SlideShare a Scribd company logo
1 of 3
1
Dr. Mohammed Alruby
Freeway space
Prepared by
Dr. Mohammed Alruby
2
Dr. Mohammed Alruby
Freeway space:
= is the inter-occlusal space (vertical distance) between maxillary and mandibular teeth when the
mandible is in natural or physiologic rest position under the reciprocal coordination of elevator
and depressor masticatory muscles.
= McNamara, stated that; the rest position of the mandible is influenced by the activity of elevator
muscles through stimuli from peripheral receptor such as those located in TMJ, periodontal
ligament, gingiva, tongue, palate
= the freeway space is negatively correlated with ALFH and positively correlated with PLFH
(ramus height)
= freeway space increase in deep bite cases
Peterchonchak 1987:
Definition: natural rest position of the mandible, suspended by reciprocal coordination of elevator
and depressor muscles with upper and lower teeth separated.
=He takes S N ----- Mp angle to describe the face into:
a- Low angle; short face
b- High angle: long face
= He make another study and increase the sample of subjects and his aim is directed to;
a- Compare freeway space FWS with cephalometric parameter
b- Compare FWS with angle classification
Results:
a- Angle classification not correlated to FWS
b- FWS has inverse correlation to S N---- MP angle
Fuggi 1977:
Demonstrate that transcutaneous electrical nerve stimulation TENS produce deconditioning of
musculature by reducing muscle spindle feedback
N: B: the muscle relaxation that result from TENS: induce proprioceptive disfacilitation of the fifth
motor nerve and is not a fatigue phenomenon because of increased electo-myographic activity of
the musculature.
FWS types: ( Jakleson 1978)
1- Adaptive FWS: the inner occlusal space that exist when patient is instructed voluntary to
allow the jaw to relax
2- True FWS: jaw position after induced muscular relaxation by transcutaneous electrical
nerve stimulation (TENS)
N: B; when need to measure FWS we must put the patient in rest position, normal FWS 3mm at
canine region
Methods for measuring freeway space:
1- Direct intraoral method: by using caliper in patient mouth at canine region
2- Direct extraoral method: two marks on face, nose and chin on sagittal plane and measure
the difference between the rest and occlusion
3- Indirect extraoral: two cephalometric radiograph, one in rest and other in occlusion
3
Dr. Mohammed Alruby
Methods for rest position:
1- Phonetic method: repeat letter m or ward Mississippi and the mandible present in rest
position after 1 to 2 seconds after exercise
2- Command method: after swallowing
3- Non command method: examine patient when he has not aware
Methods for measuring true FWS:
1- TENS: transcutaneous electrical nerve stimulation: that made deconditioning of the muscles
by eliminating the proprioceptive sensory input from the existing malocclusion
TENS, is applied to the motor division of the 5th
cranial nerve
Mode of action of TENS:
a- Reduce the muscle spindle feed back
b- Block the 5th
cranial motor nerve fibers
c- Inhibition of upper motor neuron on the motor nucleus of trigeminal nerve deactivation
of the gamma motor neuron drive to the muscle spindle
==Results of TENS: reduce the elevator muscle stretch reflex and thus reducing the
resting EMG activity of masticatory muscles
==True FWS is larger than adaptive FWS 1.8: 2.9 respectively according to Konchack
There is a significant correlation between adaptive freeway space and Sn-Mp angle also
ALFH
==Normal FWS; 2 – 4mm
== <2mm: open bite
== >4mm: deep bite
2- Bite plate: traditional method:
= It can be used as a valuable diagnostic tool in measurement of correct vertical dimension
and true freeway space. Also in diagnosis and treatment disorder and bruxism
= For measuring: put bite plate in patient mouth for sufficient time to allow eliminate the
sensory input for the malocclusion, then move it and the orthodontist can measure the FWS
by instruct the patient to relax the mandible
When the amount of freeway space is larger than normal, there is great chance for
correction of deep bite by guiding the vertical alveolar development

More Related Content

What's hot

removable orthodontic appliances
removable orthodontic appliancesremovable orthodontic appliances
removable orthodontic appliancesWaqar Jeelani
 
