacademy.comwww.indiandentalacademy.com

Type of Rick - A - Nator
When constructing the Rick - A - Nator, the clinician
must decide whether the appliance is to be fixed or fixed -
removable.
• Fixed attachment - The type has the 0.036" wires soldered
directly to the lingual of the molar bands. One important
advantage of this type is that the patient cannot remove the
appliance andthus you are assured of 24 hrs of wear - time.
Also, with the fixed type there is less breakage and the
appliance is more stable.

• Mia attachment - Table female part of the Mia attachment
is soldered to the lingual of the molar band. The male part
of this attachment is soldered to the 0.036" connector wire
and fits into the female part from the mesial. After the
molar bands are cemented, the appliance can easily
removed by the patient or the clinician in a meaial direction.
The disadvantage of the fixed type is that if the patient
wants to remove the appliance to eat or clean it they cannot
do so. Also, if the clinician wants to remove the appliance
to reline with acrylic, this cannot be done without first
removing the previously cemented molar bands.
• Mershon attachment - The female part of the Mershon
attachment is soldered to the lingual of the molar band. The
male part is soldered to the 0.036" connector wire and fits
into the female part from the vertical. This attachment
enables the clinician to remove the appliance with relative
ease but makes it more difficult for the patient. The
appliance is removed in a vertical direction.www.indiandentalacademy.comwww.indiandentalacademy.com

MANDIBULAR PROTRACTION
APPLIANCE
Carlos M.C. Filho (1995)
introduced the Mandibular
Protraction Appliance for the
treatment of Class II malocclusion.
It is a cost efficient appliance with
ease of fabrication & rapid
installation, with infrequent
breakage. It is also comfortable to
the patient. www.indiandentalacademy.comwww.indiandentalacademy.com

Mandibular Protraction
Appliance No. 1.
Fabrication
The appliance is made by
bending a small loop at right
angles to the end of a 0.032"
Stainless steel wire. The length of
the appliance is then determined
by protruding the mandible into a
position with a proper overjet,
overbite, midline correction and
measuring the distance from
mesial of the maxillary tube to the
stop on the mandibular archwire.www.indiandentalacademy.comwww.indiandentalacademy.com

Another small right angle circle is then bent in an
opposite direction into the other end of the 0.032" stainless
steel wire. The angulation of these circle bends can vary to
allow free sliding along the mandibular archwire. One
appliance circle is placed over the maxillary archwire
against the molar tube, and the other circle against the
mandibular archwire stop. Both circles are then closed
completely with a plier.
Function
It slides distally along the mandibular archwire and
mesially along the maxillary archwire upon opening and
returns to rest against the mandibular archwire stop and the
maxillary buccal tube on closing. However, to allow
sufficient clearance for sliding along the mandibular
archwire, bicuspid brackets must be omitted, and a buccal
offset in the lower archwire is often needed.

Mandibular Protraction Appliance No.2
The MPA No.2 is fabricated by making right angle
circles in two pieces of 0.032" stainless steel wire. A small
piece of rigid ciol or stainless tubing is slipped over one of
the wires. Coils are made from 0.024" stainless steel wire
with a Tween loop-bending plier. One end of each wire is
inserted through the other wire's loop, so that each wire
passes through the other, upto the limit of the wire coil. The
coil prevents the two wires from interfering with each other
and ensures their correct relationship.

The maxillary edgewise archwire is made with an
ordinary amount of anterior torque and with occlusally
directed circles against the molar tubes. The mandibular
edgewise archwire should have sufficient torque in the
anterior position to resist labial incisor inclination and
should have occusally directed circles against the molar
tubes. The mandibular edgewise archwire should have
sufficient torque in the anterior position to resist labial
incisor inclination and should have directed circles placed
directed circles placed about 2-3mm distal to each cuspid.
The lower archwire should be firmly cinched back by
turning the archwire down distal to the mandibular tubes,
or should have ligatures attached to tieback loops against
the mandibular molar tubes.

