MXPA00010356A - Mandibular and maxillary arch expander and jaw repositioner including pivotal mounting boss - Google Patents

Abstract

An orthodontic appliance (1) includes a mandibular arch expander (3), and a maxillary arch expander (5) which are interconnected by a pair of adjustable connector assemblies. The maxillary, and mandibular arch expanders each include front (13), and rear (41) orthodontic bands which have bosses (15, 17) to facilitate connection of the connector assemblies to the arch expanders. The connector assemblies include an expandable tube assembly (7), and a rod (105) which extends through said expandable tube assembly. The expandable tube assembly has a mount at a first end thereof adapted to connect the connector to the rear orthodontic band of the maxillary arch. The rod has a mount adjacent a second end of the expandable tube assembly adapted to be connected to the front orthodontic bands of the mandibular arch expander. The tube assemblies each include a hollow posterior tube (103), and an anterior tube (101) which are telescopically connected. Further, the anterior tube includes indicators, in the form of spaced apart tick marks (121). An improved pivotal mounting boss (300) for attachment to front or rear orthodontic bands (13) on a mandibular arch expander (3), and a maxillary arch expander (5). The pivotal mounting boss includes a base casing (302). A screw (33) is threadely engaged in the base casing. The base casing (302) has an opening for the insertion of an arch wire (W). The opening (308) can be pre-angled to assist in root angulation when the arch wire (W) is inserted.

Description

MANDIBULAR AND MAXILAR ARC EXPANDER AND MANDIBULAR REPOSITIONER INCLUDING PIVOT ASSEMBLY REINFORCEMENT DESCRIPTION OF THE INVENTION This invention relates generally to orthodontic devices and, in particular, to an improved pivot receptacle for a fixed mandibular arch and maxillary arch expanders that are connected together to allow anterior positioning of the jaw to the closure. Orthodontists who treat children often get room in the infant's mouth for the mandibular incisors that have not sprouted and to increase the distance between the tusks for narrow arch forms, as well as to distill the first molars of the jaw so that a total increase in arch length is available in the lower dental arch from the first molar to the first molar. In addition, the orthodontist may have the need to expand the palate accordingly. Mandibular and maxillary arch expanders are known in the art for expanding and widening mandibular and maxillary arch lengths. The use of such arch expanders helps to avoid the need for removal of the tooth from the permanent tooth due to excessive deformation. However, such mandibular arch expanders are rather bulky in design, prevent mobility of the tongue, are uncomfortable for use and interfere with good oral hygiene. The devices must be substantial in design to withstand the twisting or levering mechanisms during chewing. To facilitate the corresponding lengthening of the maxillary and mandibular arches, telescopic mechanisms have been used to promote the forward repositioning of the lower jaw as the patient closes in the occlusion. Such devices are commonly referred to as Herbst appliances. Current Herbst appliances include a hollow tube and a bar that is received telescopically in the tube. The tube is connected to the maxillary arch expander and the bar is connected to the mandibular arch expander. In general, the tube and the bar are connected to a stainless steel band or crown by means of a pivot connection. The pivot generally comprises a base receptacle that is welded to the band or crown and a screw that is inserted through a buttonhole formed on the end of the hollow tube or bar. The screw threadably engages the base receptacle and is adjusted, leaving sufficient clearance for the eye to pivot around the screw. Frequently the orthodontist uses a dental brake connected between two ends between the arc expander. In the past, to accommodate the dental brake, the orthodontist or technician had to first attach a rectangular cable tube to the band or then attach the base band over the top of the rectangular tube. This arrangement has a relatively high profile caused by the stacking of the rectangular tube and the base receptacle together with the increased welding mass. It is a primary object and of the present invention to provide a dental appliance that includes a mandibular expander of the Herbst type. It is an object of the present invention to provide an improved pivotal mounting reinforcement that can accommodate a dental brake by a mandibular expander. Another object is to provide such an improved pivotal mounting flange that is integral and does not require the use of a separate dental brake tube. A further object of the invention is to provide the pivotal mounting reinforcement that allows for lower profile welding or welding. Yet another object of this invention is to provide the pivotal mounting reinforcement that can accommodate a dental brake for a mandibular expander that is more comfortable for the patient. Another object of the invention is to provide the pivotal mounting reinforcement that can accommodate a dental brake for a mandibular expander that can have a pre-twisted, pre-angled dental brake opening in the base receptacle that aids in root angulation when the brake is inserted. dental. Another object of the invention is to provide the pivotal mounting reinforcement that can accommodate a dental brake for a mandibular expander