Orthodontic Tools Which Work: 2 by 4 Appliance | 2×4 Orthodontic Braces

What is Orthodontic 2 by 4 Appliance| 2×4 Orthodontic Braces

The journey to the perfect smile is directly associated with maintaining the ultimate dental and oral health. When it comes to orthodontic problems, bite issues fall among the most common in both children and adults. This is where a 2 by 4 appliance steps in. Although frequently used in orthodontics, a 2 by 4 appliance failed to get the exact popularity as devices similar to it. However, what makes a 2 by 4 appliance stand out is its multipurpose use, as well as favorable results stemming for its application.

To make things clearer, let’s dig deeper into how a 2 by 4 appliance helps treat various orthodontic issues, including crossbite.

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What is a Crossbite?

What is a Crossbite?

In dentistry, a crossbite represents a common orthodontic condition which manifests in early childhood. In cases of a crossbite, the top and bottom teeth are improperly placed in the back of the mouth. Typically, the condition shows a significant positioning of the upper and bottom teeth behind one another. In addition, a crossbite is divided in two main types. The first type of crossbite is also known as posterior crossbite. The problem occurs when the top, back teeth find themselves deeper than the bottom teeth. At the same time, an anterior crossbite is a condition in which the top, front teeth lay far behind the bottom teeth.

Conclusively, a 2 by 4 appliance is a great way to treat both types of crossbite.

In some cases, just as with crossbite, a 2 by 4 appliance can also solve teeth overcrowding issues.

What is a 2 by 4 Appliance?

A 2 by 4 appliance is an orthodontic tool, very similar looking to braces. The appliance itself is fixed and works based on an easy activation. Mostly used in children, a 2 by 4 appliance impacts a wide range of problems, thus also showing lasting effects.

Among the most important aspects in using this device, is knowing the primary teeth won’t be affected by the treatment. Of course, the appliance’s usage and installment requires a bit of force, but no pain whatsoever. Still, in cases of painful experiences, your orthodontist can prescribe milder sedatives to help with the discomfort.

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How is a 2 by 4 Appliance attached?

In most cases, a 2 by 4 appliance is placed onto the first molars and on all 4 incisors of the arch. Fitting a 2 by 4 appliance well is crucial in treating crossbite successfully. In the process, some patients are likely to experience a certain extent of root damage, too. However, no tooth loss has been reported as a result of wearing a 2 by 4 appliance.

As soon as the treatment is complete, your orthodontist may also use retainers to further strengthen and fix the teeth. Retainers will also serve the purpose of preventing crossbite reoccurrence.

How does a 2 by 4 Appliance work?

Initially, the fixed device uses four brackets bonded onto the new maxillary permanent incisors. At the same time, two bands of the device are cemented with a wire holding the device together to support the teeth even further. Sometimes, your doctor may also use rubber tubings and coil springs to ensure the brackets and bands proper placement.

What are the benefits of wearing a 2 by 4 Appliance?

According to plenty of research-based examination, a 2 by 4 appliance offers plenty of treatment benefits. First off, a 2 by 4 appliance is far more versatile than remaining orthodontic devices. With that, the device targets a greater range of problems and acts on effectively solving them.

What is more, the device is worn no longer than 6 months, which boosts its efficiency even more. Some of the other main benefits a 2 by 4 treatment include:

  • Reducing overjet, in order to balance the ectopic incisors.
  • Providing a more effective tooth alignment, through a 3D teeth management.
  • Rotating the misaligned teeth and correcting diastemas.
  • Managing incorrect tooth inclination as well as angulations.
  • Accelerating the postponed eruption of a central incisor, thus enabling a greater freedom in repositioning the teeth.
  • Increasing the self-esteem.
  • Offering a quicker, yet equally successful treatment.
  • Cheaper than remaining orthodontic treatments.
  • Maintaining the ideal shape of the arch.
  • Controlling the anterior teeth development.
  • Enabling an easier application and smoother wearability.
  • Targeting several issues all at once.
  • Preventing Class II malocclusions in early childhood.
  • Minimizing the potential root damage during the treatment.

