The Rapid Palate Expansion 4-Banded Hyrax Appliance can be used successfully in patients with mild-to-moderate transverse constriction when they are in the late mixed or early permanent dentition (sutures presumably still patent). This appliance eliminates the palatal acrylic, using an all-stainless metal framework instead...and although this design makes it much easier for the patient to keep clean, there is a greater chance that fewer skeletal -- and more dentoalveolar -- adaptions will be observed. Note: Pre-formed bands may be selected and sent with the prescription or bands may be custom fit. In addition, because this appliance uses four bands for retention, seating can present challenges.

Recommended:
• Leave separators in place until the delivery appointment.
• When the path of insertion is a problem, gentle pressure will often allow seating over time.
• Cement bands with a glass ionomer cement.