British Journal of Orthodontics

ISSN: 0301-228X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/yjor19

Stabilization of Functional Treatment: The

Waveney Goal Post Appliance

Nora M. Stratford B.D.S., M.D.S., D.Orth. & Jennifer A. Scott D.D.S., B.D.S.,
D.Orth.

To cite this article: Nora M. Stratford B.D.S., M.D.S., D.Orth. & Jennifer A. Scott D.D.S., B.D.S.,
D.Orth. (1988) Stabilization of Functional Treatment: The Waveney Goal Post Appliance, British
Journal of Orthodontics, 15:2, 123-125, DOI: 10.1179/bjo.15.2.123

To link to this article: http://dx.doi.org/10.1179/bjo.15.2.123

Published online: 21 Jun 2016.

Submit your article to this journal

Article views: 1

View related articles

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=yjor19

Download by: [Tufts University] Date: 01 December 2016, At: 13:04

 British Journal of Orthodontics/Vol. 15/1988/121-125

Stabilization of Functional Treatment:

The Waveney Goal Post Appliance

NORA M. STRATFORD, B.D.S., M.D.S., D.ORTH.

JENNIFER A. ScoTT, D.D.S., B.D.S., D.Orth.
Orthodontic Clinic, Waveney Hospital, Ballymena, N. Ireland BT43 6HH
Received for publication February 1987

Abstract. The Waveney Goal Post Appliance was designed to stabilize the second supportive phase of
Clark's Twin Block therapy (1982). It is to be worn full time and is simple to construct, and well tolerated.
It can be ·used to stabilize the dentition following most forms offunctional treatment.
Index Words: Myofunctional Treatment, Stabilization Myofunctional.

Introduction
In appropriate cases the use of a functional ap-
pliance provides a suitable and effective method of
treatment. Functional appliance therapy generally
aims to correct the anteroposterior discrepancies
of the dentition and to produce a good facial
contour. These appliances fall mainly into two
groups. Those based on: (a) the Monobloc; and (b)
the Functional Regulator. One of the most recent
modifications of the Monobloc is the Twin Block
System described by Clark ( 1982). Due to an
increase in the referral of young patients with severe
skeletal problems, the authors started using this
technique on the basis that full-time wearing of the
appliance together with extra oral traction should
produce results more quickly than an appliance
worn less continuously. FIG. I The Waveney Goal Post Appliance, three-quarter
occlusal view.
The Twin Block Technique
Clinicians familiar with the Twin Block Technique veloped to be used during the second stage of this
will know that it consists essentially of three stages. form of treatment.
l. An active stage, where the anteroposterior dis-
crepancies are corrected leaving lateral open The Waveney Goal Post Applialil'e
bites.
2. A support stage, where these lateral open bites The Waveney Goal Post Appliance (Fig. l) has the
close. same objectives as Clark's Stage 2, namely the
maintenance of the forward functional posture of
3. The retention stage, designed to maintain full the mandible while the premolar teeth establish an
intercuspation and the corrected anteroposterior interdigitating occlusion, so resolving the pre-
relations. viously induced lateral open bites. This appliance is
The authors found the appliance suggested by an upper Hawley retainer incorporating a palatally
Clark (1982) for use in the second supportive stage placed wire frame-work or 'goal post' designed to
to be ineffective in their hands in that it did not engage the cingula of the lower incisor teeth in
maintain the corrected overjet adequately. The their corrected occlusion. Patients have found this
Waveney Goal Post Appliance was therefore de- appliance to be easy to wear as it is not bulky, is
124 N. M. Stratford and J. A. Scott
FIG. 2 Adjustment of The Waveney Goal Post Appliance: (I)
vertical; (2) horizontal; (3) lateral; and (4) plier access.
aesthetically acceptable, and causes few problems
at meal times. However, there is often a need to
adjust the appliance during the period of wear,
which is usually up to 6 months. Bends in the
frame-work were therefore included to increase the
length of wire, allowing for adjustments of the goal
post in the vertical and horizontal directions. It
was found that plier access near the acrylic and a
requirement for lateral adjustment also needed to
be incorporated. The orientation and direction of
these bends are crucial to allow for the correct
adjustment of this appliance (Fig. 2).
FIG. 3 Detail of the relationship of The Waveney Goal Post Appliance to the lower anterior teeth.
HJO l'ol. 15 No. 1
Construction of the Appliance
Clinical
Upper and lower impressions with a bite regis-
tration for study models are taken at the end of
the first stage of treatment. The casting of the upper
impression is duplicated to provide a working
model for appliance construction.
Technical
The appliance consists of an acrylic base plate
incorporating a low labial bow inserted distal to
the canine teeth. Adams cribs on the first permanent
molars are constructed of 0.7-mm hard drawn
stainless steel wire, and the modified goal post is
constructed in 0.8-mm wire and inserted into the
acrylic palatal to the premolars (Fig. I).
The Waveney Goal Post needs to he formed by
an experienced technician, so that with careful
adaptation of the wire, it contacts very lightly the
cingula of the lower anterior teeth as they occlude
(Fig. 3). Study models aid in judging the depth of
the goal post so that it engages the lower anterior
teeth as described. A set of working models could
be mounted on a straight line articulator. hut in
practice this has not been found to be necessary.
Case Management
I. Twin Block appliances are worn full time until
a normal molar relationship has been established
and the overjet is reduced. This usually takes
810 Mar /9RX
0 The Wavcney Goal Post Appliance is presented as
FIG. 4 The relationship oi"The Waveney Goal Post Appliance
to the lower incisor teeth.
between 4 and 6 months. The blocks are trimmed
to allow for eruption of the first molar teeth
into occlusion. This usually takes 2-4 months.
2. The Wavcney Goal Post Appliance is fitted
(Fig. 4). It is worn full time until premolar
intercuspation has been produced. This takes
approximately 3-6 months.
3. Retention consists of wearing the appliance full
time for 3 months followed by 3 months night
time wearing. This generally concludes the treat-
ment.
Waveney Goal Post Appliance 125
Conclusion
a simple means of maintaining corrected antero-
posterior discrepancies while new neuro-muscular
patterns are established. Initially, it was devised to
be used for the support and retentive phases of
Clark's Twin Block Technique (1982). It was found
by the authors to be more effective than the
appliance recommended by Clark and can be
used as a retainer following most forms of active
functional appliance therapy. It is of simple con-
struction, minimum bulk, and is well received by
patients. It is quick and relatively inexpensive to
produce.
Acknowledgements
The authors wish to thank the technicians of the
Department for interest in the idea, readiness to
modify the original designs and technical guidance
in developing the prototype of the appliance. They
are also grateful to Mr J. Dempsey, Medical
Photographer, for his suggestions and illustrations
and to Mrs Sharon Gillespie for her preparation
of the typescript.
Reference
Clark, W. J. (1982)
The Twin Block Traction technique,
European Journal(}{ Orthodontics, 4, 129--138.