FIXED FUNCTIONAL

APPLIANCES AND ITS

MODIFICATION
Dr Deepshikha
MDS 2nd YEAR
INTRODUCTION
 Fixed Functional Appliance was introduced first in dentistry
by Dr. Emil Herbst of Germany at the 5th International
Dental Congress in Berlin in 1909.
 The ideal time for treatment with fixed functional appliance
is permanent dentition (to ensure a stable intercuspation of
teeth post treatment) and after the pubertal growth spurt (to
reduce retention period). (Issacson, 1990).
 Flexible Fixed Functional Appliances (FFFA)

1. The Jasper Jumper

2. The Adjustable Bite Corrector

3. The Churro Jumper.

4. The Amoric Torsion Coils.

5. The Scandee Tubular Jumper

6. The Klapper Super Spring

7. The Bite Fixer

THE JASPER JUMPER
 The major drawback of the Herbst appliance is its lack of
flexibility. This restriction of lateral movements of the
mandible lead to the introduction of the Japser Jumper by
Dr. James Jasper in 1987.
 The Jasper Jumper is a relatively new tooth borne
functional appliance capable of producing rapid change in
occlusal and intermaxillary relationships.
 The Jumper's flexibility makes oral hygiene easy,
and because the appliance curves away from the
occlusal table on closing, it does not interfere with
chewing.

References :Graber T M, Rakosi T, Petrovic AG. 1997

 The system is composed of two parts

• The Force Module and

• The Anchor Units

 The force module is constructed of a stainless
steel coil or spring that is attached at both ends to
stainless steel endcaps, in which holes have been
drilled in the flanges to accommodate the
anchoring unit.
• This module is surrounded by an opaque polyurethane
covering for hygiene and comfort.

• The modules are available in seven lengths, ranging from

26 mm to 38 mm in 2 mm increments.
 Each Jumper is marked "UR" (upper right) or "UL" (upper
left) with one of seven sizes.
 Do not attach a Jumper upside down or on the wrong side;
this will cause binding and subsequent archwire, bracket, or
appliance breakage.
PRINCIPLE OF ACTION

When the force module is

straight, it remains passive.
As the teeth come into
occlusion the spring of the
force module is curved
axially producing a range of
forces from 1 to 16 ounces.
 If properly installed to produce mandibular
advancement, the spring mechanism is curved or
activated 4 mm relative to its resting length, thus
storing about 8 ounces (250g) of potential for
force delivery.
 If less force is desired, the jumper is not activated
fully.
• 2 ) Anchor units:
• A number of methods are available to anchor the
force modules to either the permanent or mixed
dentitions.
• .
• 1) Attachment to the main arch wire:
• The most common method and the
method originally designed by Dr.
Jasper
 Dr. Jasper `s method. When the jumper
mechanism is used to correct a class II
malocclusion, the force module is attached
Posteriorly to the maxillary arch by a ball pin
placed through the distal attachment of the
force module.
 The ball pin is anchored in position by having the
clinician place a return bend in the ball pin at its
mesial end.
• The module is anchored anteriorly to the lower arch
wire (0.018"x 0.025“)
• Bayonet bends are placed distal to the mandibular
canines and small Lexan bands are slipped over the
archwire to provide an anterior stop.
• The mandibular archwire is threaded through the hole in
the anterior end cap and then ligated in place.

• The first and second bicuspid brackets are removed to

allow the patient greater freedom of movement.
 If there is no appliance of that size, select the
next larger size and allow the ball pin to protrude
more distally from the upper molar tube
 Disadvantages:
 When only the lower 1st bicuspid bracket used to be
removed as originally suggested by Dr. Jasper, jaw opening
used to be limited as the lower portion of the jumper tends
to bind at the 2nd bicuspid.
 Replacement of a broken jumper required removal of the
entire archwire.
 2) Dr COPES METHOD

