Ortho Organizers Nitanium Palatal Expander 2 Appliance

We strongly recommend a trial fitting of the assembled appliance (without cement and using the Ice Spray), prior to final placement.

• If Molars are Severely Rotated: We recommend you use our Nitanium Molar Rotator prior to using the expander. This will make insertion of the N.P.E.2 much easier.
• Upon Initial Activation of Expander: The Ortholoy Finger Springs, in most cases, will NOT touch the lingual of the bicuspids. This is normal. Only after rotation and expansion occurs will the Finger Springs touch the bicuspids. Therefore, do not initially adjust the Finger Springs unless they interfere with treatment.

Precaution: Please advise your patients not to flex or press the finger springs with their hand and or tongue. Repeated pressing or flexing of the finger spring could lead to the breakage of the finger spring wire.

Adjustments : All the adjustments should be made outside the mouth.

• Do not use any type of wire cutter to bend wires. If bending adjustments are necessary, please use a flat-nosed plier such as a Bird Beak, How or Mathieu plier.
• If adjusting Nitanium wire: We suggest using a Nitanium Expander Adjusting Plier. This special 3-pronged plier allows bending adjustments without damaging the wire.
• If adjusting Finger Springs: The Ortholoy Finger Springs can withstand three or four bends in any location EXCEPT at the preformed 45° bends.

We suggest using one of the following techniques to assist in making Finger Springs adjustments :

a) Using Two FLAT-NOSED Pliers – or Flat-Nosed Plier and your fingers to bend Finger Springs. Place one set of pliers just mesially of the tube and the last 45° bend; then using another set of pliers (or your fingers), gently adjust the Finger Spring to desired position.
b) Using fingers to bend Finger Springs – Hold the Finger Spring just mesially of the tube and the last 45° bend with your thumb and index finger, then use other
hand to adjust Finger Spring to desired position.
NOTE: The Finger Springs may be shortened if necessary. Both the Finger Springs and Adjusting Loops are made of Ortholoy

• When the mandibular permanent first molars are in a normal position, measure in millimeters across the arch, central pit to central pit. Then subtract 4mm from this measurement. The result will yield the size of the rotator to use in the maxilla and includes 1.5 to 2mm of over-correction from the width of the molars bands and lingual sheaths. (When the rotation and expansion is greater then 4mm, we recommend you use the Nitanium Palatal Expander 2.)
• Pre-size the molars with the molar band/sheath assemblies. Insert rotator into both lingual sheath assemblies until the distal rotator blade snaps into the latching indent of each sheath. For additional support, tie in the appliance by attaching a Hand-ee-Last ligature or ligature wire from the front of each rotator arm to the back of each rotator blade.
• Mix band cement and place in both molar bands.
• Using the Ice Spray, chill the palatal wire of the rotator assembly.
  NOTE: Avoid spraying the molar bands. (Chilling the palatal wire makes it easier to place the appliance.)
• Take the chilled assembly, place and seat one molar band, and then the other band. Check for secure fit until the cement has hardened. Clean off excess cement after cement has set.
• The rotator is activated when it is warmed by the mouth and reaches 94° F.
• To remove appliance, simply cut the Hand-ee-Last ligature or wire ligature tie and snap rotator out of each molar sheath.
• If desired, additional adjustments can be made to the appliance using the Nitanium Expander Adjusting Plier.