multi guide 2013 .pdf



Nom original: multi-guide_2013.pdf
Titre: The MULTI Appliance User Guide
Auteur: Franco Bruno

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Le MULTI Appareil
Mode d'emploi
Dr. Franco Bruno -- ARONA -- francobruno@me.com
© Dr. Franco Bruno and

1

2

INDEX
 Introduction
 The Multi Appliances
 Multi-S®
 Multi-T®
 Multi-P®
 Multi-TB®

 Indication
 Contraindications
 Diagnostic Tools
 Management Tools
© Dr. Franco Bruno and

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INTRODUCTION
Qu'est ce qu'un Multi Appareil ?

© Dr. Franco Bruno and

4

Les multi-Appareils
 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; or as a functional
appliance for correcting skeletal class 2 problems; or
as a myofunctional appliance for muscles and tongue
education
 Obviously it’s possible to make the 3 things in the same
time.

© Dr. Franco Bruno and

5

Le Système Multi
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
© Dr. Franco Bruno and

6

Multis Caractéristiques principales
 Pre-Formed
 Monobloc
 Protrusion
 Oral Shields
 Soft Bite Plane
 Ramp
 Holes
 Lip-Bumper
© Dr. Franco Bruno and

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Préformé
 No Impressions Needed
 Ready to Use

© Dr. Franco Bruno and

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Monobloc
 Acts on the upper and lower teeth in the same time
 The patient has to keep the mouth closed

© Dr. Franco Bruno and

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Avancée
 Open and advanced mandibular position
 TMJ Unlocking
 Class 2 Correction

© Dr. Franco Bruno and

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boucliers orales
 Perioral muscles stretch
 Class 2 correction
 Mouth Breathing correction
 Habits correction

© Dr. Franco Bruno and

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Soft Bite-Plane
 Self-Adapting
 TMJ protection

© Dr. Franco Bruno and

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Ramp
 Tongue Reeducation

© Dr. Franco Bruno and

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Trous
 Breathing
 Increase the elasticity in the anterior part of the bite
for a better deepbite correction

© Dr. Franco Bruno and

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Lip-Bumber
 Stabilize the Appliance

© Dr. Franco Bruno and

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The Multi System
Only 4 Appliances

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The Multi-S

®

© Dr. Franco Bruno and

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The Multi-S

®

 Age: from 4 to 6 y.o.
 Teeth Guidance: upper and lover incisors
 Soft Silicon
 Indications
 Deciduous Teeth
 Early Mix Dentition
 Early Lower Crowding
 DeepBite in Deciduous
 Thumb Sucking
© Dr. Franco Bruno and

1 SIZE

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The Multi-T

®

© Dr. Franco Bruno and

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The Multi-T

®

 Age: from 6 to 9 y.o.
 Teeth Guidance: upper and lover incisors + canines
 Indications
 Early and Late Mix Dentition
 Lower Crowding
 DeepBite
 Class 2
 Thumb Sucking
 Tongue Reeducation

© Dr. Franco Bruno and

1
SIZE

20

The Multi-P

®

© Dr. Franco Bruno and

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The Multi-P

®

 Age: from 9 to 14 y.o.
 Teeth Guidance: upper and lower incisors, canines,
first premolar
 Indications
 Late Mix Dentition
 Permanent Teeth
 Class 2
 DeepBite
 OpenBite

© Dr. Franco Bruno and

2
Volumes
2
Lengths
Sizes

22

Multi-P Volume Faible
®

 Normofacial Patients
 Brachifacial Patients
 13 Sizes
 2 length: short and long

© Dr. Franco Bruno and

Short
ECXPLS10
ECXPLS15
ECXPLS20
ECXPLS25
ECXPLS30
ECXPLS35
ECXPLS40
ECXPLS45
ECXPLS50
ECXPLS55
ECXPLS60
ECXPLS65
ECXPLS70

Size
10
15
20
25
30
35
40
45
50
55
60
65
70

Long
ECXPLL40
ECXPLL45
ECXPLL50
ECXPLL55
ECXPLL60
ECXPLL65
ECXPLL70

Size
40
45
50
55
60
65
70

23

Multi-P Volume Elevé
®

 Normofacial Patients
 Dolichofacial Patients
 11Sizes
 2 length: short and long

© Dr. Franco Bruno and

Short
ECXPHS20
ECXPHS25
ECXPHS30
ECXPHS35
ECXPHS40
ECXPHS45
ECXPHS50
ECXPHS55
ECXPHS60
ECXPHS65
ECXPHS70

Size
20
25
30
35
40
45
50
55
60
65
70

Long
ECXPHL45
ECXPHL50
ECXPHL55
ECXPHL60
ECXPHL65
ECXPHL70

Size
45
50
55
60
65
70

24

Règle spéciale

© Dr. Franco Bruno and

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Comment utiliser la règle
 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

Adaptez le Multi-P au patient et vérifiez que les
dents sont placées correctement dans les guides

© Dr. Franco Bruno and

26

Multi-P Selection
®

Placez le marqueur élevée entre l'incisive maxillaire latérale gauche et la canine.
© Dr. Franco Bruno and

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Multi-P Selection
®

Lire l'échelle entre l'incisive latérale droite et la surface mésiale de la canine
© Dr. Franco Bruno and

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Multi-P Usage
®

Si vous n'avez pas besoin de distaliser les forces: le point canin doit rester au milieu de la fente
© Dr. Franco Bruno and

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Multi-P Usage
®

En cas d'entassement: le point canin doit être ½ mm mésiale pour le pousser distalement
© Dr. Franco Bruno and

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Multi-P Usage
®

Si la canine est hors du guide, l'appareil ne conduit pas les dents proprement
© Dr. Franco Bruno and

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The Multi-TB

®

© Dr. Franco Bruno and

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The Multi-TB

®

 Use with Braces
 Teeth Guidance: NO
 Indications
 Deep Bite
 Tongue Trust
 Class 2

© Dr. Franco Bruno and

1
SIZE

33

Indications

© Dr. Franco Bruno and

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Durée de traitement
 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

© Dr. Franco Bruno and

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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 and Multi-P corrects overjet around 0.5 mm/
month
®

© Dr. Franco Bruno and

®

36

inconvénients
 Are not recommended for patients with a history of
severe TMJ problems
 Multi-T / Multi-P : 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

© Dr. Franco Bruno and

37

Inconvénients
 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

© Dr. Franco Bruno and

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© Dr. Franco Bruno and

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Points et Astuces
Utilisation clinique

© Dr. Franco Bruno and

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Arche d'Extension

© Dr. Franco Bruno and

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Arche d'Extension

0.036

© Dr. Franco Bruno and

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Boutons

© Dr. Franco Bruno and

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bouton poussoir

© Dr. Franco Bruno and

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bouton poussoir avec contrôle de la
racine

© Dr. Franco Bruno and

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Bouton De Rotation

© Dr. Franco Bruno and

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Bouton de basculement

© Dr. Franco Bruno and

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Torque Button

© Dr. Franco Bruno and

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Comment modifier l'appareil

© Dr. Franco Bruno and

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Suggestion de forage
BIOPERM : ECS3226
POLYFIX :

© Dr. Franco Bruno and

ECS3371



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