ABC of braces - Dr. Banach
Praxis für Kieferothopädie für Kinder nd Erwachsene in Königstein und Frankfurt.
Praxis Dr. Banach, Königstein, Kieferothopädie, Kieferorthopäde, Kinder und Erwachsene
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ABC OF BRACES

A

Active plate

In lower jaw

A removable expansion plate is used when the jaw is too narrow. This becomes evident by a lack of space between the permanent front teeth.

By turning the screw once a week from one stop to the next 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.

In upper jaw

In the upper jaw we only use the expansion plate as a retaining device after the RPE (see “RPE”) appliance has broadened the upper jaw. The expansion plate has to be worn permanently and should only be removed when eating or cleaning one’s teeth. Initially the sound of speech alters slightly, but this will pass quickly. It is advisable to talk a lot when wearing the expansion plate – for example, reading aloud is a good exercise. The expansion plate is brushed after every meal. The best way to clean it is to use soap and a sturdy nailbrush with plastic bristles. For a better taste, the expansion plate can be soaked in a mouth wash solution from time to time.
Generally, the expansion plate is a relatively pleasant device to wear and patients take to it well. Nevertheless, should anything cause discomfort after its insertion, please contact us immediately.

As retainer

In order keep treatment results stable, it is necessary to continue wearing a “stabilizing appliance”. Alongside positioners and stabilizing wires, so called retainers are used.

In our practice you have the option to insert a Thera Mon® chip into all removable upper jaw braces – like retainers. The chip records and documents the exact duration (time) the removable brace has been worn for. This increases the motivation, especially for children, for whom the wearing of removable braces demands a high degree of discipline.

» Youtube-Video

Anchor pins

Derotation of strongly twisted teeth

Closing the gap after extraction of upper first large molars

Teeth too far out are moved inwards

Closing the gap in a case of agenesis in small lower molars

Anchor pins are tiny titanium screws that are inserted into the jaw bone. First and foremost, they serve as anchoring points for fixed orthodontic tools in the mouth. Particularly when individual teeth have to be moved, or when conventional anchorage is not possible.

 

and enable a fast and precise treatment with less undesired side-effects than the conventional treatment.

 

They are connected to the fixed braces by springs, elastic chains or wire. Forces involved are transferred to the bone instead of the neighbouring teeth.

Aqualizer

The Aquilizer is a pre-fabricated splint. It gives immediate relief to tension headaches and is suitable for most patients. The appliance is very simple but very effective. The Aquilizer also quickly releases any muscular tension triggered by clenching or grinding the teeth.

Based on the basic hydrostatic principle, this fast-splint automatically adapts to the physiological conditions of the patient. Today the Aquilizer is used in numerous medical fields, dentistry, physiotherapy and osteopathy for the treatment of CMD (craniomandibular dysfunction = jaw joint disorder).

Aquasplint

 

CMD (craniomandibular dysfunction = defective regulation of the chewing muscles or functioning of the jaw joints) can have many causes, the weighting of individual factors is still uncertain. Those affected experience pain in the chewing muscles, in the area of the ears and/or the jaw joint. Accompanying symptoms can be jaw pain, toothache, earache, as well as headaches and facial pains. An increased grinding of the teeth (bruxism) can also occur. Malocclusion (teeth misalignment) is not always the main cause – psychological factors, stress, trauma, but also weaknesses in connective tissue, as well as HWS-syndrome and hormonal factors (individually or in combination) often play an important part.

The newly-invented water splint (aqua splint) enables a fast and simple differential diagnostic of CMD and offers a straightforward and effective therapy. Aqua splint is the only self-adjusting, individually pre-fabricated splint that can be inserted immediately – without preparations, impressions, or registrations. The instant help/relief offered without laboratory procedures or adjustments has shown excellent clinical results, as well as doctor and patient satisfaction.

» Youtube-Video

Arch wires

Arch wires serve as connecting elements i.e. rails, along which the teeth can be moved. They are regularly changed during treatment, and each change brings the treatment target – the perfect alignment of teeth – one step closer.

Arch wires are available in various materials and have different strengths and traverse sections (round/square). Depending on the goal and treatment phases these are used accordingly.

B

Bands

Bands are metal rings placed around the thick molars for the attachment of orthodontic treatment devices, e.g. the Bio Bite Corrector, transpalatal and lingual arch, transversal developer and Quadhelix.

