Gary R. Wolf, D.D.S., M.S.D.

Types of Appliances

  

Bonded rapid maxillary expander

This appliance is used to widen (expand) a narrow upper jaw. The plastic over the surfaces of the back teeth provide excellent control of vertical upper jaw growth in patients that have anterior open bites. Hooks can be added for protraction and correction of developing Class III malocclusions (underbites).


Frankel appliance

This appliance is a removable functional appliance. These appliances are of European origin that have been clinically proven to correct skeletal (jaw related) problems associated with smaller or deficient size of the lower jaw (mandible). This appliance is typically used in the mixed dentition and may be in place for 12 to 15 months to be effective. It is worn all the time except for activities, eating and brushing.


Anterior tongue crib

This appliance is often used when there is an anterior tongue thrust or in some cases where a persistent digit (thumb sucking or finger sucking) habit persists. It is generally fixed to the teeth and provides a physical barrier to keep the tongue from posturing between the anterior teeth or as a reminder to keep the thumb or finger out of the mouth.


Nance space maintainer (upper) and mandibular (lower) holding arch

These appliances are space maintaining appliances used in the upper (maxillary) and lower (mandibular) arches. They are fixed to the permanent first molars with the purpose of maintaining space during the transitional tooth stage. They are very effective appliances to be used when there is early loss of the second deciduous molars or in cases where maintaining some space posteriorly will allow moderate crowding to be corrected non-extraction.


Twin Block

This appliance is a removable functional appliance used to correct moderate to severe lower jaw deficiencies (mandibular retrognathia). It is the newest of the removable functional appliances having been developed in the early 1990s. It has been proven effective by scores of clinical studies as an orthopedic appliance. Its advantage over some of the other removable functional appliances is that speech and function are less affected because of the independent upper and lower components.


Retainers

These appliances are very important and need to be worn at the completion of orthodontic treatment. Studies clearly show that teeth will continue to shift throughout life with or without the presence of wisdom teeth. Consequently after a period of full time wear these appliances are worn on a night time basis indefinitely.


Schwarz expander

This appliance is used to upright mandibular posterior (lower back) teeth that have tipped lingually due to a very constricted upper jaw (maxilla). Once the teeth are uprighted, the maxilla can be widened (expanded) more effectively and an improved functional relationship achieved.


Pendex appliance

This appliance is a type of palatal expanders that has the additional benefit of moving the upper back teeth distally to correct a Class II posterior occlusion. This can also create additional arch length to correct moderate crowding. In either case, the removal of maxillary teeth has been avoided in many cases where extractions were necessary in the past.


Elastics or Rubber bands

This auxiliary is often used to correct many problems involving tooth movement. It can be used in many different configurations. They are typically worn full time to be effective since less than hundred percent wear has been clinically shown to be ineffective.


MARA appliance (Mandibular Anterior Repositioning Appliance)

This appliance belongs to the category called fixed functional appliances. Although they have been reported in the literature for many years, they have shown increasing popularity because they eliminate some of the cooperation problems associated with the removable functional appliances. They are often in the mouth for 12 to 15 months on a 24/7 basis. Maxillary expansion can often be accomplished at the same time. This appliance works by advancement elbows keeping mandible postured forward on a continual basis.


Anterior Bite Plane

This appliance is often used either by itself or in combination with full fixed braces to help correct excessive vertical overbites (deep bites). It works by keeping the posterior teeth apart from the plastic (acrylic) anteriorly behind the maxillary incisors. It is typically worn for about six months with full fixed appliances, allowing much faster correction of the deep bite.


Reverse pull (protraction) headgear

This appliance is generally used in the mixed dentition between the ages of 7 and 9 to provide a protraction (forward) force to the maxilla to correct an “underbite” or Class III malocclusion. The appliance attaches to an expander that is bonded to the upper arch. It has been shown to be the only effective orthopedic treatment for correcting developing underbites.


Posterior bite block

This appliance is one of the most effective functional appliances to help correct an “open bite” or lack of overlap of the front teeth. It is worn full time to inhibit the upper jaw (maxilla) from growing vertically, correcting the open bite in a very stable manner.


Headgear (or night brace)

This is one of the most widely used and probably the most clinically proven orthopedic appliance used in an orthopedic practice. It effectively corrects Class II skeletal disharmonies (overbites) by restraining normal maxillary (upper jaw) growth, allowing mandibular growth to be more forward, thereby reducing the Class II discrepancy. There are several variations that are used, depending on the direction and amount of force needed.


Herbst appliance

This appliance is a fixed functional appliance, similar to the MARA (mandibular anterior repositioning appliance) except that that the mandible is postured forward on a 24/7 basis by a tube and rod assembly. Expansion is also commonly done during the anterior mandibular growth modification. It has been clinically proven to be effective since its initial use in the 1960’s.


Fixed brackets, bonds or “braces”

The majority of our patients still get these appliances even if they have had a preliminary phase with a functional appliance, expander or space management appliance. Regardless of what they look like (twin, Damon or clear) they are simply handles on the teeth and they only move teeth. They have no orthopedic or skeletal effect. The wires and elastics are used to manage and fine tune their positions.