We use the “Empower” bracket which is a self-ligating bracket manufactured by “American Orthodontics”, a company that prides itself in selling only “Made in the U.S.A.” products.
The top front braces can be the almost invisible ceramic brackets or metal brackets. Dr. Griffies only uses metal on the bottom teeth because ceramic brackets have the potential to cause wear to the top teeth if they rub together.
Take a look at the brochures to understand the advantage of using a “self-ligating” bracket for your orthodontic treatment.
Lower Lingual Arch
The lower lingual arch is used both as a Space Maintainer in young patients without all of their permanent teeth and an “anchorage” appliances in patients with full braces.
This patient presents with upper spacing and minimal overlap of the upper and lower front teeth.
In the upper arch the second premolar teeth are blocked from the arch and require removal.
From the side the back molars occlude in a good Class I relationship (we want them to stay just like this). In order to obtain a good bite the lower front teeth need to be moved back under the upper front teeth. With removal of one tooth on either side the canine teeth will be moved into the place of the first premolar and the lower front teeth brought back.
To keep the lower molars from moving forward we use a Lingual Arch to anchor as anchorage.
Space Maintenance using the Lower Lingual Arch
This patient is missing two lower baby teeth and we are awaiting the eruption of the two permanent premolars. The lower left back molar will have a tendency to move forward and block the eruption of the premolars. The Lingual arch will maintain the space and prevent movement of the molar forward.
Approximately 5 months later the two permanent premolars have erupted into place.
Nance Holding Arch
The Nance Holding Arch is used both as a Space Maintainer in young patients without all of their permanent teeth and an “anchorage” appliances in patients with full braces.
This patient presents with protrusion of her upper front teeth.
The upper canine is forward of where it should be so an upper first premolar is removed and the canine brought back into position.
This shows the Nance in place with a space available after removal of the tooth. The blue on the back molars is the “bite plate” which helps prevent the top teeth from hitting the bottom brackets and also opens the bite slightly to allow easier movement of the canine tooth.
Here an elastomeric chain (power chain) is used to slowly pull the canine back.
Finished treatment with all spaces closed and the canine in its proper position.
Space Maintenance using the Nance Holding Arch
This patient is missing two upper right baby teeth and we are awaiting the eruption of the two permanent premolars. The upper right back molar will have a tendency to move forward and block the eruption of the premolars. The Nance Holding arch will maintain the space and prevent movement of the molar forward.
Approximately 5 months later the two permanent premolars and the upper left premolar have erupted into place.
The Palatal Expander is used to increase the width of the upper jaw to correct cross bites and expand a narrow jaw to the correct width.
Expansion of the palatal expansion is accomplished using a small “key” to turn the middle jackscrew of the expander.
This patient has both crowding and a narrow upper jaw.
The upper teeth on the right are position to the inside of the lower teeth. This is called a posterior cross bite.
The palatal expander is cemented into place and expansion started.
Finished photo showing correction of both the crowding and right cross bite.
Finished photo showing correction of the right cross bite.
The transpalatal bar fits on the roof of the mouth and anchors the molars in place while the remaining teeth are moved with braces. The transpalatal bar can also be used to move the molars either to expand or turn.
This patient presents with a gap between the upper front teeth and overexpansion of the back teeth.
A transpalatal bar was placed and slowly constricted to correct the overexpansion of the back teeth.
A lower wire bonded to the inside of the lower front teeth maintains their position.
An upper wire bonded to the inside of the upper front teeth maintains their position. Dr. Griffies recommends maintaining both the upper and lower retainers for a minimal of one year. They however can be maintained for longer periods to insure retention of the correction.
Clear plastic retainers are also worn for the first year after treatment and then weekly there after. Unfortunately teeth will continue to shift as we age and the best way to prevent movement is to use a retainer periodically to insure shifting is kept to a minimum.