1. The Myobrace System -A hammer for a houseSat-Sun, January 18-19, 2014 dr. barry raphael the raphael center for integrative education www.alignmine.com drbarry@alignmine.comDay 1 PM Sunday, January 19, 14

2. Dinner Tonight? $20 per person To talk about whateverSunday, January 19, 14 3. The Goals of Airway-centric Myofunctional Orthodontics 1. 2. 3. 4. 5. 6. 7. 8.Sunday, January 19, 14Breathing through the nose Lips together at rest Correct tongue position No facial muscles moving on swallowing Optimal facial development Class I occlusion Straight teeth Better Stability long term 4. Airway-focused Orthodontics 1.Airway-focused Diagnostics 2.Prevention 3.Undo the Damage 4. Establish Good Habits 5.Interdisciplinary TreatmentSunday, January 19, 14 5. Airway-focused Orthodontics 1.Airway-focused Diagnostics 2. Prevention 3.Undo the Damage already done 4. Establish Good Habits 5.Interdisciplinary Treatment Look for the source of the imbalance. Look for the causes, not just the symptoms. Sunday, January 19, 14 6. Lesson #3 Dont be a BarkerSunday, January 19, 14 7. So whats this?Sunday, January 19, 14 8. Its a ForestSunday, January 19, 14 9. Can you see it now?Sunday, January 19, 14 10. Now?Sunday, January 19, 14 11. Must be a forest....Sunday, January 19, 14 12. Aha!Sunday, January 19, 14 13. Lets try a different approachSunday, January 19, 14 14. Whats this?Sunday, January 19, 14 15. A Person!Sunday, January 19, 14 16. A Tree StumpSunday, January 19, 14 17. The TreeSunday, January 19, 14 18. Trees...Sunday, January 19, 14 19. Heres the forest!Sunday, January 19, 14 20. Lesson #3: Dont be a Barker Step back from the teeth Start by looking at the person and work your way in. Sunday, January 19, 14 21. Level 1: Screening Chief Concern Medical History Body Form Body Function Facial Form Facial Function Intraoral Form Intraoral FunctionSunday, January 19, 14 22. Level 1: Screening Chief Concern Any Airway-related Craniofacial Dysfunction ARCD Medical History Sleep: Snoring, Chronic tiredness, Breathing: Loud breathing, URTI, allergy, asthmaBody Form Body FunctionForward Head posture, Frontal asymmetry Chest Breathing, BPM>14Indicator Line excess,Venous pooling Facial Form Facial Function Open Mouth Posture, MFE movement on swallowing, Gothic Arch with crowding, Swollen tonsils Intraoral Form Intraoral Function Limited tongue liftSunday, January 19, 14 23. Level 2: Exam Chief Concern Medical History Age and Dental AgeURTAsthma Swollen T &/or ASleep: Snoring Restless Tiredness Hyperactivity Hx sleep studyBody Form Frontal Posture Level of ears, eyes, shoulders, hips Ankle Pronation Lateral PostureForward head Winged scapula Locked knees Forward knuckles Plumb line SlouchingBody Function Gait Breathing mechanics Breathing rate Sunday, January 19, 14Intraoral Function Facial Form Tongue: extension, frenum Cranial Tongue: resting posture Symmetry Tongue: thrust Midface prole Mandibular prole Intraoral Form Lips and indicator Tongue: U lip/L lip Scalloping Indicator line Frenum Incisal show Arch Form Posture at rest Gothic (V-shaped) Lip competence Molar width .33 = significantSunday, January 19, 14 42. Pediatric Sleep Questionnaire: Sleep-Disordered Breathing Subscale Licensed to: the raphael center for integrative orthodontics 070129Childs Name: ______________________________ Person completing form: _____________________Study ID #: ___________ Date: ____/____/____Please answer these questions regarding the behavior of your child during sleep and wakefulness. The questions apply to how your child acts in general during the past month, not necessarily during the past few days since these may not have been typical if your child has not been well. You should circle the correct response or print your answers neatly in the space provided. A Y means yes, N means no, and DK means dont know. WHILE SLEEPING, DOES YOUR CHILD: Snore more than half the time?.... ..Y Always snore? ..Y Snore loudly? Y Have heavy or loud breathing? ...Y Have trouble breathing, or struggle to breathe? .YN N N N NDK DK DK DK DKA5 A6HAVE YOU EVER SEEN YOUR CHILD STOP BREATHING DURING THE NIGHT? .YNDKA73. DOES YOUR CHILD: Tend to breathe through the mouth