dr. amanda with straight smile solutions and today we're gonna be talking about quad hammocks
hey what's old is new again and I never stopped using these I think they're great appliances I
think people are starting to find their use again so I just wanted to give a quick shout out and
thank you to specialty appliances for sending me the demo of this model so that I could teach you
guys how to design one and how to deliver it in a patient and we'll talk a little bit about
indications for use but basically this is a great expansion appliance if you're looking
for something that you don't have to regularly activate everything is built really into the
design of the appliance and it just kind of does its job now you can't leave this thing
in forever you're talking probably three months or so plus or minus max so you need to give this
to a pretty compliant patient also it does leave a pretty gnarly imprint on the tongue it's not the
most popular appliance because it can be you definitely get some discomfort on the tongue
initially you can get some cuts so you want to make sure you pick the right patient and brief
them accordingly but basically in a nutshell you're gonna go ahead and order a quad Hilux
appliance and you can go ahead and deliver these in adults too so that's totally fine to deliver a
minute adults that have like a cross bite or a narrow upper arch I'll take these any day over
bending wires and doing cross elastics so and you can have buckle hooks soldered on the side of them
so that you can attach braces to them you can also use this as pre orthodontic therapy and deliver
this in kids or even adults before you do aligners if you want to get some great expansion have the
aligners go quicker there's also a mandibular version of this appliance I think we call it a
Dobby arch if I remember correctly uhm and similar but different you're gonna get mostly tipping with
these appliances you know not necessarily bodily movement but for any case they're really great so
basically what I do before I design and deliver one is I go ahead and I use my Boley gauge which
is right here and I take measurements at the point where the wire X is the solder joint here and here
okay and then like I'm kind of doing this without looking but in any case you can see what I'm doing
take the measurement in any case this was I think was about 34 millimeters you also want
to take the measurement at the tip of the points here I think this was about 21 millimeters you're
looking for I would say about 4 millimeters of expansion built into the appliance four or five
millimeters honestly the easiest way that I just expand it and sometimes they come pre expanded
from the lab so you need to see I mean obviously if it's coming on and off the model passively it's
not expanded it's not gonna do anything so you have to build the expansion into it they may pre
expand it for you so um figure out what you're getting but it's pretty simple this is actually
submitted on here right now and it's permanence mat so I can't pull it off but if it I was able
to pull it off I'd grab it and I'd hold the bands each in one finger and I would pull gently until
I got that four millimeters of expansion some people will use a 3-prong plier to do it but
for me the pull technique works better evenly pulling and getting that four millimeters of
expansion both here and here although if you want more expansion in the anterior region you can pull
up here a little bit more and if you want more in the posterior region then you're going to pull a
little bit more down here so there's not an exact science and the beauty is you're gonna see these
patients every three to four weeks anyway so you want a little bit more expansion than I'm looking
for ideally obviously other things that you're gonna be doing is checking the buccal roots as
you go along Chucky's for mobility sensitivity things like that bite opening up a couple things
you'll be looking for for the most part it's a pretty easy appliance once they get used to it
the first week like I said is rough but that's pretty much it that's where the quad helix is so
a great Universal expansion appliance and it's pretty much idiot-proof you really can't screw
this up as long as you don't leave it in too long so definitely three to four weeks is max I
mean if you had a super constricted palate um you know maybe you could take it out and reactivate
it you can even reactivate it in the mouth but I really think that four millimeters is really
quite enough if you're needing so much more you probably don't want tipping anyways probably in
a growing child want to consider sutural you know actual skeletal expansion and in an adult you want
to be considering surgery so that's pretty much it that's how you use a quad helix hopefully that
helps and thanks again de specialty appliances for the demo this is dr. Amanda with street smile
solutions and we here today to talk a little bit more about activating the Quan helix I know you
saw my previous video that the model was cemented so I wasn't able to show you how to activate it
but just told you theoretically how to do it but I did get another model sent to me by specialty
appliances laboratory - thank you very much to Olivia and Scott for sending me the other model
so I can show you all how to activate it so it's really easy you're just gonna pop it off the model
so let me just take a step back like I said in the other video most of the time they're gonna send it
to you not activated that means you're gonna have to activate it yourself don't freak out it's super
easy you saw the video earlier how you do it it really depends on where you want the expansion but
usually just going to give a bilateral tug to the molar bands to activate it about four millimeters
make sure you use the boolean gauge in order to measure it the first few times because you're not
gonna really know how much to do it then when it comes time to actually cement it you you will have
to you know constrict it a little bit in order to get it on one cool way you can do it is to
throw like an orthodontic rubber band around this area up here to keep it condensed so it's easy to
cement but anyways all you're gonna do is give a little tub to the molars okay that's it that's all
you're gonna do and now when you land it up next to the model you'll see it's just slightly wider
okay so it's gonna be a little tricky you're gonna have to load your band cement and then cement it
at the same time in order to get it to seat so like I said the rubber band technique works really
well but you know you need four handed dentistry you're gonna go ahead and band it oopsies see
how tricky it is of course I'm not really using center here I'm just as much anyone but you can
see it's that activation okay because it likes to pop off so definitely make sure that the patient's
biting down hard and on rules until it fully cements and that's how you activate a claudia
likes remember keep an eye on your patient these things work relatively fast you want to make sure
you recall them every three to four weeks you're looking for a maybe 20% more expansion than you
actually want sometimes you may have to pop it off and reactivate it but usually one time is enough I
wouldn't leave it in any more than three to four months max because it will push teeth outside the
bone if it's really activated and she's leave it in too long really that's pretty much it yep go a
little bit wider and then afterwards if you need to maintain your whip you can always make like a
dance or a trance paddle arch or something like that okay because this has activity or
you can make this passive and leave it in but I think it's better just to put something else in
anyway that's pretty much how your activator quad helix I hope you all have a great day thank you