The Spahl Split Vertical Eruption Acceleration Appliance System

By Dr. Terrence Spahl
Edited by Rob Veis, DDS

INDICATIONS:
Susan, an 18-year-old female patient is just coming out of Phase I mandibular advancement treatment with Clark Twin Blocks. Although her anterior incisors are coupling nicely, she still has a large posterior open bite. Unfortunately, Susan is leaving for college in five months. What is the best way to bring her posterior teeth into occlusion within the limited treatment time left?

Jeff, a 14-year-old male patient, is in the late stages of mandibular advancement therapy with a functional appliance such as an Orthopedic Corrector with the mandible nicely advanced. But with being in a school play, band practice, debate team practice, and a new girlfriend, he simply isn't wearing his appliance for a sufficient time each day to complete the eruption of his posterior teeth. How will you close his unresolved posterior open bite?

Your 40-year-old "TMJ" patient has successfully worn a pull-forward chewing splint for a year eliminating severe headaches and recapturing the discs in the process. Upon removing the splint, the typical results are observed: The mandible cannot be forced back to its original pretreatment retruded position; when the patient bites down a proper anterior overbite/overjet incisal relationship exists; but a large posterior open bite also now exists. The patient is decay-free and has never had any back teeth filled. She does not want a large number of posterior crowns or an overlay removable partial denture to resolve the gap between the upper and lower posterior teeth. Because of the patient's age and the numerous social interactions required in her job, passively erupting the posteriors with prolonged 18-22 hour per day use of a functional appliance is not an option. How can you quickly close the posterior open bite while maintaining the patient's improved joint health?

A bilateral posterior open bite frequently occurs as part of today’s modern orthodontic/TMJ treatment plans involving any sort of mandibular advancement. The Spahl Split Vertical Eruption Acceleration Appliance System (SSV) is a practical, timely and effective multiple appliance technique. It is designed solely for the closure of posterior open bites that occur subsequent to mandibular advancement procedures.

Even under the best of circumstances involving a young growing patient who is very cooperative and diligent in wearing a functional appliance for the prescribed period each day, passive eruption of posterior teeth proceeds slowly, often taking a year or more to complete in large posterior open bite cases. In many adult cases, it is nearly impossible to obtain adequate posterior open bite closure with passive eruption alone. In both situations, the Spahl Split Vertical Appliance (SSV) can help. The advantage of the SSV system is that it gives the clinician the option of using active rather than passive forces to erupt posterior teeth and as a result, posterior open bites can be resolved rapidly.

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