Fixed functional appliances

• Additional applications :
• Can be used to support anchorage for the
retraction of maxillary anterior teeth in patient
with class I occlusions.
• In class III malocclusion – reverse
• Correction of anterior crossbites in-patiens with
pseudo class III malocclusions.
• Post surgical stabilization of class II or class III
malocclusisons.
www.indiandentalacademy.com

• Gurukeerat Singh : (JIOS 1998)
• V bend stopper for the jasper jumper instead of the
bayonet bend distal to the canine.
• Helps to separate the anterior and posterior segments thus
allowing.
• Placement of lingual crown torque in the mandibular
incisor area to prevent anterior tipping.
• Buccal root torque can be easily place in the posterior
segment when the jumper is used to distalise the maxillary
first molar or retract maxillary incisors.

MARS Appliance
• (Mandibular advancing repositioning splint)
• The MARS appliance is a functional device attached to the
archwires of a multibanded orthodontic appliance designed
to maintain class II mandibles in a protruded position.
• This appliance was introduced by Ralph M clements and
Alex Jacobson.
• The MARS appliance is composed of a pair of telescopic
struts, the ends of which are attached to the upper and
lower archwires of a multi-banded fixed appliance by
means of locking device.

• The purpose of the MARS appliance is to maintain the
mandible in a continuous protruded position during jaw
closure as well as during all opening and excursive
movements.
• The MARS appliance effects a forward repositioning of
the mandible by using the principle of compressive struts
rather than via tension, as with class II elastics, or via
predominantly muscular repositioning as with removable
functional appliances
.
• Each strut is composed of two separate parts a piston or
plunger and a cylinder or hollow tube (figure). These two
components telescope together, forming an individual strut
(figure).

• The free ends of the plunger and the hollow tube (struts)
are attached to the upper and lower archwires by means of
a slot and set screw arrangement which locks them
securely into position on the archwire.
• Two struts are required for each patient, one on the right
side and one on the left.
• The original struts were made of headgear components.
Presently the struts made by Dentanrum is used along with
the Rocky mountain lock (which have set screws) for
archwire attachment.

• The hallow tube is attached by means of a slotted set
screw attachment to the upper archwire mesial to the most
distal molar incorporated into the fixed appliance.
• The plunger is locked into position by means of a similar
slotted set screw attachment on the lower archwire distal to
the lower canines.
• The locking mechanism which is secured to the respective
archwire, is attached to the plunger and hallow tube by a
loose fitting screw which allows the struts to rotate about
the point of attachment. The loose fit permits labial
movements of the mandible.

• All preliminary rotations, space closure and alignment
procedures must have been completed before attachment
of the MARS appliance.
• The MARS appliance is always attached only to the heavy
rectangular archwires that fully engage the bracket slots.
• With the patients protruding the mandible into a class I
position, the right and left strut lengths are measured.
• The MARS strut length is that distance from the middle of
the interbracket space distal to the lower canine to the
middle of the interbracket space mesial to the maxillary
terminal molar.

• The upper member or hallow tube length is determined by
subtracting a calculated and standardized measurement of
7.4mm from the strut length. The upper member is
measured on the side opposite the attachment tab and
measurement is taken from the opening immediately
beneath the tab.
• The free end of the lower member or the plunger is then
cut so that 2mm extends out of the back of the upper
member under the attachment tab.
• One reference measurement needed for this appliance is
the PIED (Protrusive incisial edge distance) PIED is the
horizontal distance measured at the midline between the
maxillary and mandibular incisial edges with the mandible
in its maximum strained protruded position.

• The MARS appliance should be locked into position with
the mandible 2 to 3 mm posterior to the maximum PIED
measurement. In the event a patient encounters muscular
discomfort as a result of protruding the mandible too far
forwards the appliance is adjusted and locked in a less
protrusive position.
• At subsequent appointment the Pied should measured and
recorded. The authors have observed that the PIED will
increase from 0.5 to 2 mm between 3 to 4 week
appointment intervals. When the PIED ceases to increase
between appointments, the MARS appliance is then
adjusted so that a super class I occlusal relationship is
obtained.
• Two methods to lengthen the appliance

– 1) Replacement of the struts with longer upper members of
cylinders.
– 2)Placement of spacers 2 to 3 mm in length on the lower
members or pistons.
• To ensure a good, stable class I occlusal relationship the
MARS appliance should be adjusted to a point at which
the mandibular incisal edges are 2 to 3mm anterior to
their final desired (position) to allow for some relapse on
removal.
• When no further increase in PIED can be detected at two
subsequent appointments, the MARS appliance is
removed.

