Rapid palatal expander is a fixed appliance, i.e. it is bonded to your upper teeth. It is indicated for those who have a narrow upper jaw.
The main function of a rapid palatal expander is to widen the upper jaw. The two halves of the upper jaw are joined in the middle of the palate by sutures. These sutures are still opened in growing patients. Proper activation of the rapid palatal expander can widen the sutures surrounding the upper jaw bones, hence expanding the upper jaw sideways.
Once the sutures are fused in late teenage years, expansion of the upper jaw requires a combination of jaw surgery and rapid palatal expansion.
The Herbst appliance (commonly known as a bite jumper) is a fixed appliance, i.e. it is bonded to your upper and lower teeth. It is indicated for growing children or teenagers who have a smaller lower jaw relative to their upper jaw.
It uses a tube and rod mechanism on your upper and lower jaws to help guiding the lower jaw and teeth grow forward, and the upper teeth to shift backwards.
Patients are ideally started in Herbst treatment during pubertal growth spurt, typically at around ages of 11 and 12. This allows for the maximum effect of the Herbst during their growth spurt. The age can vary depending on the skeletal maturity of the patient.
The Herbst appliance is usually worn for 9 to 12 months. Braces are usually required to align the upper and lower teeth after the removal of Herbst appliance.
The facemask is a removable appliance. It is indicated for young growing children with a small upper jaw relative to the lower jaw; typically seen in a young underbite.
The facemask applies a pushing/pulling force to guide the teeth and jaws into a better relationship.
Patients are ideally started in facemask treatment when all the upper incisors have erupted (around 8-9 years of age). This allows for the maximum effect of the facemask.
The facemask must be worn consistently to be effective. Treatment duration for facemask varies, but it is usually actively worn for 12 months. Following the active treatment phase, most patients will continue to wear it at night to maintain the corrected jaw position for a period of time.
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