Removable orthodontic appliance
Removable orthodontic applianceRemovable orthodontic appliance
Removable orthodontic appliancemrboy
 
Skeletal maturity index
Skeletal maturity indexSkeletal maturity index
Skeletal maturity indexSk Aziz Ikbal
 
Head gear in orthodontics
Head gear in orthodonticsHead gear in orthodontics
Head gear in orthodonticsIshtiaq Hasan
 
Functional Matrix Theory
Functional Matrix Theory Functional Matrix Theory
Functional Matrix Theory Zynul John
 
orthodontic management of impacted canine.
orthodontic management of impacted canine.orthodontic management of impacted canine.
orthodontic management of impacted canine.Muhammad Shafad
 
Interceptive orthodontics
Interceptive orthodonticsInterceptive orthodontics
Interceptive orthodonticsmahesh kumar
 
Biomechanics in removable partial denture
Biomechanics in removable partial dentureBiomechanics in removable partial denture
Biomechanics in removable partial dentureTaseef Hasan Farook
 
Clinical examination of an orthodontic patient
Clinical examination of an orthodontic patientClinical examination of an orthodontic patient
Clinical examination of an orthodontic patientIndian dental academy
 
Space gaining methods -ORTHODONTICS
Space gaining methods  -ORTHODONTICSSpace gaining methods  -ORTHODONTICS
Space gaining methods -ORTHODONTICSSk Aziz Ikbal
 
Retention and Relapse in orthodontics
Retention and Relapse in orthodonticsRetention and Relapse in orthodontics
Retention and Relapse in orthodonticsEkta Chaudhary
 

What's hot (20)

Surgical orthodontics
Surgical orthodonticsSurgical orthodontics
Surgical orthodontics
 
Orthodontic study model and model analysis
Orthodontic study model and model analysisOrthodontic study model and model analysis
Orthodontic study model and model analysis
 
Frankel functional appliance
Frankel functional applianceFrankel functional appliance
Frankel functional appliance
 
anchorage
anchorageanchorage
anchorage
 
removable orthodontic appliances
removable orthodontic appliancesremovable orthodontic appliances
removable orthodontic appliances
 
Removable orthodontic appliance
Removable orthodontic applianceRemovable orthodontic appliance
Removable orthodontic appliance
 
Cephalometrics
CephalometricsCephalometrics
Cephalometrics
 
Skeletal maturity index
Skeletal maturity indexSkeletal maturity index
Skeletal maturity index
 
Head gear in orthodontics
Head gear in orthodonticsHead gear in orthodontics
Head gear in orthodontics
 
Functional Matrix Theory
Functional Matrix Theory Functional Matrix Theory
Functional Matrix Theory
 
orthodontic management of impacted canine.
orthodontic management of impacted canine.orthodontic management of impacted canine.
orthodontic management of impacted canine.
 
Impacted canine
Impacted canineImpacted canine
Impacted canine
 
Deep bite(1)
Deep bite(1)Deep bite(1)
Deep bite(1)
 
Interceptive orthodontics
Interceptive orthodonticsInterceptive orthodontics
Interceptive orthodontics
 
Biomechanics in removable partial denture
Biomechanics in removable partial dentureBiomechanics in removable partial denture
Biomechanics in removable partial denture
 
Frankel’s appliance
Frankel’s applianceFrankel’s appliance
Frankel’s appliance
 
Clinical examination of an orthodontic patient
Clinical examination of an orthodontic patientClinical examination of an orthodontic patient
Clinical examination of an orthodontic patient
 
Space gaining methods -ORTHODONTICS
Space gaining methods  -ORTHODONTICSSpace gaining methods  -ORTHODONTICS
Space gaining methods -ORTHODONTICS
 
Hand wrist radiographs
Hand wrist radiographsHand wrist radiographs
Hand wrist radiographs
 
Retention and Relapse in orthodontics
Retention and Relapse in orthodonticsRetention and Relapse in orthodontics
Retention and Relapse in orthodontics
 