BBC (Bio Bite Corrector)

Initial situation

After inserting the Bio Bite Corrector

The Bio Bite Corrector (BBC) is a patented appliance. It is used for patients to rectify a receding lower jaw or to improve tooth alignment. With the use of the BBC the removal of permanent dentition, treatment with an outside brace, the wearing of rubber bands and jaw surgery can all be avoided. The BBC serves as an anchor appliance to close gaps in the lower jaw.

It is a passive rigid appliance that works 24 hours a day and is therefore very successful.
The Bio Bite Corrector is entirely manufactured of titanium and laser welded. Fixing screws and spacers are manufactured of titanium as well.

This technique allows sufficient mouth opening with high wearing comfort. The ball joints in the upper and lower jaw allow lateral movements and improve wearing comfort. The Bio Bite Corrector is hardly visible from the outside.

» Youtube-Video




Beneslider

Beneslider is a good “non-compliance“ alternative to the Carrière distalizer. “Non-compliance” means that treatment success does not rely on the patient’s cooperation.

Two mini-implants (see “anchor pins“) are inserted into the palate as anchor points. In our practice this is done under local anaesthetic. The procedure is minimally invasive and mostly painless. Due to the particular suitability of the palate to absorb these small titanium screws, one merely experiences a light pressure sensation, which will disappear after a few days.

Using an impression of your palate, the Beneslider is custom-made in our laboratory and firmly bonded to the teeth.

For improved wearing comfort and to facilitate oral hygiene, we further improved the appliance in our practice by replacing the metal ring placed around the tooth with a wearer-friendly sliding ring glued in from the inside. This makes the appliance completely invisible and speaking, as well as all other functions of the oral cavity are no longer restricted.

The Beneslider works 24 hours a day and the teeth are continuously moved backwards via the mounted screws. This creates room in the front dental arch for e.g. blocked-out canines. Within a short space of time, the success of the treatment becomes visible as gaps start to form.

Once the teeth are distalised sufficiently (moved backwards), the whole appliance including the mini-implants can be removed.

The appliance can be singularly activated or combined with brackets.

The Beneslider also works particularly well when teeth have to be moved forward, e.g. when front teeth or a molar is missing, or in case of progenia (underbite).

» Youtube-Video

Bionator

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

We use the bionator as a retaining device to be worn at night time during mixed dentition, and after achieving successful growth stimulus using the Herbst appliance i.e. FMA.
The advantage of this device is that the plastic components can be abraded, to control the eruption of permanent teeth. Due to its relatively elegant appearance, patients take to it well.

Brackets

2D on model

DQ clear on model

DQ

Ice Brackets

Brackets are attachment elements commonly used in orthodontics on fixed appliances (braces). A special gluing technique bonds them to the tooth surface to form the starting point for moving teeth in fixed appliances.

What typifies a bracket is the fixture for receiving the arches, the so-called slot. The slot is a horizontally positioned slit, which is restricted above and below by the tips of a wing that serves as an anchor point for the arch with the aid of elastics bands (ligatures). The standard bracket contains two wings and is therefore described as a twin bracket. Occasionally one uses brackets with only one wing, these are called single brackets. Brackets are distinguished by the shape of their slot and can be classified as edgewise-bracket (arch is attached with ligatures), light-wire-bracket (arch is attached with pins) and self-legating brackets (the bracket itself supports the arch without ligatures). Additionally, brackets can be distinguished by where they are attached to the tooth. If they are attached to the outside towards the cheek, they are referred to as buccal-brackets. If they are attached to the inside towards the tongue, they are referred to as lingual-brackets.

The standard bracket is made of stainless steel. Both the metallic colour and the alloy containing nickel particles have led to the use of other materials. Today, alongside stainless steel, brackets are made of gold, ceramics, composite and titanium. Due to the higher purchase price of these brackets, patients usually have to pay the additional costs.

An important quality – which is a decisive factor in the choice of bracket and arch material – is friction. For many treatment concepts, the bracket should slide over the arch (sliding mechanism). Both the combination between bracket and arch materials, as well as the type of ligatures can increase or decrease friction.

Non-professional gluing techniques and bad oral hygiene, while the brackets are bonded to the teeth, can also result in permanent decalcification stains on the tooth surface.

