The MULTI Appliance User Guide - MOSmos.be/catalogues/syllabus_dr_franco_bruno.pdf · 2018-04-11 · ¡ Early and Late Mix Dentition ¡ Lower Crowding ¡ DeepBite ¡ Class 2 ¡ Thumb

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The MULTI ApplianceUser GuideDr. Franco Bruno -- ARONA

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INDEX¡ Introduction

¡ The Multi Appliances¡ Multi-S®

¡ Multi-T®& T2¡ Multi-P®& P2¡ Multi DB¡ Multi-TB®

¡ Indication

¡ Contraindications

¡ Diagnostic Tools

¡ Management Tools

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INTRODUCTIONWhat’s a Multi Appliance?

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The Multi Appliances¡ The Multi appliances are pre-formed elastodontic orthodontic devices

made in medical silicon

¡ They can be used as¡ an elasto removable appliance for straightening the teeth¡ as a functional appliance for correcting skeletal class 2 problems¡ as a myofunctional appliance for muscles and tongue education

¡ The advantage is that is possible to make the 3 things in the same time.

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The Multi System¡The Multi Appliances are an integrated system of appliances that allow the orthodontists to choose the ideal appliance according to the age and the malocclusion of the patients

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Multis’ Main Features¡ Silicone

¡ Monobloc

¡ Buccal Shield

¡ Inner Protection

¡ Stabilization Line

¡ Holes

¡ Teeth Tracks

¡ Bite Plane

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Pre-Formed¡ No Impressions Needed

¡ Ready to Use

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Silicone¡ NO Allergies

¡ Easy to Clean and Sanitize

¡ Modifiable

¡ Mechanical Predictable

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Monoblock¡ Acts on the upper and lower teeth in the same time

¡ The patient has to keep the mouth closed

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Protrusion¡ Open and advanced mandibular position

¡ TMJ Unlocking

¡ Class 2 Correction

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Buccal Shields¡ Perioral muscles stretch

¡ Class 2 correction

¡ Mouth Breathing correction

¡ Habits correction

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Inner Protection¡ Tongue Reeducation

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Stabilization Line¡ Stabilize the Appliance

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Holes¡ Breathing

¡ Increase the elasticity in the anterior part of the bite for a better deepbite correction

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Teeth Tracks¡ Breathing

¡ Increase the elasticity in the anterior part of the bite for a better deepbite correction

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Soft Bite-Plane¡ Self-Adapting

¡ TMJ protection

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The Multi SystemOnly 5 Appliances

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The Multi-S®

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1 SIZE

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The Multi-S®(ECXS)

¡ Age: from 4 to 7 y.o.

¡ Teeth Guidance: upper and lover incisors

¡ Soft Silicon

¡ Indications¡ Deciduous Teeth¡ Early Mix Dentition¡ Early Lower Crowding¡ DeepBite in Deciduous¡ Thumb Sucking

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1 SIZE

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The Multi-T

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1 SIZE

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The Multi-T® (ECXT)

¡ Age: from 8 to 12 y.o.

¡ Teeth Guidance: upper and lover incisors + canines

¡ Indications¡ Early and Late Mix Dentition¡ Lower Crowding¡ DeepBite¡ Class 2¡ Thumb Sucking¡ Tongue Reeducation

1 SIZE

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Multi-T2 (ECXT2)¡ Extended molar region¡ Optimized overjet correction¡ Enlarged upper and lower labial shields¡ Improved lip bumper shape

1 SIZE

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The Multi-T2

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1 SIZE

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The Multi-T® (ECXT2)

¡ Age: from 8 to 12 y.o.

¡ Teeth Guidance: upper and lover incisors + canines

¡ Extended molar region

¡ Optimized overjet correction

¡ Enlarged upper and lower labial shields

¡ Improved lip bumper shape

1 SIZE

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The Multi-P®& P2

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The Multi-P25

Short 10Short 15Short 20Short 25Short 30

Short 20Short 25Short 30

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The Multi-P2 26

Low/High 35Low/High 40Low/High 45Low/High 50Low/High 55Low/High 60Low/High 65Low/High 70

Short & LONG

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Special Ruler (ECXPSIZER for Multi-P®)

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(XPSIZER for Multi-P2)

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How to use the ruler¡ Measures the perimeter of the upper incisors

¡ Indicates the corresponding size

¡ In case of crowding use 1 or 2 size more

¡ In case of diastemas use 1 size smaller

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Fit Multi-P or P2 on the patientand check that the teeth sit properly in the guides

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Multi-P® Selection

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Place the elevated marker between the left maxillary lateral incisor and canine.