during the day?.Y Have a dry mouth on waking up in the morning? .....Y Occasionally wet the bed? ...YN N NDK DK DKA24 A25 A324. DOES YOUR CHILD: Wake up feeling unrefreshed in the morning? .Y Have a problem with sleepiness during the day? .....YN NDK DKB1 B21.2.Sunday, January 19, 14A2 A3 A4 43. MFO Treatment WorksheetPriority Issue: What I am Action for looking TrainerSunday, January 19, 14Referral 44. MFO Treatment WorksheetSunday, January 19, 14 45. MFO Treatment WorksheetSunday, January 19, 14 46. MFO Treatment WorksheetSunday, January 19, 14 47. MFO Treatment WorksheetSunday, January 19, 14 48. MFO Treatment WorksheetSunday, January 19, 14 49. MFO Treatment WorksheetSunday, January 19, 14 50. MFO Treatment WorksheetSunday, January 19, 14 51. MFO Treatment WorksheetSunday, January 19, 14 52. MFO Treatment WorksheetSunday, January 19, 14 53. MFO Treatment WorksheetSunday, January 19, 14 54. MFO Treatment WorksheetSunday, January 19, 14 55. MFO Treatment WorksheetSunday, January 19, 14 56. MFO Treatment WorksheetSunday, January 19, 14 57. MFO Treatment WorksheetSunday, January 19, 14 58. MFO Treatment WorksheetSunday, January 19, 14 59. MFO Treatment WorksheetSunday, January 19, 14 60. Clinical Exam* Rough Order of Examination Body Breathing Head Face Mouth Teeth*To be added to your normal routine Sunday, January 19, 14 61. Lateral Posture Plumb Line Through... 1.Ext Aud Meatus 2.Shoulder 3.Hip (greater trochanter 4.Knee 5.AnkleForward Head Posture Sunday, January 19, 14 62. Posture AnalysisSunday, January 19, 14 63. Sunday, January 19, 14 64. Sunday, January 19, 14 65. Nasopharyngeal Obstruction From Kent Lauson Straight Talk about Crooked TeethSunday, January 19, 14 66. Nasopharyngeal Obstruction and its effects Enlarged Tonsils & AdenoidsDeviated Nasal SeptumNasal ConstrictionCysts, Polyps & TumorsEnlarged TurbinatesAllergic RhinitisNASOPHARYNGEAL OBSTRUCTION Blockage of Eustachian TubesAccumulation of Inamed and pathogens in enlarged turbinates Eustachian Tubes & nasal passagesOtitis media (middle ear infection)Frequent colds & sore throats, respiratory infectionsHearing LossDisease Behavior disorders Reduced energy Reduced mental capacity ADD ADHD SIDSMouth BreathingLowered Tongue PostureGingivitis, chapped lips, bad breath, dry mouth, high decay rateHypertrophied palatal tissues (no tongue pressure)Constricted nasal cavity Lack of space for tongueAirway Obstruction: dorsum of tongue against oropharyngeal wall or soft paltateObstructive Sleep Apnea Lowered O2 IntakeSnoringSleep Cycle DysfunctionPulmonary HypertensionDaytime DrowsinessCardiac HypertensionReduced Quality of LifeMandible with lowered and retruded postureBucco-lingual maxillary muscle imbalanceConstricted and underdeveloped maxillaConstricted nasal cavityHigh V-shaped palateMouth breathing increasedLowered tongue posturePoor self image Anti-social behaviorPoor Nutrition Susceptibility to diseaseBruxismCraniomandibular dysfunctionTMJ Dysfunction TMJ condyle and disc displacement TMJ degeneration and osteoarthritisSunday, January 19, 14Anterior open bitePoor lip sealNeuro-muscular dysfuntionNeck muscle strainGummy smileLoss of lordotic curve of cervical spineSpeech problems, lisps, hyponasalityMalocclusion, crowding, overbite, crossbite, loss of vertical dimensionDifculty eatingExcess vertical developmentTongue ThrustConstricted, retruded and underdeveloped mandiblePoor facial appearanceForward head and shoulder postureMalocclusion, open bite, long face syndrome, prognathism May result in lack of skeletal muscle strength and coordinationMyofascial pain dysfunction syndrome Headaches, neck aches, ear pain, ringing/fullness, hearing loss, visual problems, limited or painful opening of jaw, neurologic disorders such as Parkinsons, Tourettes syndromeNeck aches, headaches 67. Checking Breathing Breathing Rate 10-14 15-20 >22 Movements Chest Diaphragm Sounds Sunday, January 19, 14This can be done by the assistant , while the patient isnt watchinglooking for chronic hyperventilationlooking for chronic hyperventilation 68. Facial Measurement Routine 1.Indicator line 2.Upper lip 3.Lower lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closureSunday, January 