C

Carrière Distalizer

Before othodontic treatment

Directly after inserting the Carrière distalizers

The success of treatment can be seen in the gap formation. The gaps can then be used for correcting the alignment of the canines.

End of treatment

The Carrière distalizer is a very refined appliance attached to the lateral tooth area that does not require any additional brackets. There is no aesthetic infringement and cleaning one’s teeth is easy. It comprises a pin with a hook for the elastic springs at one end and a three dimensional joint at the other.

The first large molar is moved backwards via the joint, creating space in the dental arch. Treatment proceeds without having to extract teeth, thus avoiding the negative impact this usually has on the facial profile.

Using the latest MIM technology, the distaliser is made from a mould-injected nickel-free steel alloy. The Carrière distaliser is a passive device that is activated only by applying the elastic pulleys that the patients change themselves.

In most cases, we use the Carrière distaliser at the beginning of an orthodontic treatment. Successful treatment often becomes visible as early as three to six months. Due to the simultaneous movement of the four lateral teeth (together), the treatment period shortens by half, when compared to alternative treatment methods (braces attached to the outside of the teeth or other distalizing appliances). Dipping teeth or other undesirable side-effects do not occur.

CS2000 spring

This spring connects the upper jaw to the lower jaw and alters the position of both in relation to one another. It can be used to move the jaws forward or backward. The spring replaces the conventional elastic ties and is a fixed device and thus “non-compliant” – the success of treatment does not depend on the patient’s cooperation.

D

Damon System

The Damon system works with self-ligating brackets.  Self-legating means that the arch wire is held by the bracket itself. This makes the normal attachments between bracket and arch wire (e.g. elastic ties or loops) redundant.
Its advantages are that they are easy to clean and offer maximal wearing comfort. There is also a clear version available, making the brackets virtually invisible. Its edges are smooth and the material is resistant to discolouring. 
The system goes far beyond a pure bracket and includes a whole treatment system, which aims to avoid any tooth extractions.

The system is easy to manage and practice appointments require less time. During the course of the treatment far fewer arch wire changes are necessary, which generally leads to considerably shorter treatment times.

Expansion plate for upper and lower jaw.

A colour for every taste: apple green

Cherry red

A removable expansion plate is used when the jaw is too narrow. This becomes evident by a lack of space between the permanent front teeth.

E

One-piece functional positioner


Retainer braces made of silicon to hold the newly defined relationship of the jaws in place. As a rule, the EFP must only be worn at night; however, it is a long term measure.

Elastics

Elastics are available in all colours…

… and shapes. Here: “Kitty“

Elastics are small rubber rings attached to the brackets. They generate the forces that move the teeth by normally making one group of teeth “work” against the other. Whenever brackets are used, elastics are also used.

F

Facemask


If there is an overgrowth in the lower jaw or a negative overjet in the upper jaw, we use extra-oral braces. Often the upper jaw is initially widened through RPE (also see “RPE”) before using the facemask to arrest the lower jaw and pull the upper jaw into position. In that way a rapid alignment in the jaws can be attained.

Fixed tongue crib

During the therapy (patient is still wearing the tongue crib)

– the bite is closing.

The mixed dentition of some children shows that during normal development, child-like swallowing habits (the tongue presses in-between the front teeth) persist and do not transform into adult swallowing habits (the tongue rests on the palate behind the front teeth during the swallowing process). If the child-like swallowing habits continue beyond the fourth year, the wrong positioning of the tongue can lead to tooth and jaw misalignments. This can lead the development of an open bite.

In our therapy to treat an open bite and change the swallowing habit, we use a fixed tongue crib appliance. The device is bonded to the two first large molars. This ensures that the tongue crib works 24 hours a day, and even during periods of unconscious swallowing.

Generally, the fixed tongue crib is very well accepted by the patient (Proffit, 1993). If your child is undergoing speech therapy at the same time, it is advisable to coordinate the therapy with the relevant pathologist.

Forsus

Side view

Front view

The Forsus appliance is a pressure spring, which is attached to the regular brace. It serves to correct a retraction of the lower jaw.

The appliance is attached to the upper and lower part of fixed braces. The teeth of the upper and lower jaw are then automatically pushed against one another until the misalignment of the bite is regulated. Forsus appliances are comfortable to wear; they do not impede speech and are hardly visible from the outside. Due to the continuous 24 hour effectiveness, Forsus appliances generally lead to fairly fast treatment results.