• Unlike the Herbert appliance, the MARS
appliance :
• Requires neither soldering nor extensive lab
procedures.
• Has minimal incidence of breakage
• 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 and removed from the arch wire.
• Can be place at an appropriate time during
treatment.

• Disadvantages :
• Need for a fixed multi-banded appliance limits
used in mixed dentition cases.
• Disarticulates the posterior segments form 1 to 3
mm
• Need for custom sizing of each appliance for each
patient.

Mandibular Protraction appliances : (JCO 1995)
• These appliances were developed by Calos Martin
Coelho Filho. His in – ability to purchase some of
the newer class II corrective appliances in
northern Brazil led him to develop these group of
appliance that reposition the mandible forward.
• The are also effective in treating class I patients
with exaggerated over jets and class II subdivision
patients where only one side needs correction.

Mandibular protraction appliance No. 1:
• Requires stainless steel edgewise arches in both arches.
• The mandibular archwire requires stoops such as circles,
crimpable hooks, or loops distal to the cuspids to prevent
direct contact between the appliance and the bonded
brackets.
• Bonding the cuspids and planning a connecting lingual
arch allows the clinician to use the cuspid brackets as stops
as well.
• The lower archwire should have enough lingual torque in
the anterior region to resist labial displacement of the
lower incisors form the protrusive pressure of the
appliance.

• It should be tightly cinched back with a tip down
distal to the mandibular tube or with a tie back.
• The maxillary archwire does not need a stop,
tieback or special torque adjustment.
• Each side of the appliance is made by bending a
small loop at a right angle to the end of an 0.032”
stainless steel archwire.
• The length of the appliance is then determined by
protruding the mandible into a position with
proper overjet, overbite, and midline correction
and measuring the distance from the mesial of the
maxillary tube to the stop on the mandibular
archwire.

• 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.

Functioning of the appliance
• It sides 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 (figure).
• To allow sufficient clearance for sliding along the
mandibular wire, bicuspid brackets must be
omitted and a buccal offset in the lower archwire
is often needed (figure).

• Filho noticed significant changes within four
months with this appliance. With careful patient
selection and judicious use this first design
works quite effectively.
• However,
• Impossibility of bonding the lower bicuspids
• The appliance’s limited mouth opening
• Frequent dislodgment of molar bands led Filho
to develop the 2nd protraction appliance.

Mandibular protraction appliance No. 2 (MPS 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 coil or stainless steel tubring is
slipped over one of the wires.
• The coils may be made form 0.024” stainless steel wire
with tweed loop bending plier.
• One end of each wire is inserted through the other wire’s
loop so that each wire passes through the other up to the
limit of the wire coil. The coil prevents the two wires form
interfering with each other and ensures their correct
relationship.

The Mandibular Protraction
Appliance

• The maxillary edgewire arch 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 portion to resist
labial incisor inclination and should have
occlusally directed circles placed 2-3 mm distal to
each cuspid.
• The lower archwire should be firmly cinched
back or tied back.

• The appropriate length of each arch wire
assembly is determined by placing the
archwires in the mouth 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. This distance is transferred to each
wire assembly and attachment loops are
bent in the wore ends for the maxillary and
mandibular archwire circles.

• The 2-3 mm distance between cuspid brackets and
mandibular archwire circles allows adjustment for
asymmetries that may develop during treatment.
By simply sliding the archwire to one side or the
other the midline can be attunded and more
pressure put on one side of the mouth.
• Both MPA No. 1 and No.2 rely on a combination
of combination of condylar growth and
dentoalveolar adaptation to achieve a class I
posterior occlusion.

• Advantages :
• Easily fabricated at chair side, with ordinary inexpensive
wires.
• Do not require any special bands , crowns or wire
attachments.
• No impression or wax bite registrations needed
• Easily inserted adjusted and removed can be made and
installed in about 30 minutes.
• Much smaller and thus more comfortable
• Permit a greater range of motion and are less restrictive of
movement
• Easily adaptable for preserving maxillary molar and
mandibular incisor anchorage when minimal movement of
these teeth is required

Mandibular protraction appliance No. 3 (MPA
No. 3) (JCO 1998)
• The limitations of the first two MPS designs
namely problems of breakage, restricted opening
and patient discomfort associated with MPA No. 1
and the difficulty of chair side construction of the
MPA No.2, have been over come with the
development of the MPA No. 3
• This version eliminates much of the archwire
stress and permits a greater range of jaw motion
while keeping the mandible in a protruded
position.