that is easy to manufacture, efficient in its installation and is very suitable for the intended purposes. This and other objects will become apparent to those skilled in the art upon review of the following description and accompanying drawings. In summary, the orthodontic appliance includes a mandibular arch expander and a maxillary arch expander that are interconnected by a pair of adjustable connector assemblies or Herbst type apparatuses. The maxillary and mandibular arch expanders are generally identical to the expanders set forth in U.S. Patent No. 5,645,222, and include front and back orthodontic bands. The orthodontic bands include reinforcements that facilitate the connection of the connector assemblies to the arch expanders. The connector assemblies include an expandable tube assembly and a rod extending through the expandable tube assembly so that the tube and the rod are telescopically movable relative to each other. The expandable tube assembly has a mounting on the first end thereof adapted to connect the connector to the posterior orthodontic band of the maxillary arch. The bar has a mounting adjacent a second end of the expandable tube assembly adapted to be connected to the front orthodontic bands of the mandibular arch expander. The tube assemblies each include a hollow rear tube and a front tube that are telescopically connected. Preferably, the front tube is a hollow body that is threaded externally at its rear end. The back tube has a hollow body that defines a hole and is threaded internally at its front end of the tube. The rear tube orifice is sized to accept the anterior tube so that the two tubes can be connected in a threaded manner. The back tube includes holes adapted to receive a tool to facilitate adjustment of the position of the back tube relative to the front tube to alter the overall length of the position of the retractable pull tube assembly. In addition, the front tube includes indicators in the form of against separate marks, to inform the practitioner of the length of the connector assembly. The improved pivotal mounting reinforcement is for joining the front or back orthodontic bands on a mandibular arch expander and a maxillary arch expander. The pivotal mounting reinforcement includes a base receptacle that is welded to the orthodontic band. A screw is threadedly engaged in the base receptacle. The base receptacle has an opening formed therein for insertion of a dental brake. The opening can be pre-angled to assist in root angulation when the dental brake is inserted. The orthodontic bands are interconnected by a pair of adjustable connector assemblies. The connector assemblies include an expandable tube assembly and a rod extending through the expandable tube assembly so that the tube and the rod are telescopically movable relative to each other. The expandable tube assembly has an eyelet at a first end thereof for the insertion of the pivotal mounting reinforcement screw to pivotally secure the connector to the posterior orthodontic band of the maxillary arch. The bar has an eyelet adjacent a second end of the expandable tube assembly for insertion of the pivotal mounting reinforcing screw to be connected to the base receptacle attached to the front orthodontic bands of the mandibular arch expander. BRIEF DESCRIPTION OF THE DRAWINGS FIGURE 1 is a perspective view of a mandibular arch expander and maxillary arch expander shown assembled in a mold and connected by a telescopic assembly of the present invention; FIGURE A is a plan view of the maxillary arch expander mounted in the mold with the telescopic assembly mounted thereon; FIGURE IB is a top plan view of the mandibular arch expander mounted in the mold with the telescopic assembly mounted thereon; FIGURE IC is a top plan view similar to that of FIGURE IB, but with an alternative mandibular arch expander; FIGURE ID is a top plan view of a nearest mandibular molar space that can be used with the telescopic assembly of the present invention; FIGURE 2 is a side elevational view of the telescopic assembly, partially in cross section; FIGURE 3 is a front plan view of the telescopic assembly; FIGURE 4 is a side elevational view of a bar of the telescopic assembly; FIGURE 5 is a front elevational view of the bar; FIGURE 6 is a side elevation view of a rear tube of the telescopic assembly; FIGURE 7 is a rear elevation view of the back tube; FIGURE 8 is a side elevational view of a front tube of the telescopic assembly; FIGURE 9 is a front end elevational view of the anterior tube; FIGURE 10 is a rear end elevational view of the anterior tube; FIGURE 11 is an exploded view of a pivotal mounting hinge assembly of the prior art and an orthodontic band with a rectangular tube interposed to accommodate a dental brake; FIGURE 12 is a perspective view of the pivotal mounting reinforcement assembly of the prior art of FIGURE 11 attached to an orthodontic band with a rectangular tube interposed to accommodate a dental brake; and FIGURE 13 is a perspective view of the improved pivotal mounting reinforcement assembly of the present invention attached to an orthodontic band. The corresponding reference numbers will be used through the different FIGURES of the drawings. The following detailed description illustrates the invention as an example and not as a limitation. This description will clearly allow someone skilled in the art to make and use the invention and describe the adaptations and variations of the invention, including currently considered the best mode of carrying out the invention. Returning