Functional Mandibular Advancer (FMA)

Front view

Side view

FMA upper jaw

FMA lower jaw

In terms of effectiveness, the Functional Mandibular Advancer (short FMA) is equal to the Herbst appliance. Both devices stimulate maximum growth in the lower jaw in a short space of time. The FMA constitutes two components that are attached in the upper and lower jaw with special glue. The glue releases fluoride and strengthens the tooth at the same time. A sloping level attaches to the lower jaw component, while a guiding element connects to the upper jaw component. The interaction of the two elements guides the lower jaw forward into the desired position.

The advantage of the FMA is that there are fewer components attached to the anchor teeth. Since the appliance is almost invisible from the outside, it meets the highest aesthetic demands.

Immediately after inserting the application, the muscles have to adapt to the new lower jaw position. Muscle ache and tension may occur temporarily. After a few days, the patient gets used to the new bite situation.

It takes six to nine months before the lower jaw has stabilised in its target position and the FMA can be removed.

Functional regulator II and III by Frankel (H)

The functional regulator is a removable functional orthodontic device named after Rolf Fränkel that is used for the treatment of growth and positioning anomalies in both jaws. 
Broad plastic surfaces in the cheek and lip region (oral vestibule) create a pulling tension in the muscles during activity. The pressure on the soft palate exerts a pull on the saliva and the skin of the bones below, which then stimulates desired bone growth.
To treat the various misalignments, Fränkel developed different devices. The functional regulators of the types I and II are mainly used for addressing problems with retracting lower jaws. The type III functional regulator is a classic device in functional orthodontics. It is used when growth in the lower jaw surpasses that of the upper jaw. This deviation is called progenia. The causes can be found in both lower and upper jaw. Therefore the functional regulator stretches across both jaws and includes a cheek and lip shield. These stimulate growth in the upper jaw, while a tight fit in the lower jaw seeks to reduce growth. 
 
Functional regulators have a physiological effect. Treatment with a functional regulator often takes longer than purely mechanical devices, because it relies on natural growth. The effect on the skull bone, however, creates much less tension on the bony structures. Results are guaranteed to be more stable in the long run. If treatment commences early (approx. at the age of 6 to 7), the devices are mostly well-accepted by the patients, and speech is only marginally affected. Speech therapy can also complement the insertion of a functional regulator.

G

Gap retainer

When a milk tooth – which plays an important function in creating space between teeth – is lost prematurely, it becomes necessary to keep the gap open for the subsequent teeth. Without gap retainers, the gap would be quickly crowded out by the “wandering” remaining teeth and block the way for permanent dentition. Gap retainers can used both as fixed or removable appliances.

Gelb splint

The Gelb splint is a bite splint invented by Dr. Gelb. It is used to treat problems in the jaw-joints.

H

Harmony

Harmony is a self-ligating lingual bracket system. Self-legating means that the arch wire is held by the bracket itself. This makes the normal attachments between bracket and arch wire (e.g. elastic ties or loops) redundant. Lingual means that the system is attached to the inner side of the teeth.

Herbst appliance

Front view

Side view

Today, it is almost impossible to think of modern orthodontics without this method, especially in the treatment of difficult distal bites (the upper jaw with its incisors lays too far forward and/or the lower jaw lays too far back). Many studies have shown that the Herbst appliance stimulates growth in the lower jaw.
The Herbst appliance is bonded into the upper and lower jaw. Both parts are connected via a telescopic joint that guides the lower jaw forward into the desired position. Once the muscles adjust, the desired growth change takes place, so that the lower jaw can be stabilised in its final position.
Since the Herbst appliance is glued onto the back teeth, it is almost invisible from the outside. All movements like chewing, talking and biting can be done without problems. At the same time, the glue releases fluoride and strengthens the tooth.

Side profile without…

…and with the implanted Herbst appliance.

In the first few days after fitting the Herbst appliance, biting and closing the mouth is more strenuous than usual. The muscles first have to get used to the new bite situation and one may experience muscle aches and tensions during this period. By using the triple telescope, we pretty much eliminate any chances of disturbing the mucous membranes. Initially, the screws of the Herbst appliance can cause discomfort to the lips, in which case we supply the patient with wax sticks. These are formed into small “balls” and pressed into the parts causing the irritation. In addition, you can place cotton rolls between the appliance and the cheekbone at night, to protect against pressure points.
Should something seriously trouble you about the Herbst appliance beyond this initial adaptation phase, we will be glad to assist.

