Orthodontic Appliances at Leland
Let’s explore several treatments we use in our office to correct an improper jaw/bone relationship.
Rapid Palatal Expander (RPE)
We use palatal expanders in patients ages 7-12 when their upper jaw needs to be widened. They are not used in adults because the bones in the upper jaw are fused together, making the expanders ineffective.
To expand a palate, we attach a rapid palatal expander (RPE) to the upper molars, one on the right and one on the left. To activate the expander, you’ll turn a screw joint to widen the expander.
After the final turn of the expander screw, we’ll leave the appliance in place for four to six months to ensure the bone has fully backfilled in the space created.
Timing for maxillary expansion: On average, we can expand the maxilla (the upper jaw bone) any time before age 12. At 12 years old, the mid-palatal suture “fuses,” which means that the gap turns into solid bone.
After this happens, expansion doesn’t work because there is no “weak point” we can use to expand the maxilla.
A facemask is an appliance that is worn outside the mouth, on the face, also known as an “extra-oral appliance.” It attaches to a metal orthodontic appliance fixed inside the mouth to one molar on each side of the upper jaw, similar to an expander.
Timing: TIMING IS EVERYTHING, especially with facemasks! It is extremely important that children visit an orthodontist soon after their seventh birthday.
Many kids do not need treatment at this age, but for those who do, it is critical to be completed before their jaws finish growing!
D2 is a bite correction appliance we use before applying braces. Each D2 arm (right and left) has pads that we’ll glue onto the upper canine tooth and the corresponding upper first molar tooth.
With D2, bite correction is faster and more comfortable, ultimately decreasing your treatment time.
Dr. Leland will glue two braces onto the bottom first molar teeth. You’ll wear elastics from the D2 arm on the upper canine to the brace on the lower first molar, which will correct your bite.
It is incredibly important that you wear a lower clear retainer whenever you wear elastics on the D2 appliance. After your bite is corrected, we’ll remove your D2 appliance and apply braces to continue treatment.
Leland Orthodontics uses MARA appliances in patients ages 7 to 12 when their lower jaw needs to be permanently moved forward. The forward growth of the mandible is the last dimension of jaw growth to finish.
The most effective time to use a MARA is at the beginning of Phase 2, at approximately 11½ years old. Oftentimes, patients who need a MARA also need a palatal expander, and the two can be combined together into one appliance.
We don’t use MARA appliances in adults because the lower jaw is no longer growing, making the MARA ineffective.
The MARA appliance is an intra-oral appliance with two pieces; one attaches to the upper jaw, and one attaches to the lower jaw. The purpose of this appliance is to move a mandible (lower jaw) forward in cases where it is too small or set too far back.
When the patient bites down, the MARA appliance shifts the mandible forward and holds it there for six to nine months, allowing it to grow into the proper position.