initially to FIGS. 1-1B, an orthodontic appliance 1 of the present invention is shown mounted on a mold M of a mouth. Although the apparatus 1 is shown mounted in a mold, it will be appreciated that it is designed for use in the human oral cavity to increase the size of a child's mouth so that the child's permanent teeth will not be piled up when they sprout. This will reduce the need for extractions of permanent teeth. The apparatus 1 includes a mandibular arch expander 3, a maxillary arch expander 5 and a pair of telescopic assemblies 7 extending between and connecting the mandibular and maxillary arch expanders 3 and 5 as described below. The mandibular and maxillary arch expanders 3 and 5 are substantially the same as the arch expanders set forth in the aforementioned U.S. Patent No. 5,645,422, which is incorporated herein by reference. The mandibular arch expander 3 (FIGURE IB) has a pair of separate anterior orthodontic bands 13 of which are adapted to be attached to the first mandibular molars. The bands 13 each have a reinforcement 15 placed on the tongue side of the bands and a reinforcement 17 placed on the buccal side of the bands. The buccal reinforcements 17 are adapted to receive the screws 19 for connecting the telescopic assemblies 7 to the mandibular arch expander 3, as will be described below; the respective reinforcements 15 and 17 are formed integrally on the respective bands to provide a substantial metallic body for attachment to other elements that will be described hereinafter. The improved pivotal mounting reinforcement that can accommodate a dental brake, which is the subject matter of this invention, will be described in greater detail below. The bands 13 are interconnected by an expansion complex 21. The expansion complex 21 has a pair of metal blocks 23. The blocks 23 each have three holes 25, 26 and 27 formed laterally therethrough. The holes 25, 26 and 27 of the two blocks 23 are in substantial horizontal alignment. The alignment pins 29 extend through the outer holes 25 and 27. The respective alignment pins 29 are slightly undersized relative to the respective holes 25 and 27 so that the blocks 23 will slide relative to the pins 29. The intermediate holes 26 are threaded and receive a threaded screw 33. There is at least one hole 35 formed through the middle part of the screw 33 between the opposite threaded ends. The hole 35 accommodates the insertion of a small tool to rotate the screws 33. It will be appreciated that the threaded screw 33 has opposite threaded ends. Thus, when the screw 33 is rotated in one direction, the blocks 23 are moved away from each other and when the screw 33 is rotated in the opposite direction, the blocks 23 are pulled towards each other. The blocks 23 slide over the alignment pins 29 and the alignment pins serve to stabilize the expansion screw complex. The blocks 23 are mounted on the lingual reinforcements 15 by curved arms 35 which extend between the reinforcements 15 and the block 23. The curved arms 35 may be of any length and curvature suitable for fitting adequately on the patient's teeth. The mold M is made following conventional procedures and the arms 35 are made to be of appropriate length and curvature. The arms 35 are then welded to the appropriate reinforcement 15 and to the expansion screw complex 21. A bar 37 extends rearward from each of the lingual reinforcements 15. The bar 37 may be a small hollow tube, to reduce weight or may be a solid bar As stated above, the exact position on the respective reinforcements 15 where the bars 37 are joined and the angle at which the bar 37 extends from the reinforcements 15 depends on the needs of the patient and the patient themselves. It will be appreciated that the arms 35 and the bars 37 may be an integral piece suitably flexed to form the arm and the bar or the bar and the arm may be separate pieces. The mandibular arch expander 3 also has a pair of separate posterior orthodontic bands 41. The bands 41 are generally molar bands and, in use, are attached to permanent first molars. Each band 41 has an integral reinforcement 43 placed on the lingual side of the bands. A hollow tube 45 extends forwardly from each boom 43. The hollow tubes 45 have an internal bore sized to accommodate the sliding insertion of the rods 37, as will be explained in detail below. A pair of short wires 47 extend perpendicularly from the tubes 45. The respective short wires 45 extend into the mouth and serve as occlusion supports and are welded on the respective tubes in a position corresponding to the lingual occlusal groove of the seconds. bilaterally molars bilaterally to provide additional support and stability to the tubes. The anterior pair of orthodontic bands 3 are connected to a posterior pair of orthodontic bands 41 to promote the molar distalization and the development of additional arc length by a pair of bar assembly bars and spring loaded tube. The bars 37 are slidably coupled in the tubes 45. The coil springs 49 are placed around the bar 37 and fixed between the reinforcements 15 and the end of the tube 45. The coil springs 49 are dimensioned so as to butt the ends of the tubes 45 and do not slide on the tubes 45. The coil springs 49, therefore urge the anterior bands 13 away from the rear bands 41 to increase the length of the palate. The coil springs 49 have a preset tension. The pre-set tension of the spring selected by the orthodontist to effect the development of appropriate mesial distant arch length in the bicuspid area. An alternative embodiment of the mandibular arch