ORTHOBITES By David W. Jackson, DDS, FAGD, IBO ather than Rapid Palatal Expansion, I prefer to develop arches transversely by light steady pres-sure on the teeth and the alveolar bone. This was programmed into our bodies by the Great Architect of the Universe. It runs consistent with all of his creations -that form follows function. Let me explain further. When I began my orthodontic path of learning in 1985, I encountered many great teachers. One of my fondest mentors was the late Dr. Joseph Sim. I still employ and teach his cast diagnostic method for crowd-ing, his further research in the Regional Acceleratory Remodeling Theory by Harold Frost, and his enlighten-ing concepts of “Bundles of Bones”. Dr. Sim postulated that there is much more going on in the alveloar bone when it is injured than just osteoclastic and osteoblastic activity. He further stated that each tooth carried with it its own “bundle of alveolar bone” which stayed with it as the alveolus remodeled. Over the past 25 years, I have found this per clinical experience to be true. When Rapid Palatal Expanders are employed (Figs. 1 – 2), the result is obvious – a split palatal suture. But what is really happening on a cellular level? I postulate that by causing traumatic opening of the palatal suture, one has basically injured the bone, creating the Regional Accelera-tory Phenomenon as described by Frost. The injury creates the palatal vault to change. The vault drops down; and the alveolar bone stays with the teeth as God made it to do so. I have no issue with this technique. The radio-graph presented is not that of the patient shown. I prefer though to “traumatize the Maxilla” less by employing “bundles of bone” alveloar remodeling. As I stated earlier, I have been very successful with this tech-nique over the past 25 years. My expander of choice is the Nitanium Palatal Expander2 (Ortho Organizers – Figs. 3 – 6). I like to refer to it as the “Nitanium Palatal Remodeler”. R Fig. 1 Fig. 2 Form follows function. And this never more true than in the alveloar bone. When I was a dental student, and was taught immediate dentures, I was always encouraged to save the lower canines if possible – to preserve alveolar bone. When we place the Straightwire Orthodontic Appliance, what is happening? The alveloar bone and teeth have light steady forces exerted upon them and in a 9-10 month span of time, the arches change into the arch form one desires. I prefer the broad arch (Figs. 7 – 11 demonstrate two cases employing the broad archwire system). By broadening 16 November/December 2013 JAOS
Journal of the American Orthodontic Society November-December 2013: Page 16