Appliance construction:
• The parts needed for the construction of the MPA No. 3
are (figure)
• Two maxillary tubes of 0.045” internal diameter each
about 27 mm long.
• Two maxillary loops of 0.040” stainless steel wire, each
about 13 mm, long, with a loop bent into one end at an
angle of about 130 to the horizontal.
• Two mandibular rods of 0.036” stainless steel each about
27 mm long.

The Mandibular Protraction Appliance
No. 3

• Four pieces of band material
• Two short lengths of annealed 0.036” stainless steel wire,
each with a loop in one ends, for attaching the appliance to
the maxillary molar headgear tube.
• Weld each maxillary tube to a maxillary loop. Weld two
pieces of band material around the combined wires, this
will eliminate the used for soldering.
• Prepare a stainless steel edgewise mandibular archwire by
bending an “0” loop on each side distal to the cuspid
winding the wire twice around a tweed loop forming piler.
(preferably 0.019 x 0.025” wire, 0.016 x 0.022” or 0.017 x
0.025” also acceptable).

• Prepare each 0.036” mandibular rod by
making a 90 bend at one end. Place a small
piece of tubing our the same end then crimp
and weld it so it stays fixed. Insert the
longer leg of the mandibular rod through
the “o” loop in the archwire from the
lingual. Manipulate the rod upward until it
is perpendicular to the wire.

Appliance placement :
• Place the mandibular archwire in the mouth so that
enough wire extends distal to the molar tube for a
bend down tieback. The 2nd molars may be
included to increase anchorage. More working
space available if a simple 2x6 bonded appliance
is place.
• The maxillary arch can be fully or partially
bonded using any type and size of archwire.
Round or edgewise, stainless steel or nickel
titanium.

- The MPA No. 3 almost unrestricted
opening to atleast 50-55 mm. It can also be
used unilaterally.

Adaptations of the MPA No. 3 :
• If the maxillary tube assembly is cut short of a fully
portuded mandibular position, a nickel titanium open coil
spring (0.045” internal diameter) can be placed over the
mandibular rod between the maxillary tube and the end of
the rod. This design may reduce the orthopedic protrusion,
but provides a gently continuous class II force. The force
is small enough that the mandibular rod can rest directly
against the cuspid bracket without risk of breakage.
However there is a mesial rotation of the cuspid.
• By reversing the direction of MPA No. 3, it can be used to
correct class III malocclusions and anterior cross bites.

Advantages over previous models :
• More comfortable for the patient
• Offers greater range of motion
• Equally simple and inexpensive but easier to place
• Adaptable to either class II or class III cases
• Can be used for mandibular positioning or dento
alveolar movement
• Causes less breakage.

Mandibular Protraction Appliance IV

Adjustable Bite corrector (ABC) (JCO 1995)
• Introduced by Richard P. West
• The appliance essentially consists of
• A stretchable closed coil spring and internally threaded
end cap that allows the parts to rotate freely like a nut on a
bolt.
• The axial or “push force is generated by a length of a
nickel titanium wire in the centre lumen of the spring.
• The closed coil spring is made of 0.01 8” stainless steel,
and will stretch to about 25% beyond its original length
without permanent deformation. This allows additional
range of opening with no risk of breaking the appliance or
accidentally changing its length.

The Adjustable Bite Corrector14

• The ABC can be used on either side of the mouth with a
simple 180° rotation of the lower end cap to change it
orientation.
• Functions similar to the Herbert and Jasper Jumper but
also incorporates several useful features like
• a) Universal right and lift :
• As long as the ABC is opened at least one half turn prior to
placement, the device will always swivel away form the
occlusion during function. Failure to remember this point
may cause a patient to have difficult closing mount without
biting on the spring.
• The universal feature greatly reduces inventory

• b) Adjustable length and force :
• A special ABC measuring gauge makes size selection
simple.
• After the patient has postured forward into an improved
profile with ideal overbite / overjet the point of the gauge
is placed into the mesial opening of the headgear tube. The
size is then read at point about 3mm below the contact
between lower cuspid and first premolar using the correct
appliance size ensures optimum force delivery.
• If the measurement is between sizes, remove one end cap
and exchange the nickel titanium wire for one of the
proper length, cut from the extra wire provided in the kit.
Unscrew each end cap and adjust length of spring.

• The ABC can be lengthened as much as 4 mm or
21/2 turns at each end. Beyond this there are
chances of the spring pulling out of the end cap
when the patient opens wide.
• The adjustable feature can be used for treatment of
asymmetrical problems or midline shifts, for
changing anchorage as treatment progress, or
when force needs to be varied.

