The Hilger's Appliance is used to move upper back teeth backwards upper molars.
This appliance consists of a plastic “button” that touches the roof of the mouth and spring that moves the molars back using the roof of the mouth as an anchor. Patients usually wear this appliance for approximately 6 months.
Pre-activation of the springs should be done before insertion. Bend the spring 90 degrees, so they are parallel to the midline of the palate. Be aware that 1/3 of compression is lost during placement. Insert the spring into the lingual sheath using finger pressure and a Weingart plier. Use an elastic o-ring to hold the spring to the band. The patient should be seen every three weeks, and reactivation should be done if needed. If needed, hold the center of the helix with a bird beak plier and push the spring distally. The typical rate of activation is one (1) 1⁄4 turn every three days. Most screws we use in mid-palate applications require five (5) activations per 1mm. This appliance should be cleaned every day with toothpaste and a soft toothbrush, morning and night. Encourage the patient to give sufficient time to clean thoroughly around the appliance, gums, teeth, and bands to maintain proper hygiene and prevent inflammation. 3 minutes is recommended.