The advantage of the Herbst appliance is that it works 24 hours a day – independent of the patient’s cooperation. This warrants a short treatment period of only six to nine months.
The Herbst appliance is effective in children and young people, as well as adults.
Even in patients with problematic jaw-joints, the Herbst appliance can contribute towards recovery i.e. the disappearance of complaints.

I

Incognito

“Treatment from the inside“

Incognito is a self-legating lingual bracket system. Self-legating means that the arch wire is held by the bracket itself. This makes the normal attachments between bracket and arch wire (e.g. elastic ties or loops) redundant. Lingual means that the system is attached to the inner side of the teeth.
The Incognito bracket differs from conventional appliances, in terms of conception as well as manufacture. The brackets are computer-designed and tailor-made for each patient, so that they have an optimum fit in the patient’s mouth.
The making of the brackets is a very specific process and requires manufacture in a specially equipped laboratory. Exact silicon impressions of upper and lower jaw are made. We then send these to a specialist laboratory. Here the brackets and arches are measured and designed with computer-driven CAD/CAM technology. The individual brackets are made from anti-allergic materials with a high gold content. The arch wires are precision- bend using a machine solely developed for this process. The result is a tailor-made bracket system. Using the so-called “indirect bonding technique” (glue tracks on the teeth), we then fit the brackets in one treatment session.

With Incognitos, teeth movement and treatment results can be predicted even more accurately than with universal brackets.
Compared to conventional lingual brackets, higher patient comfort is ensured through:
1. a flat bracket design (noticeably smaller brackets than conventional systems),
2. a larger bonding surface between bracket and tooth, and
3. the optimal positioning of the bracket, thanks to its computer-design.
As the brackets are made with a high gold content alloy, they offer a sensible alternative for patients with allergic reactions to nickel.

» Youtube-Video

Invisalign®

The “invisible“ treatment

Invisalign® is a treatment method used to correct tooth misalignments, and works by inserting a series of individually crafted, transparent and removable plastic aligners. For more serious misalignments, Invisalign is only moderately effective, or not at all, i.e. only effective after pre-treatment.
The original condition of the jaw is captured in a virtual computer-animated model. Using special computer graphics, a pre-determined target is then modelled three dimensionally and sub-divided into the various treatment phases. For each of these phases, specific individual aligners are made, and every tray is worn for about 2 weeks.
During this time, continuous light pressure is exerted onto the teeth, to move them into the pre-calculated position. Once in position, the next tray (aligner) is used, until gradually the optimal treatment target is reached. Depending on the degree of the misalignment, the whole treatment takes on average 12 to 24 months.

Due to its vast experience with the Invisalign system, Praxis Dr. Banach has been awarded the designation of ‘platinum provider’.

» Youtube-Video

J

Jaw-joint treatment

Most jaw-joint problems are caused by the relocation of a cartilage disc (discus, comparable to meniscus in the knee). Sufferers often complain of mouth-opening disorders, popping joints and pain in the ear. Even tensions in the cervical vertebra and relative disparities in the length of the legs can be attributed to jaw-joint complaints. By using a special diagnosis (“manual functional analysis”), and, if necessary, consulting a radiologist (for an MRI of the joint), we can usually determine the cause of the above complaints with relative ease.

A custom-made bite splint (by Prof. Gelb, New York) releases the jaw-joint and promotes healing.

If treatment with a bite splint was successful, it is worth considering whether to bring about a more optimal position of the jaw-joint through orthodontic treatment, i.e. extensive prosthetic care. This brings permanent relief and eliminates the causes of discomfort.

K

KöHy Königsteiner Hybridtechnik®

30-1-1-Hydrid-Koen-150x150

The ‘Königsteiner Hybridtechnik‘ has been specifically developed by Praxis Dr. Banach and offers a higher wearing comfort and more secure tooth alignment.
Up to now, patients with a deep bite requiring fixed braces in the upper and lower jaw, frequently encountered the problem of the upper teeth biting down onto the lower brackets, causing them to break and ultimately delaying treatment. To avoid this, one either had to cap the lower molars with cement, or glue so-called bite turbos behind the front teeth. However, both scenarios limited the ability to chew, rendering it a less than perfect solution.