19, 14 69. Indicator LineSunday, January 19, 14 70. Maxillary Height Indicator Line (Mew) Distance from most anterior point on nose to upper incisal edge Age + 23 A variable number, but important to watch over time.Sunday, January 19, 14 71. From the tip of the Central...Sunday, January 19, 14 72. ...To the Forwardmost Tip of the Nose41mmSunday, January 19, 14 73. Indicator Line 12 yo male Ideal IL = 35mmWatch during growth for >1mm increase / year35mm Watch during 42mm treatment for increase or decrease Sunday, January 19, 14 74. Take another look... `Sunday, January 19, 14 75. Indicator LineIncisor falls faster than the nose with vertical growth and retractive/extrusive mechanicsSunday, January 19, 14 76. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closure 7.Maximum Opening 8.Tongue-to-Spot Opening Sunday, January 19, 14Norm =18-20mm 77. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closure 7.Maximum Opening 8.Tongue-to-Spot Opening Sunday, January 19, 14Double Upper Lip 78. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closure 7.Maximum Opening 8.Tongue-to-Spot Opening Sunday, January 19, 14 79. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closure 7.Maximum Opening 8.Tongue-to-Spot Opening Sunday, January 19, 14 80. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closureSunday, January 19, 14 81. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closureSunday, January 19, 14 82. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closureSunday, January 19, 14 83. Facial Measurement Routine 1.Indicator Line 2.Upper lip 3.Lower Lip to chin 4.Competence at rest 5.Incisal show 6.Strain on lip closure 7.Lip ConditionSunday, January 19, 14 84. Soft Tissue Evaluation and DiagnosisOcclusion - CI CII CIII - normal overbite/Overjet open bite deep bite.Sunday, January 19, 14 85. Soft Tissue Evaluation and Diagnosis Tongue position - normal lowered between teeth.Sunday, January 19, 14 86. What is wrong with these children?Only correct diagnosis can lead to correct treatmentVideos courtesy of Dr. John FlutterSunday, January 19, 14 87. Swallowing Styles...Sunday, January 19, 14 88. What do you see?12 things Open mouth posture Long lower third Eye shadows Allergic crease Anterior Tongue Thrust Anterior Open Bite Lisp Takes breath beforeswallow Throws head back to swallow Left ear high and rotated out Dull eyes Sunday, January 19, 14Also look for: T&A Allergies Lingual Frenum Pronated Feet and Rotated Pelvis Hypocapnia 89. What do you see?10 things Shoulder Breathing Open mouth posture Facial muscles active on swallow (woodpecker) Head dip on swallow Stuffy Nose Gothic Arch Breathing Before drinking Anterior Tongue Thrust Right ear highSunday, January 19, 14Also look for: Frenum Bruxism T&A Hypocapnia 90. What do you see?11 things Open Mouth Posture Blows cheeks Lip activity on swallow Cheek activity Hypermentalis Anterior tongue thrust Larger lower lip Muscular denitionbelow lower lip border Temporal bone rotation Bigger, higher right eye Tiny nostrilsSunday, January 19, 14Also look for: Frenum T&A Tongue between teeth on swallow 91. What do you see?7 things Lips active on swallow Open Mouth Posture Mentalis action on swallow Contraction of Buccinator on swallow Lip Entrapment Left Ear rotation Muscular denition around lipsSunday, January 19, 14Also look for: Forward Head Posture Scalloping on Tongue 92. What do you see?6 things Blows out cheeks Hypermentalis Tight lip muscles onswallow Lateral mandibular shift Bimaxillary Retrusion Concave proleAlso look for: Tongue between teeth Class II div 2 Tongue Scalloping Sunday, January 19, 14 93. What do you see?10 things Lateral head tilt Temporal rotation Long lower 1/3 Asymmetrical upper lip movement Mentalis Eye shadows Midface deciency Blows cheeks Lower lip eversion Small oral apertureSunday, January 19, 14Also look for: Tongue Scalloping High Vault Frenum T&A 94. Face: JointsSunday, January 19, 14 95. Intraoral Measurement Routine 1.Maximum opening 2.Tongue-to-spot opening 3.Molar width 4.Palatal vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil grading Sunday, January 19, 14 96. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 97. