Orthodontic Appliances
Retainment Appliances
Retainers
When braces are removed, the patient is often fitted with a special device called a retainer, such as the name implies, retains the proper arch and location of the teeth (which can sometimes shift out of position without a retainer). Retainers should be worn for as a patient want their teeth to remain straight.
Space Maintainer
The space maintainer does just as the name implies; it holds space in the upper or lower jaw.
In cases where baby teeth are lost early, this appliance is used to prevent other teeth from drifting into the spaces needed for permanent teeth yet to come. It may also be used as a retainer after an expansion appliance is removed to maintain the width that was gained during treatment.
The wire rests on the tongue side of the teeth and is connected on both sides to bands that fit around the molars. This appliance is comfortable to wear and easy to brush around.
The space maintainer stays in place until the permanent teeth erupt enough to hold their own space, or until full orthodontic treatment begins.
Active Treatment Appliances
Expander (RPE)
Expansion devices are used in growing patients to increase the width of the upper jaw. A narrow upper jaw often results in crossbite, where upper teeth bite inside of the lower teeth. This can lead to unfavorable growth and uneven tooth wear. Another benefit to widening the upper jaw is that it creates more space allowing for better eruption of the permanent teeth. An expander, anchored to wither the primary or permanent molars, is joined by a turn screw mechanism at the roof of the mouth. The appliance is activated at home, and typically remains in place for 4-6 months.
Addressing Skeletal discrepancy with an expander at the appropriate time can often avoid more dramatic treatment options such as extraction of permanent teeth or surgical correction. Although not as common, extraction may still be the best option for excessive crowding.
Carriere
The Carriere Motion appliance corrects the front to back bite discrepancy and is used prior to braces or Invisalign. Rubber bands, connected between the Carriere and a single bracket on the opposing arch, provide the force necessary to correct the bite coordination. A clear retainer is also worn on the teeth of the opposing jaw to prevent them from shifting as the bite is aligned.
Overall, treatment with the Carriere Motion appliance offers patients an esthetically pleasing, easy to manage option to correct compromised bite. By addressing the bite early in treatment while motivation is high, most patients can expect to achieve the bite correction in 3-5 months, This also allows less time in braces or aligners and decreases the need for full time rubber band wear toward the end of treatment.
Turbos
Used with or without braces, these tiny brackets, commonly referred to as Turbos, are fixed to the tongue side of the two upper teeth. This will provide more “shallow” bite, preventing the lower teeth from impinging the tissue behind the upper front teeth. This will also aid in creating a more appropriate biting relationship. When braces are required to be worn at the same time, Turbos will prevent a patient with a “deep” bite from making contact with the lower braces.
In the beginning, when Turbos are placed, it is normal for only the front teeth to make contact when biting down. Over the next few weeks, the back teeth will begin to touch again while leaving the front teeth in a much-improved biting relationship.
The Turbos may remain on teeth during the course of treatment to help prevent relapse and to stabilize the new tooth position.
