Cemented upper expansion and braces
Dr. Garvey used a cemented upper expansion appliance (RME) with braces on top in early care for a patient with a complete posterior right and anterior cross-bite. The expander will increase the width of the upper jaw and correct the posterior cross-bite and the upper braces will move the upper front teeth out of anterior cross-bite. The under-bite patient (called Class III) should have early interceptive care to stimulate the mid-face or upper jaw which is usually back and the lower jaw is forward from a side view. It is very strong in family heredity. This care only took 6 months. The last photo shows coil springs which will make more room for the cuspids to erupt later. The patient often have sleep apnea or will snore and find it hard to breath out of the mouth. After the expander the nasal airway improved to nasal function and the snoring and sleep apnea are improved. The profile is also results in a dramatic functional and esthetic improvement.