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 1450% of Max Opening 98. Start Clucks, to CavesFrom Paula Fabbie, COM Sunday, January 19, 14 99. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14Modern Average: 35mm Paleo Average:50mm 100. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 101. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14Palatal Cyanosis Proper contact of the tongue on the palate and the negative pressure causes proper oxygenation of the palatal tissue. Lack of pressure of the tongue and the positive air pressure inhibits oxygenation and the palate will look cyanotic - yellowish/blueish in a caucasian. 102. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 103. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 104. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 105. Intraoral Measurement Routine 1.Maximum Opening 2.Tongue To Spot Opening 3.Molar Width 4.Palatal Vault 1. Shape 2.Color 5.Malampati 6.Uvula 7.Tonsil Grading Sunday, January 19, 14 106. Functional Exams Lip tone testing Capnometry Sleep screening Videography and reading the faceSunday, January 19, 14 107. Sunday, January 19, 14 108. 2 COBlood Gas Capnometer Pulse oximeterSunday, January 19, 14Monitoring 109. Sleep ScreeningSunday, January 19, 14 110. Cardio-Pulmonary Coupling Dr. Robert Thomas Electrocortical Modulation Heart Rate VariabilityRespiratory rateHigh Freq Coupling Low Freq Coupling Very Low Freq Coupling Sunday, January 19, 14 111. Sleep Quality Index Stable SleepUnstable Sleep Sunday, January 19, 14SQI = HFC:LFC 112. SleepImage M1 monitor Monitor Carry Case Software (PC) Reports Scheduling Help Cable Batteries supplied Patches supplied PhD reads reports $185/month Sunday, January 19, 14www.sleepimage.com 113. Imaging Photography Videography Cephalometrics 3D ImagingSunday, January 19, 14 114. Airway-focused Orthodontics 1.Airway-focused Diagnostics Tomorrow... 2.Prevention 3.Undo the Damage already done 4. Establish Good Habits 5.Interdisciplinary Treatment Our ultimate goal is to keep children from getting sick. By knowing the causes, we can prevent the disease.Sunday, January 19, 14 115. Airway-focused Orthodontics Tomorrow... 1.Airway-focused Diagnostics2. Prevention 3.Undo the Damage already done 4. Establish Good Habits 5.Interdisciplinary Treatment As much as possible, reverse the condition TOWARD the genetically programmed ideal. Sunday, January 19, 14 116. Airway-focused Orthodontics 1.Airway-focused Diagnostics 2. Prevention 3.Undo the Damage already done 4. Establish Good Habits 5.Interdisciplinary Treatment Retraining Proper Oral-Rest Posture, Oral Function, and other good health habits for a lifetime of stabilitySunday, January 19, 14 117. Arch Development in conjunction with the TRAINER SystemRecommended Age Group: 5-12 yrsSunday, January 19, 14 118. Trainer Influence of Pre-Orthodontic Trainer treatment on the perioral and masticatory muscles in patients with Class II division 1 malocclusion 1.Tancan Uysal*,**, Ahmet Yagci*, Sadik Kara*** and Sukru Okkesim***European Journal of Orthodontics ,2011, Volume 34, Issue 1 Pp. 96-101...POT appliance showed a positive inuence on the masticatory and perioral musculature. Sunday, January 19, 14 119. 3. The Myobrace System 1.History and Purpose 2.Types and uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 120. 3. The Myobrace System 1.History and Purpose 2.Types and uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 121. Sunday, January 19, 14 122. Dr Chris Farrell Dr Chris FarrellBDS SYDNEY UNIVERSITY, AUSTRALIA Dr. Farrell graduated from Sydney University in 1971. Since that time he has been a clinician in private practice in Australia and England. Was not comfortable with the excessive extraction of teeth required by the orthodontists at the time. Received much education from Dr. John Mew (UK) and Dr. Harold Gelb USA. Greatly inuenced by Garliner, Prof. Hinz and Prof. Frankel - All of whom were looking beyond the teeth and onto faces, muscles and posture. Observation and extensive study of research over the years showed that extraction of teeth did not resolve orthodontic crowding and craniofacial