Rapid Palatal Expander
The Rapid Palatal Expander (RPE) is a fixed device that expands the upper jaw. When we are young, the upper jaw is made up of two halves, right and left, separated by a cartilage suture. After puberty, this cartilage suture begins to ossify or fill with bone. RPEs are used to skeletally widen the upper jaw when patients are young to take advantage of the stretchiness of this cartilage suture. This is called skeletal expansion and is used to correct a posterior crossbite.
RPEs are made up of two bands or rings fitted to the upper molars that are attached to a framework that in sits in the roof of the palate. Within the framework, there is a screw that is turned periodically that widens the framework 0.25 mm. After expansion is complete, the RPE is left in the mouth for a minimum of 3 months to reduce relapse.
The QuadHelix is another type of fixed expander that allows us to rotate the upper molars at the same time of expansion. Unlike the RPE, no turning is required and the appliance is activated in the office. The QuadHelix is also used to correct posterior crossbites that are more dental than skeletal in nature, and to regain space due to early loss of primary teeth.
Lingual Holding Arch
The Lingual Holding Arch (LHA) is a space maintaining appliance that is fixed in place on the lower first molar s. It can be used as a fixed retainer after Phase 1 or during treatment as part of your individualized plan. It consists of two bands fitted and cemented to the lower molars connected to a metal arch that fits along the tongue side of the lower teeth.
Braces and wires are used to align the teeth within their respective arches; however orthodontic treatment is more than that! We want your upper and lower teeth to fit properly together in a healthy bite. Rubber bands are tiny elastic bands that hook onto the brackets allowing us to place various forces between the upper and lower arches. By using different shapes and directions, the rubber bands pull and push the arches toward one another. Rubber bands are extremely important to getting the most ideal result for you and are changed 3-4 times a day as you take them out to eat and brush.
The Powerscope is a fixed spring appliance that is secured to your upper and lower wires during treatment. It pushes the upper arch backward and the lower arch forward to align the arches into a proper ideal bite. As with rubberbands, the powerscope directs force between the arches, but it is not removed and remains in place for approximately six months depending on severity.
Headgear is a device that has been around a while! It is an extraoral appliance that places force on the upper molars to move them backward. If used during growth, it holds the upper jaw in place to allow the lower jaw to “catch up” and improve the profile. Unlike the old days of headgear, modern day headgear is only worn at home and during sleep. We will not ask your child to wear headgear at school, sports or even sleep overs.
Reverse Headgear or Facemask therapy is an extraoral appliance that pulls the upper jaw forward. It is most often used in conjunction with an RPE to correct an anterior crossbite or underbite in the younger patient. It is worn at home and during sleep only.