Types of Appliances

To successfully complete your orthodontic treatment plan, patients must work together with the orthodontist. The teeth and jaws can only move toward their corrected positions if the patient consistently wears the elastics (rubber bands), headgear, or other appliances as prescribed.

Some of the more common appliances used by Dr. Studebaker are:

Separators (Or Spacers)

Separators are little rubber doughnuts that may be placed between your teeth to push them apart so that orthodontic bands may be placed during your next appointment. Spacers usually stay between your teeth for several days, and they are taken out before your bands are put on. They often cause some soreness, but this goes away in a few days. If a spacer comes out a day or two after its placement, call our office for a replacement. If a spacer comes out a day or two before your regularly scheduled orthodontic visit, it is not necessary to call our office for a replacement. In this situation, a loose spacer means that enough space was created between your back teeth. Please avoid sticky or chewy foods. Also do not floss those teeth that have spacers between them.

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Reverse Pull Headgear (RPHG or Facemask)

Facemask or reverse-pull headgear (RPHG) is an orthodontic appliance typically used in growing patients to correct a skeletal/dental discrepancy when the lower jaw is ahead of the upper one (underbite). RPHG works by pulling forward and assisting the growth of the upper jaw (maxilla), allowing it to catch up to the size of the lower jaw (mandible). The RPHG is usually combined with an maxillary expander that widen the upper jaw, supports the elastic traction of the RPHG, and prevents the loss of anchorage on the maxillary arch . Reverse-pull headgear needs to be worn between 12 to 22 hours per day, but typically 14 to 16 hours a day is effective in correcting the underbite.

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The Forsus appliance works by posturing the patient's lower jaw in a forward position, and over time promotes growth in pubertal adolescents, helping to eliminate excessive overbites, improve the fit of teeth and possibly prevent the need for jaw surgery. The major advantage of this system over headgear or elastics is that it does not rely on patient cooperation. The length of time that the Forsus appliance is worn varies depending on the level of correction needed for each case.

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Herbst® Appliance

This Herbst appliance is used in young patients whose lower teeth and jaw are too far back. This appliance reduces overbite by inhibiting maxillary anterior growth and incrementally advancing the lower jaw to promote natural growth. Depending on the amount of bite correction needed, the Herbst appliance is normally worn for eight to 15 months.

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Rapid Palatal Expander

The RPE (rapid palatal expander) or Hyrax appliance is used to "expand" (widen) a narrow upper jaw. A key is inserted into the appliance and, with a pendulum-type movement, swiveled backward. An in-office demonstration will be provided so that you can properly turn the key at home. Dr. Studebaker will prescribe the desired number and frequency of turns and you should stop turning the appliance after the days indicated. A space may open between the upper two front teeth during the first few weeks as the appliance widens the upper arch. The space will disappear in the following weeks once the turning has stopped and braces are placed. This appliance typically stays in place six to 12 months after desired expansion is achieved to avoid relapses on the expansion achieved.

RPE Usage

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Quad Helix Appliance

The Quad Helix appliance is a fixed, spring-loaded orthodontic appliance using four helix springs used to widen your jaws and allow more room for the teeth to erupt into the mouth. The Helix is activated prior to cementation and will be adjusted as necessary throughout your treatment. The expander is generally worn for several months.

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Lingual Arch

The lingual arch is a wire that connects your molars. This appliance is glued to your molars and is not removable. The purpose of the lingual arch is to hold back your upper or lower first permanent molars and prevent them from moving forward. The lingual arch can also be used as a source of anchorage in Class II treatment cases or in extraction cases to prevent molars from moving forward while closing extraction spaces.

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Nance Holding Arch

The Nance holding arch consists of two bands around the back teeth and an acrylic button that covers part of your anterior palate. The Nance button can be used as a space maintainer, in cases in which baby teeth have been lost prematurely, and the first molars need to be prevented from coming forward. The Nance holding arch is also used for additional support to help drive back the anterior teeth. This appliance causes little discomfort and has little effect on the speech.

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The pendulum-expander (Pendex) appliance is a fixed active appliance that is designed to both widen the upper jaw and move the molars in a backwards direction. This typically serves to correct both crowding, and in some cases, flaring of the front teeth. The Pendex appliance is initially “turned” once per day for a period of approximately three to four weeks. Depending on the severity of the problem, Dr. Studebaker may increase or decrease the number of turns. After the palatal expansion is complete, an additional adjustment(s) is made by Dr. Studebaker. This adjustment (or activation) will begin to move the molars in a backward or posterior direction.

The Pendex appliance is typically left in place for approximately six months and, upon its removal, a fixed retainer-type appliance (called a Nance) is delivered to maintain the correction. Depending on the age of the patient, and the presence of permanent teeth, braces can be used in conjunction with this appliance.

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Elastics (Rubber Bands)

Wearing elastics (rubber bands) improves the fit of your upper and lower teeth. Wear rubber bands as instructed because the rubber bands work far more efficiently if they are worn as prescribed.

Class II Elastics

Class III Elastics

Triangle Elastics

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Carriere Distalizer

The Carriere Distalizer is a passive appliance that attaches only to the canine and first permanent molar. This appliance provides a non-extraction method to correct Class II maloclusions.  A lingual arch is used as anchorage for the Carriere Distalizer. Class II elastics are worn to activate this appliance.  Dr. Studebaker typically uses the Carriere Distalizer at the beginning of orthodontic treatment. Once the class II correction is achieved, treatment can then be continued with use of traditional braces or clear removable appliance therapy (such as Invisalign).

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Positioners complete the final tooth movements in your orthodontic treatment. With your full cooperation, you should only need to wear the positioner appliance for four to eight weeks.

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Retainers may be removable or fixed. They hold your teeth in their new, correct positions after your teeth have been straightened. Your orthodontist will instruct you on how to care for your retainer and about the duration of the wear. Wearing your retainer as directed is crucial to prevent regression of your treatment.Click here for more information on how to care for your retainer.

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