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The interceptive and/or preventive orthodontic is a treatment used in primary and mixeddentition. Myobrace is a removed, preformed appliance that can be used to treat malocclusionduring the growing period. It is built with the purpose of joining the benefits of a functionalappliance with the alignment effect. The aim of this work is to describe the appliance: its use, itstherapeutic indication and the mode of use.
Myobrace is an appliance produced by Myofunctional Reasearch Co. (MRC MyofunctionalResearch Co., Queensland, Australia), a group that for 20 years studied and projected orthodonticdevices in order to treat malocclusions by myo-functional education and by removing the softtissue dysfunctions. Functional orthodontic believes that functions are guided by form and thatmalocclusions are often caused by incorrect myo-functional habits. As a result of this, if a patienthas a correct breathing, swelling and tongue position, the jaws and the arches can grow balanced.If not (for example in case of oral breathing) a malocclusion can occur.
The Myobrace system is an evolution of a previous appliance, the Training Sistem (TS). Myobracejoins in one device the functions of habit correction, arch development, dental alignment and thenretention.The Myobrace system is designed for different stages of dentition, so it can be used in a big rangeof patients (from kids to adult): Myobrace for junior system can be used during primary dentition,Myobrace for Kids or for Teen during mixed dentition (the first for early mixed dentition, thesecond for late mixed dentition), Myobrace for adult during permanent dentition. Myobrace is a single block appliance for both the arches, it is made in elastomeric material. The main components are: a)Soft outer structure:inspired by Trainer System with improved characteristics, givescomfort and adaptability to the structure.b)Dynamicore:is the inner core that guides arch development. The "Dynamicore" is a nylonelement and it is the main difference from the Training System. It has different functions: itmakes labial and buccal shields stronger in order to increase the arch's expansion byremoving the force of perioral and buccinator muscles and it exerts forces on the teeth toguide them in their correct position.c)Tooth slot:the appliance has different slots to guide the teeth in a correct first classrelationship, without crowing them. The guiding effect is greater during teeth eruption,with the possibility to correct more severe crowding and less risk of relapses. Indeed, theperiodontal ligament matures completely after teeth eruption: so if the teeth erupt in thecorrect position, the periodontal ligament is able to mature around the teeth that are in aright and stable position.d)Labial and buccal shields:the purpose of these shields is to turn away the pressure of thelips and the cheeks, so that arches can develop. They can be used to correct the habit ofsucking finger or lips.e)Tongue tag:it is positioned behind anterior incisors, where there is the palatine papilla.The aim is to educate the correct swallowing by giving a target to the patient. In this waythe tongue is guided in the correct position during the activity(swallowing) and when it ispassive.f)Tongue guard and elevators: removes the tongue interposition during shallowing andguides it in the correct position.g)Extended Lip bumber and high sides: discourages overactive lip function and encouragesnasal breathing. Myobrace works in four stages: habit correction, arch development dental alignment andretention. The habit correction function can be increased with functional exercises thatencouraging nasal breathing, correct tongue position and swallowing as well as strengthening anddeveloping of orofacial musculature. The arch development and the dental alignment are achievedby the labial and buccal shields that turn away the pressure of perioral and buccinator musclesand by the tongue education that allows the arches development and the alignment of the teeth. Retention is very important in Myofunctional Philosophy: if the alignment is achieved with amyofunctional education, the function itself can avoid the relapse.Myobrace can be used to treat first class malocclusions with open bite or deep bite, second classmalocclusions (first and second division) and to remove oral habits.The appliance must be used during the whole night and 1-2 hours at daytime. During the dailyphase, it is important that the appliance is worn in the right mode to train the correct night use.The instructions to be followed are: lips must be closed anytime except when speaking; breathingmust happen through the nose; there must not be lip activity when swallowing.This device can be used during sport activity too (except during aquatic sport like swimming) and itcan also function as mouthguard.Myo-Brace, unlike Training System (that exists only is one size), exists in seven different sizes. Theproper size is chosen with a special ruler. The ruler measures the size of the anterior teeth (fromdistal margin of later incisor of one side to the distal margin of lateral incisor of the other side).The ruler must be placed in direct contact with the teeth, so it is better to measure on the plastermodel too. If crowding or diastemas prevent the correct measuring, it's better to measure thesingle tooth sizes with a normal ruler and sum them to find the matching size. If the choice is inthe middle between two different sizes it's better to choose the largest one.
Myo-Brace is a valid appliance that can be used to treat many clinical problems. The union of themyofunctional therapy and the teeth alignment effect in a single device allows it to fit to differentpatients especially during the growing period. A study shows that patients using a guidanceappliance during the eruption period need fixed therapy less and if they need it, the treatmentperiod is shorter.
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