Similar to free way space.docx

Orthopedic Test for the wrist joint
Orthopedic Test for the wrist jointOrthopedic Test for the wrist joint
Orthopedic Test for the wrist jointHezekiahAyuba1
 
functional examination
functional examinationfunctional examination
functional examinationKumar Adarsh
 
etiology and ttt mechanics of open bite cases.docx
etiology and ttt mechanics of open bite cases.docxetiology and ttt mechanics of open bite cases.docx
etiology and ttt mechanics of open bite cases.docxDr.Mohammed Alruby
 
method of physical examination of central nervous system
method of physical examination of central nervous systemmethod of physical examination of central nervous system
method of physical examination of central nervous systemDr Kaushal Kumar Sinha
 
management of facial a symmetry.docx
management of facial a symmetry.docxmanagement of facial a symmetry.docx
management of facial a symmetry.docxDr.Mohammed Alruby
 
effect of functional appliances on facial growth.docx
effect of functional appliances on facial growth.docxeffect of functional appliances on facial growth.docx
effect of functional appliances on facial growth.docxDr.Mohammed Alruby
 
mechanics with orthopedic treatment.docx
mechanics with orthopedic treatment.docxmechanics with orthopedic treatment.docx
mechanics with orthopedic treatment.docxDr.Mohammed Alruby
 
Hand rehabilitation following flexor tendon injuries
Hand rehabilitation following flexor tendon injuriesHand rehabilitation following flexor tendon injuries
Hand rehabilitation following flexor tendon injuriesAbey P Rajan
 
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...Dr Bhavik Miyani
 
Median nerve injuries
Median nerve injuriesMedian nerve injuries
Median nerve injuriesMahak Jain
 
Screening methof of Local anaesthesia
Screening methof of Local anaesthesiaScreening methof of Local anaesthesia
Screening methof of Local anaesthesiaGaurabi Chakrabortty
 
New microsoft office power point presentation
New microsoft office power point presentationNew microsoft office power point presentation
New microsoft office power point presentationPRIYAPRAJEESH
 

Similar to free way space.docx (20)

Orthopedic Test for the wrist joint
Orthopedic Test for the wrist jointOrthopedic Test for the wrist joint
Orthopedic Test for the wrist joint
 
functional examination
functional examinationfunctional examination
functional examination
 
Buat riyan
Buat riyanBuat riyan
Buat riyan
 
etiology and ttt mechanics of open bite cases.docx
etiology and ttt mechanics of open bite cases.docxetiology and ttt mechanics of open bite cases.docx
etiology and ttt mechanics of open bite cases.docx
 
DEMONSTRATION- reflex.ppt
DEMONSTRATION- reflex.pptDEMONSTRATION- reflex.ppt
DEMONSTRATION- reflex.ppt
 
Horizontal jaw relation
Horizontal jaw relationHorizontal jaw relation
Horizontal jaw relation
 
method of physical examination of central nervous system
method of physical examination of central nervous systemmethod of physical examination of central nervous system
method of physical examination of central nervous system
 
management of facial a symmetry.docx
management of facial a symmetry.docxmanagement of facial a symmetry.docx
management of facial a symmetry.docx
 
Carpal Tunnel Syndrome
Carpal Tunnel SyndromeCarpal Tunnel Syndrome
Carpal Tunnel Syndrome
 
effect of functional appliances on facial growth.docx
effect of functional appliances on facial growth.docxeffect of functional appliances on facial growth.docx
effect of functional appliances on facial growth.docx
 
mechanics with orthopedic treatment.docx
mechanics with orthopedic treatment.docxmechanics with orthopedic treatment.docx
mechanics with orthopedic treatment.docx
 
Hand rehabilitation following flexor tendon injuries
Hand rehabilitation following flexor tendon injuriesHand rehabilitation following flexor tendon injuries
Hand rehabilitation following flexor tendon injuries
 
Inferior alveolar nerve block
Inferior alveolar nerve blockInferior alveolar nerve block
Inferior alveolar nerve block
 
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...
Journal Club Impact of Ultra Sound Therapy on Myofascial Pain Dysfunction Syn...
 