discrepancies. He realised that newer techniques had to be developed to treat these many patients more effectively. Now practices treating children and adults for Orthodontics and TMJ exclusively. Dr. Farrell holds three worldwide patents for new dentalappliances and is developing other innovations in his practice in Queensland, Australia, specic to the early treatment of orthodontic problems in children and TMJ disorder in adults.Sunday, January 19, 14Dr Chris Farrell BDS SYDNEY UNIVERSITY, 123. Dr Farrell produces the Ortho TRAINERThe Ortho Trainer Sunday, January 19, 14World First use of 3D solid modeling and stereo-lithography on intra-oral appliance 124. MRC HEAD OFFICE AUSTRALIASunday, January 19, 14 125. MRC MEGA CLINICS COOMERA VISITING ORTHODONTISTS FROM JAPAN AND RUSSIASunday, January 19, 14 126. MRC EUROPE MRC EUROPE office Waalwijk, NETHERLANDSSunday, January 19, 14 127. MRC USA MRC USA office Southern CALIFORNIASunday, January 19, 14 128. MRC USASunday, January 19, 14 129. DR FARRELL presents 2012 LECTURE to MYOFUNCTIONAL ORTHODONTICS ORTHODONTISTS AND DENTISTS IN JAPANSunday, January 19, 14 130. MRC CLINICS TRAINING CENTER AUSTRALIASunday, January 19, 14 131. MRC CLINICS ROBINA and SYDNEY2.5 x 3.44.6 x 3.4 1.2 x 2.83.8 x 2.8 3.2 x 3.8 3.5 x 4.31.9 10.17 3.2 x 3.8 2.33.5 x 5.01.2 2.5 x 2.92.62.95 x 2.92.95 x 2.83.0 x 1.7 2.95 x 2.83.5 x 42.3 x 2.3 3.2 x 1.8DESIGNED and CONSTRUCTED by MRC Sunday, January 19, 14 132. MRC CLINICS ROBINA and SYDNEYDESIGNED and CONSTRUCTED by MRC Sunday, January 19, 14 133. MYOFUNCTIONAL ORTHODONTICS the new approach to the diagnosis, treatment and clinical management of malocclusionVanee Ganesaratnam BOralH (Griffith Univ) Oral Health Therapist Orafacial Myologist Sunday, January 19, 14Dr Chris Farrell BDS SydneyDr Rohan Wijey BOralH, Grad Dip Dent (Griffith) 134. MRC CLINICSPRACTICE MANAGEMENT SYSTEMMYOFUNCTIONAL RESEARCH CO Goal over the last 20 years Improve the facial and dental development of the growing child by treatment and prevention of mouth breathing and detrimental myofunctional habits. Our goal is to have healthier children for life. Sunday, January 19, 14 135. 3. The Myobrace System 1.History and Purpose 2.Types and uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 136. PRIMARY DENTITIONSunday, January 19, 14MIXED DENTITIONDEVELOPING PERMANENT DENTITIONPERMANENT DENTITION 137. Sunday, January 19, 14 138. STAGE 1HABIT CORRECTION4-6 MONTHS Sunday, January 19, 14STAGE 2ARCH EXPANSION4-6 MONTHSSTAGE 3 FINAL ALIGNMENT & RETENTION4-6 MONTHS 139. THE MYOBRACE SYSTEM Myobrace appliance group generally consists of three appliances covering three stages of treatment. MIXED DENTITION - Kids SERIES STAGE 1HABIT CORRECTIONSTAGE 2ARCH EXPANSIONSTAGE 3 FINAL ALIGNMENT & RETENTIONNasal Breathing Lips Together Tongue on the palate 4-6 MONTHS Sunday, January 19, 144-6 MONTHS4-6 MONTHS 140. MYOBRACE FOR KIDS- K1Made of exible silicone to adapt to any arch-form and poorlyaligned teeth.Its exible nature means that it offers improved retention for night-time use.Breathing holes assist the transition to correct nasal breathing.Extended lip bumper discourages strong, overactive lip muscles.Sunday, January 19, 14 141. MYOBRACE FOR KIDS- K2Features Dynamicore with a Frankel Cage which assists in developing the arch-form and improving the dental alignment.Tongue tag, guard and elevators train the tongue to position properly.Extended lip bumper discourages strong, overactive lip muscles.Sunday, January 19, 14 142. MYOBRACE FOR KIDS- K3Firm polyurethane construction provides excellent tooth alignment and retention.Hollow tongue tag; tongue guard and elevators train the tongue to sit in nal correct position and prevent thumb sucking.Extended lip bumper discourages strong, overactive lip muscles.Sunday, January 19, 14 143. Sunday, January 19, 14 144. STAGE 1HABIT CORRECTIONSunday, January 19, 14STAGE 2ARCH EXPANSIONSTAGE 3 FINAL ALIGNMENT & RETENTION 145. Sunday, January 19, 14 146. STAGE 1HABIT CORRECTIONSunday, January 19, 14STAGE 2ARCH EXPANSIONSTAGE 3 FINAL ALIGNMENT & RETENTION 147. MYOBRACE FOR INTERCEPTIVE CLASS III- I3NFlexible silicone adapts to any arch-form and poorly-aligned