Digital Workflow for Manufacturing a Modified Transpalatal Arch for Scissor Bite Correction

A scissor bite in the area of the second molars is often a therapy-resistant problem in everyday clinical practice. Conventional elastics for correcting scissor bite reinforce the extrusion of the molars and are dependent on the cooperation of the patient. Therefore, an intramaxillary application of force with the aid of a modified transpalatal arch with distal extensions has proven to be advantageous. On the one hand, it combines the palatine tilting of the upper molars with an intrusive effect and on the other hand it works in a compliance-independent manner. In this article, the digital workflow for manufacturing such an appliance is presented on the basis of a clinical case. Digital planning of such a transpalatal arch takes place in just a few steps with the aid of common orthodontic software tools. After manufacturing in the CAM process, this simple apparatus can be adhesively attached. The described workflow represents both an alternative manufacturing method of a TPA for scissor bite correction and is intended to present a simple clinical application that is suitable for entry into the world of digitally planned and CAM manufactured orthodontic appliances.