Our Appliances  

Banded appliances are microetched for increased retention.

We fabricate our own turrets to allow electrosoldering technique.

We are at home with the unusual situations like the long band and loop.

There is no prefabricated band for 1st primary molars but you can use a chrome steel crown that is larger than the tooth (or crown in this case) and simply make a band by cutting the occlusal portion away. Then place the bands and get a compound impression - we do the rest.

The variety in retention is endless. Most important - does the retainer seat well, does it have retention and can it keep the anterior teeth from rotation. What greater motivation than a custom retainer of your patient's choice?

We have been making active orthodontic appliances since the beginning. Maxillary expansion has been shown to be a stable phase of early treatment:

Bonded maxillary expansion is clinically a simple procedure, requiring an impression of the upper arch. Treatment time (active) is about 4 weeks not including passive retention.

The above four photos represent a first phase treatment from maxillary constriction and crossbites in all quadrants to an expanded maxilla without crossbites and from severe class III to class I.

From this overclosed class III profile to a full, esthetic class I profile.

A word about first phase treatment:

There is little to love about first phase treatment. Growth is unpredictable, retention is lengthy and most of the studies show relapse of first phase gains with regard to attempts at skeletal change - 1mm of skeletal improvement is not much gain for a year of functional appliance wear. Mandibular dental expansion has great relapse potential. All that said - there is a path for early care on which most of us could agree. Space maintenance is a pure form of early care - no arguments there. Maxillary expansion, crossbite correction, early class III intervention, reduction of protrusive anteriors , severe anterior rotations, serial extraction and assistance with delayed or severly ectopic eruptions - that's about it.

How do you retain to Phase II if you align the upper anteriors early? First phase retention has always been a challenge. The dentition is changing, the age group can be less than cooperative and the length of retention can be long. A maxillary Hawley will generally not survive the lunchroom - the retainer in the napkin trick. First we believe that nite wear is sufficient to retain teeth; second, a rigid orthodontic retainer is not necessary.

This is our take on a great phase I retainer - a combination of other techniques - taking the best from each one. This retainer will hold the 6 yr. molar rotation, it will hold the maxillary expansion and the anterior tooth positions and the middle segment of permanent teeth will erupt with little modification. Best of all it can be motivational with a photo of your favorite dog or a flag right in the center.