teeth. Its exible nature also means that it offers improved retention for night-time use.Tongue tag, guard and elevators train the tongue to position properly.Small breathing holes and dual arch-form prevent mouth breathing (a common problem in Class III patients).Sunday, January 19, 14 148. MYOBRACE FOR INTERCEPTIVE CLASS III- I-3Features Dynamicore with a Frankel Cage which assists in developing the arch-form and improving the dental alignment.Tongue tag, guard and elevators train the tongue to position properly.Small breathing holes and dual arch-form prevent mouth breathing (a common problem in Class III patients).Sunday, January 19, 14 149. MYOBRACE FOR INTERCEPTIVE CLASS I-3H III-Firm polyurethane construction provides excellent tooth alignment and retention.Hollow tongue tag; tongue guard and elevators train the tongue to sit in nal correct position and prevent thumb sucking.Small breathing holes and dual arch-form prevent mouth breathing (a common problem in Class III patients).Sunday, January 19, 14 150. MYOBRACESunday, January 19, 14INTERCEPTIVE CLASS III 151. Shields the soft tissue from brackets. Recommended Age Group: 12 - 15+ yrs Most effective during the early stages of permanent dentition Improves stability Speeds up orthodontic treatmentSunday, January 19, 14 152. MYOFUNCTIONAL TREATMENT OF MALOCCLUSIONBRACES SERIESSunday, January 19, 14 153. Sunday, January 19, 14 154. STAGE 1STAGE 2HABIT CORRECTIONARCH EXPANSION4-6 MONTHS4-6 MONTHSSunday, January 19, 14STAGE 3DENTAL ALIGNMENT4-6 MONTHSSTAGE 4RETENTION4-6 MONTHS 155. MYOBRACESunday, January 19, 14FOR TEENS 156. MYOBRACE FOR TEENS- T3Features Dynamicore to assist in developing the arch-form which provides more space for the erupting dentition.The tooth slots separate and align the anterior teeth.Tongue tag, guard and elevators train the tongue to position properly.Sunday, January 19, 14 157. MYOBRACESunday, January 19, 14FOR LATE MIXED DENTITION 158. Sunday, January 19, 14 159. STAGE 1HABIT CORRECTION4-6 MONTHSSunday, January 19, 14STAGE 2ARCH EXPANSION4-6 MONTHSSTAGE 3 FINAL ALIGNMENT & RETENTION4-6 MONTHS 160. MYOBRACE FOR ADULTS- A1Soft and exible material adapts to a wide range of arch-forms and poorly aligned teeth.The soft material allows for better retention and comfort in the initial stages of treatment.Breathing holes assist the transition to correct nasal breathing.Extended lip bumper trains the lower lip.Sunday, January 19, 14 161. MYOBRACE FOR ADULTS- A2Medium-hardness polyurethane provides arch development and puts small force on the teeth for improved dental alignment.Tongue tag, guard and elevators train the tongue to position properly.Extended lip bumper discourages strong, overactive lip muscles.Sunday, January 19, 14 162. MYOBRACE FOR ADULTS- A3Firm polyurethane construction provides excellent tooth alignment and retention.Extended lip bumper discourages strong, overactive lip muscles.Hollow tongue tag; tongue guard and elevators train the tongue to sit in nal correct position and prevent thumb sucking.Sunday, January 19, 14 163. MYOBRACESunday, January 19, 14FOR ADULTS 164. MYOFUNCTIONAL ORTHODONTICSthe new approach to the diagnosis, treatment and clinical management of malocclusion WHAT IS MRC CLINICAL APPLICATIONPATIENT EDUCATIONTHE PROBLEMHOW TO STARTTHE CAUSES OF MALOCCLUSIONRESEARCH WHY IT WORKSSunday, January 19, 14CURRENT ORTHODONTIC SMYOFUNCTION AL ORTHODONTIC S 165. MRC CLINICS CASE FILENo 1 Permanent dentition Blocked out CanineSunday, January 19, 14 166. Patient Name: MYOBRACE K1/BWS - K2 - K3 DOB 20.08.92 RHYS WADE - COOPER 21/04/2010 30 August 2005Sunday, January 19, 1421/04/2010 30 August 2005 167. Patient Name: MYOBRACE K1/BWS - K2 - K3 DOB 20.08.92 RHYS WADE - COOPER 21/042010 30 August 2005Sunday, January 19, 1421/04/2010 30 August 2005 168. Patient Name: MYOBRACE K1/BWS - K2 - K3 DOB 20.08.92 RHYS WADE - COOPER 26/10/10 30 August 2005Sunday, January 19, 1426/10/10 30 August 2005 169. Patient Name: MYOBRACE K1/BWS - K2 - K3 DOB 20.08.92 RHYS WADE - COOPER 21/04/2010 30 August 2005Sunday, January 19, 1428/09/2011 30 August 2005 170. MRC CLINICS CASE FILENo 2 Mixed Dentition Anterior OpenbiteSunday, January 19, 14 171. T4K - MYOBRACE K1 Patient Name: RHYS WADE - COOPER - DOB 20.08.92 10/11/2008 30 August 2005Sunday, January 19, 1410/11/2008 30 August 2005 172. T4K - MYOBRACE K1 Patient Name: RHYS WADE - COOPER - DOB 20.08.92 12/07/10 30 August 2005Sunday, January 19, 1412/07/10 30 August 2005 173. T4K - MYOBRACE K1 Patient Name: RHYS WADE - COOPER - DOB 20.08.92 10/11/2008 30 August 2005Sunday, January 19, 1412/07/10 30 August 2005 174. 