The Right Bite Sleep and TMJ Pain Care
Orthodontic expansion in adults is possible using braces but it is limited to the amount of bundle bone available for the teeth to move in the socket and get an expanded arch form. Even with the best possible braces we can only achieve about 1.5 to 2 mm per side in the posterior teeth which may not be sufficient in patients who have a very narrow upper jaw and posteriorly positioned lower jaw. So, in patients who require more expansion, the ideal minimally invasive method to gain 3D expansion is using a DNA appliance to stimulate the epigenetic potential of the body.
In patients who require nasal airway volume to be significantly increased along with maxillary expansion, the only minimally invasive technique is the MARPE (mini impant assisted rapid palatal expansion) such as the MSE appliance (maxillary skeletal expansion) which in conjunction with a piezoelectric saw can split the suture with ease in adults.
Going one step further if this procedure can be done in conjunction with an ENT surgery under general anesthesia, the patient is more comfortable and gets his ENT issues such as DNS, Inflammed turbinates also getting treated at the same along with upper jaw expansion.
In general the orthodontic appliances can augment the growth of the airway in children till the age of around 12 years after which the bones are mature and do not grow further. In adults it is not possible to augment the airway using the traditionally available methods such as fixed braces. They only move the teeth and cannot expand the airway.
Novel appliances such as the DNA appliances and ALF appliances however have proven to bring about airway expansion in adults. A better understanding of these holistic appliances is required to adapt these newer appliances into practice.
Whereas the ALF (Activated Lightwire functionals) is a slow, sensory appliance it is seen to bring about natural expansion in mostly younger children and adolescents, in can be used in adults to release their cranial stresses and enhance the rhythm of the tissues and the bones in the cranio maxillary complex.
The DNA appliance on the other hand is a more sophisticated appliance and more suited for adults as it’s a bit more bulky and requires constant monitoring the activation by the doctor/patient to get long term results. Research has shown increase of upto 250% in volume of the airway post DNA treatment.
Correct use of these novel appliances can bring about airway expansion without the need for surgery in most adult patients who need airway augmentation.
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