Early Orthodontic Treatments
Space Maintainer - Lingual Arch

A lingual arch is an orthodontic device which connects two molars in the upper or lower dental arch. The lower lingual arch (LLA) has an archwire adapted to the lingual side of the lower teeth. In the upper arch the archwire is usually connecting the two molars passing through the palatal vault, and is commonly referred as "Transpalatal Arch" (TPA).

LLA and TPA are fabricated by placing bands on the molars. These are connected to the archwire. The wire can be soldered to the bands or inserted into lingual sheaths welded to the molar band (removable LLA and TPA).

Passive Use

LLA is frequently used as a space maintainer for the lower teeth. In such a case a LLA maintains the molar position. LLA and TPA can also be used to stabilize molar position in the attempt to avoid side effects that can take place during orthodontic therapy. As a space maintainer LLA is frequentely used in cases where an early loss of the second deciduous molar takes place. In such a case LLA prevents the permanent molars from migrating mesially (forward) thus blocking off the eruption space for the premolar teeth. LLA is also used in order to maintain the so-called "Leeway space", which is the extra space available in the arch when the deciduous molars are exfoliated and replaced by smaller permanent premolars.

Active Use

LLA and TPA, if removable, can also be activated in order to obtain molar movements in all planes of space. LLA and TPA are more frequently activated to expand or reduce the intermolar distance and to rotate the molars. In this way it is possible to reshape the whole dental arch if molars are connected to the other teeth by means of a buccal archwire.

The transpalatal arch (TPA) can be used as an adjunct during orthodontic treatment to help control the movement of the maxillary first molars in 3 dimensions, including producing molar rotation and uprighting, maintaining transverse dimensions posteriorly during treatment, and maintaining leeway spaces during the transition of the dentition. The purpose of this retrospective cephalometric study was to test an additional function of the TPA: its ability to enhance orthodontic anchorage during extraction treatment.

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