One of the important phases of Orthodontic treatment is arch development. Although controversy still exists whether to expand or extract to gain space, there is a clear indication for arch development in many cases.
A study of the appliances used for this purpose reveals they are mostly detrimental to correct function and encroach on tongue space. This is just one reason why poor results are often obtained. Multi banded appliances are also poor tools in obtaining significant arch development. Extraction of permanent teeth is therefore the only option, even though the research shows the results are no more stable.
The TRAINER System™
was developed for correction of the underlying myofunctional habits, which are the cause of many orthodontic problems. Correction of tongue position and function plus mode of breathing has a major positive effect on dental and facial development. However, virtually all arch development appliances encroach on tongue space and tend to make myofunctional problems worse.
The Farrell BENT WIRE System™ (BWS™) was developed in response to the need for combined myofunctional treatment and arch development. The BWS™ was also designed for use in conjunction with MRC's popular TRAINER System™. The T4K™ for mixed dentition, the T4B™ and T4CII™ for use with braces and the T4A™ for permanent dentition.
The TRAINER System™ combined with the Farrell BENT WIRE System™ can effectively replace existing Phase 1 treatment. This dual treatment approach gives substantial arch development with very light forces provided by a simple and inexpensive fixed appliance. No palatal bar is needed, eliminating the speech and functional problems of the common acrylic and quad helix appliances.
The BWS™ and TRAINER System™ usually achieve good dental alignment but often further aligning of the anterior teeth is needed. This can be achieved by continuing with the Phase II (harder) TRAINER or the MYOBRACE System™. The advantage of the MYOBRACE System™ is that it maintains arch form with DynamiCore™ and has individual tooth slots to obtain accurate dental alignment.
Alternately, the Farrell BENT WIRE System can be combined with fixed brackets in seamless integration with the T4B™ ( TRAINER for Braces™) or T4CII™ which combines arch development and Class II correction in conjunction with partial or full fixed brackets, while continuing the all-important myofunctional training.
Stability is greatly improved due to the use of the TRAINER to correct tongue position and function, plus mode of breathing. In fact the technique depends on the use of the TRAINER System™ for its effectiveness.
Because the BENT WIRE System™ is a fixed appliance, the compliance problems of phase one-type appliances are eliminated. The patient enjoys normal speech and no visible appliance during the day. Children like the system particularly for this reason.
The BWS™ is composed of commonly used and readily available components. Download the BWS™ Manual
for a list of required instruments. The list acts as a guide for selecting materials and instruments. The BWS tube is unique and must be obtained from MRC. All other items can be obtained from a local supplier.
There’s no need for laboratory construction of the BWS™ - it can be performed entirely “in office” without need for a laboratory technician. Each appliance takes less than five minutes to make and the components are inexpensive and readily available. This also means breakages can be rapidly and inexpensively rectified while the patient is still in the chair.
A key advantage of the BWS™ is that it can be easily modified to compensate for badly misaligned teeth. For example, it can de-rotate and align laterals and restore lost C space.
The BWS™ is held in place using a ligature from the distal of the tube to the ligature loop of the wire. Effectively the result is that you guarantee the BWS™ stays in - and you increase the depression of the upper anteriors.
Always ensure the TRAINER is worn daily in conjunction with the BWS™ program. The TRAINER must be used one hour a day plus overnight while sleeping. Subsequent visits should be scheduled for every three to four weeks. At each visit check for improvement in myofunctional habits and always reinforce TRAINER use.
At these visits, question the patient about the previous adjustment and how long the teeth were sensitive. This will guide you regarding the degree of activation. Always ensure the TRAINER is worn daily in conjunction with the BWS™ program. This is how bone development is achieved without the use of acrylic and expansion screws. If the TRAINERS are not worn, slow down the adjustment or remove the BWS™ for a period of time.
Treating function and form simultaneously produces outstanding non-extraction results. All you are doing is correcting arch form and getting function back to normal.
Arch Development with the BWS™.
for a video on the Farrell BENT WIRE System™, or download the NEW BWS™ Procedures Manual