Growth Modification & Dentofacial Orthopedics

Dentofacial orthopedics focuses on guiding jaw development and facial growth in growing patients. In selected cases, treatment may be used to stimulate growth, redirect growth, or help control excessive development, depending on the skeletal pattern and timing of treatment. The goal is to improve not only tooth alignment, but also facial balance, bite relationships, and long-term functional stability.

Growth Modification & Dentofacial Orthopedics
Extraoral Orthopedic Appliances

Extraoral Orthopedic Appliances

Extraoral appliances are used in selected growing patients to influence jaw growth and skeletal relationships.

  • Facemask therapy may be used to encourage forward development of the upper jaw in appropriate cases
  • Headgear may be used to help control maxillary forward growth or support correction of certain bite relationships

Features & benefits:

  • Helps guide facial growth during development
  • Useful in selected skeletal bite discrepancies
  • May reduce the severity of future orthodontic problems
  • Most effective when used at the proper stage of growth

Removable Functional Appliances

Removable Functional Appliances

Removable intraoral appliances are designed to influence jaw position and growth in growing patients.

  • Twin Block
  • Other custom removable functional appliances, depending on the needs of the case

Features & benefits:

  • May help encourage mandibular advancement in selected Class II cases
  • Can improve overjet and jaw relationship during growth
  • Custom-made for the individual patient
  • Best results depend on consistent wear and good compliance

Fixed Non-Compliance Appliances

Fixed Non-Compliance Appliances

Fixed functional appliances work continuously without depending on daily patient wear, making them useful in selected cases where compliance is limited.

  • Herbst appliance
  • Forsus appliance

Features & benefits:

  • Continuous orthopedic and orthodontic effect
  • Does not rely on removable wear compliance
  • Commonly used in selected Class II correction during growth
  • Can be integrated with braces treatment when indicated

Palatal Expansion & Orthopedic Maxillary Expansion

Orthopedic expansion is used to widen the upper jaw when the maxilla is too narrow in relation to the lower arch or overall facial balance. In selected patients, this can help improve crossbite correction, arch width, smile balance, and space for alignment. Unlike tooth movement alone, orthopedic expansion is designed to influence the underlying skeletal foundation when timing and case selection are appropriate..

Features & Benefits  

  • Helps correct a narrow upper jaw
  • May improve posterior crossbite and transverse discrepancies
  • Can create space in selected cases

Types of Expansion

Removable expanders 
Used in selected growing patients for mild to moderate expansion needs.
Benefits: custom-made, removable, and useful in appropriate developing cases.

Fixed tooth-borne expanders 

Hyrax-type expanders
Such as RPE or Hyrax-type expanders, used to provide continuous and controlled expansion.
Benefits: full-time action, greater consistency, and effective correction in selected transverse cases.

Bone-borne or skeletal expanders 

MARPE

Such as MARPE, used in selected cases where greater skeletal effect is desired.
Benefits: more advanced orthopedic expansion with reduced reliance on dental tipping alone.

A Personalized Orthopedic Approach

Orthopedic treatment is most effective when carefully timed and based on precise diagnosis. Whether the goal is maxillary expansion or growth modification, the ideal approach depends on age, growth stage, skeletal maturity, facial balance, and the severity of the underlying discrepancy. At Dr. Basel Al-Midani’s practice, treatment is planned with close attention to function, jaw relationships, and long-term stability—delivering a more individualized orthodontic experience designed to support healthier development, improved balance, and a harmonious smile.