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: Moments and forces delivered during symmetrical derotation of upper molars by 10 Goshgarian-type (GTPB) and 10 Zachrisson-type transpalatal bars (ZTPB) were measured in laboratory experiments using a computer-based strain gauge. The bar passivity in sagittal, transverse, and vertical planes was first assessed at the measurement apparatus. Then each end of the 20 passive bars was symmetrically activated by 10 mm in the sagittal plane using a template. The activated bars were placed into lingual attachments of the measuring apparatus, and three consecutive measurement steps were done for each bar. Measurements were made when the attachments were at 0 degrees, 5 degrees, and 10 degrees of deactivation. The mesiodistal (sagittal) forces, the horizontal forces, and the moments of rotation at the right and left attachments were measured at each step. The horizontal forces and the moments of rotation of the two designs had statistically significant differences. Greater moments of rotation were produced by the GTPB. The ZTPB produced significantly lower contractive horizontal forces than did the GTPB at 5 degrees and 10 degrees of deactivation.
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    Pediatric dentistry 16(5):360-1. · 0.56 Impact Factor
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    ABSTRACT: I determined the effect tongue forces imparted on a palatal bar has on the growth and development of the dentofacial complex of the Macaca irus. Ten female Macaca irus monkeys with mixed dentition were used in this experiment. The animals were divided into four groups, two animals were treated for 30 days, two for 90 days, and four for 180 days, with the remaining two animals serving as controls. The following results were obtained. 1. There was disocclusion on the maxillary and mandibular first molars. 2. Elongation of the mandibular first molars resulted from intrusion of the maxillary first molars. 3. The maxillary complex displayed a positional change with slight clockwise rotation. 4. Growth of the frontozygomatic site in the anteroinferior direction was inhibited. 5. There was no anterosuperior mandibular growth. 6. Changes in the maxillary suture and positioning of the teeth were mainly due to the effects of the tongue function imparted on the palatal bar. With enough control of the vertical growth of the maxilla can be validated. This is one of many methods of treating Class II malocclusion.
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