Long-term stability of lip bumper therapy followed by fixed appliances

Lip bumper treatment has been shown to successfully increase arch width, procline the incisors, and distalize molars. However, few studies have been performed showing the long-term stability of lip bumper treatment. In this study, mandibular casts taken by a single practitioner from 51 patients treated with lip bumpers without rapid palatal expansion were analyzed at pretreatment, post-lip bumper treatment, posttreatment, and long-term out of treatment. Measurements of arch width, arch depth, arch length, and anterior crowding were made. During treatment, there was a mean decrease in irregularity of 3.73 mm, with a posttreatment increase of 0.76 mm, for a net decrease of 2.97 mm. Despite posttreatment decreases, significant gains in arch width were maintained for extended periods of time. The intercanine width had a net increase of 1.78 mm (19% relapse), first premolars 3.39 mm (26% relapse), second premolars 2.58 mm (34% relapse), and first molars 2.17 mm (20% relapse). Lip bumper treatment along with fixed appliances is an effective means to obtain long-term increases in arch width and decreases in the irregularity index.