Functional Orthopedics

The three major components of the stomatognathic system are the teeth, the bone, and the musculature. A balanced stomatognathic system exists when there is normal expression of a person’s hereditary pattern, without the influence of unfavorable internal or external forces. Abnormal forces cause malocclusion. Most patients’ malocclusions entail more than just the malposition of teeth alone. Often there are orthopedic discrepancies and muscular dysfunctions as well. In treating these patients, equal importance must be placed to correcting both the dental and skeletal abnormalities.

Functional appliances are used to control and direct orthopedic and muscular forces in an effort to prevent or correct malocclusion. They are designed to influence the growth and development of the facial skeleton in a vertical plane, a horizontal plane or both.Functional appliances are designed to work hand-in-hand with nature. The uniqueness of functional appliances is their mode of force application. They do not act on teeth like conventional appliances, using springs and elastics, but rather transmit, eliminate, or guide forces. Some of the natural forces that can be controlled by functional appliances: muscle activity from the tongue, lips, cheek; tooth eruption; and growth direction of the maxilla and mandible.

When treating children, functional therapy is typically used to give the patient’s normal hereditary pattern a chance to express itself. Therapy must begin early to ensure using growth to its greatest advantage. Functional therapy may also be used when treating adult patients. Although the sequence of treatment and the types of appliances used may be different when treating an adult, the basic concepts remain the same:

• Always respect the health of the Temporomandibular Joint. Create a harmonious balance between the muscles, bones, and teeth.
• Treatment direction will totally depend upon the diagnosis of the patient’s existing skeletal, dental and muscular relationship. All three components must be addressed to achieve a stable result.