The main "EXPERT' in AGGA is Bill Dickerson:  https://www.lviglobal.com/

Do I agree with everything?  No.  With kids they use RAGGA/RGGA (removable version).  I see that there tends to be a lengthening of the face with anything obstructing the bite from closing.  Ex. Myobrace (lengthens the face... says so in their literature).  Acrylic between teeth and talking can stretch the philtrum.  I know that Bill's dentists (at least one I spoke with) shaves down as they go.  In ways I like what they're doing.  Cute kids.  I think for forward movement,... unless there's an anterior open bite or the front teeth are super big and tall and the back molars angle down excessively (hard to explain - but looking like a anterior open bite almost)… then acrylic is not something I'd use.  When it comes to saggital appliances... the y-shape or anything AGGAish with acrylic turned by key will give much more forward movement than springs.  However, springs can be very good to tilt out teeth.  Depends on the objective.

AGGA is basically the same thing as this:  https://www.youtube.com/watch?v=HMeYJOGo0C0   That will give a sense of facial effects (the papers are the before... the kid in the chair is the after).

For kids, in my opinion and experience... turn-key is pretty harsh.  It really isn't necessary much of the time.  Lighter forces allow for the body to adapt.  This give a much more natural aesthetic.  I like braces if young enough.... or alf or something that applies a light continuous pressure.  That is what the whole Damon movement is based on.  Even DNA and some of the newer stuff out there is basically a rejection of the harsh torture-style devices that can and do injure the aesthetic qualities of the face.  The turn-key is going out, as it should.

You may ask then... why DNA does turn-key?  I think they-themselves are looking for ways to get away from it.  Their wireframe device is quite nice.  The public is just undereducated on this.  Unless the public stands up in rejection of intermediately applied strong forces and understands that the body adapts better (more natural = more aesthetically) to alternatives... then there won't be the market forces that reject this.  The thing is, though... as you're experiencing... it's a FRIGGEN shot in the dark.  There's a true dearth of information in existence.  That is why I wanted to share this stuff.

Additionally, functional devices are the cheapest way to do orthodontics.  They require less visits... that is also behind the Damon movement (greater frequency between visits = less chair time).  Generally, I like more visits.  More visits... longer treatment times.  That will allow the body to naturally adapt to treatment and for any concerns during treatment to properly be recognized.  We're with our kids like all the time.  The orthodontists see them every blue moon.  The thing is... we can see what's happening where they cannot.  The only orthodontists who I personally see pushing longer treatments are true artists.... sculptors... who take pride in their work.

To be clear, though... turn-key is decent for palatal movement, including AGGA.  The front teeth as permanent, need to be carefully managed... meaning if you push on them directly, then root absorption is more likely to occur.  I suppose that is why AGGA is nice... because the teeth need to be in bone.  So, like I said.. it depends on the objective.  For serious forward movement of the maxilla in a child... AGGA or facemask are both used.

Thanks for sharing!

Also, who are the orthodontists with the most practical experience with patients using the AGGA appliance? It's similar to my first question, maybe, but I'm hoping others with knowledge of specific orthodontists will chime in. Thanks again!

Posted by: katherine4

Also, who are the orthodontists with the most practical experience with patients using the AGGA appliance? It's similar to my first question, maybe, but I'm hoping others with knowledge of specific orthodontists will chime in. Thanks again!

Bill Dickerson has a network of dentists who so RAGGA.  I personally wouldn't put my kid in a RAGGA as the teeth are blocked from touching each other.  There are saggitals that push forward.  Any ortho lab would show you around and say who orders what.  That being said, an anterior open bite or true divergent growth patterns would do well with acrylic behind the back teeth.  LVI I believe trains their dentists to shave down the acrylic between the teeth.  I'm not an expert.