The Upper Palatal Expander is a fixed brace designed to widen the upper jaw. It was first introduced by Angell in 1877. However, he was not taken seriously as the mere possibility of an upper palatal expander (GNE) was disputed and the procedure was initially forgotten about for decades. It was re-discovered after 1945 as a result of the work of Haas, Timms and Derichsweiler and its indisputable place in orthodontics is now assured. The appliance is usually fixed with tapes to the 1. molars and the 1. premolars and, as of very recently, also fixed on plastic tracks around all the posterior teeth. The very rigid appliance is held in place by a jack screw in the middle, which, over a period of 2-8 weeks makes it possible for the two halves of the upper jaw to be gradually pushed apart by up to10 millimeters. New bones are then allowed to grow in the middle, so the GNE is perhaps the only truly orthopedic device in orthodontics. Normally, surgery would be the only way to achieve such skeletal effects.
Using a GNE is very often the expedient thing to do, because many orthodontic patients have an upper jaw that is too narrow. The desired widening of the jaw with a GNE is skeletal, as it actually works by allowing new bones to form, whereas a removable brace is just intended to achieve a slight outward tilting of the posterior teeth which will not remain stable. The GNE has many healthy side-effects that are all based on improving breathing through the nose; fewer colds and sinus problems, improved aeration of the inner ear through the Eustachian tubes resulting in an improvement in ear symptoms, better sleep and less bed-wetting. There is no other orthodontic appliance that has such a holistic effect and provides such good value for money. Although the Upper Palatal Expander is the absolute first choice every time, it is unfortunately used too infrequently in Germany and is often disparagingly described as brutal “blowing up of the palate”.