Median nerve injuries
Median nerve injuriesMedian nerve injuries
Median nerve injuries
 
Tendon transfers for radial nerve palsy
Tendon transfers for radial nerve palsyTendon transfers for radial nerve palsy
Tendon transfers for radial nerve palsy
 
Screening methof of Local anaesthesia
Screening methof of Local anaesthesiaScreening methof of Local anaesthesia
Screening methof of Local anaesthesia
 
Facial palsy
Facial palsyFacial palsy
Facial palsy
 
New microsoft office power point presentation
New microsoft office power point presentationNew microsoft office power point presentation
New microsoft office power point presentation
 
Median nerve injuries
Median nerve injuries Median nerve injuries
Median nerve injuries
 

More from Dr.Mohammed Alruby

Extra-oral forces and appliances.docx
Extra-oral forces and appliances.docxExtra-oral forces and appliances.docx
Extra-oral forces and appliances.docxDr.Mohammed Alruby
 
effects of extra-oral appliances and forces.docx
effects of extra-oral appliances and forces.docxeffects of extra-oral appliances and forces.docx
effects of extra-oral appliances and forces.docxDr.Mohammed Alruby
 
orthodontic appliance and treatment philosophy.docx
orthodontic appliance and treatment philosophy.docxorthodontic appliance and treatment philosophy.docx
orthodontic appliance and treatment philosophy.docxDr.Mohammed Alruby
 
orthodontic mangement of orthognathic cases.docx
orthodontic mangement of orthognathic cases.docxorthodontic mangement of orthognathic cases.docx
orthodontic mangement of orthognathic cases.docxDr.Mohammed Alruby
 
diagnostic aids part 3, photograph and radiograph.docx
diagnostic aids part 3, photograph and radiograph.docxdiagnostic aids part 3, photograph and radiograph.docx
diagnostic aids part 3, photograph and radiograph.docxDr.Mohammed Alruby
 
diagnostic aids part 2 study cast, cast analysis.docx
diagnostic aids part 2 study cast, cast analysis.docxdiagnostic aids part 2 study cast, cast analysis.docx
diagnostic aids part 2 study cast, cast analysis.docxDr.Mohammed Alruby
 
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docx
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxdiagnostic aids part 1 diagnosis, examination, BMR, EMG.docx
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
 
smile and orthodontic implication.docx
smile and orthodontic implication.docxsmile and orthodontic implication.docx
smile and orthodontic implication.docxDr.Mohammed Alruby
 
orthodontic biology of tooth and supporting structure.docx
orthodontic biology of tooth and supporting structure.docxorthodontic biology of tooth and supporting structure.docx
orthodontic biology of tooth and supporting structure.docxDr.Mohammed Alruby
 
guide lines for infection control.docx
guide lines for infection control.docxguide lines for infection control.docx
guide lines for infection control.docxDr.Mohammed Alruby
 
mangement of canine abnormalities.docx
mangement of canine abnormalities.docxmangement of canine abnormalities.docx
mangement of canine abnormalities.docxDr.Mohammed Alruby
 

More from Dr.Mohammed Alruby (20)

Rotation in orthodontics.docx
Rotation in orthodontics.docxRotation in orthodontics.docx
Rotation in orthodontics.docx
 
Torque in orthodontics.docx
Torque in orthodontics.docxTorque in orthodontics.docx
Torque in orthodontics.docx
 
Extra-oral forces and appliances.docx
Extra-oral forces and appliances.docxExtra-oral forces and appliances.docx
Extra-oral forces and appliances.docx
 
effects of extra-oral appliances and forces.docx
effects of extra-oral appliances and forces.docxeffects of extra-oral appliances and forces.docx
effects of extra-oral appliances and forces.docx
 
orthodontic appliance and treatment philosophy.docx
orthodontic appliance and treatment philosophy.docxorthodontic appliance and treatment philosophy.docx
orthodontic appliance and treatment philosophy.docx
 
distalization appliances.docx
distalization appliances.docxdistalization appliances.docx
distalization appliances.docx
 