Initially developed for aesthetic reasons, lingual treatment has since advanced and we were able to find a much more comfortable solution for the patient. We now bond the lower jaw brackets to the inner side of the teeth. Not only does this look better, it also improves the quality of life by avoiding cement caps and bite turbos. The insides of the teeth are also less prone to de-mineralisation because of the self-cleansing attributes of saliva.

Königsteiner Mini Ants®

31-1-Mini-ants-150x150

The ‘Königsteiner MiniAnts’ are a lingual bracket system developed in our practice.
We developed this bracket design for patients with severe crowding in the lower jaw frontage, so that even with an acute lack of space we can still position all brackets perfectly. This keeps the length of treatment to a minimum.

We have been carrying out lingual treatment since establishing our practice in 1997, actively following, shaping and applying all the development steps of this method. Across Germany, Praxis Dr. Banach is one of the practices that most frequently applies lingual treatment – we thus have the greatest possible experience.

L

Ligature

Is a thin wire or elastic used to fix the arch wire to the bracket.

Lingual technique (Braces on the inside)

Braces on the inside

We have been carrying out lingual treatment since establishing our practice in 1997, actively following, shaping and applying all the development steps of this method. Across Germany, Praxis Dr. Banach is one of the practices that most frequently applies lingual treatment – we thus have the greatest possible experience.

When the brackets of a fixed brace are attached to the inner side of the teeth, it is referred to as lingual technique.
The advantage of the lingual technique is that the teeth can be moved in all dimensions, yet the brackets are completely invisible from the outside and meet the highest aesthetic requirements. So, if you are in a meeting, nobody will notice that you are wearing braces. The inner side of your teeth is also more resistant to de-mineralisation, due to the self-cleaning attributes of saliva. Lingual brackets are either universal miniature brackets e.g. 2D, or can be custom-made for the patient, e.g. WIN- bracket.

Lingual arch

The transpalatal/lingual arch stabilises the jaw after an expansion. During the mixed dentition phase, it acts as a “retainer” in the “support area” (region of the milk teeth 5, 4 and 3).  The arch retains enough space for the erupting teeth. The transpalatal/lingual arch is a fixed retainer brace firmly attached to the first large molars.

Lip shield

We use the lip shield to treat crowded teeth in the lower dental arch and as a retaining device after having created space in the lower jaw.
It is partially removable and held in place by two bands fixed to the 6th tooth. The lip shield sits between the teeth and lips, and changes the muscle balance between tongue and lips, by keeping the lips away from the teeth. With the cooperation of the patient, the pressure of the tongue can thus eliminate the crowding of the lower teeth without any further orthodontic corrective measures.

P

Positioner /Retainer

A retainer is a tooth stabilising device used during orthodontic treatment. Retainers allow jaw bones and newly positioned roots to adapt better to their new positions. The danger of teeth migrating back to their original position can be avoided by a retainer.

Q

Qaudhelix

The so-called Quadhelix is another device used when the upper jaw is too narrow and has to be broadened. Its name stems from the four loops that run along the upper jaw. The device is glued into the upper jaw via two metal rings (“bands”) on the first thick molars (6th tooth). The special glue releases fluorides that protect the teeth.

At first, it feels unusual for the tongue to share the space with the braces. Still, one should avoid playing around with the tongue on the Quadhelix. Brushing the teeth also appears more difficult than before, and yet it is very important, since fixed appliances require intensive care to prevent any remaining food from getting stuck.
Usually the Quadhelix is a fantastic appliance – quietly working, invisible to others and effective without troubling the patient.

R

Rapid Palatal Expander (RPE)

The RPE immediately after insertion …

…and after turning the screw 14 times

RPE stands for “rapid-gum-expansion“. At first this may sound rather odd, however, the palate in children and teenagers still consists of two parts that are relatively loosely joined together and will only knit into bone as they grow older.
The RPE is used when the upper jaw is too small. By pushing the two halves of the palate outwards, the upper jaw broadens. This becomes visible in the outward migration of the two middle incisors. The space gained prevents having to extract teeth.
However, not only the upper jaw broadens – the nasal passages that form part of the upper jaw complex also do, which can lead to improved nasal breathing.

