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Mandibular Anterior Repositioning Appliance (mara)

Mandibular Anterior Repositioning Appliance (MARA) is a non-removable, fixed Class II Functional Appliance. It is used in dentofacial orthopedics in growing kids and teens. MARA is designed to address specific short lower jaw issues, improve jaw alignment, and open the airway and facial aesthetics.

FAQs

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Mandibular Anterior Repositioning Appliance (MARA) is a fixed, rigid functional orthodontic appliance. It is used in dentofacial orthopedics to correct Class II malocclusions, where the large ‘overbite’ in a growing child/ teen is caused by a short lower jaw and a retrusive chin.

MARA operates on the principle of mandibular advancement, encouraging lower jaw growth in a forward direction. This is achieved by combining fixed upper and lower components interacting via interfering upper ‘elbow’ and lower ‘stop.’ As the patient bites down, opens, and closes their mouth, MARA guides the lower jaw into a more optimal forward position and holds the lower jaw forward throughout treatment. This gives time for the patient’s jaw joint to remodel in a forward position, correcting the short jaw look. Patients with a large ‘overbite’ are corrected through a series of gentle, incremental ‘jumps’ by activating MARA over time.

Improved Facial Aesthetics:

By repositioning the lower jaw forward in short lower jaw patients, MARA improves the facial profile by giving a stronger lower jaw and a more pronounced chin. This contributes to a more balanced facial profile, enhancing aesthetics and harmony.

Non-Extraction Solution:

MARA is often a non-extraction alternative for cases where tooth extraction might have been considered in traditional orthodontic treatments.

Fixed, Class II functional Appliance solution:

MARA is fixed onto teeth. It is stuck on and non-removable. Therefore, MARA is a good alternative for patients with poor compliance with removable functional appliances like Invisalign MA. It is important to note that MARA is bulkier and more intrusive than Invisalign MA. Therefore, MARA is much more uncomfortable than Invisalign MA.

No telescopic arms:

MARA does NOT have telescopic arms like the Herbst appliance. Instead, MARA has a much more discreet and compact way to advance the lower jaw via interfering with the upper ‘elbow’ to lower ‘stop ’ compared to the Herbst appliance. With the MARA, the patient can still move the jaw side to side freely while eating and speaking. This greatly improves the comfort and acceptance of the patient.

Customisable mandibular advancement:

The MARA’s design allows for precise control over the advancement of the lower jaw. By modifying the number and timing of adding MARA shims to advance the lower jaw, we can customize the rate of lower jaw advancement to ensure patient comfort.

Targets short lower jaw WITH Asymmetry:

MARA allows our Orthodontic Team to manage complex cases with short lower jaw AND asymmetry (crooked face) by customizing the number of MARA shims per side. This allows MARA to advance one side of the lower jaw more than the other, correcting lower jaw asymmetry simultaneously.

Simultaneous alignment with fixed braces:

MARA allows fixed braces to be placed simultaneously if needed. This helps to reduce treatment time and provides early improvement of the smile for the patient’s happiness.

Determining if MARA is suitable for a growing patient involves thoroughly examining their orthodontic condition and the patient’s growth status. Typically, MARA is recommended for individuals with Class II malocclusions caused by a short lower jaw, and its effectiveness is influenced by factors such as the patient’s age and compliance. Treatment duration varies but is often comparable to traditional braces.

A patient needs to be assessed by an experienced orthodontic clinician trained in growth assessment and dentofacial orthopedics. Please seek consultation with MyBracesClinic’s Orthodontic Team early to prevent missing out on your child’s active growth period.

  • Patients using the MARA may experience an adjustment period of about 2 weeks.
  • Patients must get used to the MARA against the inner cheek in the initial ‘settling in’ period. Ulcers may be experienced on the inner cheek and sides of the tongue. This is usually temporary, and ulcers disappear after 2 weeks.
  • Dietary habits need to be modified with MARA to avoid crunching ice cubes and hard nuts.
  • It is usual for patients to feel tired and sore in the jaw muscles during the initial phase and the activation of MARA.
  • Regular follow-up appointments are essential to monitor progress, make necessary adjustments, and check for loose or broken MARA parts.
  • Proper oral hygiene and care are crucial to ensure that MARA functions optimally throughout the treatment duration.
  • Treatment duration with MARA varies from patient to patient and typically lasts 9-18 months.

Conclusion

The Mandibular Advancement Repositioning Appliance (MARA) is a testament to the ever-evolving landscape of orthodontics. Its ability to address Class II malocclusions while offering a comfortable and aesthetically pleasing alternative makes it an appealing choice for many patients. If you’re considering orthodontic treatment and have concerns about jaw alignment, consult an experienced orthodontist at MyBracesClinic to explore whether the MARA might be the right solution for your unique needs. Embrace the journey towards a beautifully aligned profile and smile with the MARA!

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