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twin block<br><br><div>lower incisal capping </div> <div><ul><li>{{c1::Doesn't prevent}} proclination of lower incisors </li><li>decalcification of tips of lower incisors in a few cases where the oral hygiene was poor. </li></ul></div> <div> </div> <div>Labial Bow </div> <div><ul><li>{{c1::not always}} required </li><li>it is necessary to upright severely proclined incisors, it must not be activated until {{c1::full functional correction is complete and a Class I buccal segment relationship}} is achieved. </li><li>The lips act like a labial bow and lip pressure is effective in uprighting upper incisors, making a labial bow superfluous. </li><li>no labial bow → ↑ aesthetics without ↓ effectiveness of the appliance</li></ul></div> <div> </div> <div>The Delta clasp</div> <div>The crucial difference from Adam’s clasp is that <br>{{c1::<br>the retentive loops are shaped as a closed triangle, or a circle or ovoid as opposed to an open U-shaped arrowhead as in the Adams clasp. <br>}}<br><br></div> <div>The advantage of the closed loop is that </div> <div>{{c1::</div> <div><ol><li>the clasp does not open with repeated insertion and removal </li><li>maintains its shape better </li><li>requires less adjustment, </li><li>less subject to breakage. 10% for the modified arrowhead Adams clasp and 1% for the delta clasp.</li><li>excellent retention on lower premolars, and is suitable for use on most posterior teeth </li></ol></div> <div>}}</div> <div> </div> <div> </div> <div>Ball-ended clasps </div> <div><ul><li>routinely employed {{c1::mesial to lower canines and in the upper premolar or deciduous molar}} region </li><li>to gain {{c1::interdental retention from adjacent teeth}}.</li></ul><br></div><hr> <div><br>C-clasps </div> <div>useful in {{c2::mixed dentition where they can be used for peripheral clasping on deciduous molars and canines.}}<br></div><div> </div> <div> </div> <div>Since the upper arch is wider than the lower, it is only necessary to cover the lingual cusps of the upper posterior teeth, rather than the full occlusal surface. </div> <div>This has the advantage of <br><br></div> <div>{{c2::</div> <div><ol><li>making the clasps more flexible.</li><li>allows access to the interdental wires of the clasps for adjustment. </li></ol></div> <div>}}<br><br></div> <div>moving the inclined plane mesially to the first premolar region. → </div> <div>{{c2::</div> <div><ol><li>↓ efficiency of the appliance.</li><li>↓ response to mandibular advancement. </li></ol></div> <div>}}<br><br><div>Mesial movement of the inclined plane is therefore not recommended</div></div><br><div>Twin Block Sagittal Appliance </div> <div>The position of the anterior cut determines how many teeth are included in the anterior segment. <br><br></div> <div>If only the central incisors are retroclined, a cut distal to {{c2::</div><div>the central incisors}}</div><div>the lateral incisors may also be advanced by placing the cut distal to {{c2::the lateral incisors}}. <br><br></div> <div>If the cut is positioned distal to the canines or premolars the distalization of posterior teeth increases in proportion to the number of teeth included as anchorage in the anterior segment.<br><br><hr></div><div><div><br>After the first 10 days of TB delivery and full-time wear, if the patient is failing to posture forward consistently to occlude correctly on the inclined planes. This would indicate that {{c3::the appliance has been activated beyond the level of tolerance of the patient’s musculature.}}<br><br></div> <div>Management<br><br></div> <div>{{c3::</div> <div><ul><li>reduce the forward mandibular displacement until the patient closes comfortably on the appliances. </li><li>The angulation of the inclined planes may be reduced to 45° if the patient is failing to posture consistently forward to occlude the blocks correctly</li></ul></div> <div>}}<br><br></div> <div>This response is more likely in the patient who has a {{c3::vertical}} growth pattern</div> <div>At {{c3::the first monthly }}visit→ positive progress should already be evident with respect to better facial balance</div> <div> </div> <div>patients with a {{c3::vertical growth pattern }}may not respond well to functional therapy, because their potential for {{c3::horizontal growth is poor}}</div> <div> <br>in cases of asymmetry:</div> <div>{{c3::<br><div><ol><li>Correction of asymmetry in the construction bite</li><li>The sagittal screw is turned more frequently on the side that requires more distal movement </li></ol></div></div><div>}}<br></div></div>.