Expansion plate for the lower / upper jaw 

Expansion plate for the upper jaw...

...and the lower jaw

In our practice, we use the expansion plate if the lower jaw is too narrow. It shows as a lack of space between the permanent front teeth. By turning the screw once a week from one stop to the other in the direction of the arrow (see picture), the lower jaw will broaden within a few months and, in many cases, the later extraction of permanent teeth can be avoided.

 The Bionator 

The Bionator

The Bionator

The Bionator is a so-called bimaxillary device, which means it consists of one plastic body for both lower and upper jaw. In the upper jaw, the plastic is skeletonised heavily, leaving plenty of room for the tongue.

We use the bionator as a retaining device, to be worn at night during mixed dentition, and after achieving successful growth stimulus using the Herbst appliance i.e. FMA (see above).

The advantage of this device is that the plastic components can be grind down, to control the erupture of the permanent teeth. Due to its relatively elegant appearance, patients take to it very well.

 The Twin Block 

The Twin-Block

The Twin-Block

The Twin Block consists of an upper and lower jaw component. Fixed to them are slanting pieces of plastic that hold the lower jaw in a more forward position to what the patient is used to normally.

We only use the Twin Block when the lower jaw is a fraction too far back and has to be moved forward during growth, and if a very good patient cooperation is given.
Initially, biting is strained because the position of the jaw is unfamiliar.

The device has to be worn at all times, even during sports or at school.

Clean the Twin Block after every meal, preferably with a nailbrush with plastic bristles and soap. For a better taste, you can bathe the Twin Block in a Meridol solution.

 The Facemask 

If there is an overgrowth in the lower jaw (”mesial bite” or “underbite”), we initially use extra-oral braces, or the so-called facemask.
The facemask is our sole extra-oral brace and you only have to wear it at home.
The Facemask is still the most effective device for the difficult therapy of treating an underbite. With the aid of elastic pulleys, it exerts a forward pull on the upper jaw, which stimulates its growth. At the same time, the pushing force on the chin contains the growth of the lower jaw. In that way a rapid alignment in the jaws can be attained.
The facemask can be particularly effective if the base of the upper jaw was widened through RPE (also see “RPE”) beforehand, thus pre-mobilising the upper jaw parts. (Götz, 2000).

Before therapy

After correcting the mesial bite

To treat a mesial bite successfully, it is crucial to start treatment at an early stage (also see “early treatment”) and have full patient cooperation.

 Functional Frankel III regulator 

Functional Frankel III regulator

With the functional Frankel III regulator (short “Frankel III”) the plastic components lie in the cheek region. Intricate wires are positioned in the palate region, leaving enough space for the tongue not to impede on speech. An archwire is closely set against the front teeth of the lower jaw containing its growth. Acrylic plates in the upper jaw hold the soft tissue of the cheeks and lips in place and stimulate growth in the upper jaw.
We use the Frankel III after treating a mesial bite with a facemask. It can bring about additional growth to attain an optimisation in the jaw position toward one another. Frankel III also requires good patient cooperation.