The appropriate length of each wire assembly is
determined by placing the archwires in the mouth and
having the patient position the mandible with the correct
overjet, overbite, midline and molar occlusion. The distance
between the mesial surface of the maxillary molar tube and
the mandibular circle is then measured on each side. The
distance is transferred to each wire assembly, and
attachment loops are bent in the wire ends for the maxillary
and mandibular circles.

The Universal Bite jumper
It can be used in al phases
of treatment in the mixed or
permanent dentition & with
removable or fixed appliance.
Like other mandibular
propulsion appliances, the UBJ
uses a telescopic mechanism, an
active coil spring can be added if
necessary. It can be used in class
II or III cases.

In its normal configuration,
the UBJ is attached to the maxillary
Headgear tube with a ball pin. In the
mandibular arch sliding rods end in
a 900
hook that is fixed to the
archwire. Lower cantilever type of
UBJ is also available when used with
removable acrylic splints; two lateral
UBJs link the maxillary moral areas
& the mandibular 1st
premolar areas.
They are attached to 1.2-mm ball
clasps, which are constructed on the
working cast & then incorporated
into the them formed splints. The
lower loop of the UBJ should be
oriented in an anteroposterior
direction. www.indiandentalacademy.comwww.indiandentalacademy.com

The UBJ is generally said to obtain ½ -2-3 maximum
mandibular advancement. Re - activation is made every 6-8
weeks by crimping 2-4mm splint bushing onto the rods. UBJ
with NITI coil spring do not need to be activated. Adjusting
one side or the other of the appliance can easily midline or
asymmetrical problems.
Advantages
• Immediate orthopaedic action without waiting for dental
alignment
• Used to treat midline / Asymmetrical problems
• Simple, sturdy, inexpensive, Comfort and Acceptance
• Inventory requirements are minimum
• Used at any stage of treatment
• Low profile, less buccal irritation

FLEXIBLE FIXED FUNCTION APPLIANCE
Advantages
• These appliances has more elasticity and flexibility when
compared to RFFAs.
• It allows lateral movement of the mandible.
• Good mouth opening.
• Achieve more dental changes than skeletal changes.
Disadvantages
• Unwanted dental changes are common when compared
to RFFAs.
• Fracture is more common compared to RFFAs (mainly in
area that have more acute angle).
• Fatigue of the springs are common thereby reducing the
effective force.
• Tendency of the patient to chew on the appliance.
• Esthetically poor when compared to RFFAs
(Protuberance of the cheeks).www.indiandentalacademy.comwww.indiandentalacademy.com

EUREKA SPRING
John Devincenzo (1997) designed this appliance. The
forerunner to this spring was a system devised by Northcutt
(1974).
Indications
•Dental C-II malocclusion
•Upper molar distalization
•Lower incisor advancement
Contra indications
•CL-II open bite
•Procumbent incisors
•Deep buccal over bite / Posterior cross bite

Mechanisms
• Telescopic Rods with integral light force compression
springs
Anchorage
• Fully banded U & L arch with torque control with TPA
Effect on
• Distalizing, intrusive, expands laterally upper molars.
The devise incorporate significant changes to the
Northcutt's design including triple telescoping action,
flexible Ball and Socket attachment, a completely encased
spring that remains intact even if the devise becomes
disengaged, and a shaft for guiding the spring.

The main component of the spring is an open wound
coil spring encased in a plunger assembly. The ram is made
from a special work hardened SS wire that has been
precision machine with three different radii. At the
attachment end the Ram has either a closed or an open ring
clamp that attaches directly to the archwire. The plunger
had a tolerance f 0.002 inch within the cylinder. A triple
telescoping action permits the mouth to open as wide as
60mm before the plunger becomes disengaged, even if it
disengages in can be reassembled easily. The cylinder
assembly is connected to a molar tube with 0.032-inch wire
that has been annealed at the anterior end. At 0.036-inch
solid ball at the posterior end acts as a universal joint
permitting lateral and vertical movements of the cylinder.
The spring is within 1.5mm of full compression. The force
of the open wound spring is linear throughout the length of
the Ram thrust and is 16.6 gm for every mm of Ram
compression. www.indiandentalacademy.comwww.indiandentalacademy.com

The maxillary molar crown rolls buccally and
intrudes while the mandibular anteriors intrude and the
cuspid crowns tend to move lingually. since there is not a
tendency for extrusion of lower molars as in the class II
elastics, downward & backward mandibular rotation &
elaboration of the face anteriorly will be minimal. Since the
Eureka spring intrudes the lower anterior, overbite
correction is reduced, more by leveling the occlusal plane
then by the downward & backward mandibular rotation.
Thus the spring tends to create the combination of forces
ideal for improving facial from in most Class II
malocclusion. However these same forces work against a
facial from improvement during the correction of class III
problems.

