ARCH DEVELOPMENT
Rapid palatal expansion is most commonly used in the mixed or early adult dentition that exhibits a bilateral maxillary posterior crossbite. This crossbite is usually due to a deficiency of the maxillary apical base. Rapid expansion is obtained, with this design, over a two to three week period by means of turning the expansion screw twice a day. This creates enough pressure to separate the mid-palatine suture. The appliance is then worn for another three to four months to allow time for osseous healing. Here the expansion screw is positioned high in the palate for greater patient comfort. Extra heavy support wires are used to prevent the appliance from flexing as pressure is applied.
Quad Helix
This appliance provides a continuous controlled force for a variety of applications. It may be used for rotation or stabilization of molars, expansion or contraction of the arch, and even to assist in thumb, finger or tongue habit control. The appliance can either be soldered to the bands (as shown) or attached to the bands via vertical or horizontal brackets.
FUNCTIONAL ORTHOPEDICS
Herbst Appliance
The Herbst is a two piece fixed appliance used in the treatment of skeletal class II malocclusions. In this design, the mandible is held forward with sliding tubes attached buccal to the upper six year molars and the lower first bicuspids. It may be banded or bonded into place, or a combination of both depending upon the situation.
The Herbst is suggested for patients who do not readily cooperate with removable functional appliance therapy.
Blue Grass Appliance
This device treats a thumb sucking habit through counter-conditioning. Instead of thumb sucking, the patient uses their tongue to spin a teflon roller which has been placed in the most superior aspect of the palate. This has proven to be a positive approach to controlling finger and thumb sucking habits as patients feel they have acquired a new toy. The Blue Grass appliance is particularly useful in the mixed dentition stage of development.
Spinning Bead Tongue Retrainer
This myofunctional device is used to retrain proper tongue position. Patient cooperation is not required as the appliance evokes a spontaneous reaction to play with the spinner and position the dorsum of the tongue against the soft palate.
Removable Tongue Loops
Removable habit appliances can be used to restrict tongue thrusting and thumb sucking in a cooperative patient.
SPLINTS
Maxillary Bruxism Splint
This maxillary bruxism splint has clear acrylic over the entire arch and is finished with full palatal coverage. Careful finishing is required so that each opposing tooth will make equal contact on the acrylic biting surface. The occlusal surface can be finished in whatever manner desired, i.e. smooth with point contact, positive facets for opposing dentition, cuspid rise, and/or anterior guidance to disarticulate the teeth in protrusive movements.
SEPARATORS - "SPACERS"
Separators, also called "spacers", are circular metal or plastic rings which are placed between the back teeth to make space for fitting your orthodontic molar bands. The molar bands are used to hold the teeth back in a proper position, or to connect a headgear. Spacers are supposed to stay in your mouth until your next appointment to make the necessary space... in one to two weeks. They may feel chewy in the beginning when you first bite down, but that will go away in about a day. Please do not pick at the spacers, or floss around the spacers, or you could pull the spacers out. Should your spacer(s) come out prior to (more than one day) your scheduled appointment to fit your bands, please call our office to put it back in. Avoid chewing gum and sticky foods which could dislodge the spacers.
YOUR HEADGEAR
Your headgear is made of three parts:
- Facebow
- Neck/Headstrap
- Bands (cemented to teeth)
The purpose of your headgear is to hold or move your upper teeth and bone back by attaching to the biggest teeth in the bone.
Instructions:
- Wear your headgear 12 to 24 hours every day.
- You must be consistent... missing a day is like missing a week.
- At first, practice putting on and taking it off in front of your mirror.
- Know which side is up and down.
- Never force or twist the metal facebow on or off.
- Call for an appointment immediately if you ever have a problem.
- ALWAYS bring your headgear with you to your appointment.
Next: Phase 2