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For more technical information
from the author of the
Spahl Split Vertical
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SPAHL SPLIT VERTICAL APPLIANCE
Now that the orthodontic world, and more recently the "TMJ world", has learned how to advance mandibles (and hence their condyles) from a pre-treatment "up and back" position, which often implies condylar compression of the bilaminar zone, to a more correct physiologic location down and forward (placing the condyle in the "comfort zone" or "tolerant zone" of the joint), there remains one clinical problem facing all practitioners who use this technique. As the mandible is advanced, due to the combination of anterior incisal guidance on the front end, and eminential osseous guidance on the back end, there is always an attending posterior open bite that appears when the mandible is orthopedically relocated down and forward. (Anterior open bites are of course an exception to this rule.) This leaves the practitioner with the problem of closing up the posterior open bite, either prosthetically or orthodontically, in order to obtain the necessary posterior molar contact to support that joint in its newly relocated (and often pain relieving) position. This may be accomplished through orthodontic techniques in essentially two ways: by means of passive reciprocal eruption of the posteriors towards one another, or by means of active reciprocal eruption. We are all familiar with the time honored techniques of Bionator appliance usage, the cornerstone of the entire Functional Jaw Orthopedic philosophy. But with no play on words intended, that specifically is one of the main problems with the technique, the time necessary to permit passive eruption to occur. In adult cases, barring locking bites of the deep curve of Spee type, passive eruption can be so time consuming in some cases as to make both patient and clinician question if it is ever going to occur. Here is where active eruptive forces come in handy.Taking a cue from the Biofinisher technique of the famous Dr. Jack Lynn, an appliance design was sought out that would fill the following list of objectives. First it would have to involve the use of active eruptive forces that could relatively quickly move posterior teeth in opposing arches occlusally so as to close up posterior open bites attendant to conventional mandibular advancement procedures. Secondly it would have to protect the newly erupted "green" teeth from excessive occlusal forces during mastication which would tend to "round trip" the posteriors by inducing forces that would drive the teeth back down into their sockets again thus reversing the eruptive process and allowing for potential nerve damage and/or alveolar process and dental pain. Thirdly it should be esthetic as well as simple and easy to use, and that means user friendly to both clinician and patient. Lastly, it would help it were simple enough in design so as to only require a modest lab fee.It is truly believed that just such an appliance (or appliance pair) has been developed by this author and dubbed a Spahl Split Vertical appliance or an SSV. It consists of two appliances that work together as a pair that are the essence of simplicity. It may be distantly thought of as Jack Lynn's Biofinisher appliance (to which it owes an important part of its lineage) which has been split horizontally in halves, hence the name. The first part consists of a traditional maxillary fixed bite plane, an appliance that has been in use almost as long as there has been
orthodontics.
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