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Regular Treatment Plan

Indications for the
Pre-Orthodontic Trainer

Contra-Indications for the
Pre-Orthodontic Trainer

Uses of The Trainer to assist in Other Treatments

Patient Issue

Fitting and Adjustment

The Research




The TRAINER¨ is made from a non-thermoplastic polyurethane. The material has both flexibility and inherent memory. The premoulded upper and lower labial bows have a similar effect to that of orthodontic archwire. That is, they are premoulded to the parabolic shape of the natural arches and adapt to large and small arches alike.

As with archwire, the TRAINER¨ does not require to be different sizes, only distal length varies, which can be trimmed accordingly to the distal position of the first permanent molars. The labial bows combined with anterior tooth channels afford a constant force on misaligned anterior teeth to assist in the correction of their position. There is a starting TRAINER¨ made of a soft and very flexible material for maximum compliance. This also allows it to adapt to the most severely misaligned teeth. The starting (blue) TRAINER¨ imparts only light force on the teeth, then after 6-8 months the firmer (pink) TRAINER¨ , which imparts a much higher force on the misaligned anterior teeth, is implemented. This is the principle behind the straight wire technique, starting with a light wire then progressing to firmer wire as the teeth come into better alignment. (only 1.7gm of force is required to move an anterior tooth 5) Computer design technology has allowed this principal to be incorporated into the TRAINER¨.


Incorrect tongue position and function, tongue thrusting and oral habits are the cause of many malocclusions. 1, 3, 7, 9 More attention has been given to these factors recently as factors in relapse. Correction of these aberrant forces imposed on the dentition can assist dental and skeletal alignment. 4, 8 The TRAINER¨ has an unique myofunctional training system to assist correction of these habits.

The design incorporates a tongue tag for proprioceptive location of the tongue tip. The raised section on the tag trains the child to place the tongue tip in the correct "position" with the TRAINER¨ in place. This also acts as a "reminder" to place the tongue tip correctly without the TRAINER¨. Myofunctional therapists use this tongue positioning as a basis of their re-training of the oral musculature. The Tongue guard prevents a tongue thrust swallow when in place, which is a position "training" process for the tongue. Lip bumpers or Mentalis stretchers are incorporated to stretch and deactivate overactive mentalis contraction, associated with a tongue thrust swallow. Lip bumpers have been shown to gain arch length in mild to moderately crowded cases. 4

The TRAINER¨ stops mouth breathing when in place. The double mouthguard design of the the TRAINER¨ forces the child to breathe through the nose. Most children who exhibit open mouth posture can nose breathe. They are habitual mouth breathers and can be trained to breathe correctly.

"It was observed that children with open-mouth posture displayed a significantly slower pattern of maxillary growth compared with children who display anterior lip seal posture." 9

Particularly when worn overnight, the TRAINER¨ helps to prevent maxillary arch loss and slowed growth so common in mouth breathers. 7, 9 Woodside and Linder-Aronsen showed "a change from mouth-open to mouth-closed breathing was associated with greater mandibular growth expressed in the chin and greater facial growth expressed in the midface." 8 Passive arch expansion and mandibular growth is achieved by changing mode of breathing.

A Functional Appliance

The TRAINER¨ acts like a functional appliance, (Activator and derivatives) being premoulded into a class I (edge to edge position). The difference is that it does not need to be specially fitted, and the flexible material used prevents breakage, which is one of the biggest disadvantages of other functional appliances.

A combination of important features

The TRAINER¨ has been shown to be effecting malocclusion in children 6-11 years when worn a minimum of one hour daily plus overnight. As only very light forces are required to move anterior teeth (about 1.7gm 5), the use of the combination of light aligning forces, removal of aberrant myofunctional forces from the tongue, the lower lip and correcting mode of breathing, plus the features of a functional appliance is the mechanism that makes the TRAINER¨ so effective. It is particularly good for class II malocclusions, as it "trains" a class I relationship, as well as retracting upper anteriors and advancing the mandible. It also assists maxillary development and mandibular restriction in class III cases. (Unsuitable for severe class III cases)

As a replacement for existing treatment

The TRAINER¨ allows treatment of dental alignment as well as the traditional functional appliance role. In addition the myofunctional training of tongue position, swallowing and mode of breathing encompass the most recent findings of research in this subject. The problems of compliance, although still present, are minimised by the use of more flexible and thinner materials.

The lower cost and easy implementation makes routine treatment of the child with a developing malocclusion possible in the majority of cases. Although, like other orthodontic appliances, it does not always produce the most ideal result, it works at three therapeutic levels not just one, as do functional appliances and fixed appliances combined. Tooth guidance, Jaw positioning (as functional appliances do) plus Myofunctional Training. This assists normalisation of growth and development and greatly improves the stability of the final orthodontic treatment result. Further treatment becomes easier and more stable.

A practical early treatment procedure

It is therefore a consideration that the pre-Orthodontic TRAINER¨ is a practical early treatment of choice for the practitioner who is now using functional appliances as early orthodontic treatment, or, for the practitioner who has not previously used early treatment because of the inherent disadvantages of other available appliances. Lower cost, easier implementation, better compliance, tooth guidance and myofunctional training make this appliance an ideal choice for the child 6-10 with a developing malocclusion. The final outcome of following most orthodontic treatment will be enhanced by the addition of the TRAINER program outlined in the following pages of this manual.

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Patent No. 5 259 762