Laser in orthodontics.docx
Laser in orthodontics.docxLaser in orthodontics.docx
Laser in orthodontics.docx
 
orthodontic mangement of orthognathic cases.docx
orthodontic mangement of orthognathic cases.docxorthodontic mangement of orthognathic cases.docx
orthodontic mangement of orthognathic cases.docx
 
medical glossary.docx
medical glossary.docxmedical glossary.docx
medical glossary.docx
 
muscles part 3.docx
muscles part 3.docxmuscles part 3.docx
muscles part 3.docx
 
muscles part 2.docx
muscles part 2.docxmuscles part 2.docx
muscles part 2.docx
 
muscles part 1.docx
muscles part 1.docxmuscles part 1.docx
muscles part 1.docx
 
diagnostic aids part 3, photograph and radiograph.docx
diagnostic aids part 3, photograph and radiograph.docxdiagnostic aids part 3, photograph and radiograph.docx
diagnostic aids part 3, photograph and radiograph.docx
 
diagnostic aids part 2 study cast, cast analysis.docx
diagnostic aids part 2 study cast, cast analysis.docxdiagnostic aids part 2 study cast, cast analysis.docx
diagnostic aids part 2 study cast, cast analysis.docx
 
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docx
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxdiagnostic aids part 1 diagnosis, examination, BMR, EMG.docx
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docx
 
smile and orthodontic implication.docx
smile and orthodontic implication.docxsmile and orthodontic implication.docx
smile and orthodontic implication.docx
 
orthodontic biology of tooth and supporting structure.docx
orthodontic biology of tooth and supporting structure.docxorthodontic biology of tooth and supporting structure.docx
orthodontic biology of tooth and supporting structure.docx
 
infection prevention.docx
infection prevention.docxinfection prevention.docx
infection prevention.docx
 
guide lines for infection control.docx
guide lines for infection control.docxguide lines for infection control.docx
guide lines for infection control.docx
 
mangement of canine abnormalities.docx
mangement of canine abnormalities.docxmangement of canine abnormalities.docx
mangement of canine abnormalities.docx
 

Recently uploaded

Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of Hospital A...
Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of  Hospital A...Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of  Hospital A...
Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of Hospital A...Era University , Lucknow
 
Globalny raport: „Prawdziwe piękno 2024" od Dove
Globalny raport: „Prawdziwe piękno 2024" od DoveGlobalny raport: „Prawdziwe piękno 2024" od Dove
Globalny raport: „Prawdziwe piękno 2024" od Doveagatadrynko
 
MVP Health Care City of Schenectady Presentation
MVP Health Care City of Schenectady PresentationMVP Health Care City of Schenectady Presentation
MVP Health Care City of Schenectady PresentationMVP Health Care
 
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 ) unlimited hard...
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 )  unlimited hard...Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 )  unlimited hard...
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 ) unlimited hard...ggsonu500
 
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...ggsonu500
 
Call Girls Ghaziabad 9999965857 Cheap and Best with original Photos
Call Girls Ghaziabad 9999965857 Cheap and Best with original PhotosCall Girls Ghaziabad 9999965857 Cheap and Best with original Photos
Call Girls Ghaziabad 9999965857 Cheap and Best with original Photosparshadkalavatidevi7
 
Call Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Aashi 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...ggsonu500
 
Low Rate Call Girls In Bommanahalli Just Call 7001305949
Low Rate Call Girls In Bommanahalli Just Call 7001305949Low Rate Call Girls In Bommanahalli Just Call 7001305949
Low Rate Call Girls In Bommanahalli Just Call 7001305949ps5894268
 
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...scanFOAM
 
Single Assessment Framework - What We Know So Far
Single Assessment Framework - What We Know So FarSingle Assessment Framework - What We Know So Far
Single Assessment Framework - What We Know So FarCareLineLive
 
Pregnancy and Breastfeeding Dental Considerations.pptx
Pregnancy and Breastfeeding Dental Considerations.pptxPregnancy and Breastfeeding Dental Considerations.pptx
Pregnancy and Breastfeeding Dental Considerations.pptxcrosalofton
 
Call Girls South Delhi 9999965857 Cheap and Best with original Photos
Call Girls South Delhi 9999965857 Cheap and Best with original PhotosCall Girls South Delhi 9999965857 Cheap and Best with original Photos
Call Girls South Delhi 9999965857 Cheap and Best with original Photosparshadkalavatidevi7
 
