Wiewiora & Dunn Dictionary
The Herbst appliance is a functional orthopedic appliance which postures the patient’s lower jaw (mandible) in a forward direction. This appliance is used in growing patients to promote forward growth of the lower jaw.
When a child is growing, it is possible to improve the balance of the jaws with a Herbst appliance. In this orthodontic situation, the doctor wants to encourage the forward growth of the lower jaw while restraining the forward growth of the upper jaw. Over a period of many months, this forward posture of the lower jaw promotes growth in the same direction. This will improve the overall result of your case. The Herbst appliance is cemented in place, so you will wear it full-time until the desired result is achieved. The Herbst is very comfortable to wear after a short adjustment period.
Perhaps the most important stage in a person’s dental development falls between the ages of five and 12. During these years, the primary teeth are lost and are replaced by adult teeth. By evaluating the teeth at an early age, the orthodontist can reasonably predict whether or not there will be enough room for the adult teeth.
Often during these developmental years, the eruption of the adult teeth can be aided by the selective removal of the primary teeth. The orthodontist can determine if this is needed, and if so, will make the appropriate recommendation to your dentist. Preliminary diagnostic records may be needed.
This procedure, called serial extraction, will not eliminate the need for eventual orthodontic treatment, but will often prevent a serious problem from getting worse, and can help the teeth and jaws to develop in a more harmonious relationship.
Once started, it is very important for the patient to be seen by an orthodontist on a regular basis in order to monitor the dental development. This, the family dentist may be informed additional teeth, which need to be removed and when definitive orthodontic therapy should begin.
The goal of first-phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other for good facial balance and esthetics.
Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can be recognized at an early age. If children after age six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth of the upper and lower jaws. Thus, a good foundation can be established, providing adequate room for eruption of all permanent teeth and good facial balance. This early correction may prevent later removal of permanent teeth or surgical procedures to align the upper and lower jaws.
Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy that cannot be treated with braces alone. Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time and the frequency of visits. Records will consist of X-rays, and photographs of the teeth and jaw structures.
Resting Period (After Phase I Treatment) – In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices may or may not be used during this period. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will help create more room for teeth to find an eruption path.
In other words, at the end of the first phase of treatment, teeth are not in their final positions. This will be accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest to enhance eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.
Second Phase of Treatment – Each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue and other teeth. When this equilibrium is established, the teeth will function together properly. They will stay healthy and look attractive. This is the goal of the second and final phase of treatment. The second phase is initiated when all permanent teeth have erupted and, usually requires braces on all teeth for an average of 18-24 months. A retainer is worn nightly after this phase to maintain the results long-term.
Advantages of Two-phase Orthodontic Treatment – Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical, facial changes. The emphasis today on living longer, staying healthy and looking attractive requires optimum treatment results. The major advantage of a two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional and esthetic result.
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment – for someone with a jaw discrepancy – is having to face the possibility of a compromised result that may not be completely functional and cosmetically pleasing.
A functional appliance is a device designed to alter the relationship between the upper jaw and the lower jaw. It is best used on patients whose bones are still growing, thus taking advantage of the relative immaturity of these bones. These appliances are custom-made and specifically designed to realign the jaws so that they are in good relation to each other and ultimately allow the teeth to fit together in a proper bite.
The Frankel appliance is removable – it can therefore be removed when eating. The Frankel works best when left in place 20 to 24 hours a day to take advantage of the slow growth that occurs within bones.
If worn properly, the Frankel appliance will provide proper dental function and good facial balance. This appliance is almost always used prior to conventional orthodontic appliances.
The rapid palatal expander (RPE) is a fixed appliance which widens the patient’s upper jaw (maxilla). This appliance is used in growing patients to help correct both crowding and cross bites. An upper jaw that is too narrow is one component of your particular orthodontic problem list.
Because you are still growing, the doctor will use an expander to guide your natural growth and widen your upper jaw. This will help create room for your crowded teeth and make sure the upper and lower teeth fit together properly.
With its sleek, aesthetic and non-invasive design, the Motion 3D Class II Correction Appliance provides greater comfort and shortens treatment time by up to four months. This advanced technology appliance delivers a natural, gentle and uniform force for distal molar movement with controlled rotation and tipping correction before brackets or other appliances are placed.
Used at the beginning of treatment when there are no competing forces in the mouth allows the distalization of the molars and premolars from 3 to 6 mm range, on average.
Orthodontic headgear is used for the correction of certain types of orthodontic problems. After the examination and diagnostic records, the orthodontist will determine if the headgear is needed in your case. This appliance creates special forces that guide the growth of the face and jaw. It is also used to move teeth into better positions or to prevent teeth from moving unintentionally.
This appliance is used in cases where the upper teeth or jaw are protruding too far forward. The headgear slows the forward growth of the upper jaw while allowing the lower jaw’s forward growth to continue. It also aids in the backward movement of teeth which have erupted or shifted too far forward.
Wearing a headgear is often the best and only way to achieve the desired results. This is why it is so important to follow the headgear instructions exactly. The more you wear your headgear, the better it works. The short-term sacrifice you make with this appliance will be well worth the healthy, beautiful smile that will be yours for a lifetime.
The Motion 3D Class III Appliance is a minimally invasive appliance intended to treat Class III malocclusions without extractions, painful orthognathic surgery or traditionally uncomfortable and obtrusive facemasks. This appliance is as easy to place as a bracket or buccal tube, and is designed to provide predictable results and create a harmonious, balanced profile, all while preserving the patient’s natural features. Intra-oral elastics connect the appliance with maxillary anchorage to activate the mandibular posterior segment and to move it bodily as a block for an ideal Class I malocclusion. Once the ideal platform is achieved, brackets or aligners are then placed to finish the case.
Facemasks – or reverse-pull headgear – is an orthodontic appliance typically used in growing patients to correct “underbites” (technically termed Class-III orthodontic problems) by pulling forward and assisting the growth of the upper jaw (maxilla). This interceptive measure can help the size of the lower jaw (mandible) to “catch up.”
Facemasks need to be worn approximately eight to 10 hours a day to be truly effective in correcting the underbite – usually anywhere from 10 to 12 months, depending on the severity of the bite and how much a patient is growing. Reverse Pull Headgear therapy is often to growing patients only.
The appliance normally consists of a frame or center bars that are strapped to the patient’s head during a fitting appointment. The frame has a section which is positioned in front of the patient’s mouth, which allows for the attachment of elastic or rubber bands directly into the mouth area. These elastics are then hooked onto the patient’s braces (brackets and bands) or an appliance fitted in his or her mouth. This creates a forward “pulling” force to pull the upper jaw forward.
The first orthodontic examination does not always result in a recommendation for immediate treatment. After evaluating your child, the orthodontist may simply want to check your child periodically while permanent teeth erupt and the jaws and face continue to grow.
This periodic examination, or observation visit, is usually scheduled at six-month intervals. These observation visits are important because the orthodontist can evaluate factors such as growth of the jaws, loss of the primary teeth, eruption of the adult teeth, and the effects of habits such as thumb-sucking, tongue-thrusting and mouth-breathing. These early observation visits allow the orthodontist to determine how and when a child’s particular problems should be treated for optimum improvement and comfort with the least time and expense. As a result, many potential problems can be kept to a minimum and the duration of orthodontic treatment can be greatly reduced.