E-Arch

Taken from “The Mandibular E-Arch” by Neal Kravitz, the E-arch is a fixed, spring-loaded expander for slow expansion of the maxillary or mandibular arches. Developed by Arnold, and popularized by Berkowitz, the E-arch was invented for maxillary orthopedic expansion in patients with cleft palates. In the mandible, the E-arch can create a modest amount (4 to 5 mm) of arch space in the lower anterior region by orthodontic tipping (rather than orthopedic change) of the lower posterior teeth, as well as distalization of the first molars.

The appliance consists of a 0.040-inch tube-like frame with a NiTi open coil spring. Seating the E-arch compresses the open coil spring and activates expansion. Therefore, the E-arch is ideal where patient compliance or parent cooperation is a concern. The E- arch is typically banded to the first permanent molars; however, if these teeth have not fully erupted, bands can be placed on the second deciduous molars. In these situations, the clinician may consider placing lingual extension arms to prevent the second deciduous molars from expanding further than the first permanent molars.

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