RPE-BP:

More than just a bonded palatal expander, the RPE-BP system is the cornerstone to Dr. Alpern's treatment philosophy. Posterior bite planes vertically unload the TMJ and free up the occlusion for faster, more patient friendly treatment. After rapid palatal expansion is completed, the posterior bite plane becomes the platform from which numerous treatment objectives can be achieved.

It acts as a disposable anchorage for use with accessories such as: Class II hooks, Class III Reverse Pull Hooks, Cross Bite Hooks, Lingual Whip Springs, Arch Wire Tubes, and Lip Bumper Tubes. An ingenious removal system built into the bite planes solves the problems associated with debonding these types of appliances.

BPHGT (Bite Plane Headgear Tube Appliance):

Dr. Alpern designed this appliance to address two potential situations encountered during orthodontic treatment. The need for a more efficient method of treating Class II division I and II deep bite malocclusions, and the patient abruptly informing you that their jaw is suddenly clicking, popping, and hurting in the middle of treatment.

The BPHGT unlocks the occlusion and frees up the bite so that orthodontic forces, as well as vertical unloading of the TMJ, can occur simultaneously.

Because the appliance is fixed (inserted into molar tubes and then ligated) patient compliance concerns are eliminated. By matching the body wire size to that of your existing molar tubes, it can be added to any existing molar buccal tube assemblies preventing the need for rebanding or an appliance change.

The lab requires a maxillary model with a very clear, accurate impression of the molar tubes. It is important that the size of the existing molar tubes be noted on the prescription.

MIROS (Molar Incisal Resting Orthopaedic Splint):

Developed out of Dr. Alpern's frustration with Functional appliances, the MIROS was designed to give maximal orthopaedic effect to the mandible; and to attempt, in as strong a way as possible, to control the vertical growth of the posterior maxillary area. It has a maximal orthopaedic effect forward on the condylar head by solidly gripping the lower incisors and cuspids and preventing a forward tipping movement.

The design is stronger and yet less bulky than most functional appliances. The lab requires a maxillary and mandibular model along with a construction bite reflecting the desired position of the mandible. Dr. Alpern recommends that for every millimeter of advancement you allow 3mm of vertical opening.

Multi-Functional Appliance:

This appliance combines the MIROS with the RPE-BP for the simultaneous achievement of true maxillary palatal expansion, and the orthopaedic protraction of the mandible. This is accomplished with a unique tube and pin design. It is this tube and pin attachment that permits maxillary expansion and mandibular protraction from one appliance. The lab requires a maxillary and mandibular model along with a construction bite reflecting the desired position of the mandible. Again, Dr. Alpern recommends that for every millimeter of advancement you allow 3mm of vertical opening.

IWTO Retainer (Invisible Without The Occlusal):

The first maxillary invisible retainer without occlusal coverage. It is designed to give maximum retention, esthetics, comfort and speech function while permitting full dental cusp/fossa interdigitation and unencumbered TMJ freedom of motion. The posterior region can be trimmed below the height of contour to allow for settling or above the height of contour to maintain the existing position as desired. A small lip covers the incisal edge of the centrals and laterals to act as a stop that prevents the retainer from slipping gingivally. The lab requires an accurate maxillary model that includes the maxillary tuberosity. This is very important to the success of the appliance because a sufficient amount of plastic in this region is needed for circumferential strength.

IWTE Retainer (Invisible With The Edge):

A variation of the IWTO used specifically for retention of open bite cases where some settling of the anterior teeth might be desirable. The lip covering the incisal edge of the centrals and laterals from the IWTO design is eliminated and the anteriors are left free to settle. A plastic edge covers the buccal cusp of the first bicuspid to prevent the retainer from slipping gingivally. This edge is tapered into the fossa to prevent occlusal interference. The posterior region is trimmed above the height of contour to hold the existing position. As with the IWTO, the lab requires an accurate maxillary model that includes the maxillary tuberosity. This is very important to the success of the appliance because a sufficient amount of plastic in this region is needed for circumferential strength.

CCR (Continuous Clear Retainer):

For those cases that do not offer enough maxillary tuberosity to properly fabricate the IWTO, Dr. Alpern recommends his CCR design. It has no wires crossing from buccal to lingual and no interference with occlusion and settling. There is much greater control of corrected positions due to circumferential retention from centrals to second molars and broad coverage (5-6mm) on the labial side.

Patients like it because it has no wires visible from the labial side making it more esthetically pleasing. The labial acrylic section is attached to circumferential molar clasps with small elastics, giving it a great deal of flexibility and the ability to reposition anterior teeth like a spring retainer. The lab requires an accurate maxillary model that extends past the second molars. It is important that the second molars are included in order to properly fit the circumferential molar clasps.

Super Spring Retainer:

An active appliance designed to provide efficient and consistent rotation and tipping of desired anteriors. This is enhanced by helical springs positioned vertically for a maximum amount of seating flexibility and continuous force. Clasping is provided by distal extensions that engage lingual undercuts on the bicuspids and first molars. The lab requires an accurate mandibular model and an opposing arch if resets may be effected by a limited amount of overjet.