Photos of Macy from New Hampshire, USA

Macy is 28. She says, "At my initial consultation, the orthodontist said she wanted to treat me for a moderate deep (over) bite, slight crowding in both upper and lower arches, and a displaced right second bicuspid which had shift to the inside of my arch and was now biting to the inside of its lower partner (a crossbite of one tooth).  She recommended I get full braces, elastics, and a transpalatal arch (TPA). 

"At the placement appointment, I got full braces on both upper and lower arches and Class II elastics to help start correcting the deep bite. The elastics run from my upper canine to my lower first molar on both sides. I also had metal ligature ties on all my teeth to take care of the various twists and shifts that were a result of the crowding.

"At my first adjustment, they snapped the transpalatal arch into a slot on the inside of my first molar bands and then used metal ligature ties to secure it into place. The device itself is a thin metal rod that slopes up toward the roof of my mouth, makes a rounded V -shaped bend toward the back of my mouth and runs back down to the other molar. I was warned it would make an impression on my tongue and probably would cause soreness and discomfort for about a week (more like two), and I would probably find it hard to speak at first (that didn't go away). Long noodles of any kind became part of my "bad" foods list because they would be a bear to try to extricate from around the appliance. 

"The transpalatal arch's purpose is to maintain the width of my upper arch between the first molars so my braces can pull the second bicuspid back in line using the molar as an anchor and reference point. If the arch wasn't in place, my first molar would shift in to join the second bicuspid much the way my first bicuspid did when the orthodontist's office finally tied that second bicuspid firmly into the arch wire. The arch will stay in until my bicuspid is back in line with my other teeth and stable in its new position."

Macy's Transpalatal Arch device

Macy's braces and elastics

Macy's "laceback" ligature ties.  In a laceback, they do a "figure eight" on the ligature ties. They put the wire around the bracket and twist on to the next bracket where it's looped again. Macy says, "I couldn't find much about them except they help tilt my teeth back and are part of the bite aligning process." Note that the arch wire is held in place with a wire tie, not an elastic. 

After seven weeks with a braided wire and lacebacks, Macy got a smooth wire (it's copper colored on the tooth side) with elastics hooks on each side and stop loops in front of my first molars. Lacebacks were put on again. The elastics go from that hook to the hook on her lower first molars.

These two photos show the progress on Macy's lower teeth in about one year. The photo on the left was at the first adjustment, and the photo on the right is more recent.