Class Two Management with fixed Appliance
By DR : Ahmed ,A,sokkar & DR : faezaa
Undersupervision : orthodontic department
CLASS 11
MALOCCLUSIONS
• "Distal" relationship of mandible to maxilla
• The mesiobuccally cusp of the maxillary
first permanent molar articulate mesial to the buccal
Groove of the mandibular first permanent
Types of class 11
• *DIVISION I-The
Maxillary incisors labioversion
• *DIVISION 2- Maxillary centrals
incisors are near the normal or slightly in
linguoversion
• Maxillary lateral incisors have tipped labially
SKELETAL CLASS 11
MALOCCLUSIONS
•
Skeletal discrepancies are often associated with dental Class Il
malocclusions.
•
A] Mandibular Deficiency
•
B] maxillary excess
Nongrowing
patient
Growig
Patient
Dental
Sekeletal
Orthopaedic
/(functional
Sekeletal
Fixed
appliance
Surgical
Treatment
Fixed appliances
• Those are orthodontic devices which have attachment that are fixed onto the
tooth surfaces , and force are exerted on tooth via these attachment using
arch wires and other auxiliaries
• Those appliances cannot be removed or activated by patient
Indications of Fixed Appliances
 Class 2 malocclusion
 Mandibular deficiency
 Overbite reduction by intrusion of incisors
 Correction of mild to moderate skeletal discrepancy
 Multiple tooth movements required one/arch
 Active mandibular growth
 Intrusion / Extrusion of teeth
 Normal maxillary development
Contraindications of fixed appliance
• Extremely sever malocclusion
requiring orthognathic surgery
• Poor dental health
• Poorly motivated patient
• more expensive than removable
appliances.
• Damaged appliances that apply miss –
directed forces cannot be removed by
patient.
• Fixed orthodontic appliance require
special training of operator
Component of fixed appliances
A. Passive components
• Band
• Bracket
• Buccal tube
• Lingual attachments
• Lock pin
• Ligature wire
B. Active components
• Arch wire
• Spring
• Elastic
• Separator
Systems of working for fixed appliances
• Contemporary fixed appliances are variation of Edge wise appliance
system
• Another system is Begg appliances
( it contains rectangular slot but doesnot use rectangular arch wire)
• Currently Begg appliance system has been modified into Tip-Ege
Types of fixed appliances
Herbest appliance
• In 1905 Emil herbest introduced a fixed appliance in Germany
• Consists of rigid maxillary and mandibular framework
• The mandible is maintained in a
Forward positin by means of metal rod
,the tube telescope mechanism that is attached from the
Maxillary first molar to mandibular first molar
Case treated with Herbest appliance
Jasper Jumper
• Its was introduced by American orthodontist , James Japer
• It has replaced the rigid telescope mechanism with flexible plastic
covered open coil spring
• Attached directly to the auxiliary wires with
Complete or partial fixed appliance in place
Case treatment with jasper jumper
Mara appliances
• Mandibular advancing repositioning appliance
• This appliance was introduced by Ralph.M clements & Alex Jacobson(1982)
Composed of a pair of telescopic struts
• the MARA is a unique noncompliance Class II correc-tor that does not directly connect the
maxillary and mandibular arches. It advances the mandible so that the patient functions in a new
protrusive position.
• Attached & fixed from the upper first molar
To the mandibular first molar.