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Bonded Rapid Palatal Expander
Description:
The Bonded RPE is constructed with a palatal expansion screw
whose .045 metal arms
are soldered to an .036 wire framework. The framework encircles
all of the posterior teeth and
supports the acrylic posterior bite plane. The occlusal pads aid
in controlling torque and theyreduce the amount of vertical
(skeletal) opening that occurs as a result of treatment. It is
best
used for children between the ages of 8 and 12 years.
Indications for use of bonded Rapid Palatal Expansion Appliance
(RPE):Constricted Maxillary Arch.Crossbite.
Class III growth pattern.
Crowded Maxillary incisors and/or crowded cuspids.Patients with
TMD or patients with obstructed nasal airway.
Contraindications for use of bonded Rapid Palatal Expansion
Appliance (RPE):
Patients with cleft palate or lip.The majority of adult
patients.
Vertical (skeletal) growth patients.
Alternate Appliances:
Maxillary Transverse Appliance with occlusal pads
Schwarz Appliance with occlusal pads.Galella Type Modified Haas
Appliance.
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Clinical Procedures:
1. Complete maxillary and mandibular alginate impressions.
Obtain a wax bite atnormal bite relation.
2. Pour models with lab stone.3. Send case to lab with a
completedOrthodontic Technologies laboratory prescription
form.4. Trial fit the appliance, adjust as needed, and prepare
for bonding in place.5. Give instructions to the patient and parent
on wear, care, and adjustment procedures.
Delivery Suggestions:
The posterior segments, all aspects both buccally and lingually,
should be cleaned withpumice to remove all surface buildup. It is
important to get a good bond of the appliance to the
teeth without any voids in the bonding material so as to prevent
unwanted decay from occurring.
If the product you are using requires etching we recommend that
you only etch circumferentially.Etching the occlusal makes removal
of the appliance and clean up very difficult. Some
practitioners prefer to use a separator such as Chap Stick on
the occlusal aspects of the teeth
prior to bonding.
Two suggested materials that may be used for bonding the
appliance in place are: a light
cured orthodontic bonding resin which has the advantage of time
to clean excess before curing,
or, a glass ionomer resin which has the advantage of releasing
fluoride (has a 4 minute worktime). With either product, consult
the manufacturers directions for specifics on how to use their
product for bonding to acrylic.
Adjustment suggestions:
The palatal expansion screw has a central barrel with holes
drilled through at 90 degreeangles to each other, permitting a key
to be inserted into one of the holes and rotated 90
degrees, which will open or expand the appliance mm. Four turns
of the key will equal 1mm of expansion.
This appliance is ideal for expanding the transverse width of
the palate for patients from
age 8 to 12 years of age. The adjustment begins by the
practitioner demonstrating the technique
for turning the screw to the parent. Then, the parent or a third
party who accompanied the childturns the screw one turn (1/4 mm).
Each daily adjustment is usually one or two turns of the key
(1/4 mm or 1/2 mm each day). If the patient is older, age 13 to
18 years, it is suggested that the
expansion proceed more slowly with only 2 to 3 turns per
week.
When the expansion forces begin, there may be some discomfort
reflecting the increased
force in the palatal area. The patient can be advised to take a
mild pain-relievers if needed
(ibuprofen is recommended).
Length of treatment time and results expected:
Depending on the age of the patient, the palate begins to
separate within a few days along
the union of the paired maxillary bones. The younger the
patient, the more rapid is the beginning
of the palate separation. At that time, a slight soreness may
develop beneath the nose, and aspace will appear between the two
maxillary central incisors (diastema). Activation of the screw
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Precautions:
Orthodontic Technologies will provide a swivel key for turning
the screw, but, if a regular
metal key is used a piece of dental floss should be tied to the
key to avoid inadvertent aspiration
while adjusting the expansion screw. Demonstrate the proper way
to insert, turn, stop andremove the key. In some cases the parent
misunderstands and tries to adjust it by turning the key
forward, then back, before withdrawing the key! This method of
adjustment, of course,accomplishes nothing. Be sure the responsible
adult understands the method for turning the key
by having them practice one turn chaiside.
For Additional Information CallORTHODONTIC TECHNOLOGIES, INC.
1-800-346-5133Email: [email protected]