To guarantee the success of the treatment, the RPE appliance has to be turned by a screw once a day. With a special key, the designated screws are moved in the direction of the arrow. In order to stabilise the rapid broadening of the upper jaw in the long run, the RPE device remains in the mouth for approx. another 3 months after the last turn of the key.
Even amongst adults, a palatal expansion is still possible. Although the palatal suture has already become bony, it can be weakened surgically. Because the RPE device bonds onto the teeth, chewing will be more difficult at first, however, one soon gets used to it.
The teeth and RPE device have to be brushed carefully after every meal. The metal pieces and screws in the palate must also be cleaned thoroughly.

Retainer braces /removable braces

Retainer brace

In order to stabilise successful treatment, it is important to continue wearing a retainer appliance. Alongside positioners and stabilising wires, so called retainer braces are used.

Thera Mon® chip in upper jaw dental braces

In our practice you have the option to insert a Thera Mon® chip into all removable upper jaw braces, like retainers. The chip records and documents the exact duration (time) the brace has been worn for. This increases the motivation, especially for children, for whom the wearing of removable braces demands a high degree of discipline.

» Youtube-Video

Active plate in upper jaw

After a broadening the upper jaw with an RPE (see “RPE“), we use an active plate. The expansion plate has to worn on a permanent basis and should only be removed when eating or brushing one’s teeth.
Initially the sound of speech alters slightly, but this passes quickly. It is advisable to talk a lot when wearing the expansion plate – for example, reading aloud is a good exercise. The expansion plate is brushed after every meal. The best way to clean it is to use soap and a sturdy nailbrush with plastic bristles. For a better taste, the expansion plate can be soaked in a mouth wash solution from time to time.

 

Generally, the expansion plate is a relatively pleasant device to wear and patients take to it well. Nevertheless, should anything cause discomfort after its insertion, please contact us immediately.

S

Sagital developer/ transversal developer

The transversal developer is a fixed expansion brace for the lower jaw. Similar to the expansion plate, the transversal developer widens the lower dental arch by up-righting (expanding) the teeth. Growth can thus be encouraged in a manner that prevents any teeth extraction at a later stage.

The transversal / sagittal developer is glued to the first large molars in the lower jaw via two metal rings (“bands”) and can work 24 hours a day, independent of any cooperation from the patient. The special glue releases fluorides that protect the teeth.
If there is anything about the transversal developer that disturbs you, or should one of the bands have come loose, please do not hesitate to contact us immediately.

Speed brackets

Speed is an active self-ligating bracket system.  Self-legating means that the arch wire is held by the bracket itself. This makes the normal attachments between bracket and arch wire (e.g. elastic ties or loops) redundant. In our practice, we use the Speed brackets as an alternative to the Damon system.

Snoring patient treatment with Somnodent

The latest insights in sleep research show that snoring is caused by the backward tilt of the lower jaw during sleep. Snoring not only disturbs the peaceful sleep of your partner, but can also be dangerous to the snorer due to temporary respiratory arrest.

With the aid of a simple treatment appliance, to be worn at night, snoring can be kept in check.
The most recognised device worldwide is Somnodent. In our practice we adjust this device to suit the individual needs of our clients. Compared to other devices, this appliance offers the highest wearing comfort and greatest success.

Sports mouthguard

A mouth guard provides protection for your teeth during sporting activities. The National Youth Sports-Foundation estimates that annually over five million teeth are knocked out through sports injuries in the US. The mouth guard is individually adjusted in our practice to fit exactly onto the teeth of the sportsman or woman. It sits securely and allows for undisturbed breathing and normal speech.     
After taking a dental imprint of upper and lower jaw, we prepare the mouth guard in our laboratory using an elastic, long-lasting rubber that complies with the highest hygienic standards.

The mouth guard completely encloses the upper row of teeth. A two millimetre thick bite plate made of rubber between the rows of teeth absorbs any sudden pressure impact (e.g. being hit by a stick, or pushed by an arm, head or shoulder).

Various colours can provide a customised design (e.g. one’s club colours), which makes it more attractive for children.

T

Transpalatal arch – lingual arch

The transpalatal/lingual arch stabilises the jaw after an expansion. During the mixed dentition phase, it acts as a “retainer” in the “support area” (region of the milk teeth 5, 4 and 3).  The arch retains enough space for the erupting teeth. The transpalatal/lingual arch is a fixed retainer brace firmly attached to the first large molars.

Transversaldeveloper

The transversal developer is a fixed expansion brace for the lower jaw. Similar to the expansion plate, the transversal developer widens the lower dental arch by up-righting (expanding) the teeth. In this way, growth is encouraged while avoiding any teeth extraction at a later stage.

