Myofunctional Appliance Therapy: Role Of The Vestibular Screen

Myofunctional Appliance Therapy: Role Of The Vestibular Screen

• Vestibular screen is also known a lip modular.
• Vestibular screen extends in vestibule and lies in contact with alveolar process.
• There are no teeth in contact with vestibular screen.

• Vestibular screen prevents pressure from cheek to act on dentition. Due to this, tongue becomes free to exert the force. This leads to the passive expansion of the arches.
• Pressure from lips becomes directed to incisors. This pressure leads to lingual movement of labially proclined teeth.
• Lower jaw move forward.
• Hypotonic lip gets activated and tonicity of lips improved.
• Maxillary incisors get retroclined.
• Apical base gets passively expanded.
• There is differential eruption of molars.
• When protrusive bite is taken there is mandibular advancement.

• Appliance should be constructed in the clear acrylic.
• Place the working model in normal occlusion or take the
• protrusive bite for Class II division 1 malocclusion.
• Wax up of the appliance is carried out.
• Appliance directly influences the anterior segment due to this incisal third of anterior teeth is not covered by the wax.
• Appliance does not influence the posterior segment directly. It acts by remaining away from the appliance. To effect the change, buccal surface of the teeth and the alveolar process are covered by two layers of wax till distal aspect of fist permanent molar in permanent dentition. It extends to the vestibular depth.
• In deciduous dentition appliance extends till distal surface of second deciduous molar.
• Provide the correct curve between upper and lower incisors and lower labial sulcus to accept lower lip.
• Make the edges less thick than buccal vestibular sulcus depth.
• Allowances are made for labial and buccal frena.
• Process the appliance with heat cure or self cure acrylic.
• Trim and polish the appliance.

• Appliance should be worn by patient every night and during day when possible.
• Lip seal exercises should be carried out for 30 to 45 minutes/day.
• Breathing holes should be reduced in size.
• Areas where tooth contact is present, padding with quick setting self cure acrylic is done.

• As active and passive appliance.
• For correcting tongue thrusting, thumb sucking and lip biting habits.
• For correcting mouth breathing, thumb sucking and lip biting habits.
• For correcting mild distocclusion.
• For correcting flccid hypotonic orofacial musculature.
• For counteract the deficiencies in lip posture and function.
• For correcting mild proclination of incisors.

• Appliance is simple and versatile during early interceptive treatment.
• Oral screen provides good muscle balance between tongue inside and buccinators mechanism outside.
• It corrects the faulty relationship of upper and lower lips to each other and near normal lip seal is possible.
• It leads to the development of proper functioning occlusion.
• It provides effective mechanism for eliminating hyperactive mentalis activity.

• Does not provide complete mechanotherapy.
• It is only the phase I correction of an orthodontic problem.