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Bimaxillary Expansion

September 24, 2022

In this brief lecture clip, Dr. Rebecca Bockow demonstrates the remarkable results possible for children with severely crowded teeth when treated with early jaw expansion techniques. Note that the final position of the patient's teeth shown has been achieved without the use of braces or clear aligners.

Dr. Rebecca Bockow is a dual-trained board-certified orthodontist and periodontist – one of only a handful in the country. She lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development.

“So looking at a case here, if we look at this young man, he came to our practice at age eight, and you can see he has a double crossbite on both sides. I will tell you that the lateral incisors, maxillary lateral incisors, and the lower left canine exist radiographically, but there's just not enough room for them in the arch.

“You can see here how crowded he is. He has large tonsils, large adenoids, and so you can see here. He had difficulties breathing with his lips together even for that eight-second CBCT scan. So we have an airway blockage both at the level of the adenoids and at the tonsils leading to a low tongue posture, probably a major contributing factor to his small upper jaw.

“So we did two rounds of maxillary expansion in order to make room for all of the adult dentition to come in. And here he is; not a single bracket has been placed. No clear liners have been used here. All we've done is two rounds of upper expansion and about two years' worth of slow, meticulous lower dental uprighting.

“And so by doing upper and lower expansion, we've created enough room for the bone, and that has, in turn, allowed room for the adult teeth to come in. So you can see here looking at this side by side seeing how if we develop the arches early, we can create enough room for the teeth to come in.”

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