RPE vs TPA... what is the difference?

[Al]

Another question, please...

My arch is narrow and very similar (if not identical) in shape to kisses14 in her braces story (pics 4 posts down; thank you for sharing, kisses).

My arch is "squished in" from both sides, so it's more like a really squished omega (the letter) rather than a V. Both of the last orthodontists I have visited said that along with braces, I would need a Trans-Palatal Arch expander, which he was going to fit on prior to braces.

From reading up on here, I see that a TPA is different from an RPE (Rapd Palate Expander) and that while the latter was meant more for expanding, the former is meant more for maintaining width? Since my arch is that squished, I am wondering if a TPA will do a sufficient job.

I have to talk a lot for a living (sales) and the orthodontists had all been made aware of that, so I am wondering if that had any effect on their decisions at all (I hope not). One thing the last two orthos agreed on was that Invisalign was out of the question, as it would do little to naught for my narrow palate. Hence, I have pretty much crossed off the first ("highly recommended") ortho off my list, as she completely failed to even mention my narrow palate to me, something which is so glaringly obvious now that I know what I'm looking at.

So, the question again is... in people's experience here -- and some of you are amazingly knowledgeable -- can a narrow palate be expanded with a TPA with the same success as an RPE? Just in case I misheard my last ortho, I have another appointment booked for next week, where I hope to go over a final list of questions.

Thanks again for all of your help. This is really helping me build a properly aligned and informed journey for the next couple of years.

P.S. It looks like Invisaligns are definitely out and I'll likely end up with Clarity tops and stainless bottoms.

P.P.S. Apologies for not posting own photos and using kisses14's instead. I promise to add my own when the real journey begins. Plus, I was *really* hoping for a cleaning first.

[Al]

Karen, I copied and saved the Rainbow Passage the first time I came across it in one of your posts! LOL

I am sure that whatever treatment I end up with, my speech will be affected to one degree or another. I am very fortunate in the fact that I am in the right mental state today where I can easily overcome the social phobia/shyness that may come with either the braces or the "new speech". Of course I say that now with neither braces nor palate expander in place and will probably be back here crying in your shoulder the first time I try to order a "thtrawberry thake with ekthra thtraberrieth, pleeth" this summer.

[JesseJames]

I have a TPA.
I can't tell you if it expands the arch or not, i got mine to anchor my molars in place so they don't move into the extraction gaps.
What I can tell you is that after a couple of weeks my speech isn't any different than before the braces and TPA. The first week or so is rough. I didn't think i'd ever talk normal again, but than suddenly everything got easy. Hope that helps a little bit.

[Lisa65]

Another TPA wearer here. As far as I know a TPA will not increase your arch width (or at least not much) but will maintain arch width at the molars. Bear in mind that brackets and wires can do a lot on their own.

If you look at my blog here (scroll down to the bottom of the page) you will see what I mean. My top arch was narrow and crowded but in 3 months it has widened out a lot.

viewtopic.php?t=12724&start=300

However, the fact that your ortho called it a trans palatal arch EXPANDER makes me wonder if he is going to use an actual expander which will gradually widen your arch by means of a screw turned at regular intervals. It might be worth a phone call to clear this up. In general, arch width gained in adults using expanders but no surgery, is mostly down to tipping of the teeth, but you can gain some useful space this way.

[Brandyleigh35]

NO, a TPA will not expand you, it is meant to maintain space in your mouth once expansion has been achieved. Basically it is just a curved wire that attaches to two hooks on the inside of your back molar brackets.

I had a SARPE (surgically assisted rapid palate expansion) last March. Not sure how old you are but this is actually the more recommended approach for adults as it is faster and considered to be more stable. Non-surgical palate expansion can often cause tipping of the teeth and is not as stable in the long term. I won't get into all of that though as there are plenty of other posts on here regarding that subject. Just do a search and you will see.

Anyway..I had both an RPE and then the TPA. The RPE is larger, and a much more substantial appliance. it hooks onto our molars, but also has like little bars that run down your teeth to almost your canine. I had my palate surgically fractured, then we turned the key in the RPE 1/4mm twice a day for 18 days. The bars work with the whole appliance to evenly expanded (push) your teeth outward. If you go to my blog link below and click on February and scroll to the bottom of the page you will see the RPE. There are a bunch of pics in March also showing how much space we achieved, and in May about mid way down the page you can see the TPA. They ae very differen appliances. Once my palate was fully expanded (I expanded 10mm) we waited about 10 weeks, then a TPA was installed to maintain my space. With surgical expansion new bone growth actually fills in the expanded areas so there is very little relapse once healed, even still though you figure you will lose about 1mm in space once the RPE is taken out, so most orthos will overexpand you a bit, knowing you will have some marginal regression. This amount could be quite a bit more with non surgica expansion though, and many doctors will not use a TPA at all as they do not feel they can adequately maintain the space in the palate.

I would talk to your doctor, as I know there are many types of RPE's out there. Some less cumbersome then others. I also have a job where I talk all day long, and quite frankly I just had to deal with it for a few months. It is sortof about prioritizing. I mean if you are committed to getting things fixed and want it done right, it means you may have to suffer for your cause a bit. Personally....I'm thrilled with my results thus far. I go into Surgery next Thursday for Upper, lower, and genio to complete my journey and know that it will all be worth it in the long run. It has definitely had its moments, and honestly the RPE was truly the worst part of my entire journey, but when you see the results it achieves it is really nothing short of amazing, and worth the 3 months of aggravation to get it.

One more thing. Not sure how far you are willing to go with all this, but if surgery is something you would be willing to do you should tell your ortho. I found that mine originally had never said anything about a palate expansion. His original plan was to file my teeth down to make them fit better. When I saw the OS for a consult, he was like.....oh no, you need a surgically assisted rapid palate expansion., that is the only way we are going to get your occulsion corrected. When I asked my Ortho about it he said that he had just assumed I would not want to go the surgical route and thus didn't recommend it, however, he did agree that this would be my best course of action. So... If you are willing to do whatever it takes to fix things (including surgery) make it clear to your doctors that you want the best, most close to perfect results you can have, and that you would consider surgery if that is what it takes. You will probably get much more honest info from them then as opposed to them just telling you what they can do to make things appear better, even if they are not.

Hope this helps some!

Brandy

[Al]

Thanks, everyone. You're a wealth of knowledge, as usual. I'll be asking the ortho(s) some more questions next week.

[OrangeGeek]

Hello,

I'm getting the quad expander on Thursday...can any of you tell me how much it will hurt? Also, my ortho is placing it in my top so that it expands and eventually my bottom will just follow on on its own. How long did that process take for the rest of you?