The transversal / sagittal developer is glued to the first large molars in the lower jaw via two metal rings (“bands”) and can work 24 hours a day, independent of any cooperation from the patient. The special glue releases fluorides that protect the teeth.
If there is anything about the transversal developer that disturbs you, or should one of the bands have come loose, please do not hesitate to contact us immediately.

Twinblock

The Twin block consists of two removable bite plates and is used for correcting functional jaw misalignments.
It is a comfortable and can be worn day and night. The Twin block is now the most widely distributed orthodontic devices worldwide. The devices are “patient friendly” and bring about a consistent correction of malocclusions while greatly improving the facial harmony.

W

WIN-Bracket

This is a special bracket used in lingual treatment (“braces on the inside“). It is custom-made for each patient according to tooth shape, and thus very comfortable to wear. Due to its broad bonding base, the adhesive force of the WIN on the teeth is extremely effective.

It is made of steel alloy and very flat. The body of the bracket is not moulded, instead it is densified by laser beams from a metal powder. Afterwards the bracket slot is milled with high precision.

We have been carrying out lingual treatment since establishing our practice in 1997, actively following, shaping and applying all the development steps of this method. Across Germany, Praxis Dr. Banach is one of the practices that most frequently applies lingual treatment – we thus have the greatest possible experience.

Judging from our experience, the WIN bracket system is currently the best system available on the market – both for the patient in terms of wearing comfort and treatment success, as well as for the handler in its superb application.

2D lingual brackets

The 2D-lingual bracket is extremely flat and in combination with its specially rounded edges, the patient hardly feels it. We predominantly use this bracket system in the lower jaw, where the 2D-braces are attached to the inside of the teeth; however, we can also combine them with ceramic brackets fitted to the outside of the teeth in the upper jaw (Königsteiner Hybrid-System).
During the conventional approach, whereby brackets are attached from the outside, it often happens that patients with a deep bite will “bite-off” the brackets in the lower jaw with their upper teeth. To avoid this, plastic superstructures are built onto the molars to artificially open the bite.

The method developed by us is extremely comfortable for the patient, because attaching the brackets on the inside in the lower jaw and on the outside in the upper jaw means that normal bite habits can instantly be resumed. Elaborate superstructures are avoided.

Technology

Alongside the professional expertise of our team, the equipment of our practice is of key importance both for treatment success and the patient’s comfort during treatment. That is why we at Praxis Dr. Banach place great emphasis on always staying in tune with the times when it comes to technical innovations. For the benefit of our patients we continually invest in modern practice equipment. Here are some examples:

Digital x-rays

Digital x-ray machine Orthophos XG

Since 2014 all our x-ray images are done digitally. For you as a patient this means:

  • Up to 90% reduction in radiation exposure compared to classic analog technology.
  • Digital x-rays offer a higher image quality compared to conventional images and expose teeth and bone structures in more detail. In addition, images can instantly be reworked on the computer and brightness and contrast can be adjusted. In this way they support a fast and accurate diagnosis. The digital images can be passed on to the patient, participating doctors or medical staff. Cumbersome and bad quality copies are a thing of the past. The digital technology is also environmentally friendly. Analog x-ray films and particularly the chemicals used in conventional technologies are dispensed with completely. In this way the application of digital x-ray technology makes an important contribution towards conserving and protecting a healthy environment.

Intraoral scanner

True definition intraoral scanner

Prior to any treatment, the initial status of your dental condition needs to be accurately documented. To further plan the treatment, we require an exact impression of teeth and bite. Normally this is done using a special paste and a metal impression tray. This method requires a lot of patience among patients, because the paste has to first dry in the mouth. Often the required amount of material also triggers a gagging sensation, and in many cases the impression has to be repeated when the quality is not satisfactory.
For documenting your dental situation our practice now uses an intraoral scanner. The scanner is swept across the surface of the teeth without touching them and produces a digital image of the impression. The benefits for our clients are:
Much more pleasant process – no moulding material or bulky impression trays.
The image of the dental situation is very precise and allows for a perfect fitment of your treatment device.
We can check the quality of the scan instantly on the screen and correct it if necessary. Errors and inaccuracies that might occur in normal impressions are avoided.
The results can be immediately viewed on a computer screen. In that way you get a good graphic impression which was not possible before.