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Multi-P® Selection

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Read the scale between the right maxillary lateral incisor and the mesial surface of the canine

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Multi-P® Usage

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If you don’t need distalizing forces: the canine’s cusp has to stay in the middle of the slot

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Multi-P® Usage

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In crowded cases: the canine cusp has to be ½ mm mesial for pushing it distally

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Multi-P® Usage

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If the canine is out of the guide the appliance does not drive the teeth properly

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The Multi-DB

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The Multi-DB¡ Age: from 11 to 14 y.o.

¡ Teeth Guidance: upper and lower incisors, canines, first premolar

¡ Incisal Reinforcement for DeepBite

¡ Indications¡ Late Mix Dentition¡ Permanent Teeth¡ Class 2¡ DeepBite¡ OpenBite

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2 LengthsSizes

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Multi-DB Low Volume¡ Normofacial Patients

¡ Brachifacial Patients

¡ 16 Sizes

¡ 2 lengths: short and long

¡ Incisal reinforcement for Deepbite

Short SizeXPNLS35R 35XPNLS40R 40XPNLS45R 45XPNLS50R 50XPNLS55R 55XPNLS60R 60XPNLS65R 65XPNLS70R 70

Long SizeXPNLL35R 35XPNLL40R 40XPNLL45R 45XPNLL50R 50XPNLL55R 55XPNLL60R 60XPNLL65R 65XPNLL70R 70

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The Multi-TB®

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The Multi-TB® (ECXPSIZER)

¡ Age: 8 y.o. and older

¡ Use with Braces

¡ Teeth Guidance: NO

¡ Indications¡ Deep Bite¡ Tongue Trust¡ Class 2 1 SIZE

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Indications

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Treatment Time¡ From 9 to 18 months¡ Crowding: 8 – 10 months¡ Deep-Bite: 8 – 12 months¡ Class 2: 12 – 18 months

¡ Minimum wear: night-time plus 2 hours / day

¡ Ideal wear: 14 hours / day

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Indications¡ Multi Appliances corrects overbite around of 0.5

mm/month

¡ Multi-S® corrects overjet around 0.3 mm/month

¡ Multi-T®& T2 and Multi-P®& P2 corrects overjet around 0.5 mm/month

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Drawbacks¡ Are not recommended for patients with a history of

severe TMJ problems

¡ Multi-T®& T2/ Multi-P®& P2 : are not recommended for cases with undeveloped root apices in the incisal segments (use Multi-S)

¡ Are not recommended in cases of congenitally missing incisors, extra or impacted permanent teeth

¡ Are not recommended in cases with more than 4 mm. of incisal diastema of the upper incisors

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Drawbacks¡ Are not recommended in cases with severely tapered

or square shaped arch forms or super large archform (ovoid)

¡ Are not recommended if there is less than 3 mm of free protrusion starting from the teeth to teeth position

¡ Are not recommended in cases with forward condile position

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Tip & TricsClinical Use

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Expansion Arch

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Expansion Arch47

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Buttons

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Pushing Button

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Pushing Button with Root Control

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Rotation Button

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Tipping Button

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Torque Button

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How to modify the appliance

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Drill Suggestion

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BIOPERM : ECS3226

POLYFIX : ECS3371

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Drill Suggestion

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Grinding caps : ECM1003

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How to add Silicon¡ 3 STEPS¡ Roughen The Appliance¡ Treat with Ethanol for 1 minute¡ RMBond® (J00256) or Odontosil

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Diagnostic ToolsCephalometrics for the Functional Therapy

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Simplified Harvold Analysis

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Angle of Convexity

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Norms: 20° ± 3°

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Harvold Triangle

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HarvoldNorms

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giovedì 8 novembre 12

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McNamara Vertical

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Norm at 9 years :

Point A: +2 ± 2 mmPogonion: -6 ± 2 mm

Adults

Male:Point A: +1 ± 1 mm

Pogonion: -1 ± 2 mm

Female:Point A: +0 ± 1 mm

Pogonion: -2 ± 2 mm

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Interincisal Angle

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Norms: 130° ± 5°

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Occlusal planeto the radicular maxillomandibularplane

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Norms: 87° ± 3°

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L1 to Dental Plane

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Norms: +1 mm ± 2 mm

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Subnasal Vertical

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Soft Point A: 0 ± 2 mm

Upper Lip: +2 ± 2 mm

Soft Pogonion: -4 ± 2 mm

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Management Tools

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First Month69

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From Month # 270