expander 3 'of the present invention is shown in FIGURE IC. The mandibular arch expander 3 'is substantially identical to the mandibular arch expander 3 shown in FIGURE IB. However, it varies in the construction of the expansion complex 21 '. The 3 'arch expander includes separate anterior orthodontic bands 13' having lingual reinforcements 15 '. The expansion complex 21 'includes a hollow tube 61 extending from a reinforcement 15' and a bar 63 extending from the other reinforcement 15 '. The angles at which the tubes 61 and the bar 63 extend from the respective reinforcements depend on the shape of the patient's mouth. The bar 63 is slidably engaged in the tube 61. A coil spring 65 is rotatably mounted about the bar 63 and fixed between the reinforcement 15 'and the end of the tube 61. The spring 65 is sized to couple the end of the tube 61 and does not slide on tube 61. Therefore, the spring 65 urges the front bands 13 'away from one another. The spring 65 has a predetermined force to be supplied between the molars to widen the width of the anterior fangs. The maxillary palate expander 5 (FIGURE IA) has a pair of separate anterior orthodontic bands 71 that are adapted to join maxillary molars. Each band 71 has a reinforcement 73 placed on the lingual side of the bands. The respective reinforcements are formed integrally in the respective bands. There is an integral curved member or hook 75 extending inwardly or lingually from the reinforcements 73. A pair of separate posterior orthodontic bands 77 are positioned rearwardly of the anterior bands 71. The bands 77 each have an integral lingual reinforcement 79 and an integral buccal reinforcement 81. The lingual reinforcements 79 have an integral curved member or hook 83. The buccal reinforcements 81 each have a screw hole for restoring a screw 85 for connecting the telescopic tube assemblies 7 to the maxillary arch expander 5. The anterior orthodontic bands 71 are connected to the posterior orthodontic bands at 77 by a bar 87. In addition, the hooks 75 and 83 are embedded in plastic plates 89 and 90. The respective plastic plates are molded to fit the palate of the patient. Each plate, with the associated anterior and posterior bands, comprises half of the expander 5. The halves of the expander 5 are deviated from one another to widen the maxillary arch. There is a substantially U-shaped bar 91 embedded in the plate 90. The bar 91 has limbs that extend outwardly and at substantially right angles to the plastic plate 90. The coil springs 96 and 97 are rotatably supported around the limbs, respectively. A pair of short tubes 99 are embedded in the plate 89. The tubes 99 extend out of the palate plates 89 at substantially right angles to the palatal plate. The tubes 99 are in complementary alignment with the ends of the U-shaped bar 91 and are slightly oversized so that the limbs can slide into the tubes. The springs 96 and 97 couple the ends of the tubes 99 and exert tension force to separate the halves of the apparatus. The appropriate tension can be exerted by means of selected springs with the appropriate tension. To facilitate the transverse development of the lower jaw relative to the upper jaw, the maxillary and mandibular arch expanders are interconnected by telescopic Herbst type assemblies 7, which are shown in detail in FIGURES 2-9. The two assemblies are identical and include a back tube 101. An anterior tube 103, and a rod 105 that extend through the two tubes 101 and 103. The posterior tube 101 includes a hollow body 107 that is open at its front ends. And later. The body 107 has an outer diameter that is substantially constant between its front and rear ends. The front end 109 is threaded externally as in 111. An arm 113 extends upwardly from the body of the tube 107 in the front part 115 of the body. The arm 113 has an eyelet 117 at its free end, the eyelet having a hole 19 therein. Intermediate to its front and rear ends, the rear tube 101 includes a plurality of counter-markings 121 which are used to indicate the amount of advancement of the anterior tube 103 on the rear tube 101 as will be described below. The countermarks 121 are preferably approximately one millimeter apart. The anterior tube 103 includes a hollow body 123 that defines a hole 125 therethrough. The tube 103 is open at its rear and front ends 127 and 129 respectively. The front end 127 of the tube tapers inwards, as in 131 so that the front of the tube 103 has an outer diameter smaller than the rest of the body of the tube 123. As seen in FIGS. 8 and 10, the body 123 also tapers slightly from the back of the surface 131 to the back 129 of the body 123. The tube 123 is threaded internally at its front end as in 133. The diameter of the hole 125 is slightly larger than the outer diameter of the front tube 101, and threads 111 and 133 of tubes 101 and 103 respectively, are machined or otherwise shaped so as to engage. Therefore, the front and rear tubes 101 and 103 are connected in a threaded manner. The notches or holes 135 are formed on the exterior of the body of the rear tube 123. The notches 125 are adapted to receive a tool having a head correspondingly. The tool can be used to rotate the posterior tube 103 relative to the anterior tube 101 when the apparatus 1 is mounted in the mouth of a patient. The bar 105 is generally a straight bar. It has a generally constant diameter slightly larger than the inner diameter of the anterior tube 101, so that it can slide relative to the tube 101. At its rear end, the bar 105 has a grommet 141 having a hole 143.

