Dr. Darick Nordstrom has designed several appliances that are used in conjunction with the ALF philosophy. The basic concept is to create appliances that do not lock up the maxilla in a block of acrylic. Therefore the appliances are very small and easy for the patient to wear. This permits the cranial sutures to assume their natural posture. The appliances, used in conjunction with cranial manipulations, will allow for a more permanent dental result and aid in the elimination of multiple dysfunctions.
The basic Advanced Lightwire Functional (ALF) appliance is considered a removable/fixed appliance. While it utilizes closely adapted cribs, the appliance should be retained in the mouth with composite ledges to prevent the patient from removing the appliance. The light wire construction allows for the patient to maintain good oral hygiene during all phases of use. This is a versatile appliance that can be used in virtually any configuration you can visualize. It can be made with twin blocks, lip bumpers, single and twin cribs, and even with buccal tubes to be used in conjunction with brackets. The basic ALF is only the beginning.
The ALF LB incorporates a lip bumper to relieve lower anterior crowding. True bony apposition occurs to create the space for crowded lower anteriors. The ALF LB works great to reopen the space in the cases of extracted lower primary canines. In both primary and mixed dentition it is recommended that the two or three wire double crib be used on the primary molars.
The three wire crib is used in cases where the primary molar may be lost during treatment. It is a simple matter to cut the crib from the lost molar and still maintain a full crib on the adjacent molar.
The N-Sagittal is used for division two cases and where it is desirable to reopen the spaces closed by first bicuspid extraction. The N-Sagittal is a light wire, easy to wear and adjust appliance. Caution should be used in opening the omega loops. They should never be adjusted more that one half to one millimeter. Over adjustment of the light wire omega loop can lead directly to breakage of these wires. Even with these seemingly modest adjustments, movement is very rapid and accurate.
The N-Sagittal TB is the ALF adaptation of the Twin Block. The Omega loops in the upper arch allow for rapid unlocking of the pre-maxilla while the twin blocks keep the anterior open for clearance. This is an excellent design for class two division two cases, and TMJ treatment where you are working to capture the condylar position.
The lower appliance is formed in a Biocryl splint with anterior blocks. The lower splint can be split after repositioning has been accomplished and an anterior omega loop added for lower arch development.
The OmNi series adapts the ALF philosophy of light wires forces, premaxillary development, and minimum size to acrylic appliances. The distributed posterior anchorage and springy anterior wire make it very effective for class III reverse pull cases. First bicuspid clasps can be added, and a lip bumper soldered to the clasps.
The upper or lower OmNi is easily modified with a removable lip bumper, splint overlay, class II or III elastics, and cross-bite corrections.
The OmNi-2 is a remarkable design that is more effective than most appliances for mandibular repositioning. This design allows maximum tongue space due to the repositioning rakes on the buccal of the appliance. The vertical opening can vary depending on the patient's individual requirements.
The OmNi-2 appliance is constructed on the Accu-Liner articulator for functional occlusal planes. The appliance allows for a limited amount of lateral movement and unlimited protrusive and opening. These movements encourage a healthy remodeling environment for the TM joint.
For additional information about Advanced Lightwire Functional appliances, or courses in the use and application of the appliances, contact Murdock Laboratory.