Hence the force will have a tendency to intrude the
maxillary anteriors & depress the mandibular molars. Thus
there will be a tendency towards a development of an
anterior open -bite as the maxillary anterior are pushed
forward & upward. The mandibular molar crown will tend
to roll buccally production an increase in intra- molar
distance. This may increase the tendency for a posterior
crossbite. Additional downward& backward mandibular
rotation, which is frequently desirable, will not occur. It is a
Hi- tech breakthrough for Class II treatment. It is a
revolution any tool for the dental correction of antero -
posterior discrepancies. Do not expect any orthopedic effect
from the Eureka springs. All correction is entirely
dentoalveolar.

Jasper Jumper
Flexible produces sagittal and intrusive forces affords
freedom of mandibular movement.
Parts
Force module
Indications
Dental and skeletal C-II malocclusion with maxi excess
deep bite with retroclined incisors
Contra indications
• Root resorption
• Open bite
• Vertical growers
• Min vestibular space
• Crowding
• Bi maxillary protrusion
• Obtuse mandibular angle
• Open bites www.indiandentalacademy.comwww.indiandentalacademy.com

Mechanics
Inter maxillary springs in
compression
Anchorage
Fully banded lower arch
with torque control.
Effect on
Distalizing, intrusive,
expands laterally upper molars.
Manufacturer
American orthodontics.

The disadvantage of the herbst appliance are the
rigidity of the Herbst- bits jumping mechanism itself.
Although every attempt is made to allow freedom of
movement by enlarging the attachment holes of the tubs and
plunger to the axles, the bite jumping mechanism restricts
lateral movements of the mandible.
In an attempt to overcome these problem, Jasper
developed a new pushing device that is flexible. The
appliance produces both sagittal and intrusive forces, as does
mandibular movement.
The Jasper jumper appliance can be attached to most
of the commonly used fixed appliances. The system is
composed of two parts, the forces module and the anchor
units. www.indiandentalacademy.comwww.indiandentalacademy.com

Force module
The force module, analogous to the tube and plunger
parts of the Herbst, is constructed by a stainless steel coil or
spring that is attached at both ends to stainless steel end
caps, in which holes have been drilled in the flanges to
accommodate the anchoring unit. This module is
surrounded by opaque polyurethane covering for hygiene
and comfort.
The modules are available in seven lengths, ranging
from 26mm - 38mm in 2mm increments. They are designed
for use on either side of the dental arch. When the force
module is straight it remains passive, as the teeth come into
occlusion the spring of the force module curves axially. As
the muscles of mastication elevate the mandible producing a
range of force from 1 to 16 ounces, this kinetic energy is then
captured when the force module is curved.www.indiandentalacademy.comwww.indiandentalacademy.com

This force is converted into potential energy to be
used for a variety of clinical effects. If properly installed to
produce mandibular advancement, the spring mechanism
will be curved or activated 4mm relative to its resting length,
thus storing about 8 ounces (250gm) of potential energy for
force delivery.
If less force is desired the jumper is not fully
activated. Increasing the activation beyond 4mm does not
yield more force from the module, but only builds excessive
internal stress in the module. The tendency to increase the
force for faster treatment results is to be avoided. To
determine the proper length of the module measures from
the mesial of upper I molar buccal tube to distal of lower
lexan ball. Adding 12mm to this measurement will give the
appropriate length of the module.www.indiandentalacademy.comwww.indiandentalacademy.com

If the Class II molar relationship is not corrected
completely by the initial activation, the module should be re-
activated after 2-3 months. The modular system is activated
by shortening the attachment to the maxillary I molar. The
pin extending through the face bow tube is pulled anterioly 1
to 2 mm on each side to re-activate. Activation of the force
module can also be made through adjustments in the lower
arch- crimpable (1-2mm) placed mesial to the Lexan ball.

