Z wto Centre The D-Gainer Appliance Below is a review of the D-Gainer appliance that Dr. Bagden refers to in his lectures. It provides a great way of creating space, especially for the cuspids, and allows transverse development in the early dentition by using the Damon. System in conjumetion with high tech. Damon archwires. It creates the space by working within the “Qptimal Force Zone” together with the archwires, providing a “shield effect”, to jle transverse development. The D-Gainer appliance is ideal for mixed dentition cases due to the design omitting the bonding of cuspids and bi-cuspids. The D-Gainer St Step Guide ‘Step 1 - Bond upper/lower 6'¢.and incisors - 21/12 itep 2 - If required, incigors with segmental 014 or 14x25 Damon copper NiTi (as indja,1). This may take up to 12 weeks | Step 3 - Once theiincisors are aligned, place 17x25 TMA, through tubes dh 6's and through a medium NiTi pi coil, then ofito the incisors (dia.2). Leave 5mm of wire distal to the byccal tube, then cinch, this for'the increase inarch length produced by transverse adaptation. Activate the medium NiTi open coil spring 14-2 times bragket width. ‘Step 4 - Recall the patient 2 months later to Feview space gbtained. Leave 17x25 TMA in place, reactivating if necessary, witherimpable stops. Step 5 - Next visit 2 months later for a check appointment. Amount of space created should be at the rate of 2mm per month (Imm each side). ‘Step 6 - Next visit, around 8 months, move into 19x25 stainless steel, keeping the NiTi coils in place, reactivating if necessary, ith crimpable stops. ra Space Created for cuspid plus arch development Step 7 - Bond bi-cuspids with Damon, then finish case as normal.