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ISSN0975-8437
INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(1):98-99
CASE REPORT
Mandibular Arch Expansion- A New Treatment Approach by Transverse
Transforce: A Case Report
Jagat Sharda, Gaurav Sharma, Promod Shetty, Archana Sharda
Abstract
Constricted mandibular arch shows difficulty in orthodontic treatment owing to their asymmetric
shape and occlusal relationship. The treatment options may be many depending on the clinician’s ability
and perception to the problem. This case report describes management of constricted mandibular arch by
transverse transforce, thereby successfully correcting the mandibular arch and establishing a good occlusal
relationship.
Key Words: Constricted Mandibular Arch; Transverse Transforce.
Received on: 1/09/2010
Introduction
One of the primary goals of an
orthodontic treatment is to attain and preserve
facial attractiveness.(1) If a treatment plan does
not begin with a clear view of its aesthetic
impact on the patient, then the results can be
disastrous. Transforce lingual appliances are
designed to correct arch form in patients with
contracted dental arches.(2, 3)
Palatal and lingual appliances insert in
horizontal lingual sheaths in molar bands. No
activation is required after the appliance is fitted.
Both sagittal and transverse appliances have
additional components to achieve 3-way
expansion where this is indicated.(4) These
appliances may be used in correction of all
classes of malocclusion at any stage of
development, from mixed dentition through
permanent dentition.(5) This case report shows
correction of constricted mandibular arch by
transverse transforce appliance.
Case Report
A 15 years old female patient reported to our
department with a chief complaint of irregularly
placed upper and lower front teeth. Patient had a
convex profile, mesoprosopic face, and
potentially incompetent lips. Patient is skeletal
class I with mild severity and anteriorly placed
maxilla and hypo divergent jaw bases. Patient is
dental class II div I subdivision left side with
9mm of over jet and 6mm of overbite.
Objectives of the treatment was a) correction
of constricted mandibular arch, b) correction of
proclination and spacing in upper arch, c)
correction of crowding in lower arch, d)
correction of molar relationship and e) correction
of over jet and overbite. Non-extraction
treatment plan was decided with Transverse
Transforce in lower arch, to idealize the arch
Accepted on: 1/11/2010
forms and then fixed functional appliance for
correction of molar relationship and achievement
of normal over jet and overbite.
Transverse transforce appliance comes in 2
sizes for upper arch (size 1-29mm and size 232mm) and in 2 sizes for lower arch (size 126mm and size 2-28mmm). Each expander
contains nickel titanium springs generating
approximately 200 grams of force. In this patient
size 1 transverse transforce for 6 months was
given (Figure1). After 4½ months of delivering
this appliance, approximately 7mm expansion in
inter canine width was achieved. The appliance
was left for 1½ months for retention, after this
fixed functional appliance was given (Figure 2).
Figure 1
Figure 2
Discussion
Interceptive treatment with this new
series of pre-activated lingual appliances offers
new possibilities for arch development, in
combination
with
fixed
appliances.(5)
Advantages of transforce appliance are, a) it
produces 200gm of gentle biocompatible force,
b) it can treat all classes of malocclusion, c) its
force module provides gentle biocompatible
force, d) no lab work is required, e) no activation
is required after the appliance is fitted, and this
principle is extended to a series of appliances for
sagittal and transverse arch development, f) both
©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 1 JANUARY-MARCH 2011
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ISSN0975-8437
INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(1):98-99
sagittal and transverse appliances have additional
components to achieve 3-way expansion where
this is indicated, and g) the invisible lingual
appliances may be used in correction of all
classes of malocclusion at any stage of
development, from mixed dentition through
permanent dentition, and this approach has wide
indications in adult treatment.(1-3)
Conclusion
In conclusion this is a simple prefabricated appliance with minimal discomfort to
the patient and no laboratory work required.
Affiliation of Authors: 1. Dr. Jagat Sharda, M.D.S,
Professor, 2. Dr. Gaurav Sharma,B.D.S, Post graduate
student, 3.Dr. Promod Shetty, M.D.S, Professor,
Department of Orthodontics, 4. Dr. Archana Sharda,
M.D.S., Senior Lecturer, Department of Public Health
Dentistry, Pacific Dental College and Hospital,
Debari, Udaipur, Rajasthan, India.
References
1. Owen AH. Morphologic changes in the
transverse dimension using the Fränkel appliance.
American Journal of Orthodontics 1983; 83 (3):
200-17.
2. Links L, Scotland U, Clark WJ, Lea L. Arch
development with trans-force lingual appliances.
World J Orthod2005;6(1): 9-16.
3. Clark W. Transforce lingual appliances for arch
development. Journal of Clinical Orthodontics
2005;39(3):137.
4. Cozza P, De Toffol L, Mucedero M, Ballanti F.
Use of a modified butterfly expander to increase
anterior arch length. Journal of Clinical
Orthodontics 2003;37(9):490-5.
5. O'Grady PW, McNamara Jr JA, Baccetti T,
Franchi L. A long-term evaluation of the
mandibular Schwarz appliance and the acrylic
splint expander in early mixed dentition patients.
American Journal of Orthodontics and
Dentofacial Orthopedics2006;130(2):202-13.
Address for Correspondence
Dr. Jagat Sharda, M.D.S, Professor,
Department of Orthodontics,
Pacific Dental College and Hospital,
Debari, Udaipur – 313001.
Rajasthan, India.
E-mail: [email protected]
Source of Support: Nil, Conflict of Interest: None Declared
©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 1 JANUARY-MARCH 2011
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