The Churro Jumper
Indication
• C-II Traction
Contra – indication
• Deep bite
Mechanics
• C-II coil springs in tension
Anchorage
• Fully banded lower arch with torque control
Effect on upper molars
• Extrusive
Manufacturer
• Pacific coast manu Ltd.,

The Churro Jumper is effective and inexpensive
alternative force system for the antero-posterior correction of
Class II and Class II and III malocclusions. Although the
Churro Jumper was conceived as an improvement to the
MPA, it functions more like the Jasper Jumper. In the Class
II mode each Jumper attaches to the maxillary molars by a
pin that passes through a circle on the distal end of the
Jumper and then through the distal end of the Headgear
tube. It is secured by bending the pin down on the mesial
end of the tube.
The medial end of the Churro Jumper is an open circle
that is placed over the mandibular archwire, against the
canine bracket and squeezed shut with the Howe plier. In
its passive form the Churro Jumper is not flexed. However,
when the pin is pulled forward enough to cause the Jumper
to bow outward towards the cheek, the appliance begins to
exert a distal and intrusive force against the maxillary molar
and a forward and intrusive force against the mandibular
incisors as it attempts to straighten.www.indiandentalacademy.comwww.indiandentalacademy.com

Construction
The Churro Jumper can be fabricated in a number of
ways, as long as a series of 15-20 symmetrical and closely
placed circles are formed in a wire size can be 0.028"- 0.032".
A wire as large as 0.036" will be too difficult to work with,
and anything smaller than 0.028" will not be strong enough
to resist breakage. The 0.030" wire has proven the most
adaptable and useful of all the sizes tried.
The coil be formed hand with a bird beak plier, but
this is a slow and laborious task that often results in
asymmetrical circles. A turret can be made from a wooden
handle; a headed nail, and a headless nail that approximates
the thickness of a 0.040" or 0.045" wire and acts as a spindle
around which the circles can be formed. Another effective
way to make symmetrical coils is to hold the 0.040" or 0.045"
wire spindle in a tabletop vise and wind the wire around it.www.indiandentalacademy.comwww.indiandentalacademy.com

Once the Churro wire has 15 - 20 circles, and the ends
are on the same side and the same plane, the appliance is
removed from the metal shaft, and new wires can be formed
until a collection is available for completion.
A small disposable plastic syringe is filled with a
mixed polyvinyl impression material (extrude) that is
injected into the lumen of the Jumper. This fills the
appliance with a material that does not restrict its flexibility,
but prevents the coil from opening and pinching the tongue
and cheeks as it functions.

Determination of the Length
The length of Jumper is determined by the distance
from the distal of the mandibular canine bracket to the mesial
of the headgear tube on the maxillary molar band, plus 10 - 12
mm. This measurement is transferred to the Churro Jumper,
with the coil closer to the canine bracket than to the headgear
tube. A circle is then formed at each termination mark on the
Churro wire, so that the coils of the Jumper lie against the
cheek and the terminal circle face the teeth. The maxillary
circle is completely closed, but the mandibular circle is only
partially closed to allow its placement over the mandibular
archwire and subsequent closure.

Advantages
• Provide constant force
• Used UNI/BI – laterally – C-II / C-III malocclusion
• Anchorage assisted. Therefore prevents moving into
extraction sites.
• Cost is less
• Can be made as needed from materials in clinic
• Universal size
• When broken in expensively replaced
• Easy to learn
Disadvantages
• Restriction mouth opening intolerable
• Arch wire breakage if large wires not used
• Patients with low tolerance for discomfort parallel break app
• Mouth with chewing, nervous tics parallel force poorly
• Effect depends on permanent dentition
• Must be manufactured in office
• Severable adjustable inter maxillary force spring (SAIF)www.indiandentalacademy.comwww.indiandentalacademy.com

Forsus - Fatigue Resistant Device
This is an innovative three telescopic appliance with
coil spring in its exterior part. This feature makes it
resemble some flexible functional appliances.
In comparison with AFF its great advantage lies in
coil spring resistance to breaking. The coil spring is applied
by its sliding on a rigid surface avoiding in this way
angulations at the fixing points.
It is sold in kits that include different length sizes for
left and right side.
In the original presentation the appliance is placed in
the mandible on the round-segmented arch that is included
in the kit. The appliance slides along the arch and facilitates
opening of the mouth and lateral movements. The resulting
force concentrates more on the anterior and inferior sectors.