• Attachment parts :
• Special molar clips or the eyelet pin at the upper
molar headgear tube.
• Starter jig” with, an eyelet at one end just large
enough for attaching the jig to the molar hook at
the lower molar.
• A number of additional Jig designs are also
available.
• All these allow easy removal and replacement
when so desired.

• Repairs and emergencies :
– Wire fractures are infrequent with the ABC.
– If the spring breaks it will usually be in the
centre, where forces are concentrated during
“bowing” or force application.
– Repair is easy, where the end caps are
unscrewed and the coil spring or nickel
titanium wire is replace with a new one from
the kit.

Orthodontic Preparation :
• A full size rectangular archwire with 10-15° of lingual
crown torque, placed in the lower incisor region, will
overcome the tendency of the incisors to flare labially.
• The archwire must be tied back or bent distally to resist
forward displacement.
• A TPA, can help prevent expansion across the upper first
molars. Additional buccal root torque to a removable TPA
will also counteract any intrusion of the buccal cusps.
• Lingual tipping of the maxillary incisors can be overcome
by the addition of lingual root torque in the incisor region
of the archwire or by using full size rectangular archwire
in pretorqued bracket with the archwire tied back.

Mixed dentition treatment :
• In class II patients requiring maxillary expansion,
the ABC can be attached to a bonded palatal
expander, with headgear tubes embedded in the
carylic or normal buccal attachments in the upper
molar bands.
• When measuring for ABC size in such a case,
move the lower point of attachment distally to
create a more vertical force. This will prevent the
open bite that often occurs during palatal
expansion.

Permanent dentition treatment
• The ABC inhibits forward growth of the mxilla while
encouraging maximum functional effect and forward
growth of the mandible .
• The simplest method of attaching the ABC to the lower
molar is by a jig to a lip bumper or auxiliary archwire tube
in the molar bracket.
• A tieback or tie down loop in the jig will ensure that forces
are not concentrated at the lower anterior teeth if the distal
bend in the archwire should break off.

• All jig wires should be bent with gentle curves in
both horizontal and vertical planes. Sharp bends
will cause binding and interference as the ABC
slides back and forth during function.
• Attachment to the upper molar is through the
molar clip or eyelet pin.
• If the treatment goal is to distalize the upper
molars, a section of active open coil spring can be
placed on the archwire between the molars, so the
force of the ABC at the first molar is transmitted
to the 2nd molar as well.

• Anchorage :
• The ABC can be used for upper molar anchorage
control during retraction of anterior teeth for space
closure.
• The class II “push” force of the ABC creates full
time maximum anchorage at the upper molars
while bringing the lower posterior teeth forward
form the pull at the jig attachment.

The Eureka Spring (JCO 1997)
• Introduced by john De Vincenzo
• The main component of the Eureka spring is an
open wound coil spring encased in plunger
assembly
• The ram is made form a special work hardened
stainless steel that has been precision machined
with 3 different radii.
• At the attachment end the ram has either a closed
or an open ring clamp that attaches directly to the
archwire.

EUREKA SPRING

• The plunger has a tolerance of 0.002” within the cylinder.
A triple telescoping action permits the mouth to open as
wide as 60 mm before the plunger become disengaged.
• The cylinder assembly is connected to a molar tube with a
an 0.032” wire that has been annealed at the anterior end.
• An 0.036” solid ball at the posterior end acts as a
universal joint, permitting lateral and vertical movements
of the cylinder.
• The Eureka spring comes in only 2 sizes one for extraction
and one for non-extraction cases and left and the right
sides are interchangeable.

Advantages :
• Ability to function with the need for patient co – operation
• Esthetic acceptability the eureka spring because of its
small size and lack of protuberances into the buccal
vestibule, is almost invisible.
• Resistance to breakage : produces forces of only 140g-
170g at the points of attachment as compared to 220-280g
of Jasper Jumper.
• It never functions in any mode other than straight
compression which is evenly distributed over the entire
length of the spring.

• The spring life is 3 to 6 months.
• Ability to produce rapid movement : this is in spite of its
low force levels because the Eureka spring continues to
work even when the
• mouth is opened as much as 20 mm as when sleeping or
when the mandible is thrust forward as far as 10 mm, in
an attempt to minimize the force.
• Functional acceptability to patients. Promoted by its
miniaturization and worry free operation, as well as its
rapid movement.
• Ease of installation
• No auxiliary archwires or extra impressions for
laboratory fabrication are needed.

