Gerber Pull-Forward Orthopedic Appliance for Mandibular Advancement

When used clinically, the Gerber Pull Forward (GPF) appliance has many advantages over the bulkier and non-functional options: it is the most reliable appliance available to gain adult patient cooperation while advancing a posteriorly positioned mandible.

The Gerber Pull-Forward Orthopedic Appliance is utilized primarily for the advancement of the mandible
for adult orthodontic/orthopedic, airway, craniocervical and TMD correction. This original article discusses these applications and the design of the appliance.

The development of this type of appliance arose from the need to discover a clinical orthopedic modality specifically designed to move the mandible into stable functional and neuromuscular balance. Additionally, it was recognized that any dental orthopedic appliance must be one that would attain and maintain neuromuscular balance during and after intraoral treatment.

It is understood that the Maxillary Lingual Cusps are the functional points of the proprioceptive response for the recruitment of the masticatory muscle fibers. In other words, how strong and with what degree of coordination do you chew? These proprioceptors are not only situated in deep muscle, as in other human locomotive systems, but also within the periodontal ligaments. Thus with any appliance design, the synergistic function of the mandible and these functional cusps are responsible for the occlusal forces being directed down the long-axis of the teeth. (Figs. 1-2)

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Jay Gerber

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