A Rapid Palatal Expander (RPE) is an upper appliance that places pressure on the upper jaw (maxilla) by turning a midline screw. The pressure separates the mid palatal suture thus making the maxilla wider, which can correct crossbites and create space. RPEs are used often to correct posterior crossbites.
We can correct posterior crossbites as soon as we see them because we can obtain more room for other unerupted teeth. Also, a posterior crossbite, if it’s only on one side, can cause the lower jaw to grow asymmetrically to that side. Therefore, correction of a posterior crossbite helps prevent asymmetrical growth of the lower jaw.
Since we are separating a mid palatal suture, it is better to do this procedure at a younger age before the palatal suture becomes fused.
With adults, the maxilla can be expanded by using an RPE and having surgery performed by an oral surgeon. This procedure is called Surgically Assisted Rapid Palatal Expander (SARPE). During the surgery the palatal suture is opened with side releasing incisions and all the expansion is completed at one time. Some orthodontists will have the patient turn the expander after the surgery but most let the oral surgeon complete the task.
Between the ages of 11 and 15 is the most common time for orthodontic treatment, and for good reasons. By 12, most if not all of the permanent teeth have erupted and are in place, and crooked teeth, gaps and bad bites can easily be detected. These problems will rarely correct themselves, so this is when most parents decide to seek adolescent orthodontic treatment.
At Kersten Orthodontics we make every effort not to extract permanent teeth. This can be aided with early treatment methods such as expansion of the jaws and moving upper molars. There is however times where tooth removal are unavoidable.
We do not use headgear at Kersten Orthodontics. Instead we use tooth movement systems such as the Carriere and Forsus springs for jaw correction.
A Forsus appliance is a fixed appliance that works on the upper and lower teeth at the same time. It works by pulling the top teeth back and pushing the bottom teeth forward so that your bite matches up. This device effectively has eliminated the use for a long headgear treatment.
Carriere Tooth Movement System
The Carriere Distalizer is an orthodontic device developed to correct a bite without removing permanent teeth when teeth have erupted incorrectly. With an effect similar to headgear, but without the use of a bulky appliance, the Carriere Distalizer pushes upper teeth back to create a corrected bite prior to the addition of braces. How does the Carriere Distalizer work?
The Higgins crossbow appliance designed by Dr Higgins in Delta BC
The appliance is used to correct upper jaw narrowness as well and lower jaw shortness. This has effectively replaced the headgear in our practice . It is fixed in place for maximum effectiveness and eliminates poor results due to poor cooperation.
The Higgins Crossbow is comprised of a upper expansion appliance or RPE or rapid palatal expander and a lower device which is connected to the RPE by 3 m forsus springs to advance the lower jaw orthopedically into correct jaw alignment. Braces are still needed to correct tooth alignment and position.