Dr. Rob Veis

There is nothing worse than receiving an appliance back from the lab only to find out that it just won’t do what you intended it to do. In the last issue we presented some typical prescriptions that had lead to failure. In this article, we will explore how the common facets of orthodontic appliance design (as presented in Space Maintainers’ Principles of Appliance Therapy for Adults and Children textbook) can be applied to help dramatically increase your success rates.

Quite honestly, if you don’t fill out your prescriptions carefully, you will get what you ask for but not what you really need. Depending on the lab to design your appliance by writing “PLEASE CALL” is a mistake. Although Space Maintainers’ staff are experts in appliance design and will assist you in any way they can, ultimately, correct appliance design is your responsibility. Yet, we also have to realize that properly designing an appliance is simply not as easy as it looks. Space Maintainers has developed the “Principles of Appliance Therapy for Adults and Children” textbook to help you better integrate Appliance Therapy into your practice. The textbook is an incredible tool supplying:

1. An excellent overview of the hundreds of appliance designs available today.
2. An “Anatomy of an Appliance” section, which covers every component that goes into designing an appliance, allowing you to modify any appliance in the textbook to meet your needs.
3. A quick reference format that makes selecting the section which best describes the problem you are trying to solve an easy task. Select an appliance by number but then be sure to modify this design to meet your specific needs.

Use this textbook when you are completing your prescription to ensure nothing is left out of your design. In the initial stages, think of your prescription as a teaching and communication tool as well as a design sheet. Every time you fill a prescription out completely, you will become more proficient in the art of appliance design. I am confident that if you take the time to complete every step I suggest in these articles you will not only learn how to design appliances, but you will also receive an appliance that will do what you want it to do. In this article we’ll begin by looking at the “General” requirements you should ensure are included:

Diagnostic Information
This step is essential if you want to be successful. Take the time to do a complete diagnosis. Only so much can be ascertained from a set of study models alone. Give the technicians the information they need to understand your treatment objectives and properly fabricate your appliance. Don’t be afraid to write a narrative. And, don’t forget to include your patient’s name and age.

Construction Bite
Be sure to supply the laboratory with a construction bite that gives the desired vertical and anterior/posterior relationship.

Models (working casts)
Excellent stone casts are essential to making a proper diagnosis and properly constructing an appliance. If your casts are distorted, you can be assured that your appliance will not fit. Take the time to closely inspect your casts before you send them to the lab. This small step will save you time and money by avoiding re-appointing a patient to take new impressions.

Special Services

Duplicate and return models – Space Maintainers does return working models. However, if you like to have your original cast untouched, please let us know.

Fabricate Study Models – Keeping study models as records of your treatment is recommended.

Emergency Service – When you need an appliance made fast, request special handling.