Mixed Dentition Tanner Airway Appliance

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Instructions for lab slip:

Acrylic Placement in Relation to Canines:  Select "Lingual" if the anterior teeth are crowded and you want to develop space for the anterior teeth to erupt as the Maxilla develops, or if there is already crowding in the permanent teeth, and you want to help them straighten as their maxilla develops.  Select "Distal" if there is already adequate or excess spacing between the anterior teeth and you want to focus on the forward development of the Maxilla and Mandible.  Developing the canines forward/sagitally will help to develop the cheek bones as well as improve the patients' airway.

Lateral Angulation of Screws:  Most often this will be along the "Ridge".  Having the screws parallel to the ridge will gradually increase the width of the arch as the Maxilla develops predominantly forward/sagittally.  Select "Straight" if the ridge is already very wide (~ 40mm intermolar width or more) and you do not want increased width while you are getting forward growth.  Select "Slightly Widen" if the ridge is very narrow and you want to begin developing more width at a faster rate.   

Vertical Angulation of Screws:  Select "0-5 degrees" for someone with an underdeveloped Maxilla who does not have a lot of vertical growth, for a patient with an open bite, or end to end bite.  Select a higher degree if the anterior teeth have grown vertically, if there is a significant overbite, and/or if they are developing a gummy smile.

Occlusal Coverage:  This will usually be 3 or 4mm for a patient in mixed dentition who will be eating with the appliance in place.  Select 1-2mm for an older child, in mixed or permanent dentition, who will not be eating with the appliance in place.  If no occlusal coverage is desired, please select 1-2mm and make a note in the bottom Note column: request no occlusal coverage.  Occlusal coverage helps maintain stability of the teeth and bite, but it is optional.

Incisal Coverage (Amount of Acrylic over the Lingual aspect of the Incisors):  Select increased incisal coverage (2, 3, 4mm) if the anterior teeth are retroclined or in a vertical and downward growth pattern.  Increased incisal coverage will help to change the direction of growth with the acrylic over the lingual surface.  The acrylic surface may be smoothed back as treatment progresses.  Select less incisal coverage to reduce excessive proclining of the anterior teeth.  Having the acrylic farther away from the incisors (-3mm) will promote more horizontal growth which is best in children with open bites or end to end bites.  Having acrylic over the teeth in an end to end bite may develop an open bite.

Palatal Coverage:  This will determine the amount of acrylic, or width of acrylic, on the anterior aspect of the palate.  Around 6mm is generally a good width to use.  Less width may help someone with a high palatal vault for their palate to lower.  A patient with a normal palate could have more width to help promote horizontal growth and less width to reverse vertical growth.

Wire Arm:  Wire arms are used to guide the lateral incisors forward/sagittally when the canines are blocked out.  The arm will help to keep the incisors developing forward/sagittally and develop space for the canines, which will often fall right into place as the patients' bone develops.

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