• Low cost : similar in cost to the jasper jumper but
less expensive than the fixed Herbst appliance.
• Minimal in ventory requirement
• Optimal direction of force
• Delivers a push force against mandibular anterior
and maxillary posterior teeth.
• It also has a vertical intrusive component at the
maxillary molars and mandibular although this is
minimal due to direct archwire attachment, rather
than via auxiliary wire.

• Stromeyer’s study, which was a cephalometric evaluation
of 50 consecutively treated bilateral class II patients with
the Eureka spring indicated the following.
• Average anteroposterior correction was at the rate of
0.7mm/month.
• For every 3mm of anteroposterior correction the maxillary
molars intruded 1mm and the mandibular incisors intruded
2 mm.
• The maxillary dentition moved distally 1.5mm and the
mandibular dentition moved mesially 1.5mm.
• No increase occurred in anterior facial height between the
delichocephalic and brachy cephalic subgroups.

The churro jumper (JCO 1998)
• Introduced by Ridhardo Castanon, Mario S Valdes and
Larry White.
• The Churro Jumper furnishes orthodontists with
aneffective and inexpensive alternative force system for
the anteroposterior correction of class II and class III
malocclusions.
• It was developed as an improvement of the MPA of
Coelho.
• The name was taken from a Mexican Cinnamon twist.
• Although the churro jumper was conceived as an
improvement to the MPA, it functions mere like a Jasper
Jumper.

Clinical Use of the Churro Jumper

The Churro Jumper

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.
• The wire size can be 0.028” to 0.032”. A wire as large as 0.036” will
be too difficult to work, anything smaller than 0.028” will not be
strong enough to resist breakage. The 0.030” wire has proven the most
adaptable and useful all the sizes tried.
• The coil can be formed free hand with a bird beak plier, but this a slow
and laborious task that often results in asymmetric circles.
• A turret can be made from a wooden handle, a headed nail and
headless nail that approximates the thickness of an 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” spindle in a table top wise and wind
the wire around it.
• Once the churro has 15-20 circles and the ends are on the
same side and in 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 amount of mixed polyvinyl impression material is
injected into the lumen of the jumper with the help of a
plastic syringe. This fills the appliance with a material that
does not restrict its flexibility but prevents the coils form
opening and pinching the tongue and the cheeks as it
functions.

The churro Jumper as a class II force :
• Since the churro jumper requires reciprocal anchorage and
appropriate mandibular arch is critical for its success in
class II cases.
• The largest possible edgewise wire must be used with an
0.018” appliance this will usually be an 0.018”x 025”
archwire, although an 0.0175” x 0.025” wire can also be
used. Any wire smaller than these invites breakage. With
an 0.022” appliance, either a 0.019” x 0.025” or even a
0.021” x 0.025” archwire must be used.
• The mandibular archwire must be cinched back tightly to
limit mandibular incisal flaring.

• The size and type of maxillary archwires is not critical, it
can be selected solely with regard to the specific maxillary
needs of the case. This wire can be tied back or not,
depending on whether enmasse movement or selected
molar displacement us desired.
• Because the churro needs space to slide on the mandibular
archwire atleast the first premolar brackets should be
omitted. It is advantageous to place a buccal offset in the
wire just distal to the canine bracket so that the jumper
also has buccal clearance, which permits unrestricted
siding along the wire.

• The length of the 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 10-12mm. This measurement is transferred to the
churro jumper with the coil closure 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 circles 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.

• A pin made of annealed 0.036” is used to secure
the maxillary circle through the distal of the
headgear tube. The maxillary pin is pulled
mesially through the headgear tube unit the
jumper has slight buccal bow in it, and is then
turned down. Initially, the pin is not cinched
tightly against the tube, which improves patient
comfort and allows space for later adjustments. At
subsequent appointments as the teeth move and
adjust to the forces of the churro jumper, the
headgear pin is pulled forward to reactivate it.

• The mandibular circle is placed over the
mandibular archwire against the canine bracket
and squeezed short with a home piler. The force of
the churro is so light that canine brackets are
seldom broken.
• The churro jumper usually requires no more than 4
to 6 months to correct a class II malocclusion, but
for insurance, should be left in place until the
bicuspids present a firm class I occlusion.

Mode of action :
• In its passive form, the churro is not flexed
• However when the pin is pulled forward enough to
cause the jumper to bow outward the cheek, the
appliance begins to exert a distal and intrusive
force against the maxillary molar and a forward
and intrusive force against the incisors as it
attempts to straighten.

