What are the stages of AGGA treatment? How long will it take?
There are 2 stages of treatment, each lasting about a year.
The Growth Phase – for up to a year you will wear AGGA, visiting me once a month to have the appliance adjusted. It is during this first phase that the bulk of forward facial growth occurs.
During this stage you will develop a sizable gap between your canines and premolars on each side of your upper jaw, providing visual evidence of the rapid forward advancement of your maxilla. These are the famous “AGGA gaps.”
At the beginning of Phase 1 when I install AGGA, I will also adhere bite plates onto your lower molars. These are flat acrylic buildups that transform those molars into flat, neutral biting surfaces. These flat surfaces allow your lower jaw (mandible) to slide itself constantly into new, more-forward positions in synchrony with your forward-growing maxilla. While the upper jaw develops forward, the lower jaw remodels itself forward.
This forward-repositioning of the lower jaw, made possible by the forward expansion of your upper jaw, is a critical step in decompressing the airway and your jaw joints, which is the ultimate goal of treatment.
The “Controlled Arch” Braces Phase – Once sufficient growth and remodeling of the upper and lower jaws has been achieved, we will tidy up the teeth with braces. This finishing phase allows further development of the dental arches while guiding all teeth to their proper positions.
In particular, we will need to bring the back teeth forward to occupy the new frontal real estate created by AGGA in your upper jaw. You will have the option to place implants in the spaces normally occupied by your second premolars as an alternative to bringing the molars all the way forward. This, however, is not necessary, especially for those patients who never had premolars pulled as part of a prior orthodontic procedure.
Those who have had the misfortune of having some permanent teeth removed (or are missing teeth for another reason) might choose to replace those teeth with implants. Patients who opt for implants will be referred to an implant specialist.
There is a second goal of the Controlled Arch braces phase of treatment: widening of the arches. While AGGA achieves a dramatic amount of forward growth, it is during the Controlled Arch phase that special metal arches are installed along the gums behind the upper and lower teeth. These arches provide a widening stimulus which works in harmony with the stimulus of the braces.
Together, AGGA and the Controlled Arches provide forward and sideways growth.