Metal Mouth Message Board

Hi,

Does anyone know anything about herbst and twin block appliances? My younger sister has been told she will need one of them. I was just wondering if anyone knows which one is better/more comfortable?? From reading some other posts, it is clear that a removable appliance is preferred, but she is worried that the twin block may affect her speech more? I dont really know anything about them. Just wondered if anyone could help. Thanks

Grace

both ar mand repositioning appliances. IOW, they move the lower jaw forward to correct overjet.

There are fixed and removable versions of the twin block.

I generally prefer the TB to the Herbst but thats just me. The removable TB has the advantage of also having a midline screw to allow for upper arch expansion while simultaneously advancing the lower jaw.

There are TONS of different appliances to advance the mandible.

There are TONS of different appliances to advance the mandible.

Just if you wish to see a few of them, and find a few keywords for a search near your home, see in my www below in Gerätegalerie B.
For example activators or bionators (the difference between them is mainly the shape of wires) can either be built bulky, or can be built such that they hardly affect speech.
As for the more recent Pro-Stab plates, detailed info in 3 languages in in the case examples chapter, or directly via
http://www.sanfte-zahnklammern.de/fallb ... /stab.html
All 3 appear to me more comfortable than the twin block (which does NOT mean to prefer fixed appliances, which hinder proper chewing to more or less extent and so on...).
In my forum there is a fresh case (Ãœberbiss) where they seem to intend Pro-Stab plates. Upper and lower jaw can not only be expanded independently. The plates can be equipped with almost ANY corrective element. To do more things at the same time. Or if upper and lower jaw are ot equally severe, one of the plates can be detached and worn additional hours per day.

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I prefer fixed appliances than removable.

There are some reasons: the appliance is more simple and easy to use, doesn't affect speach, and the patient can eat with the appliance.

All the functions (breath, mastication, speech...) can be corrected at the same time.

Also you can expand the maxilla, advance the mandible and correct the overbite at the same time.

I used for 8 years the Herbst, however I prefer another device which is well described at
www.ritto-appliance.com

there is a fixed version of the Twin block as well

@akr

I prefer fixed appliances ... more simple and easy to use, doesn't affect speach, and the patient can eat with the appliance.

The child has no other choice than to eat with the appliance, I would express it. And keeping the teeth clean is much less simple that with a removable.
The mentioned appliance is less hindering than the Herbst, of course, and the mechanism resembles very much the removable shown before.
I think that some of the 8 – 12 year old „examples“ with this fixed appliance would also have been accessible for holistic Bionator treatment.
But of course, fixed appliances better ensure profit. Removables require some psychological skills.

All the functions (breath, mastication, speech...) can be corrected at the same time.

All 1-piece functionals give training for nose breathing. And concerning mastication, properly built functionals give an effect that is not obvious: they soon re-programme the chewing musculature such that it holds the mandible more forward, even without the appliance in mouth, lasting for hours.
I had myself an activator against my pronounced deep bite (10 mm) and I felt myself this neuronal background activity, while the new „driver“ was installed.

Also you can expand the maxilla, advance the mandible and correct the overbite at the same time.

As with Fränkel´s function correctors, with the before-mentioned Pro-Stabs, with an U-Bow activator or with an activator equipped with a selective screw as shown here:

The upper half can be expanded. The side regions have to be machined such that they allow the side teeth to grow in plane and occlusion.

Fixed vs. removable: When dealing with teens my mantra has been:

When in doubt go fixed... ... and always be in doubt....