Passive use of Lingual Arch and Transpalatal Arch
- Lingual arch (LLA) maintains molar position in cases of lower teeth space maintenance.
- LLA and Transpalatal arch (TPA) stabilize molar position to avoid side effects during orthodontic therapy.
- LLA prevents migration of permanent molars in cases of early loss of deciduous molars.
- LLA blocks off eruption space for premolar teeth in cases of early loss of deciduous molars.
- LLA maintains Leeway space in the arch after exfoliation of deciduous molars.
- TPA can be used as an adjunct for anchorage in extraction treatment.
- Studies show negligible difference between patients who received TPA and those who didn't.
- TPA cannot provide absolute anchorage to prevent mesial movement of posterior molars.
- TPA is effective in cases of palatally displaced canine teeth without requiring expansion.
- TPA prevents buccal tipping of molars in Burstone-type Segmental Arch mechanics.
Active use of Lingual Arch and Transpalatal Arch
- LLA and TPA can be activated to obtain molar movements in all planes of space.
- LLA and TPA are frequently activated to expand or reduce intermolar distance and rotate molars.
- TPA can be activated to maintain molar position in open bite cases with TADs for intrusion.
- LLA and TPA archwires are usually made of stainless steel for passive use.
- Beta-titanium wire is more effective for activating LLA or TPA for molar displacement.
Studies and Research
- Brennan and Gianelly (2000) used lingual arch in mixed dentition to resolve incisor crowding.
- Zablocki et al. (2008) studied the effect of TPA during extraction treatment.
- Baccetti et al. (2011) conducted an RCT on treatment of palatally displaced canines with RME and/or TPA.
- Fiorelli and Melsen (1995-2018) discuss the biomechanics of lingual arches.
- Tsetsilas et al. (2015) analyzed symmetric and asymmetric expansion of molars using Burstone-type TPA.
Other uses of Transpalatal Arch
- TPA can be used to prevent premolar space closure in cases of molar movement as a group.
- TPA is used to prevent buccal tipping of molars in Burstone-type Segmental Arch mechanics.
- TPA is used in cases of open bite to maintain molar position during TAD-assisted intrusion.
- LLA and TPA archwires are typically made of stainless steel for passive use.
- Beta-titanium wire is more effective for activating LLA or TPA for molar displacement.
General Information
- Lingual arch and Transpalatal arch can be used for passive or active purposes.
- Lingual arches are used to maintain molar position, prevent migration, and block off eruption space.
- Transpalatal arches are used for anchorage, stabilization, and prevention of buccal tipping.
- Stainless steel archwires are commonly used for passive use, while beta-titanium wire is preferred for activation.
- Various studies and research have been conducted on the effectiveness and biomechanics of lingual and transpalatal arches.
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). The TPA was originally described by Robert Goshgarian in 1972. TPAs could possibly be used for maintaining transverse arch widths, anchorage in extraction case, prevent buccal tipping of molars during Burstonian segmented arch mechanics, transverse anchorage and space maintenance.
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).