In this way there is no
interference with continuous arches
used during the treatment which offers
wide application independently of the
method applied.
The appliance may be fixed in
various ways according to the needs of
the patient.
The device gives you the power
to control the amount of force, whether
through various available sizes, or
through the direct attachment to the
lower arch and the use of a stop for
activation. Thus the appliance may be
used in cases of mixed dentition and it
allows for dental asymmetry correction
when higher force on both sides is
needed.www.indiandentalacademy.comwww.indiandentalacademy.com

Forsus Nitinol Flat Spring
The appliance’s flat surface
is more esthetically acceptable
and it offers more comfort.
It is available in various
sizes for different patients or to
get more activation.
Forsus Nitinol Flat Spring
requires no laboratory setup,
making chairside installation
quick and easy.

The Forsus Nitinol Flat Springs, available in three
different bypass designs, accommodate a variety of moalr
attachments making it compatible with your current
appliance system. This flexibility eliminates your need for
specially molar attachments and reduces your inventory of
bands and tubes.
The Forsus Nitinol Flat Spring is slim, flat and made
of Super-Elastic Nitinol. Nitinol is always at work,
delivering consistent forces. Force levels remain constant
from the initial setup to the time of removal. The result is
faster, more efficient treatment.
Forsus is a trademark of 3M Unitek Corporation.

Severable Adjustable Intermaxillary Force Spring (SAIF
Spring)
SAIF Spring is a fixed force system, which are
available in either 7mm or 10mm lengths. The 10mm spring,
extended from the 2nd
molar to the cuspid, provide the
optimal horizontal force for anterio-posterior correction.
Placement of right and left springs takes about 5
minutes. The procedure is as follows.
• During mixed dentition treatment, while using a functional
utility archwire, simply crimp a hook onto the anterior
vertical leg of the wire. With full fixed appliances, make an
offset bend in the maxillary to be placed. This will prevent
the crimpable hook from sliding on the archwire and opening
spaces.

• Offset the eyelet end of the spring so that it points.
perpendicular to the spring and can slip easily over the molar
hook.
• Close the molar hook so that the eyelet will not slip off.
• Activate the spring 2-3mm, and cut off the excess leader
coil.
• After attaching the leader over the anterior hook, close both
the leader and the hook so that they will not come apart.

Orthopreparation
A Headgear effect type of movement is achieved by not
cinching or tying back the maxillary archwire but rather by
allowing the archwire to remain straight and slightly
extended past the buccal tubes.
Canines can be retracted in both extraction and non-
extraction patients with the posterior maxillary dentition
supported by the force.
To maximize mandibular change the movement of the
maxillary posterior dentition should be minimized. The
archwire should be cinched or tied back, as is accomplished
routinely in the mandibular dentition. In addition, a
transpalatal arch should be used to obtain intra-arch
anchorage and minimize posterior tooth movement. A fixed
lower lingual arch also is recommended.
The rectangular stainless steel archwire to be used is
given with a slight labial root torque in the anterior segment
to prevent the flaring of the anteriors.www.indiandentalacademy.comwww.indiandentalacademy.com

CONCLUSION
Current generation of Fixed Functional appliance is in
no position to speculate on the biologic basis of the clinical
results that have been observed. No valid claims are being
proposed at this time. The findings in the case presented
seem fairly typical of the small number of cases presently
being treated with the appliance. It is hoped that meaning full
information will emerge form future studies, the sample size
reaches significant proportions.
Selection of fixed functional appliance is prime
importance for an individual patient depending on whether
both orthopedic and orthodontic effect or only anterio-
posterior dental effects are to be carried out.

Fixed functional appliance

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Fixed functional appliance