3. The Myobrace System 1.History and Purpose 2.Types and uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 175. Pee BreakSunday, January 19, 14 176. Sunday, January 19, 14 177. Read the Package...Sunday, January 19, 14 178. Read the Package...Sunday, January 19, 14 179. Read the Package...Sunday, January 19, 14 180. Read the Package...Sunday, January 19, 14 181. Read the Package...Sunday, January 19, 14 182. Read the Package...Sunday, January 19, 14 183. Read the Package...Sunday, January 19, 14 184. Read the Package...Sunday, January 19, 14 185. Read the Package...Sunday, January 19, 14 186. Read the Package...Sunday, January 19, 14 187. Read the Package...Sunday, January 19, 14 188. Read the Package...Sunday, January 19, 14 189. Read the Package...Sunday, January 19, 14 190. Read the Package...Sunday, January 19, 14 191. Read the Package...Sunday, January 19, 14 192. Sunday, January 19, 14 193. 2.1) Protocols: Trainers 1) Appliance Delivery 2) Comfort check 3) Routine visits 4) Post treatment maintenanceSunday, January 19, 14 194. 2.1.1) Protocols: Trainers: Appliance Delivery1.The Try-on 2.The Four Things 1. Bite Down 2. Lips together 3. Breath through your nose 4. Tongue on Tag 3. The Two Things 1. Lips together 2. Tongue on TagSunday, January 19, 14 195. 2.1.1) Protocols: Trainers: Appliance DeliverySunday, January 19, 14 196. 2.1.1) Protocols: Trainers: Appliance Delivery1.The Try-on 2.The Two Things 3.Wearing Schedule1.1hr/day plus sleeping 1.No Two Things while Sleeping 2.OK to Ramp up5 min10 min20 min30 min5 min10 min20 min30 min5 min10 min20 min5 min10 min5 min Sunday, January 19, 1460min60+sleep 197. 2.1.1) Protocols: Trainers: Appliance Delivery1.The Try-on 2.The Two Things 3.Wearing Schedule1.1hr/day plus sleeping 1.No Two Things while Sleeping 2.OK to Ramp up 3.Choose activities and make calendar 4.OK to Split time SunActivity 1 Activity 2 Sunday, January 19, 14TVMonTueHomework HomeworkWed Ride to SoccerGaming Reading Gaming ReadingThu HomeworkFriSatTVMovieLaundary 198. 2.1.1) Protocols: Trainers: Appliance Delivery1. The Try-on 2. The Four Things 3. Wearing Schedule 4. Score CardSunday, January 19, 14 199. Sunday, January 19, 14 200. Sunday, January 19, 14 201. Sunday, January 19, 14 202. Sunday, January 19, 14 203. 2.1.1) Protocols: Trainers: Appliance Delivery1.The Try-on 2.The Four Things 3.Wearing Schedule 4.Score Card 5.Warnings1.Dont chew 2.Dont let Dog chew 3.Fee to replace$85-200 Sunday, January 19, 14 204. 2.1.1) Protocols: Trainers: Appliance Delivery1. The Try-on 2. The Four Things 3. Wearing Schedule 4. Score Card 5. Warnings 6. Send them homeSunday, January 19, 14 205. Follow-up Visits Activity Center Child observed in group setting wearing the trainer Exercise Review Therapist reviews and assigns exercises www.Trainerkids.com Wire Expander and Trainer Adjustment Seen by me at every visit Progress Records Photos, etc.Sunday, January 19, 14 206. Sunday, January 19, 14 207. Sunday, January 19, 14 208. Length of Treatment Depends on Growth Depends on Cooperation Usually, 12 (to 24 months) Then monitor growth Re-evaluate for Further Treatment Braces???Sunday, January 19, 14 209. Whats the benefit? (especially if braces are needed anyway?) Preventative rather than corrective Addresses the cause of the problem Better stability Less extractions Less stress on the jaw joints Better looking facial appearance Easier on the roots of the teeth Less time in braces Teeth are easier to clean Myobrace stays at home Better health through better breathing, posture, nutrition, etc Reduced cost (if braces not needed) Sunday, January 19, 14 210. What are the drawbacks? Child and family must be motivated For perfection, braces may be needed.Sunday, January 19, 14 211. Whats the cost Depends on Age About 1/3-1/2 of braces Includes everything up until baby teeth are lost Except lost or broken appliances My GuaranteeSunday, January 19, 14 212. My Little-to-lose Proposition Not the right treatment? : 90 % credit Still need braces : 50% creditSunday, January 19, 14 213. 