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ortho the international C.E. magazine of orthodontics

12 I I C.E. article_ Bent Wire System _Abstract _Maxillary and mandibular expansion has been proposed to increase the arch perimeter and to avoid extractions during orthodontic treatment. Althoughcontroversyhaspersistedoverthestability ofexpansiontechniques,thereisanincreasingtrend toward“non-extraction.”Thispaperdescribesanovel method to produce expansion of the dental arches, and,atthesametime,totreatmusculardysfunctions that may be the etiological factor of the malocclu- sion. The system has been developed by Myofunc- tional Research Co. (MRC), Queensland, Australia, as a simpler method of phase one expansion, which mayproduceimprovedstabilitybecauseof simulta- neous habit correction in selected cases. Two cases treated with the Farrell Bent Wire System™ (BWS™) are described, and the advantage of this method of treatment is discussed. _Introduction Expansion of the jaws has been increasingly performed in orthodontics to achieve better oc- clusal and maxillary relationship and, in doing so, improving oral functions. Maxillary and mandibular expansion has been proposed since Edward Angle to avoidextractions(Dewel,1964).Thispaperpresentsa novelmethodtoproducedentalarchdevelopmentin themaxillaandthemandible,whileatthesametime correcting or maintaining the inter-maxillary rela- tionship either if a sagittal and/or vertical problem exists or a Class I malocclusion with normal overjet andoverbiteispresentatthebeginningoftreatment. 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 whenitisperformedintheearlypermanentdentition (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 lowernasalandmaxillarybasewidths,withthemax- illa moving forward and downward (Chung, 2004; Sari, 2003; Iseri, 2004). These changes in the maxilla produced by the expansion are accompanied by a spontaneous man- dibular response, which increases the dental arch perimeter(Lima,2004;McNamara,2003)androtates the mandible posteriorly (Sari, 2003; Chung, 2004). ortho2_2012 How to avoid extractions when treating malocclusions Authors_German O. Ramirez-Yañez, DDS, PhD, and Chris Farrell, BDS Using MRC’s Bent Wire System and Trainer Systemforarchdevelopment This article qualifies for C.E. credit. To take the C.E. quiz, log on to www.dtstudyclub. com. The quiz will be available on Sept. 17. _c.e. credit part II