The active plate is a removable brace for just one jaw. It was first devised by Charles Nord in 1929 and was later improved by A.M.Schwarz and recommended for multiple treatment options. It consists of a plastic body, wire fasteners and active components such as springs and screws.
Active plates, like all other removable appliances, are only useful for a small variety of tooth movements. They only cause simple tooth tilts, but no physical tooth movements, so they are only suitable for simple treatment tasks.
The wearing time is essential
There’s even an additional restriction, because they have to be worn at least 15 hours a day to gain a good therapy result.
Actually, studies about wearing times have shown, that children don’t wear them more than 10 hours a day because of the speech impairment. In fact, the active plates are almost only worn at night, so that the tooth movements are not reliably achieved and 30-50% of treatments end in failure.
Even if the active plate were worn 16 hours a day as required, physical tooth movements, lengthening and shortening of teeth would be practically impossible to achieve, and rotations of teeth only with restrictions, and even this only for incisors. All these tooth movements, on the other hand, are easy to perform with fixed braces.
All treatment tasks can be performed better, faster and more comfortably for patients with fixed appliances. Also, the “elongation” of the upper jaw shown above is actually mostly just an unwanted outward tilting of the posterior teeth. If a real skeletal expansion of the upper jaw is desired, a fixed palatal expansion is needed.
German “platers”
However, the use of the active plate requires little knowledge, manual dexterity and physical effort on the part of the doctor. In addition, under the German fee system, orthodontists earn considerably more profit with removable braces than with fixed appliances. For these reasons, active plates are still highly prized by many orthodontists. Internationally, German orthodontists are therefore also smiled at as “plate setters”.
Children are not very enthusiastic
Young patients’ enthusiasm for the plates, on the other hand, usually lasts only about 1-2 months. After that, the active plate is usually only worn in the pocket during the day. It is a good thing that a second phase with fixed braces is usually planned after the “straightening”. However, it would be more honest to simply eliminate the active plate without replacement. The active plate is an obsolete brace that should no longer be used at all today.
Unnecessary treatment step
Against this background, there is no longer any justification for the use of the active plate. Nevertheless, against all scientific evidence, it is still a very frequently used brace for children and adolescents in Germany. Our young patients have to pay for this contradiction, but not least also the health insurances with high expenses for unnecessary treatment steps.
Even if the active plates today are usually produced in all kinds of funny colours, often with symbols of the favourite football club etc. incorporated, this does not change the fact that the active plate is not an appropriate means of treatment for today’s orthodontic treatments!
Tip for parents
When choosing an orthodontist, pay attention to how much emphasis is placed on treatment with active plates and other removable braces on the website. If a lot of text and pictures are devoted to the presentation of removable appliances, you may suspect that the practice is working in an old-fashioned and inefficient way – to the detriment of your child!