Maxillary disjunction: truths and myths

The anatomy of the face and, consequently, its appearance, depends to a large extent on the occlusion (the 'bite') of each person, so it is important to maintain the best possible situation in our teeth to ensure proper aesthetics and to ensure that no damage is done to our masticatory system.

In many cases, the professional experts in Orthodontics in the Murcia Region patients are found to have dental crowding that is solved with classic 'brackets', with lingual orthodontic systems such as Incognito o Harmonyor with plastic orthodontics, such as Invisalign.

However, on other occasions, and after an exhaustive cephalometric and radiographic analysis and analysis of the patient's photographs and models, orthodontists find that there are bone 'discrepancies'The upper jaw is larger than the mandible, or vice versa, or both are too small for the patient's face, or both are too large.

X-rays, models and photographs complete a thorough clinical examination for an accurate diagnosis.
X-rays, models and photographs complete a thorough clinical examination for an accurate diagnosis.

One of the most common situations is to find that the upper jaw is 'narrower' than the lower jaw, which usually manifests itself as a 'crossbite', so that the upper and lower jaw are 'narrower'. the upper teeth on one or both sides bite 'on the inside' of the lower teethThe new system, rather than 'on the outside', as is the usual practice.

Note how on the left side of the image the upper teeth bite 'inside' the lower teeth.
Note how on the left side of the image the upper teeth bite 'inside' the lower teeth.

In these cases of crossbite, an experienced orthodontist will assess the need to expand or disjunct the jaw, in order to compensate for its narrowness, taking advantage of the patient's growth, so this is a treatment focused on children's patients, who are still growing.

A McNamara circuit breaker, with acrylic, will allow excellent vertical control.
A McNamara circuit breaker, with acrylic, will allow excellent vertical control.

A circuit breaker, which can be used with strips, acrylic, etc. of different types, depending on the characteristics of the patient, is a prosthetic element. custom-designed which will 'separate' the palatal suture and increase the maxillary width, thus resolving the skeletal problem in a short time.

Occlusal view of the circuit breaker, custom-made for the patient
Occlusal view of the circuit breaker, custom-made for the patient

One fact to bear in mind is that, once disjunction has begun, the space between the upper central incisors, the 'pallets', tends to widen, due to this increased space, something that should not alarm the patient's parents, as it will result in an advantage for the permanent teeth to finish setting in the mouthIt is preferable to have enough space for all of them.

The 'vanes' have separated. Note that the device is almost invisible from the outside.
The 'vanes' have separated. Note that the device is almost invisible from the outside.

Once disjunction has been completed and crossbite has been resolvedDepending on the characteristics of the patient, it may be necessary to fit multibracket fixed appliances, which will be at the discretion of the orthodontist who, together with the parents, will assess the occlusion and aesthetic needs of the patient and the improvements to be achieved in each case.

The circuit breaker is almost imperceptible externally.
The circuit breaker is almost imperceptible externally.

In any case, the patient's bone bases will have been harmonised with maxillary disjunction, avoiding recourse to maxillofacial surgery solutions in adult patients in whom disjunction is not possible, as growth has already been completed.