3. The Myobrace System 1.History and Purpose 2.Types and Uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 214. Trainers: Comfort Check 2. How is your daytime wear? Great! Heres my card Too Busy Education Not Linking to other activities Excuses Encouragement, I was sick Offer alternatives I told her she didnt have to wear it. We had a family blah blah Sad Puppy Eyes (Bite your tongue) Cant Breathe, Gagging SunAct ivit Act y1 ivit y2Mo nTVRea dingGa min gTueHo me wor Ga min k gWe d Rid e to Rea Soc ding cerThuFriSatHo me wor kSpo nge bob Lau nda ryMo vieAirway trainingSunday, January 19, 14 215. Trainers: Comfort Check 3. Nighttime wear Normally takes time Cant fall asleep Falls Out At Night (FOAN)Taping Sunday, January 19, 14Delay starting 15 Min before sleep, Airway trainingCheck Daytime wear, Airway training 216. Micro-pore, Paper Medical TapeSunday, January 19, 14 217. Trainers: Comfort Check4. Motivation Attitude check Looking for results Encourage Patience Talk about alternatives Sunday, January 19, 14 218. Trainers: Comfort Check4. Motivation : The bicycle speech7 out of 7Sunday, January 19, 14 219. Trainers: Comfort Check4. Motivation : The bicycle speech5 out of 7Sunday, January 19, 14 220. 3. The Myobrace System 1.History and Purpose 2.Types and Uses 3.Clinical Protocols 4.Patient Education and Motivation 5.Follow-ups and Trouble shootingSunday, January 19, 14 221. Trainers: Comfort Check So, how does it feel? Is it comfortable? 1.Buccal gingiva, especially around erupting teeth 2.Retromolar pads 3.Incisive papilla 4. Doesnt t over BWS 5.Unexplained apthous ulcers 6.Allergic Reactions 7.Unexpected results Sunday, January 19, 14 222. 2.1.2) Protocols: Trainers: Comfort CheckComfort check Buccal Gingiva blanching1. Comfort: Common irritations Buccal gingival, especially around erupting teeth Retromolar pads Incisive papilla Unexplained apthous ulcersSunday, January 19, 14 223. Trainers: Comfort CheckComfort check 1. Comfort: Common irritations Buccal gingival, especially around erupting teeth Retromolar pads Incisive papilla Unexplained apthous ulcersSunday, January 19, 14 224. Trainers: Comfort CheckComfort check 1. Comfort: Common irritations Buccal gingival, especially around erupting teeth Retromolar pads Incisive papilla Unexplained apthous ulcersSunday, January 19, 14 225. Trainers: Comfort CheckComfort check 1. Comfort: Common irritationsSunday, January 19, 14 226. Trainers: Comfort CheckComfort check 1. Comfort: Common irritations Buccal gingival, especially around erupting teeth Retromolar pads Incisive papilla Unexplained apthous ulcersSunday, January 19, 14 227. Trainers: Comfort Check Retromolar PadsSunday, January 19, 14 228. Trainers: Comfort Check Retromolar PadsSunday, January 19, 14 229. Trainers: Comfort Check Retromolar PadsSunday, January 19, 14 230. Trainers: Comfort Check Incisive PapillaSunday, January 19, 14 231. Trainers: Comfort Check Incisive PapillaSunday, January 19, 14 232. Trainers: Comfort Check Doesnt Fit over BWSSunday, January 19, 14 233. Trainers: Comfort Check Doesnt Fit over BWSSunday, January 19, 14 234. Trainers: Comfort Check Doesnt Fit over BWSSunday, January 19, 14 235. Trainers: Comfort Check Apthous UlcersNot related to contact with trainer Use oral ointment Restart use when sores gone Ramp up timeSunday, January 19, 14 236. Trainers: Comfort Check Allergic Reactions3 Days of wearSunday, January 19, 14 237. Trainers: Comfort Check Allergic ReactionsSunday, January 19, 14 238. Trainers: Comfort Check Allergic ReactionsNext: T4K Hard Sunday, January 19, 14 239. Unexpected ResultsSunday, January 19, 14 240. Airway-focused Orthodontics Tomorrow... 1.Airway-focused Diagnostics 2. Prevention 3.Undo the Damage already done 4. Establish Good Habits 5. Interdisciplinary Treatment Only by working together will we get to the root of the problem. Sunday, January 19, 14