2024 HCAT Healthcare Technology Insights
2024 HCAT Healthcare Technology Insights2024 HCAT Healthcare Technology Insights
2024 HCAT Healthcare Technology InsightsHealth Catalyst
 
Russian Escorts Delhi | 9711199171 | all area service available
Russian Escorts Delhi | 9711199171 | all area service availableRussian Escorts Delhi | 9711199171 | all area service available
Russian Escorts Delhi | 9711199171 | all area service availablesandeepkumar69420
 
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...ddev2574
 
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...sandeepkumar69420
 
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdf
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdfSARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdf
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdfDolisha Warbi
 
Low Vision Case (Nisreen mokhanawala).pptx
Low Vision Case (Nisreen mokhanawala).pptxLow Vision Case (Nisreen mokhanawala).pptx
Low Vision Case (Nisreen mokhanawala).pptxShubham
 

Recently uploaded (20)

Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of Hospital A...
Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of  Hospital A...Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of  Hospital A...
Disaster Management Cycle (DMC)| Ms. Pooja Sharma , Department of Hospital A...
 
Globalny raport: „Prawdziwe piękno 2024" od Dove
Globalny raport: „Prawdziwe piękno 2024" od DoveGlobalny raport: „Prawdziwe piękno 2024" od Dove
Globalny raport: „Prawdziwe piękno 2024" od Dove
 
MVP Health Care City of Schenectady Presentation
MVP Health Care City of Schenectady PresentationMVP Health Care City of Schenectady Presentation
MVP Health Care City of Schenectady Presentation
 
Russian Call Girls Jor Bagh 9711199171 discount on your booking
Russian Call Girls Jor Bagh 9711199171 discount on your bookingRussian Call Girls Jor Bagh 9711199171 discount on your booking
Russian Call Girls Jor Bagh 9711199171 discount on your booking
 
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 ) unlimited hard...
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 )  unlimited hard...Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 )  unlimited hard...
Gurgaon Sushant Lok Phase 2 Call Girls Service ( 9873940964 ) unlimited hard...
 
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 90 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
 
Call Girls Ghaziabad 9999965857 Cheap and Best with original Photos
Call Girls Ghaziabad 9999965857 Cheap and Best with original PhotosCall Girls Ghaziabad 9999965857 Cheap and Best with original Photos
Call Girls Ghaziabad 9999965857 Cheap and Best with original Photos
 
Call Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Aashi 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Aashi 7001305949 Independent Escort Service Bangalore
 
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
Gurgaon Sector 68 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few ...
 
Low Rate Call Girls In Bommanahalli Just Call 7001305949
Low Rate Call Girls In Bommanahalli Just Call 7001305949Low Rate Call Girls In Bommanahalli Just Call 7001305949
Low Rate Call Girls In Bommanahalli Just Call 7001305949
 
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...
 
Single Assessment Framework - What We Know So Far
Single Assessment Framework - What We Know So FarSingle Assessment Framework - What We Know So Far
Single Assessment Framework - What We Know So Far
 
Pregnancy and Breastfeeding Dental Considerations.pptx
Pregnancy and Breastfeeding Dental Considerations.pptxPregnancy and Breastfeeding Dental Considerations.pptx
Pregnancy and Breastfeeding Dental Considerations.pptx
 
Call Girls South Delhi 9999965857 Cheap and Best with original Photos
Call Girls South Delhi 9999965857 Cheap and Best with original PhotosCall Girls South Delhi 9999965857 Cheap and Best with original Photos
Call Girls South Delhi 9999965857 Cheap and Best with original Photos
 
2024 HCAT Healthcare Technology Insights
2024 HCAT Healthcare Technology Insights2024 HCAT Healthcare Technology Insights
2024 HCAT Healthcare Technology Insights
 
Russian Escorts Delhi | 9711199171 | all area service available
Russian Escorts Delhi | 9711199171 | all area service availableRussian Escorts Delhi | 9711199171 | all area service available
Russian Escorts Delhi | 9711199171 | all area service available
 
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Rohini Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
 
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...
Russian Call Girls Mohan Nagar | 9711199171 | High Profile -New Model -Availa...
 
