Frankel functional appliance /certified fixed orthodontic courses by Indian dental academy

FRANKEL FUNCTION REGULATOR
www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education

 Prof Dr Rolf Frankel
born in Leipzig on
March 29.
 He has been an
outstanding
contributor to
functional appliance
thought & the
creator of the
Function regulator
(Frankel) system of
appliances.

Buccinator mechanism
 The laws of muscle action.
 The integrity of dental arches and the
relationship of teeth to each other.
 Of-setting of the tongue pressure by buccal
and labial muscles during mastication.
 Hence aberrations of muscle function can and
do produce marked mal relationships of the
dental arches.

Guiding effect of Buccinator mechanism

THE FRANKEL PHILOSOPHY
 The major part of the Frankel appliance is confined to
the oral vestibule.
 The concept of shielding the perioral musculature.
 The Function regulator of Frankel differs from other
functional appliances in the Sense:
The Frankel appliance is largely confined to the
oral vestibule.
Stresses the influence of the functional
matrix, the buccinator mechanism and the Orbicularis
Oris complex.
The dynamic barriers to optimal growth of the
cranio facial complex in three dimensions of space.

The vestibular arena of operations
The classic concept of
“Pushing the dental
arches out from within”.
vestibular constructions
act as an artificial
“Ought –to –be” matrix.
Appliance as an exercise
device for oral
gymnastics.
The primary role of the lip
and check musculature in
arch form development
as opposed to the tongue.

Sagittal correction
The major draw backs in the
past.
The appliance is anchored
to the maxillary dentition.
The role of acrylic pad.

Differential Eruption Guidance
 As the mandibular dentition is free .
 Rules out the demanding and precise
grinding, so often needed in other
functional appliances.

Minimal Maxillary Basal effect
 Newton`s third law of motion.
 According the Mc. Namara this effect
is very little on the maxilla.

Periosteal pull by Buccal shields & lip pads.
 Periosteal pull hypothesis.
 This working hypothesis, which was under research at the
American Dental Association Research institute by Graber et
al ( unpublished study, 1988), clearly shown that the buccal
shields due stimulate bodily buccal movement of posterior
teeth and buccal plate activity far beyond the activity
observed in controls.

Visual Treatment objective –
As an Diagnostic Test
 Gives a clue to the operator regarding the
importance in facial appearance and profile when
subjected to any type of functional appliance.

Indications for the Function Regulator

Type I
 Class I
Early treatment
Late treatment
 Class II div I
Early
treatment
Late
treatment

Type II
 Class I
Early treatment
Late treatment
 Class II div I
Early treatment
Late treatment
Class II div II
Early treatment
Late treatment

Type III
Early treatment
Late treatment
Type IV
Early treatment

CONSTRUCTION OF FUNCTION
REGULATOR

Separation of Teeth
 Recommendation for early separation
of teeth.
 Slicing of teeth.

Impression Taking
 Actual reproduction of the resting
vestibular sulcus depth.
 Consistency of the impression
material.
 Use of thermal- sensitive tray in
clinical procedures.
 Reduces the cost effective chair side
trimming.

Trimming of working Model
 Failure to reproduce adequate sulcus depth.
 Trimming is done to produce the necessary
tissue tension.
 Carved back about 5mm from the greatest
curvature of the alveolar base with a pear
shaped carbide bur and office knife.

Wax Relief
 Outlining the area with pencil.
 Subsequent covering with layers of
pink base plate wax.

 The wax covering is especially important in the
region of the maxillary first deciduous molars,
because this is the region of greatest arch
narrowing in most class II Div I malocclusions.

Fabrication of wire components

General rule
 All the wires should be bent with
smooth curve.
 The vestibular wires are placed
1.5 mm from the alveolar mucosa.
 Wires should follow the natural
tissue contours.
 The distance between the wires
and the wax padding should be
approximately 0.75mm.

Maxillary wires

Mandibular wires

The FR – 2

The FR- 3

FR –IV

Construction bite
 Procedures differ in both the degree of
vertical opening and amount of forward
posturing of the mandible.
 One of the limitations of the Frankel appliance
is the vertical opening.
 In case of large overjet step by step
advancement is emphasized.
 Hence, for a clinician a good rule of thumb is
that greater the sagittal component lesser the
vertical component.

MODE OF ACTION OF THE
FUNCTION REGULATOR
 Interception of aberrations of muscle
function.
 Frankel appliance with holds muscle
pressure acting on the developing jaws
and the dento alveolar area.
 Passive expansion achieved through
relief of force from the
neuromuscular capsule (the buccinator
mechanism).

CHANGES BROUGHT BY FRANKEL
APPLIANCE IN THE OROFACIAL
COMPLEX.

Increase in Intra oral space (Sagittal
and Transverse)
 Achieved mainly through
buccal shields and lip pads.
 Favouring the forces acting
from within the oral cavity
(the tongue).
 Movement of the teeth in
the direction of least
resistance.
 Effect of stretch on the
contiguous soft tissue.

 Supporting effect on the
lower lip.
 Establishment of a
competent lip seal.
 The physiological
relevance of hermetic
closure of the oral
functioning space.
 The concomitant action
of the Buccal shields and
labial pads.

 Enhancing basal bone
development.
 Frankel emphasizes
maximal superior
extension of the upper
lip pad.
 The transverse and
sagittal development of
the apical base is
possible only as long as
there is some natural
growth potential
remaining.

Vertical space increase
 The Importance of
construction bite.
 According to Frankel,
the disturbance in
vertical development is
more often caused by the
cheeks, than the effect
of the tongue.
 screening effect of
buccal shields

Mandibular protraction
 “Sensory feed back
mechanism” through lingual
acrylic shield.

Muscle function adaptation
 Development of new pattern of motor
functions.
 Preventing the deforming influence on
the bony structures.
 Creation of a new shell by the appliance.
 Massaging effect of pads and shields.
 The appliance loosens up the tight
muscles and improves tonicity.

FR for vertical maxillary excess
 Patients with excessive vertical growth
or “long face” syndrome”.
 The dominant morphological feature.
 The original FR relies only on the inter
proximal cross over wires and occlusal
rests to control the vertical eruption of
the maxillary dentition, while the
mandibular dentition is permitted to
erupt freely.

The schedule of appliance wear
 The first couple of weeks 2-4 hrs.
 The next period of 3 weeks 4-6 hrs.
 Speech improvement.
 The third appointment.
 Treatment progress checked regularly at 4
Week intervals.
 As treatment progresses there should be a
gradual improvement in the facial
appearance.

CONCLUSION
 No universal or cook-book formula is
available within the orthodontic
literature.
 A no of tools are available to the
clinician to attempt correction of
maxillo-mandibular malrelationships.
 Regardless of the appliance used
there is a large and similar amount
of variation in individual patient
response to treatment.

THANK YOU !!
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Frankel functional appliance /certified fixed orthodontic courses by Indian dental academy

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Frankel functional appliance /certified fixed orthodontic courses by Indian dental academy