Article title: Modifications of the palatal crib
Author(s):Gawlik JA, Ott NW, Mathieu GP
Journal: Journal of Dentistry for Children
Volume (number):
Date: November-December 1995
Major Topic: Habit breaking appliances
Type of Article: Professional Opinion
Main Purpose: Review purpose and design of habit breaking appliance and recommend improvements in design
Materials and Methods:
Literature concerning habit-breaking appliances was reviewed. The most common problems were discussed and recommendations to the design were made.
Findings:
Design of palatal crib appliance: bands on first permanent or second primary molars. A palatal arch wire is formed using a .036 or greater diameter heavy stainless steel wire. Shorter lengths of wire are positioned and soldered to the arch to form a smooth rounded crib. Sharp spurs or hay rakes should not be used. Wires should be passive with .5-1mm relief from the tissue. The crib should be in the intercanine area, covering the extent of the open bite. It should also not interfere with the mandibular teeth.
A problem encountered with this appliance is the wire embeds into the palatal tissue. When this happens, removal can be very painful and require local anesthesia.
Modified design: Orthodontic acrylic can be added to the palatal region of the appliance, so that it is supported by the acrylic and the wire is incapable of being imbedded in the palatal tissue. Palatal acrylic and a crib can also be added to a Hawley retainer, but this treatment is often compromised by poor compliance.
Key points/Summary:
Goals of a habit therapy include a design that is nonpunitive, unobtrusive and nondamaging to oral soft and hard tissues.
The author recommends addition of an acrylic palatal button with .040 or .045 inch palatal wires.
Assessment of article:
It’s a pretty good idea. Habit appliances are pretty much a toss-up anyway. I’ve seen them imbed, but usually the kid is sucking even thought the appliance is there.
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