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In this Issue
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From the CEO Hello, The BWS™ (Farrell BENT WIRE System™) has been devised to use with the TRAINER System™. It is not revolutionary, but a simplified version of previous appliances. Many doctors continue to use outdated expansion appliances without understanding their deficiencies. First, using our current knowledge of arch form related to malocclusion, you will see in the following picture crowding is associated with incorrect arch form and this is directly determined by tongue position and function. Compare the dimensional differences between the normal, crowded, class II Div 2 arch form. Generally the narrowness of the arch form occurs more in the anterior and premolar area.
As we have seen confirmation from the research of Dr German Ramirez, the TRAINER develops this anterior arch form by retraining tongue position and function. Intermolar dimension does increase, but not as much as the other dimensions. In the early mixed dentition, the T4K™ is ideal for correcting this arch form, however, in more severe cases, or in the late mixed dentition, the patient cannot position the tongue correctly, so the tongue does not have sufficient force for a long enough period to effect the desired arch form changes. Arch expansion by physical not functional means is required.
The Farrell BENT WIRE System™ has the ability to impart the correct forces to develop the anterior arch form more than the intermolar distance (Bottom Left). There is no palatal component to encroach on tongue space, so as the arch is expanded the tongue can occupy its correct position without interference. The TRAINER is used the same as usual - one hour per day, plus overnight while sleeping, further increasing the rate and stability of the arch form correction. This is the fundamental difference between the BWS™ and other types of treatment.
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Expansion of the jaws has been increasingly performed in orthodontics to achieve better occlusal and maxillary relationship, and so, to improve oral functions. Maxillary and mandibular expansion has been proposed since Edward Angle to avoid extractions (Dewel, 1964). There is a controversy regarding the ideal time for performing the expansion. Sari and co-workers reported that rapid maxillary expansion by means of a fixed screw (eg. Hyrax) produces better results when it is performed in early permanent dentition (Sari, 2003). Although this statement appears to be supported by other studies (Chung; Housley, 2003; Spillane, 1995), maxillary expansion may also be successfully done in older adolescents and adults (Stuart, 2003; Iseri, 2004; Lima, 2000). In the maxilla, rapid and semi-rapid expansion produce an increase of the lower nasal and maxillary base widths, with the maxilla moving forward and downward (Chung, 2004; Sari, 2003; Iseri, 2004). These changes in the maxilla produced by the expansion are accompanied by a spontaneous mandibular response, which increases the dental arch perimeter (Lima, 2004; McNamara, 2003) and rotates the mandible posteriorly (Sari, 2003; Chung, 2004). Mandibular displacement is associated with an increase in facial height (Sari, 2003, Chung, 2004). An expected relapse in the amount of expansion has been reported by some authors (Hime, 1990; Housley, 2003), which appears to be the result of that pressure delivered by the cheeks on the maxillary arch and the resistance to deformation of maxillary sutures and surrounding tissues to maxillary expansion. Nevertheless, maxillary and mandibular expansion rise up as one of the important phases of orthodontic treatment, producing arch perimeter increase, and so, avoiding teeth extractions. Thus, the aim of the report "Dental Arches Expansion with Ortho-System", writen by myself and Dr Chris Farrell (available for download via the MRC website) is to present a new method to produce maxillary and mandibular expansion, and at the same time, to treat soft tissue dysfunction that may be responsible for treatment relapse (Ramirez-Yañez, 2005). A couple of cases treated with the Farrell BENT WIRE System™ are presented to explain the proposed treatment. The TRAINER System™ combined with the Farrell BENT WIRE System™ (BWS™) simultaneously produces arch development and treats the myofunctional habits. The TRAINER™, a pre-fabricated functional appliance, has amply demonstrated to relocate the mandible (Usumez, 2004), to correct improper forces produced by the muscles of the cheek and lips (Quatrelli, Ramirez-Yañez, 2005a) and to change the dimensions of the dental arches (Ramirez-Yañez, 2005b). However, in those cases where more maxillary and mandibular expansion is required to avoid teeth extractions, the TRAINER™ combined with the BWS™ produces higher amounts of expansion, and therefore, a higher increase in arch perimeter. An advantage of this system is that it does not involve acrylic in the palate. A functional appliance designed with acrylic on the palate and which is not properly built, may lower the tongue encouraging tongue thrusting, and thus, either worsening the malocclusion or producing a relapse. The TRAINER™ is a pre-fabricated functional appliance, which means no laboratory involvement, and the BWS™ can be entirely constructed “in office”. The BWS™ neither is composed by acrylic nor occupy the palate, and so, permits a normal talking to the patient. The following two cases show the effect of the Ortho-System on arch development.
Best regards, |
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MRC Global - A World Perspective
Getting to travel around so much of the world has many wonderful benefits. Amongst these benefits is seeing many small, yet more effective clinics evolving worldwide through using straightforward and uncomplicated techniques for the correction of arch development and bad oral habits. Extraction is only carried out where absolutely necessary, and treatment methods such as the Farrell BENT WIRE System™ (BWS™) are being used to minimise the need for brackets. It seems the public is driving the growth of these clinics in many countries as they are looking for simpler, easier treatment where patients are walking away with better faces and better long term stability. The Farrell BENT WIRE System™ is certainly an integral part of this. The technique can be easily learnt, and integrated with the TRAINER System™ allows you to accomplish simpler cases. Information on the BWS™ is available via the Myoresearch website, including videos and our new BWS™ Manual. Look out for more on the BWS™ in the new web based seminars starting with Dr Farrell in the months to come.
Regards, |
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More on the 
Scientifically Speaking|
"I'm really pleased with the Myofunctional Appliances and all the services that you are delivering to us. Very quick and efficient." Dr Rita Goulart |
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To assist development of teeth and jaws in the growing child. |
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The MRC Complete Systems CD-ROM is a complete collection of everything you need to know about the MRC systems. |
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Myobrace.com is an informative website about the MYOBRACE® and all it's features. |
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Published by: MRC CEO & Founder: Editor: Jill Steptoe |
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