The transpalatal arch: an alternative to the Nance appliance for space maintenance.

Department of Pediatric Dentistry, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
Pediatric dentistry (Impact Factor: 0.56). 29(3):235-8.
Source: PubMed

ABSTRACT The loss of multiple primary molars in the primary or transitional dentition will, in many instances, lead to disturbances of the developing dentition. To prevent this, an appliance can be constructed to maintain the relationship of the remaining teeth and to guide the eruption of the developing teeth. Traditionally, the treatment of choice for maxillary loss is the placement of a Nance appliance. An alternative appliance that may be considered for use is the transpalatal arch or bar. The purpose of this clinical report was to describe the transpalatal arch appliance and present its advantages over the more common Nance appliance, thus encouraging clinicians to prescribe its use in certain clinical situations.

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    ABSTRACT: Aim : This study evaluated assess the mechanical properties and forces produced by transpalatal bars made from low-nickel alloy. Methods: Using a template, a single operator made all transpalatal bars from 0.032" and 0.036" wires of two different alloys, thus originating four groups, namely: A8 (0.032" conventional stainless steel), B8 (0.032" low-nickel stainless steel), A9 (0.036" conventional stainless steel), and B9 (0.036" low-nickel stainless steel). The bars were then activated and mounted onto a device developed to serve as a support for mechanical assay in a universal testing machine (Emic DL 10.000). The values of resilience and ductility were obtained using the Origin 8 software. Results: No statistically significant differences (P > 0.05) were observed between Groups A8 and B8 neither between A9 and B9 for 0.5-, 1.0-, and 5-mm deformations. However, statistically significant differences (P < 0.05) were found in all groups for 15-mm deformation. Groups B8 and B9 showed greater ductility and resilience compared to groups A8 and A9, respectively. Conclusions : Low-nickel stainless steel transpalatal bars release the same amount of force for activations less than 10 mm compared to those made from conventional stainless steel. Mechanically, the low-nickel stainless steel bars are more ductile and resilient.
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    ABSTRACT: In cases where the loss of a primary tooth is unavoidable and the child is at a development stage it is important to preserve the remaining space by a space-maintainer. To evaluate the response and characteristic behavior of three different space-maintainers (band and loop, Nance appliance, and Trans-palatal arch) subjected to masticatory forces with 3D Finite Element Analysis. It is a three dimensional digital solid model was prepared with a ‘Solid Edge V20’ software. The ‘ANSYS Workbench’ software was used in conjunction with ‘Solid Edge V20’ to simulate the behavior of the objects (teeth and the devices) under structural loading conditions. The forces and constraints are applied in appropriate magnitude and direction. The Von mises stresses, strains and deformation were derived for all three designs and jaw without device. Range of deformation for band and loop is 0 to 4.6292e-6, for Nance-appliance is 0 to 3.7612e-6 and for trans-palatal arch is 0 to 3.7666e-6. The deformation range for the model without the appliance is 0 to 4.9676e-6. The finite element analysis shows that, the Nance appliance shows the least deformation among all the three selected designs.
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    ABSTRACT: Premature loss of primary teeth can result in a loss of arch length and have a negative effect on occlusion and alignment, often increasing the need for orthodontic treatment. Use of space maintainers can reduce the severity of problems such as crowding, ectopic eruption, tooth impaction and poor molar relationship. This article presents a review of the consequences of premature tooth loss and discusses the appliances commonly used for space maintenance.
    Journal of the California Dental Association 08/2013; 41(8):612-8.


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