A mandibular molar space seal 201 is shown in FIGURE ID. As can be seen, it is similar to the mandibular arch expander of FIGURE IC. The mandibular molar space shutter 201 has a pair of spaced anterior orthodontic strips 213 that are adapted to be attached to the first mandibular primary molars. The bands 213 each have a reinforcement 215 placed on the lingual side of the bands and a reinforcement 217 placed on the buccal side of the bands. The buccal reinforcements 217 are adapted to receive the screws 219 for connecting the telescopic assemblies 7 to the mandibular arch expander 3. The respective reinforcements 215 and 217 are formed integrally on respective strips to provide a substantial metallic body for the attachment of other elements that are they will describe next. A hook 218 extends from the buccal reinforcement 217 and points forward toward the front of the patient's mouth. The bands 213 are interconnected by an expansion complex 221. The expansion complex 221 is identical to the expansion complex 21 'of the mandibular arch expander 3'. A bar 237 extends rearwardly from each of the lingual reinforcements 217. The bar 237 can be a small hollow tube, to reduce the weight or it can be a solid bar. As stated above, the exact position of the respective edges 217 when the bars 237 are joined and the angle at which the bars 237 extend from the reinforcements 217 depends on the needs of the patient and the patient himself. The mandibular molar space plug 201 has a pair of separate posterior orthodontic bands 241. The bands 241 are generally molar bands and, in use, are attached to the first permanent molars. Each band 241 has an integral reinforcement 243 placed on the lingual side of the bands. A hollow tube 245 extends along the lingual side of the band and through the stiffener 243. The hollow tubes 245 have an internal bore sized to accommodate the sliding insertion of the rods 237. The rods 237 dimensioned so as to pass through. of the tubes 245 to extend beyond the back of the tubes 245. The anterior pair of orthodontic bands 213 are connected to the posterior pair of the orthodontic bands 241 to reduce the separation between the molars using a pair of bar and tube assemblies loaded spring. Bars 237 are slidably engaged in tubes 245 as noted. The coil springs 249 are connected to the bar 237 behind the rear molar band 241 and the hooks 217. As seen, in this position, the springs 249 are in an expanded state. The respective helical springs 249, therefore, pull the strips 213 and 241 toward each other to decrease the spacing between the molars. The coil springs 249 have a preset tension. The pre-set tension of the spring is selected by the orthodontist to effect the development of appropriate mesial distant arch length in the bicuspid area. The telescopic tube assemblies 7 are assembled by the threaded connection of the front and rear tubes 101 and 103, and the sliding of the rod 105 within the tube assembly. The bar 105 is slid into the tube assembly so that its eye 141 will be at the opposite end of the eyelet assembly from the front tube 117. As best seen in FIGURE 1, the tube assemblies 7 extend between the bands anterior 13 on mandibular arch expander 3 and posterior bands 77 on maxillary arch expander 5. Screws 85 of the maxillary arch expander pass through eyelet 117 of anterior tubes 101 to pivotally connect the tube assembly to the expander of maxillary arch. Similarly, the screws 19 of the mandibular arch expander 3 pass through the eyelets 141 of the bar 105 to connect the assembly 7 to the mandibular arch expander 3. When it is initially inserted into the patient's mouth, the telescopic tube assemblies 7 are dimensioned so that the rear end 129 of the rear tube 103 is in contact with the eye 141 of the rod 105 when the patient's mouth is closed. This will apply forward pressure on the jaw. Therefore, with all three components (ie, mandibular and maxillary arch expanders 3 and 5, and telescopic tube assemblies 7 and 8) installed in the patient's mouth, apparatus 1 will allow cross-sectional development, of arch length, palate expansion and mandibular advancement, simultaneously without requiring patient cooperation. By rotating the tube 103 in one direction, the tube 103 will advance on the tube 101, to trim the overall length of the tube assembly 7. Conversely, by rotating the tube 113 in a second direction, the tube 103 will be retracted in relation to the anterior tube, to increase the overall length of the tube assembly. The extension of the movement of the tubes 101 and 103 relative to one another is measured by the counter-markings 121. The internal threads 33 of the tube 103 and the counter-markings 121 of the tube 111 are placed in their respective tubes, so that when the tube 101 it is screwed into the tube 103, the counter-markings 121 will be exposed. Turning the two tubes one relative to the other, the number of exposed countermarks increases or decreases, depending on the direction of rotation, to indicate how far the tube assembly has been lengthened or shortened by the rotation of the tubes one with relationship to the other. Therefore, by reading the number of exposed countermarks, the practitioner can determine the amount of advance that has been presented, as well as the overall length of the assembly 7. A prior art mounting reinforcement assembly assembled arbitrarily to accommodate a dental brake is shown in detail in FIGS. 11 and 12 and is generally indicated by reference number 275 shown in use with an orthodontic band 276. It will be appreciated that assembly 275 is described as being attached to an orthodontic band although it may be Join a stainless steel crown too. The assembly 275 functions as the reinforcements described above attached to the orthodontic bands. However, the assembly 275 