Unilateral / Bilateral use :
• This jumper can be used unilaterally in cases of
class II subdivision malocclusions.
• The bilateral class II churro jumper is most
suitable for patients who need mandibular incisors
advancement. Not a very good choice for class II
bimaxillary proclination cases.
• By reversing the attachments, the churro jumper
can also be used to treat class III malocclusions.

Advantages :
• Provides a constant, indefatigable force.
• Can be used either unilaterally or bilaterally.
• Can be used in class II or class III cases.
• Helps maintain anchorage.
• Very inexpensive.
• Can be constructed from commonly available
materials universal in size.
• When broken, easily replaced.
• Staff members can quickly learn how to repalce an
appliance

Disadvantages :
• Restriction of mouth opening to 30-40 mm
• Archwire breakage if larger wires not used.
• Patients with a low tolerance for discomfort will
often break the appliance.
• Patients who incessantly move their mouths while
chewing, taking and nervous tics will fare poorly.
• Its maximum effectiveness depends on a
permanent dentition to retain its effect.
• It must be manufactured in the office.

The universal bite jumper (JCO 1998)
• Introduced by Xavier Calvez
• This is a fixed functional which can be used in all
phases of treatment, in the mixed or permanent
dentition and with removable or fixed appliances.
• This jumper also uses a telescoping mechanism,
can also have an active coil spring if necessary. It
can be used in class III cases if mounted in a
reverse configuration.

The Universal Bite Jumper

• I) Fixed appliance configuration
• In its normal configuration, the UBJ is attached to the
maxillary headgear tube with a ball pin which is bent so it
can be tied with a ligature to the hook on the molar band.
• A TPA or expander can be used to control palatal width.
• In the mandibular arch the sliding rod ends in a 90° hook
that is fixed to the archwire.
• The premolars should be left free, while 0.022” brackets
are banded from canine to canine.

• The 0.021” x 0.025” mandibular stainless steel
archwire should have a stop and a buccal offset to
allow clearance for sliding, should be cinched
back tightly and also be attached to an ausiliary
sliding, archwire which is fixed in two places to
the main arch.
• No laboratory preparation is required. The UBJ is
fitted in the patient’s mouth and cut to the
appropriate length for the desired mandibular
advancement.

II. Lower cantilever configuration :
• In this design the loop on the rod is fixed to a lower cantilever,
consisting of a 2.4 mm x 1.4 mm oval Remanim wire, with a welded
ball clasp, from the mandibular molar crown to the interproximal area
between mandibular 1st prmolar and canine.
• An 0.048” welded lingual arch links the two mandibular molars and
contacts the lingual surface of the mandibular incisors.
• An 0.025” tube adjacent to the cantilever allows positioning of the
mandibular incisor realignment archwire.
• Thus advantage of this configuration is the possibility of immediate
orthopedic action without waiting for dental alignment.

II. Removable splint mounting
• When used with removable acrylic splints, two
lateral UBJs link the maxillary molar areas and the
mandibular first premolar areas.
• They are attached to 1.2mm ball clasps, which are
constructed on the working cast and then
incorporated into the thermoformed splints.
• The lower loop of the UBJ should be oriented in
an anteroposterior direction.

• A single median UBJ can be used to link the
removable splint from the middle rear area of the
palate to the lingual surface of the mandibular
incisor.
• The UBJ is attached to two transverse axles,
which allow opening and lateral movements.
• The median UBJ provides muscular therapy as it
prevents the tip of the tongue from contacting the
lower lip.
• Most children are able to speak well with this
appliance, given a little time to adjust. Cheek
impingement is eliminated and it is the author’s
experience that the tongue is not irritated with this
design.

Adjustments :
• The UBJ is generally set to obtain aim ½ to 2/3
rds maximum mandibular advancement.
• Reactivation are made every 6 to 8 weeks by
crimping 2 to 4 mm splint bushings on to the
rods.
• Midline or asymmetrical problems can easily be
treated by adjusting one side or other of the
appliance.

