Expansion Appliances
Expansion appliances increase the width of the jaws to broaden the smile and to prevent the extraction of permanent teeth. These appliances work best before all of the permanent teeth erupt.
Before Treatment
After Treatment
Her smile compared to her parents.
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Narrow smile of her father
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This patient was treated with expansion.
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Her mother has a narrow smile.
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Notice the broad smile! |
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| Before Expansion |
After Expansion |
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| Before Expansion |
After Expansion |
Different Types of Expansion Appliances
1. Pendex Appliance with Springs
Upper Pendex Appliance expands the width of the upper jaw and can move the molars back with springs.
A Case Where The Pendulum Appliance Was Used To Correct A Narrow Arch And A Crossbite.
Crossbite And Constricted Arches Before Treatment
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Before Expanding the Upper Arch
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After Expanding The Upper Arch
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2. Basic Upper Expansion Appliance
Upper Expander without springs
3. Expander Used With The Herbst Appliance
4. Pendulum Appliance
This appliance moves the molars back to correct a protrusion and crowding.
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| Inserted in Mouth |
After the Teeth Have Been
Moved Back |
5. Upper and Lower Expanders
Lower Expansion
These appliances expand the lower arch to broaden the smile and in many cases can prevent the extraction of permanent teeth.
1. Lower Fixed Expander
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| Before expansion |
After expansion - Lower arch
width was increase 5 mm. |
2. Lip Bumper
Case treated with the lip bumper
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| Before the lip bumper |
After the lip bumper |
Holding Appliances
Some cases require a Nance to hold the upper arch and upper molars in place and some need a lingual arch to hold the lower molars and lower arch width.
1. Upper Nance Appliance
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| Teeth are held while all of the teeth erupt. |
Front and back teeth are moved back
with braces & elastic chains. |
2. Lower Lingual Arch
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Habit Appliances
Some patients need appliances to help them break harmful habits.
1. Thumb or Finger Appliance
2. Tongue Thrusting Appliance
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| Spurs are used for tongue thrusting. |
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| Example of a tongue thrusting habit. |
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Herbst Appliances
Herbst Appliance To Correct Protrusion
According to a survey of orthodontic laboratories, the Herbst appliance has become the most popular appliance for correcting protrusions. This is due to the orthodontists' desire to find a technique that requires a minimum amount of patient cooperation.
The correction of the protrusion afforded by the Herbst appliance occurs through a combination of skeletal and dental changes brought about by forward positioning of the lower jaw.
The Herbst Appliance
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| Lower Jaw Is Held Forward |
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We have used growth appliances for over twenty years. The first types were removable, and they produced excellent results when the patients wore the appliances. However, many were worn only part-time or were lost because they were removable.
Space Closure Herbst
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| Before |
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| After |
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| Space made with Herbst |
Space closed after treatment |
Removable Appliances
It was difficult to talk with the removable appliances and many appliances were lost.
Removable Frankel Appliance
Great appliance but was not worn well by many patients.
The Herbst has given me an easier and a faster way to correct protrusions. Dr. Rogers has trained hundreds of orthodontists in this technique through lectures and my video. The results that we can achieve are remarkable.
This case was treated with expansion and the Herbst. Notice the improvement in the profile.
Before treatment - notice the constricted dental arches and the severe protrusion.
Profile Improvement
There is an immediate profile improvement when the Herbst Appliance is inserted.
Profile before and after the Herbst
After treatment - notice the attractive smile.
Herbst Appliance with missing lower teeth (Before and After)
Growth Changes With The Herbst
Learn more about the Herbst Appliance by viewing our Herbst Videos.
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Headgear
This is an example of one type of headgear. The headgear is utilized to make space in the upper arch or to let the lower jaw catch up with growth when there is protrusion of the upper teeth.
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Turning your Appliance
The Pendex or Pendulum Appliance
- This appliance moves the molars back to create space for other teeth and/or to correct a protrusion of the upper teeth. This usually avoids the extraction of permanent teeth.
- After the molars are moved back, they will be held by another appliance (a Nance) while the side teeth and front teeth are moved back into the space.
- Food will get caught around the appliance so all patients are encouraged to use a Water Pic. All patients must use fluoride, and we ask that sweets and soft drinks be eliminated because of the hard-to-clean areas.
Expansion Appliances
- Your expander must be turned with a "key". How often you turn the expander will depend on the instructions you receive from Dr. Rogers and Dr. Andrews. Follow them carefully.
- Your expander is turned by placing the "key" into the key hole in the center screw and gently push the key towards the back of the mouth. You will notice a new hole appear in the front when the expander is turned all the way to the back.
- A noticeable effect of the divider is that the front teeth begin to separate. This is a sign that the expander is working properly. The space will begin to close naturally when turning has stopped, but the bone segments stay in place.
- Food will get caught around the expander so all patients are encouraged to use a WaterPik or similar device. All patients must use fluoride, and we ask that sweets and soft drinks be eliminated because of the hard to clean area.
- After the expansion screw has been turned the proper amount, the patient will continue to wear the expander for several months. This allows the mouth to stabilize and insures that the widening will not relapse.
- Never turn your expander more than two times per day.
- Sometimes turning the key of your expander causes slight pain near the bridge of the nose and out toward the cheekbones.
- It will be difficult to talk and swallow at first, but after approximately 10 days you will become accustomed to your expander. Hang in there!
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