is modified to allow the joining of the brakes. The prior art assembly 275 includes a short segment of square tubing 277 that is attached to the band 276 by welding Sl for example. The square tubing is placed over the orthodontic band to join a dental brake if necessary. A mounting reinforcement 278 includes a base receptacle 280 and a screw 282 is then welded onto the top of the square pipe. Those skilled in the art will appreciate that the prior art assembly 275 requires a substantial weld joint Sl to secure the elements resulting in a high profile reinforcement. In addition, the installation of the reinforcement on the band requires additional costs and time. An improved pivotal mounting reinforcement is illustrated in FIGURE 13 and is shown in the application in FIGURES 1, IC and 2 which is generally indicated by reference numeral 300. Mounting reinforcement 300 includes a base receptacle 302 and a threaded screw 304. Base receptacle 302 includes a generally cylindrical base segment 304 and a concentric cylindrical body segment 306. Base segment 305 has an opening 308 formed therein. In the illustrated embodiment opening 308 is rectangular and is designed to accommodate a conventional dental brake W. See FIGURE 14. The base segment can be placed on the orthodontic band 276 and welded to the spot with weld S2. It will be appreciated that the opening 308 may be placed at a predetermined angle as desired by the orthodontist for root angulation. It will be appreciated that less welding S2 is required to join the reinforcement 300 to the orthodontic band resulting in a less bulky and lower profile arrangement than that shown in FIGURE 12.

The body segment 306 includes an internally threaded hole 310 for the threaded engagement of the screw 304. The screw 304 is inserted through the eye of the orthodontic device described above and clamped, leaving enough free space for the eyelet to rotate or pivot about of the screw. In view of the foregoing, it will be noted that various objects and advantages of the present invention have been achieved and other advantageous results have been obtained. Since several changes can be made in the above constructions without departing from the scope of the invention, it is intended that all matter contained in the above description or shown in the accompanying drawings be construed as illustrative and not in a limiting sense.

Claims (25)

1. CLAIMS 1. An orthodontic device for expanding and lengthening the mandibular and maxillary arch of a human patient, the apparatus characterized in that it comprises: a mandibular arch expander having a pair of anterior orthodontic bands, a pair of posterior orthodontic bands, a first assembly of mandibular expansion to expand the mandibular arch expander and a second mandibular expansion assembly to lengthen the mandibular arch expander; a maxillary arch expander including a pair of anterior orthodontic bands, a pair of posterior orthodontic bands, and a maxillary expansion assembly for expanding the maxillary arch expander; and a telescopic assembly that extends between and connects the mandibular and maxillary arch expanders; the telescopic assembly having a first end and a second end, the first end of the telescopic assembly that is operatively connected to one of the anterior and posterior bands of the mandibular arch expander and the second end of the telescopic assembly that is operatively connected to the other of the anterior and posterior bands of the maxillary arch expander; the telescopic assembly that includes an assembly a tube assembly and a slide bar received in the tube assembly, the telescopic assembly that is adjustable to lengthen the assembly in the patient's mouth during treatment using the orthodontic appliance, without restoring to remove the bar from the tube assembly. The orthodontic appliance according to claim 1, characterized in that the first end of the telescopic assembly is operatively connected to the front band of the mandibular arch expander and the second end of the telescopic assembly is operatively connected to the posterior band of the arc expander. maxillary. The orthodontic appliance according to claim 1, characterized in that the tube assembly of the telescopic assembly includes a hollow back tube and a front tube which are adjustably connected together, and the bar extending at least partially through the tube previous; the anterior tube having a mounting on a front end thereof adapted to connect the anterior tube to one of the maxillary and mandibular arch expanders; the bar having a mounting on one end thereof adapted to connect the bar to the other of the maxillary and mandibular arch expanders. The orthodontic appliance according to claim 3, characterized in that the anterior tube assembly is adapted to be connected to the maxillary arch expander and the bar assembly is adapted to be connected to the mandibular arch expander. 5. The orthodontic appliance according to claim 3, characterized in that the front tube assembly and the bar assembly include eyelets having holes therethrough; the mandibular and maxillary arch expanders that include reinforcements over the respective orthodontic bands, the reinforcements that are adapted to accept a fastener that mounts the eyelets to said reinforcements. 6. The orthodontic appliance according to claim 5, characterized in that the fastener is a screw. The orthodontic appliance according to claim 3, characterized in that the anterior tube includes a hollow body having a rear end externally threaded and the posterior tube includes a hollow body defining a hole, the posterior tube which is threaded in internal shape at a front end of said tube; the rear tube orifice that is sized to accept the anterior tube, the posterior and anterior tubes that are connected together in threaded form. The orthodontic appliance according to claim 7, characterized in that the back tube includes holes adapted to receive a tool to facilitate adjustment of the position of the posterior tube relative to the anterior tube to alter the overall length of the tube assembly. 