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdf
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdfSARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdf
SARS (SEVERE ACUTE RESPIRATORY SYNDROME).pdf
 
Low Vision Case (Nisreen mokhanawala).pptx
Low Vision Case (Nisreen mokhanawala).pptxLow Vision Case (Nisreen mokhanawala).pptx
Low Vision Case (Nisreen mokhanawala).pptx
 

free way space.docx

  • 1. 1 Dr. Mohammed Alruby Freeway space Prepared by Dr. Mohammed Alruby
  • 2. 2 Dr. Mohammed Alruby Freeway space: = is the inter-occlusal space (vertical distance) between maxillary and mandibular teeth when the mandible is in natural or physiologic rest position under the reciprocal coordination of elevator and depressor masticatory muscles. = McNamara, stated that; the rest position of the mandible is influenced by the activity of elevator muscles through stimuli from peripheral receptor such as those located in TMJ, periodontal ligament, gingiva, tongue, palate = the freeway space is negatively correlated with ALFH and positively correlated with PLFH (ramus height) = freeway space increase in deep bite cases Peterchonchak 1987: Definition: natural rest position of the mandible, suspended by reciprocal coordination of elevator and depressor muscles with upper and lower teeth separated. =He takes S N ----- Mp angle to describe the face into: a- Low angle; short face b- High angle: long face = He make another study and increase the sample of subjects and his aim is directed to; a- Compare freeway space FWS with cephalometric parameter b- Compare FWS with angle classification Results: a- Angle classification not correlated to FWS b- FWS has inverse correlation to S N---- MP angle Fuggi 1977: Demonstrate that transcutaneous electrical nerve stimulation TENS produce deconditioning of musculature by reducing muscle spindle feedback N: B: the muscle relaxation that result from TENS: induce proprioceptive disfacilitation of the fifth motor nerve and is not a fatigue phenomenon because of increased electo-myographic activity of the musculature. FWS types: ( Jakleson 1978) 1- Adaptive FWS: the inner occlusal space that exist when patient is instructed voluntary to allow the jaw to relax 2- True FWS: jaw position after induced muscular relaxation by transcutaneous electrical nerve stimulation (TENS) N: B; when need to measure FWS we must put the patient in rest position, normal FWS 3mm at canine region Methods for measuring freeway space: 1- Direct intraoral method: by using caliper in patient mouth at canine region 2- Direct extraoral method: two marks on face, nose and chin on sagittal plane and measure the difference between the rest and occlusion 3- Indirect extraoral: two cephalometric radiograph, one in rest and other in occlusion
  • 3. 3 Dr. Mohammed Alruby Methods for rest position: 1- Phonetic method: repeat letter m or ward Mississippi and the mandible present in rest position after 1 to 2 seconds after exercise 2- Command method: after swallowing 3- Non command method: examine patient when he has not aware Methods for measuring true FWS: 1- TENS: transcutaneous electrical nerve stimulation: that made deconditioning of the muscles by eliminating the proprioceptive sensory input from the existing malocclusion TENS, is applied to the motor division of the 5th cranial nerve Mode of action of TENS: a- Reduce the muscle spindle feed back b- Block the 5th cranial motor nerve fibers c- Inhibition of upper motor neuron on the motor nucleus of trigeminal nerve deactivation of the gamma motor neuron drive to the muscle spindle ==Results of TENS: reduce the elevator muscle stretch reflex and thus reducing the resting EMG activity of masticatory muscles ==True FWS is larger than adaptive FWS 1.8: 2.9 respectively according to Konchack There is a significant correlation between adaptive freeway space and Sn-Mp angle also ALFH ==Normal FWS; 2 – 4mm == <2mm: open bite == >4mm: deep bite 2- Bite plate: traditional method: = It can be used as a valuable diagnostic tool in measurement of correct vertical dimension and true freeway space. Also in diagnosis and treatment disorder and bruxism = For measuring: put bite plate in patient mouth for sufficient time to allow eliminate the sensory input for the malocclusion, then move it and the orthodontist can measure the FWS by instruct the patient to relax the mandible When the amount of freeway space is larger than normal, there is great chance for correction of deep bite by guiding the vertical alveolar development