Uses of the Trainer to Assist in Other Treatments

Uses during orthodontic treatment

From 8-12 years most of the growth has taken place in the anterior part of the arches. The TRAINER¨ is often not able to offset major jaw discrepancies such as maxillary underdevelopment and/or major class II or III malocclusions. The tooth alignment system, although still effective, is less so as the child gets older. However, the maxillary expansion can be performed first with various appliances (Schwarz or Biobloc Stage I) and and then the patient can use the TRAINER¨ (soft or hard) for the remainder of treatment for mandibular advancement, dental alignment and myofunctional therapy. This can substantially reduce the cost (to the Dentist) of treatment of these cases.

After maxillary expansion, the patient wears the removable appliance by day and then the TRAINER¨ 1 hour per day and overnight. Treatment time 9-12 months depending on outcome. Further treatment can still be implemented later if necessary.

During functional appliance therapy

The TRAINER¨ can be used 1 hour per day, to help to correct mouth breathing (see case on video) to speed up treatment by treating the myofunctional component that is driving the malocclusion. So called functional appliances generally do not treat the myofunctional and mouth breathing habits. These appliances can sometimes make the habits worse. Use of the TRAINER¨ daily for one hour during this treatment can substantially improve the result by decreasing treatment time, enhancing arch development and improving stability. If progressing to the fixed phase this myofunctional treatment can be continued using the TRAINER for BRACES¨.

Clark Twin Block/Biobloc Treatment

Mandibular advancement appliances like the Clark Twin Block are now commonly used for class II correction. Although the correction appears successful, much of the gain can be lost when the appliances are removed for fixed appliance or retention phases. The soft tissue is often to blame. Mouth breathing and tongue habits need to be corrected in conjunction with these appliances. The TRAINER¨ is used one hour daily in conjunction with these appliances for myofunctional correction.

Biobloc treatment which heavily emphasises posture of the mandible and associated myofunctional treatment. The TRAINER¨ is an essential part of this treatment for active soft tissue correction. As maxillary expansion takes place and mandibular advancement, the soft tissues need treatment to adapt to new positions and to correct the cause of the malocclusion. After the first stage of treatment, the TRAINER¨ (Blue) is used 1 hour daily, with appliances removed, to correct myofunctional habits and improve mandibular posture. This time can then be increased in the later stages of treatment. If fixed appliances are applied, then change to the TRAINER for BRACES¨.

Use the TRAINER program in conjunction with Crozat, Clark Trombone and ALF appliances.

Post Orthodontic Treatment

In the retention phase a most important use to assist stability. Many cases that appear well treated and stable relapse to unsatisfactory levels. (see research) A large number of these would be from untreated oral musculature as observed by Angle. In the retention phase, use the TRAINER¨ 1 hour per day (with retainers removed if removable). With fixed retainers the TRAINER¨ can be used 1 hour daily plus at night as well. The soft version is preferred if the dental alignment is good, the hard version if some anterior tooth alignment or "bite settling"is needed.

Minor Relapse

When the patient returns after their retention phase and some minor dental relapse has occurred, this can be expensive to correct. First, show the patient they are causing the relapse because of the uncorrected myofunctional problems. Point out those detrimental factors of mouth breathing and incorrect swallowing. Now, the TRAINER¨ is used to help correct the myofunctional problems causing the relapse. It will also help with minor tooth alignment and arch loss.3 You must emphasise that the TRAINER¨ will not work unless it is used everyday. Minor dental relapses can be corrected in this way saving much time and added expense.

Bruxers

The soft TRAINER¨ is ideal for the child who is a bruxer, being easy to implement with specific design characteristics. i.e. the double mouthguard effect limits lateral function, while the aerofoil shaped base functions as a pivotal splint. More children than is recognised are bruxers and will tend to develop TMJ disorders if untreated. Conventional splint therapy can impair the development of the dentition, so the soft TRAINER¨ is ideal for this purpose.

TMJ treatment

TMJ disorder in children is prevalent. Riolo, Brandt and Tenhave American Journal of Orthodontics, 1987 quote incidences of 36-72% of TMJ Disorder in their study of 6-17 year olds. The TRAINER¨ has therapeutic characteristics to help with this disorder. There is an aerofoil shaped base which is thickest over the first molar area. This aids decompression of the inflamed joint and the double mouthguard design of the TRAINER¨ limits bruxing. Both helpful if the patient may have or may be developing a TMJ Disorder.

"Studies of TMJ Disorders in children have emphasised the need to continue to evaluate these problems during childhood and youth. In, fact based upon adult and childhood studies, it would appear that the signs and symptoms of temporomandibular joint disorders are highly prevalent in all age groups."

Associations between occlusal characteristics and signs and symptoms of TMJ dysfunction in children and young adults Am J Orthod Dentofac Orthop 1987;92:467-77.

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Patent No. 5 259 762