9. The orthodontic appliance according to claim 8, characterized in that the front tube includes indicators to inform the practitioner of the length of the tube assembly. 10. An orthodontic device for expanding and lengthening the mandibular and maxillary arch of a human patient, the apparatus characterized in that it comprises: a mandibular arch expander having a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; a maxillary arch expander including a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; a pair of adjustable connector assemblies; the connector assemblies each comprising an expandable tube assembly and a rod extending through the expandable tube assembly; the expandable tube assembly having a mounting on a first end thereof adapted to connect the tube assembly to the posterior orthodontic band of the maxillary arch; the bar having a mounting adjacent a second end of the expandable tube assembly adapted to be connected to the front orthodontic bands of the mandibular arch expander; The tube assembly includes a hollow back tube and a front tube which is telescopically connected, the front tube includes a hollow body having a rear end threaded externally and the back tube includes a hollow body defining a hole, the rear tube which is threaded internally at a front end of the tube, the rear tube orifice which is sized to accept the anterior tube, the posterior and anterior tubes which are connected together in threaded form. 11. An expandable connector for connecting a mandibular arch expander to a maxillary arch expander, the connector having a first end and a second end, the first end adapted to be connected to the mandibular arch expander and the second end adapted to be connected to the maxillary arch expander, the extensible connector that includes a tube assembly and a slide bar received in the tube assembly, the extensible connector that is adjustable to lengthen the extensible connector in vivo in the patient's mouth, the tube assembly connector includes a hollow back tube and a front tube which are easily connected together, and the bar extends at least partially through the anterior tube, the anterior tube, having a mounting at a front end thereof adapted to connect the anterior tube to one of the maxillary and mandibular arch expanders, the bar having a mounting on one end thereof adapted to connect the bar to the another of the maxillary and mandibular arch expanders, the anterior tube that includes a hollow body having an externally threaded rear end, and the posterior tube that includes a hollow body that defines an orifice, the posterior tube that is threaded in shape internal at a front end of said tube, the rear hole of the tube that is sized to accept the anterior tube, the posterior and anterior tubes that are connected together in threaded form. 12. An orthodontic device for expanding and lengthening the mandibular and maxillary arch of a human patient, the apparatus comprising: a mandibular arch expander having a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; a maxillary arch expander including a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; a pair of adjustable connector assemblies, the connector assemblies each comprising an expandable tube assembly and a rod extending through the expandable tube assembly, the expandable tube assembly having a first end assembly thereof adapted to connect the tube assembly to the posterior orthodontic band of the maxillary arch, the bar having a mounting adjacent a second end of the expandable tube assembly adapted to be connected to the front orthodontic bands of the maxillary arch expander, and wherein The tube assembly includes a hollow back tube and an anterior tube that are telescopically connected together, with the bar extending through the hollow back tube and connected to the anterior tube when assembled. 13. An expandable connector for connecting a mandibular arch expander to a maxillary arch expander, the connector having a first end and a second end, the first end adapted to be connected to the mandibular arch expander and the second end adapted to be connected to the maxillary arch expander, the extensible connector that includes a tube assembly and a rod slidably received in the tube assembly, the extensible connector which is adjustable to extend the in vivo extensible connector in a patient's mouth, the connector tube assembly includes a hollow back tube and a front tube which are connectable together in an adjustable manner, and the bar extends through the hollow back tube and the connected anterior tube, the anterior tube having a mounting on a front end thereof adapted to connect the anterior tube to one of the maxillary and mandibular arch expanders, the bar having a mounting on one end thereof adapted for connect the bar to the other of the maxillary and mandibular arch expanders, the anterior tube assembly and the bar assembly that include eyelets that have holes at through which the fasteners can be extended. The orthodontic appliance according to claim 10, characterized in that the back tube includes holes adapted to receive a tool to facilitate adjustment of the position of the posterior tube relative to the anterior tube to alter the overall length of the connection assembly. 