. Make an attachment out of an .017"x.025" stainless steel wire,



soldered to a Rocky 135 Mountain Lock, then bent so as to pass

distal to the lower first molar. The lock is attached between the
bicuspid and cuspid
 An alternative method is to place the lock distal to
the molar bracket with the wire bent distal to the
cuspid.
 This approach uses a free -sliding quick connect. The
wire runs parallel to the main arch wire, allowing the
Jumper to clear the bicuspid brackets
 Advantages
 1 The attachment can be made in the office
laboratory, and placement can be delegated to an
assistant — simply screw on the attachment,
measure, and place the Jumper.
 2 The jaws can open fully.
 3 Force is directed distal to the molar; if the archwire
breaks, there is no effect on the anterior teeth.
 A broken Jumper is easy to replace.
 No auxiliary tubes are needed on the mandibular
molars
 Disadvantages
 Laboratory time is required to solder and bend the
attachment.
 The Rocky Mountain Lock assembly is an
additional expense
3 USE OF FORCE MODULE IN MIXED DENTITION

 In a mixed dentition patient the use of a transpalatal arch and fixed

lower lingual arch is mandatory to control potential unfavorable side
effects.
 The Maxillary attachment is as originial attachment
 The mandibular attachment is through an archwire that
extends from the brackets on the lower incisors posteriorly
to the first permanent molars bypassing the region of the
deciduous canines and molars.
 Maximum anchorage setup for force module use of trans
palatal arch combined with fixed appliances
 Use Of Lower Lingual Arch Combined With Fixed
Appliances
SELECTION AND INSTALLATION
OF THE MODULES
 Determination of proper length of
force module.
 Twelve millimeters are added to
measurement of distance between
mesial aspect of face-bow tube
and distal aspect of Lexan ball.
 In this example, distance from ball
to face-bow tube is 20 mm. Thus
32 mm module should be selected.
 The lower arch wire in threaded through the hole
in the anterior end cap of the force module,
ligated in place and the ends of arch wire are
cinched or tied back firmly.
TYPES OF FORCES PRODUCED
 Bilateral directions of force
generated by the modules
include sagittal, intrusive
and expansion forces.
 Force module curves to
buccal, producing shielding
effect on dentition.
 Buccal force → due to intrusive force acting
along the buccal surfaces of the maxillary teeth
→ produces maxillary arch expansion.
 Modules curving outwards → Vestibular
shielding effect
 Expansion forces can be minimized or
eliminated through the use of a transpalatal arch
or a heavy arch wire that has been narrowed.
TREATMENT EFFECTS
 : Maxillary adaptations : i) Headgear effect : One treatment
effect produced most easily is distalization of the upper
posterior segment or the headgear effect.
  For this the maxillary arch wire must not be cinched or
tied back, but remain straight and extend past the buccal
tubes.
  Involves light forces (2-4 ounces)
  Minimal changes in the mandibular dentition.
  This effect can be produced in actively growing as well as
adult patients
 Retraction of anterior teeth
 Upper canines alone or all the six anterior teeth can
be retracted in both extraction and non-extraction
patients with a NiTi coil or an intramaxillary elastic,
with the posterior maxillary dentition supported by
the force module.
MANDIBULAR ADAPTATIONS
 : In producing mandibular advancement the
movement of maxillary posterior dentition must be
cinched or tied back.
 Also a transpalatal arch must be placed, to obtain
intra arch anchorage
 Level of force generated is higher (6 to 8 ounces )
than for headgear effect.
 The Jasper Jumper has 3 particular features –
 It leaves standard oral functions such as
mastication & phonetics unimpaired by virtue
of its slenderness & flexibility.
 It maintains the sence of touch of opposing
tooth.
 It cannot be removed readily from the mouth
 CASE REPORT
 Class II malocclusion treatment using
Jasper Jumper appliance associated to
intermaxillary elastics: A case report

Reference : Herrera-Sanches FS, Henriques JFC, Janson G Professor

of the Specialization Course in Orthodontics, Federal University of france
Submitted: July 6, 2009 - Revised and accepted: November 30, 2010
 A 12 year old boy, with Class II,
division 1, malocclusion, in the
permanent dentition, with
protruded upper incisors, mild
crowding of upper and lower
incisors, 7 mm overjet, 5,2 mm
overbite, convex profile and poor
oral hygiene sought treatment at
the orthodontic clinic.
TREATMENT ALTERNATIVES

 Three alternatives were offered to the patient

and his parents:

(1) The use of a headgear,

(2) Jasper Jumper appliance associated to

fixed appliances,

(3) extraction of two upper premolars. They

chose the second option, which required less
patient cooperation.
TREATMENT PROGRESS
 The patient was instructed on oral hygiene
before appliance placement.
 Brackets of the straight arch technique were
bonded, as well as bands with triple tubes
with a palatal bar cemented to the upper first
permanent molars to increase stability and
prevent side effects
 The Jasper Jumpers were selected according
the manufacturer’s instruction. A rectangular
0.019 x 0.025-in SS archwire was used in both
arches during the use of the Jasper Jumper
 The mandibular arch was tied back to the first or
second permanent molars.
 On the upper arch, the Jumper was inserted in
the round tube of the first molars with a ball pin.
 On the lower arch, the Jumper was inserted in
the rectangular archwire with a stop and acrylic
spheres over the distal side of the canine
bracket.
 The patient was seen every four weeks The
Jasper Jumper was removed when the molar
and canines reached a Class I relationship or
overcorrection
 The treatment period with the Jasper
Jumper was six months. After Jumpers
removal, the teeth were retained with 3/16-
in Class II elastics for a mean period of four
month
 The centric occlusal relationship was
checked and it was coincident to the centric
occlusion.
 After debonding, a Hawley retainer was used
during the day on the upper arch and a
modified Bionator at night during one year.
Also, a 3 x 3 lower fixed retainer was used
until the end of craniofacial growth
RESULTS
 The treatment with the Jasper Jumper
improved the patient’s profile as well as the
overjet, overbite and molar relationship.
DISCUSSION
 The mechanism of the Jasper Jumper
appliance consists in forward orthodontic force
on the mandible and a backward mechanical
loading on the maxilla. The effect of the latter
resulted in the reduction of the effective length
of the maxilla
 This was the only skeletal change caused by
the appliance
CONCLUSION
The Jasper Jumper appliance is an alternative treatment for
Class II malocclusion in the permanent dentition in non-
cooperative patients correcting this malocclusion through
more dentoalveolar than skeletal effects.

The only skeletal effect is the restricted growth of the

maxilla, but with no significant variations on craniofacial
growth standard, although a slight posterior rotation of the
mandible occurs.
 Dental changes, as the protrusion of lower
incisors and the uprighting of upper incisors are
positive for the correction of Class II malocclusion.
 The dental relation (overjet, overbite and
molar relation) is improved with this individualized
treatment
 ADJUSTABLE BITE CORRECTOR
(ABC)
   (Richard P. West) 1995
 APPLIANCE DESIGN :
 The appliance essentially consists of

• A stretchable closed coil spring and

internally threaded end cap that
allows the parts to rotate freely like a
nut on a bolt.
 The axial or “push force is generated by a length
of a nickel titanium wire in the centre lumen of the
spring.
FUNCTIONS SIMILAR TO THE HERBST AND JASPER
JUMPER BUT ALSO INCORPORATES SEVERAL
USEFUL FEATURES LIKE:

a) Universal right and left : As long as the

ABC is opened at least one half turn
prior to placement, the device will always
swivel away form the occlusion during
function.

References West R P. 1995. The Adjustable Bite Corrector. J

Clin Orthod., Oct:650 – 657.
 Failure to remember this point may cause a
patient to have difficulty closing mouth without
biting on the spring.
 This universal feature greatly reduces inventory
MIXED DENTITION TREATMENT:
 In Class II patients requiring maxillary
expansion, the ABC can be attached to a
bonded palatal expander, with headgear
tubes embedded in the acrylic or normal
buccal attachments in the upper molar bands.

PERMANENT DENTITION
TREATMENT:
 The ABC inhibits forward growth of the maxilla
while encouraging maximum functional effect and
forward growth of the mandible.

• The simplest method of attaching the ABC to the

lower molar is by a jig to a lip bumper or auxiliary
archwire tube in the molar bracket.
 Advantage
 This allows additional range of opening with
no risk of breaking the appliance or
accidentally changing its length.
 Repair of broken spring is quick and
inexpensive
THE AMORIC TORSION COILS
Introduced by amoric M 1994
• This appliance is made up of two springs, one
of which slides inside the other.
• They are intermaxillary springs without
covering and have a simplified application
system of rings on the ends.
 These rings are fixed to the upper and lower
arches with double ligatures.
 They are marketed in one size only and are
bilateral
 The force exerted by the appliance is
variable in accordance with the fixing points
on the arch
THE CHURRO JUMPER
 Introduced by Ricardo and Larry White (1998).
 The Churro Jumper furnishes orthodontists with
aneffective and inexpensive alternative force
system for the anteroposterior correction of Class
II and Class III malocclusions.

