David_ChristensenBy David Christensen, DMD, MS, Kansas City, Mo

I have been using the AdvanSync™ 2, molar-to-molar appliance for about 5 years—it is my go-to fixed appliance for growing patients who present with class II dental or skeletal relationships. AdvanSync 2 is a highly versatile appliance. In addition to correcting class II dental and skeletal discrepancies, it can be used to distalize the maxillary molars in order to create space in the anterior for crowded teeth while maintaining a full tooth smile, with no extractions.

When treatment planning with AdvanSync 2, I recommend adjusting treatment sequencing based on the patient’s facial type. “Meso” and “dolicho” facial types with mild to moderate overbites can be bonded 5-5 and fitted immediately for an AdvanSync 2. For patients showcasing a “brachy” facial type and a severe overbite, I delay delivery of AdvanSync 2 until the bite is sufficiently opened for proper advancement of the mandible. For these patients, I recommend beginning treatment by bonding 7-7 to level and align the arches. Oftentimes, I use a 19 x 25 reverse curve NiTi in the lower arch to finish leveling of the Curve of Spee. The AdvanSync 2 can then be placed and activated properly.

Ormco_AdvanSyncIn my office, we keep AdvanSync 2 appliances in place for ?12 months. In doing so, we can maximize the orthopedic effect in growing patients with condylar and fossa remodeling combined with the “headgear” effect. This also creates a simple, systematic approach to treatment by dividing it into three 4-month segments:

  1. First 4 months: Place the appliance with initial activation (approximately 4 to 6 mm) and hold.
  2. Second 4 months: Activate appliance another 4 mm and hold.
  3. Final 4 months: Activation includes overcorrection of 3 to 4 mm; hold.

After 12 months, schedule removal and bonding of the first and second molars in order to finish the occlusion.