Standard Twin Block to Open Bite (Class II Division I)
The Standard Twin Block is a removable functional appliance consisting of two (twin) bite blocks (upper and lower) that are designed to interlock at 70 degrees in such a manner that the mandible is held in a more protrusive position. Over time, the repositioning of the mandible forward eliminates the overjet. When acrylic is removed from the upper block, eruption of the lower first molars occurs -- thus eliminating the overbite. When treatment with the Twin Block is complete, the first molars will be in contact and the maxillary and mandibular incisors will be nicely coupled. In the mixed dentition, the lower molars will usually erupt passively. In the permanent dentition, the lower molars often need to be erupted actively (with vertical elastics). To ensure that the patient does not end up with a dual bite, the appliance must be worn a minimum of 7 to 9 months. When the patient’s bite is stable, retrusion of the mandible should not be possible without causing patient discomfort. Once the first treatment phase is completed and the case is at the desired vertical and AP position, it is necessary to place a Phase 2 or “Support Appliance.”
The Standard Twin Block has an upper block that covers the second primary molar or bicuspid, first molar and second molar. The lower block covers the first primary molar and two thirds of the second primary molar. It is vital to the success of the Twin Block treatment that the lower block be held ahead of the upper block at all times. To accomplish this, the blocks must be at least 5 to 6 mm thick. If they are not, adjusting them (to allow for the eruption of the lower first molars) will destroy the interlocking effect of the two blocks. Appliance retention is also critical to the success of this appliance. If you do not have first primary molars that are going to be present for 7 to 9 months --or first bicuspids that are sufficiently erupted -- it is better to choose another appliance...or delay treatment until the first bicuspids have erupted and adequate retention is available. Note: The expansion screw added to this design can be used at the same time to initiate lateral arch development.
Chan LVI Neuromuscular Orthotic L
This neuromuscular orthotic is an anatomical mandibular appliance designed to orthopedically realign the mandible to the cranium, stabilizing the temporomandibular joints in six dimensions. This relationship is determined and acquired by the use of ultra low frequency TENS. Diagnostic tests are further used to design and construct this appliance by use of accurate and objective data gathered through the use of Myotronic K6-I/K7 instrumentation using computerized mandibular scanning (CMS) and electromyography (EMG) which confirms physiologic resting musculature and mandibular trajectory in harmony with the TM Joints. A reinforcing lingual wire has been placed along with 6 interproximal ball clasps for added retention. On delivery of this appliance, detailed micro-occlusion (coronoplasty) and fine proprioceptive refinement is required with TENS to establish a simultaneous terminal contact free of any interferences at the myocentric position.
Spahl Split Vertical
The Spahl Split Vertical Appliance is very effective at closing posterior open bites -- after the mandible has been properly and thoroughly advanced by a functional appliance (such as a Bionator, an Orthopedic Corrector, the Clark Twin Block, the Levandoski Mandibular Stabilization Appliance, etc.). The Spahl Split Vertical consists of separate upper and lower devices.
The upper has a simple bite plane that is designed to hold the arches at the ideal vertical relationship. This bite plane is placed on a lingual wire attached to the first molar bands via a vertical removable bracket assembly. Because the upper is to be worn 24 hours per day, the bite plane should be kept to a minimum (to allow for comfort and ease of speech).
The lower is a wire-bodied appliance composed of an anterior bite block that covers the four lower anteriors and a pair of posterior bite blocks which cover the last molar on each side of the arch. Bonded hooks, buttons, or brackets are placed on the upper and lower cuspids, bicuspids, and first molars. When the lower appliance is in place, vertical elastics are used to initiate eruption of these teeth. By wearing this device a minimum of 12 hours a day (evenings and during sleep) eruption will occur much faster than it could through passive eruption alone.
MORA/Gelb with Anatomical Occlusion L
The general design of this appliance is similar to the #6203 MORA appliance with one important difference. Through use of a Verticulator and a very precise wax construction bite that alters the patient’s mandibular position, the occlusal surface is finished with a very precise anatomical cusp/fossa contour. The anatomical occlusal finish allows the patient to function normally at the new position. This device is to be worn at all times, even while eating. If desired, the anteriors can also be covered with acrylic.
Keeps the airway open by holding the jaw and tongue in a comfortable forward position while triggering a slight tightening of the soft tissues and muscles of the upper airway, especially the soft palate. FDA-cleared for Snoring and OSA, the Sleep Well Appliance is ideal for use in bruxing cases. It allows up to 9mm of AP advancement and maintains constant protrusiveness via the patented Protrusive Element (PE) inserts. Simple, non-threatening design and easy-to-clean, easy-to-adjust convenience yield high patient compliance.
Narval™ CC is a CAD/CAM custom-made mandibular repositioning device (MRD) -- ideal for patients with mild-to-moderate obstructive sleep apnea (OSA) and those unable to comply with continuous positive airway pressure (CPAP) treatment. It is also a first line treatment for snoring in the absence of OSA. Unique CAD/CAM technology ensures a high degree of customization for individual patients –precise fit, comfortable retention, and optimal results. Patented physiological articulation ensures maximum proximity to the occlusal plane and strong, flexible connecting rods are easy to change, permitting simple titration and adjustment in a 15mm protrusive range (-1mm increments) as treatment progresses.