Advantages :
• The UBJ offers the following advantages
• Simple, study and inexpensive
• Inventory requirements are minimal
• Can be used at any stage of treatment
• Can be used in class II or class II cases
• need for patient cooperation

• Its low profile results in considerably less
buccal irritation than with similar
appliances.
• Patient comfort and acceptance are good
• Can easily be attached to removable splints
for maximum anchorage.
• Produces good results without the

Mandibular corrector (JCO 1985)
• Introduced by Marston Jones
• It is a fixed functional that uses bilateral piston and
plunger telescopic mechanism to reposition the mandible
anteriorly and is directly attached to archwires of a
multibanded fixed appliance.
• It is used with nearly full sized edgewise archwires →
0.0175” x 0.025” in 0.018” slot and 0.021” x 0.025” SS in
0.022” slot appliance.
• Connectors holding the repositioning arms are attached to
the archwires distal to the lower cuspid brackets and
mesial to the tubes on the terminal upper molars

– The length of the repositioning arms are
determined intraorally with the patient’s
mandible advanced 3-4 mm.
– The entire procedure can be completed at chair
side in 30 minutes.
– The mandible can be advanced in small
increments of 2-4 mm at 4 week intervals until
the incisors are in an edge to edge relationship.
– Midline corrections are made by advancing the
appliance more on one side.

• A correction of 3-4 mm can be achieved
within 6 months, an overjet of 7 to 8 mm
may require 12-14 months.
• When an over treated class I occlusion has
been achieved, the appliance is removed
and short class II elastics are placed to bring
the posterior teeth into tight intercuspation.

The Horizontal anterior positioning (HAP)
appliance (Jco 1988)
• Introduced by William E. Harrell.
• The HAP appliance is a fixed functional
appliance that both repositions the mandible
and permits expansion and / or movement
during the TMJ stabilization phase.
• The components of the appliance are :

• The anterior reverse ramp, which allows for
sagittal movement of the anterior teeth
using sagittal screws, anterior repositioning
to reduce anterior disc dislocation;
encouraging growth possibilities in class II
retrognathic children; and torquing of
maxillary anterior teeth with fixed
appliances, when the anterior lip of acrylic
is removed.

• Expansion arms on the lingual of the cuspids
and bicuspids, which allow dental expansion
and keep the incisors from dumping lingually
during the use of buccal seating elastics.
• The coffin spring, which connects the two sides
of the appliance, adds strength, and can be used
for molar expansion or rotation.
• A locking mechanism, consisting of a soldered
half round tube and lock wire, that holds the
appliance in place.

• A lower “dipod”, which provides upper and
lower posterior occlusal support. A posterior pad
can be added to the HAP, but adjustments
become more difficult and the possibility of
breakage increases.
• The vertical dimension can be increased if
necessary. The bite opening effect allows for
passive or active eruption of the posterior
occlusion to help level the curve of spee.

The mandibular anterior repositioning appliance
(MARA)
• Is probably the most recent fixed functional
appliance to become commercially available
• It was introduced in 1998 by Ormco / A company
after extensive development and testing by
Dadglass Toll of Germany and James Eckhardt of
U.S.
• In the essence, it is an ingenious way to encourage
patients to keep their mandibles thrust forward to
avoid intentionally created, buccally placed
occlusal interference’s

The Mandibular Anterior
Repositioning Appliance(MARA)

• These interference’s are produced when a horizontally
adjustable vertical bar attached to the buccal surface of a
maxillary first molar stainless steel crown, hits a buccally
protruding horizontal bar extending from the lower first
motor stainless steel crown.
• Additional activations can be made by placing one or more
shims at the mesial aspect of the horizontal bar.
• Advancing the mandible forward in precise increments
can be achieved by insertion of selected shims of varying
length.

• Advantages over Herbst
• Better esthetics
• Problem with disengagement do not occur
• Breakage from lateral mandibular movements should be
less.
• Can be used concurrently with full edgewise orthodontic
appliance.
• This
– Eliminates the need for a 2 phase treatment.
– Can maintain the achieved orthopedic results, since the appliance
can continue in a non activated manner.

• Disadvantages
• Temporary stainless steel crowns needed on all first
molars.
• Some increase in anterior facial height results from the
placement of these crows.
• Fabrication only available at one commercial laboratory.
• The posterior and buccal location of the guide planes may
cause loosening of the stainless steel crowns or breakage
of the mandibular protruding horizontal bar.

The Biopedic
• Designed and introduced by Jay Collins in 1997 (GAC)
• It consists of buccal attachments soldered to maxillary and
mandibular molar crowns.
• The attachments contain a standard edgewise tube and a
large 0.070 inch molar tube. Large rods pass through these
tubes.
• The mandibular rod inserts from the mesial of the molar
tube and is fixed at the distal by a screw clamp. By moving
the rod mesially the appliance is activated.

The BioPedic Appliance
• GAC International

• This short maxillary road is inserted screw at the
mesial of the maxillary first molar.
• The two rods are connected by a rigid shaft and
have pivotal region at their ends.
• Although, it appears that there would be limitation
of mandibular opening, it is not so. The anterior
extension of the mandibular rod reaching only to
the region of the second premolar and the
maxillary molar attachment beginning at the
distal of the molar crown work more in harmony
with the arc of mandibular opening.

