In younger patients with a lot of crowding, due to either small/narrow dental arches or premature loss of teeth, early development and expansion of these arches, and space maintenance for erupting teeth, can help to avoid potential future extraction of permanent teeth, and facilitate a stable orthodontic correction. Below are some appliances that we use to help address crowding issues in our patients.
The removable expander is a functional appliance used to expand the upper dental arch by stimulating bone growth in the midpalatal suture. It is a full coverage (covers the teeth and palate) acrylic appliance with an expansion screw inserted in the middle to facilitate opening of the appliance. The screw is opened, as instructed by Dr. Moshiri, until the palate has been widened to an adequate amount. The appliance is then worn, without activation, for a period of roughly four months as a retainer to facilitate proper healing and retention of the new bone width. Download our Removable Expander handout for more information.
Removable Expanders demonstration video.
A fixed expander is a functional appliance used to widen the upper dental arch by stimulating growth of the midpalatal suture. It is attached to the teeth via solder joints to bands, along with attachments to an expansion screw inserted in the middle to facilitate opening of the appliance. The screw is opened, as instructed by Dr. Moshiri, until the palate has been widened to an adequate amount. The appliance is then worn, without activation, for a period of several months as a retainer to facilitate proper healing and retention of the new width. Download our Fixed Expander handout for more information.
Transpalatal Bar (TPA)
The Transpalatal Bar (TPA) is a fixed appliance that is attached to bands on the upper molar teeth. The bar that sits across the roof of the palate fits into a soldered clip located on the bands. When making scheduled orthodontic visits, Dr. Moshiri is able to remove the TPA from the bands to make necessary adjustments.
The TPA is used as a space maintainer if primary (baby) teeth are lost too soon, or to move the molar teeth when wires cannot provide sufficient force to accomplish the required movement. Once adjusted in the office, the TPA may cause pressure to the teeth being moved, but will subside soon after the adjustment. Download our Transpalatal Bar handout for more information.
The lip bumper is a removable appliance, used in developing children, to create and hold space for erupting crowed teeth. The appliance is used in the attempt to avoid the extraction of adult teeth at a later age. The lip bumper works by both using and eliminating some of the natural forces of the soft tissues within the mouth.
Pressure from the lower lip pushes against the front acrylic shield pushes back on the lower molars gently, creating space for erupting teeth in front. By keeping pressure away from the lower teeth at the same time, the tongue pressure gradually moves the front teeth forward to “unravel” crowding. The appliance is usually worn 12 to 18 months, although this will vary according to the severity of crowding and each child’s rate of growth. Download our Lip Bumper handout for more information.