•
• Although the Churro jumper was conceived
as an improvement to the MPA, it functions
mere like a Jasper Jumper. 
 In the class II, each jumper attaches to the
maxillary molars by the pin that passes first
through a circle on the distal end of the
jumper and the mesial end of the churro
jumper is an open circle that is placed over
the mandibular arch wires, against the
canine bracket. 
   It is more comfortable and easier for the
patient to adapt to a unilaterally applied
than a bilaterally applied force.
• Bilateral class II churro jumper is most
suitable for patients who need mandibular
incisor advancement.

References :Castanon R et al. 1998. Clinical use of the Churro Jumper. J

Clin Orthod., 32:731 - 45.
 Churro jumper as a class III force

• In the class III cases the terminal circles are

placed against the mesial of the mandibular
molars tube and the distal of the maxillary
canine bracket.

• The churro jumper can improve the

effectiveness of orthodontic therapy in class III
patients who refuse to wear class III elastics
• ADVANTAGES
• Can be used either unilaterally or bilaterally.
• Can be used in Class II or Class III cases. .
• Very inexpensive.
• Can be constructed from commonly available
materials universal in size.
• When broken, easily replaced.
DISADVANTAGES :

• Archwire breakage if larger wires not used.

• Patients with a low tolerance for discomfort will

often break the appliance.

• Patients who incessantly move their mouths

while chewing, taking and nervous tics will fare
poorly.

• It must be manufactured in the office. 

THE SCANDEE TUBULAR JUMPER
 This is a coated intermaxillary torsion spring sold
in a kit which includes the spring, the covering,
the connectors, the ballpins and the glue.
•There is no distinction between left and right.
•The orthodontist constructs the appliance, cutting
the spring to the length seeing fit.
THE KLAPPER SUPER SPRING
• Flexible spring element which is attached
between the maxillary molar and the
mandibular canine .
• The length of the element causes it to rest in
the vestibule when activated. This facilitates
hygiene and avoids occlusal surfaces. The
ends (fixing points) are different:
•
 The open helical loop of the spring is twisted
like a J-hook onto the mandibular archwire.
 On the maxillary end it is attached to the
standard headgear tube (Super Spring I) or to
a special oval tube and secured with a
stainless steel ligature (Super Spring II).
 • This new version prevents any lateral
movement of the spring in the vestibule
 Only two prefabricated sizes are available
(with left and right versions of each). The
length of the spring can be increased or
decreased by simply bending the attachment
wires.
 The horizontal configuration of the
attachment wire at the maxillary molar tube
permits distalization with good radicular
control
 The SUPER spring II can be used in the entire
range of Class II cases, from vertical facial
patterns with shallow overbites to
brachyfacial patterns with deep overbites.
 It can be used with fully bracketed
appliances and it makes an ideal auxiliary for
a variety of mechanical systems.
 The unique, unitary force couple applied by
the spring against the maxillary molar allows
a number of different application
THE BITE FIXER
 • This is a new intermaxillary spring coil.
 The spring is attached and crimped to the
end fitting to prevent breakage between the
spring and the end fitting.
 Polyurethane tubing is inside the spring to
prevent it from becoming a food
 It is generally used as a substitute for rubber
bands. The Bite Fixer works on correcting
your bite around the clock so that you will
not have to deal with carrying or replacing
rubber bands anymore.
 The Bite Fixer is designed to withstand
normal intraoral forces but, like all
orthodontic appliances, it can be damaged or
broken if appropriate care is not taken by
you
HERE ARE SOME EASY TIPS TO ENSURE
THAT YOUR EXPERIENCE WITH WEARING
THE BITE FIXER IS AS EFFICIENT AND
TROUBLE-FREE AS POSSIBLE
 1.) The Bite Fixer is designed to accommodate
normal mouth opening for eating and speaking.
Excessive wide opening, however, may damage
the appliance.
 Carefully try to feel how wide you can open before
the Bite Fixer stops you. Remember this and try to
always open a little less than the maximum
distance.
 2.) The Bite Fixer is designed to bow toward
your cheek when you close your mouth,
chew, or swallow. If for some reason it gets
between your teeth, do not bite on it. Biting
on the appliance may deform it or cause
breakage.
 3.) Always be careful about what you eat.
Avoid hard or sticky foods and be sure to cut
your food into small pieces.