In addition to all these, a 2 by 4 appliance can also protect the jaw and prevent possible obstructions. The main objective of the appliance is to achieve a better-looking facial profile and fix complications related to the maxilla and mandible jaws. Finally, a 2 by 4 appliance can be used to treat overbite as well.

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What are the disadvantages of wearing a 2 by 4 Appliance?

There are a few side-effects which can occur as a result of a 2 by 4 treatment. Obviously, with the installation of the device, the patient may experience a certain discomfort while wearing it. In addition, the appliance does not focus on correcting skeletal issues. Finally, some of the brackets may break or crack. In case this happens, make an orthodontist’s appointment to get the replaced accordingly.

When can I start 2 by 4 Appliance treatment?

According to experts in the field, the sooner you seek a 2 by 4 appliance treatment, the better. In fact, wearing this device from an early childhood enhances your chances of fixing the aforementioned issues. The first thing to do before seeking treatment is keeping an eye of a possible Class II malocclusion. Still, the best thing about this treatment is that the child doesn’t have to wait for its permanent teeth to erupt first.

Once starting treatment, it is important to teach your child how to maintain a constant oral hygiene. By cleaning and brushing the device regularly, the child avoids possible infections and additional gums problems as well. For the best treatment plan, schedule a check-up appointment with your orthodontist, also consulting him on any concern you may have.

Two by Four Appliance Uses

Having a nice smile is important to everyone and it is good to know that when yours is less than perfect, it is possible to solve it. Having a cross bite can be problematic, but it can be solved, and your orthodontist is going to have the perfect way to do it. A crossbite is a condition whereby the teeth at the top or bottom end up behind each other. When the back top set of teeth are more inside then the lower set it is called a posterior crossbite and when the front top set is behind the lower set is called an anterior crossbite. Overcrowding can also be a problem, but it will be possible to correct this with the use of a 2 x 4 appliance. There is a great advantage over certain types of treatment when it comes to using this appliance.

The space opening has to be accurate and it is vital that this can be controlled– and when using this appliance, it can be controlled easily. As it is a fixed appliance, there is also a special amount of force that will be used, and this is going to work much more effectively than it would with a removable appliance. A good thing about this form of treatment is that the primary teeth will not be affected. When there is force it is to be expected that the treatment is unfortunately unlikely to be pain free, but it can be controlled with medication. It will also be worth it when both you and the child see the final result.

How Is 2×4 Appliance Fitted?

The teeth that will have the 2 x 4 appliance fitted are the first molars and then the incisors that are in the same arch – this will be the 4 of them. Great care must be taken when fitting them to correct the crossbite. It is possible that teeth can be lost due to incisor roots connecting with the erupting canine’s crown. It is not uncommon to get some root damage. Most of the times, it will not lead to the death of the tooth.

Brackets are bonded on and at this stage the orthodontist will adjust them to be in the right position. This is not only going to be easy process but also should be relatively fast one. It may not look ideal at this stage, but it is a lot better than having to have a tooth removed. The looking good part will happen towards the end of the treatment. A lot of orthodontists will use a retainer once the procedure has been finished. It is not likely that the anterior crossbite will come back. This way the teeth will not be able to move more freely and will allow the orthodontist to monitor the progress. The orthodontist should tell you why your child is getting a retainer.


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Very good experience. The attention was great. The doctor is very punctual and they don’t make you wait, which for my busy schedule is super important. Also, the time the doctor told me I had to wear the braces was the exact time I needed and I was very happy with the results. Definitely recommend him.

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Dr. Ivanov was amazing. He was very understanding and took the time to explain, every step of the process for my daughters braces. I am proud to say with great care her braces were finally removed and the end result is the beautiful smile she now has. Thank you

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