15. The orthodontic appliance according to claim 14, characterized in that the anterior tube includes indicators to inform the practitioner of the length of the connection assembly. The extensible connector according to claim 11 characterized in that the front tube includes indicators to inform a practitioner of the length of the tube assembly. A pivotal mounting reinforcement assembly for attaching to an orthodontic band for the pivotal mounting reinforcement of an arch expansion apparatus characterized in that it comprises: a base receptacle including a base segment for attachment to the orthodontic band, base segment having an aperture formed therein, the opening placed to join a dental brace, and a body segment having a threaded hole therein; and a screw threadedly engaged in the threaded hole, the threaded screw positioned to join an eyelet of an arc expansion apparatus. 18. The pivotal mounting reinforcement assembly according to claim 17, characterized in that the base segment is joined to an orthodontic band by welding. 19. In an orthodontic device for expanding and lengthening the mandibular and maxillary arch of a human patient, the apparatus having a mandibular arch expander having a pair of anterior orthodontic bands, a pair of posterior orthodontic bands, a first expansion assembly mandibular to expand the mandibular arch expander, and a second mandibular expansion assembly for lengthening the mandibular arch expander the improvement characterized in that it comprises: a pivotal connector assembly for attaching to an orthodontic band for the pivotal attachment of a mandibular arch expander, the pivotal connector assembly that includes a base receptacle having a base segment and a body segment extending from the base segment, the base segment having an opening formed therein for insertion of a dental brake, the body segment having a threaded hole formed therein; and a screw threadedly engaged in the threaded hole. The orthodontic appliance according to claim 19, characterized in that the mandibular arch expander includes eyelets having holes therethrough for the introduction of the screw. 21. An orthodontic device for expanding and lengthening the mandibular and maxillary arch of a human patient, the apparatus characterized in that it comprises: a mandibular arch expander having a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; a maxillary arch expander including a pair of anterior orthodontic bands, a pair of posterior orthodontic bands; and a pair of adjustable connector assemblies; the connector assemblies each comprising an expandable tube assembly and a rod extending through the expandable tube assembly; the expandable tube assembly having an assembly at a first end thereof adapted to connect the tube assembly to a pivotal mounting reinforcement assembly on the posterior orthodontic band of the maxillary arch; the rod having a mounting adjacent a second end of an expandable tube assembly adapted to be connected to a pivotal mounting reinforcement assembly on the front orthodontic bands of the mandibular arch expander; each pivotal mounting reinforcing assembly that includes a base receptacle for attachment to an orthodontic band, the base receptacle including a base segment and a body segment, the base segment having an opening formed therein for the insertion of a dental brake, the body segment having a threaded hole formed therein and a screw insertable through the assembly and threadably engaged within the threaded hole. The orthodontic appliance according to claim 21, characterized in that the tube assembly includes a hollow back tube and a front tube which are telescopically connected. The orthodontic appliance according to claim 21, characterized in that the anterior tube includes a hollow body having a rear end externally threaded and the posterior tube includes a hollow body defining a hole, the posterior tube which is internally threaded at a front end of the tube; the rear tube orifice that is sized to accept the anterior tube, the posterior tube and the anterior tube that are connected together in a threaded manner. The orthodontic appliance according to claim 21, characterized in that the back tube includes holes adapted to receive a tool to facilitate adjustment of the position of the posterior tube relative to the anterior tube to alter the overall length of the connection assembly. 25. The orthodontic appliance according to claim 24, characterized in that the anterior tube includes indicators to inform the practitioner of the length of the connection assembly. SUMMARY An orthodontic appliance (1) includes a mandibular arch expander (3) and a maxillary arch expander (5) that are interconnected by a pair of adjustable connector assemblies. The maxillary and mandibular arch expanders each include anterior (13) and posterior (41) orthodontic bands having ridges (15, 17) to facilitate connection of the connector assemblies to the arch expanders. The connector assemblies include an expandable tube assembly (7) and a bar (105) that extend through the expandable tube assembly. The expandable tube assembly has a mounting on a first end thereof adapted to connect the connector to the posterior orthodontic band of the maxillary arch. The bar has an adjacent mounting a second end of the expandable tube assembly adapted to be connected to the anterior orthodontic bands of the mandibular arch expander. The tube assemblies each include a hollow rear tube (103) and a front tube (101) which are telescopically connected. In addition, the front tube includes indicators, in the form of separate counter-markings (121). An improved pivotal mounting reinforcement (300) for joining the (13) anterior or posterior orthodontic bands on a mandibular arch expander (3) and a maxillary arch expander (5). The pivotal mounting reinforcement includes a base receptacle (302). A screw (33) is threadably coupled to the base receptacle. The base receptacle (302) has an opening for the insertion of a dental brake (). The opening (308) can be pre-angled to assist in root angulation when the dental brake (W) is inserted.