• Advantages
• Can be used concurrently with banded treatment.
• Esthetic benefit
• Capability of adjusting the amount of protrusive
activation.
• Disadvantages
• Potential for more breakage and loose crowns
• Greater cost.
• Need for crowns on molars

The saif Spring
• (Severable Adjustable inter maxillary force)
First interarch force system developed by Armstrong
• In the later 1960’s and early 1970’s he introduced
the Pace Spring, later termed multicoil spring and
finally called Saif spring.
• These were first marketed by North West
orthodontics, later by Unitek, and currently by
Pacific coast manufacturing.
• They consist of two springs one inside the other
with soldered loops on each end.

• Various attachments can be placed through these loops to
secure the springs to deliver either class II or class III
force.
• They are available in 7 mm and 10 mm lengths, have an
outside diameter of 3 mm, and deliver 200 to 400 gms of
force.
• Breakage is a constant problem.
• Bit bulky, not very hygienic and there is some limitation to
mandibular opening
• However large forces are generated by these springs which
may account for the surprisingly rapid correction observed.

The Klapper Superspring II
• Introduced by Lewis Klapper in 1997, for
correction of class II malocclusions.
• On first glance, it resembles a Jasper Jumper with
a substitution of a cable for the coil spring. In
a998 the cable was wrapped with a coil and the
Klapper superspring II was the result.
• Only tow sizes are required (left and right sides
are not interchangeable) and breakage is less
frequent.
• However it differs significantly from the Jasper
Jumper at the molar attachment.

The SUPER spring II:

The Klapper Super Spring

• The Kalpper superspring II inserts from the mesial
and is rigidly secured to the molar by an oval
attachment tube.
• The Klapper superspring creates a distal root tip
movement on the molar, this may be desirable in
some patients.
• Because the Klapper superspring inserts gingivally
on the molar and cannot roll to the buccal as
readily as the Jasper Jumper, there may be a
greater vertical component to the force vector → a
pronounced curve of speed levels faster.

• Disadvantages
• Requirement of a special molar tube
• Lack of adaptability to correct class III conditions
• Limitation to maximal opening
• Potential injury to the patient if breakage occurs
and the rigid molar attachment forces the broken
portion into the soft tissues.

• Extended wear may cause excessive root
distal tipping to the maxillary molar and
more intrusion at the molars and incisors
than desired
• Palatal root torque may be excessive
• No statistical results of clinical trials are
available to date

forsus
• This appliance has the following advantages:
• l It does not require time-consuming and expensive lab
work or the use of stainless steel crowns.
• l It produces consistent treatment results in a predictable
amount of time, without depending on
• patient cooperation.
• l It can deliver an orthopedic effect to both jaws or more of
a dentoalveolar effect.
• l It can be activated more on one side than on the other, so
it excels at correcting midline
• deviations. •

FORSUS – FATIGUE RESISTANT
DEVICE

Rick-A-Nator
• This appliance consistence of two maxillary first
molar bands attached to anterior bite plate via two 0.036”
connector wires. This incisal ramp encourages the
mandible to come forward which corrects the class II
molar relationship to a class I and eliminates the overjet.
• Parts of Rick – A – Nator
• Two molar bands with lingual attachments which could be
– Fixed (soldered)
– Mia attachment (mesial direction)
– Mershon attachment (vertical direction)
• 0.036” connector wire from molar bands to incisal ramp.
• Incisal ramp (clear acrylic)

Types of Rick – A- Nator
• When construction the Rick-A-Nator the clinical
must decide whether the appliance is to be fixed or
fixed removable.
• a. 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 and thus you are
assured of 24 hours of wear time. Also with the
fixed type there is less breakage and the appliance
is more stable.

• b. Mia attachment :
• The female part of the mia 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
form the mesial. After the molar bands are cemented, the
appliance can easily be removed by the patient or the
clinician in a mesial direction. The disadvantage with the
fixed types are 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 the
acrylic, he first needs to remove the 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 case but makes it more
difficult for the patient. The appliance is removed
in a vertical direction.

Conclusion :
• Fixed functional appliances form and useful
addition to the clinician’s orthodontic
armamentarium. But many of these appliances
need further studies to substantiate the claims
made by their respective originators. With this in
mind, clinicians must take great care in selecting
the right patient sand also pay attention to every
detail in the manipulation, to attain successful
results with these appliances

Fixed functional appliances

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Fixed functional appliances