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Case Study Index


Maxillary ALF appliance in place. This Advanced Lightwire Functional appliance is designed to expand the cranial sutures, decompress the skull, and take the twists out of the dural membrane system. The Cranial Indicators developed by Dr. Smith are the only way to assess the 3-dimensional relationship of the skull bones. Performing orthodontic treatment without knowing where the skull bones are being moved can and often result in chronic pain, which none of the specialists have any knowledge. This is the reason why patient's pain patterns are never resolved.




Mandibular ALF appliance used to expand the lower arch to coordinate and match the expansion of the upper arch.




The ALF appliance has the ability to expand the compressed sutures (expansion/contraction joints) between the skull bones. Use of the ALF MUST be used in conjunction with Dr. Smith's cranial indicators in order to know if the skull is being corrected. Using the ALF as just another expansion device is a prescription for disaster. Do not assume that your dentist/orthodontist knows what he or she is doing.

Pitfalls of Conventional Orthodontics

case summary

ALF Case Report Summary
Symptoms began after conventional orthodontics were completed.
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Extraction of four bicuspid teeth is still within the realm of standard of care orthodontics. This technique unfortunately disregards cranial bone architecture. After the bicuspid teeth are removed, the braces straighten the teeth, which is a good thing. The problem arises when the extraction spaces are closed. This requires moving the front teeth backward, which causes compression and twisting of the cranial vault. If a bar of material is compressed, it creates strain patterns in the material. The human skull is no different. The resultant distortions to the skull result in strain patterns within the sutures (expansion/contraction joints between the skull bones) and the dural membrane system which passes out at the base of the skull attaches to the upper three cervical vertebrae and extends down to the sacrum (lower back). These tension patterns are the direct cause for chronic headaches, neck and lower back pain. In addition, when the upper front teeth are moved backward, the lower jaw becomes physically restricted by being pushed posteriorly to fit into the upper compressed arch. This posteriorly restricted mandibular (lower) jaw posture has the direct effect of closing the airway (sleep apnea), causing a forward head posture and loss of the normal cervical curve in the neck. The following case exemplifies the above scenario.

Debbie was a nurse who had no medical complaints. Following extraction of four first bicuspid teeth and retraction of the upper and lower six anterior teeth, Debbie developed pressure in her face, chronic headaches and facial pain. Medical consultations within the hospital in which she worked could not find any basis for her complaints. Examination of Debbie’s cranial bones revealed compression and twisting of both her skull bones and dural membranes. These physical changes were the direct result of traditional orthodontic pure mechanical treatment. Debbie had to undergo retreatment with ALF appliances to decompress her skull and take the twisting pattern out of the dural membranes. Debbie’s upper and lower six anterior teeth had to be moved forward to allow the lower jaw to come forward. Following retreatment to correct the 3-dimensional distortions within her skull, Debbie became 100% symptom free. Traditional orthodontics has no way of assessing patient’s skulls 3-dimensionally and potentially is a prescription for disaster.



Conventional braces placed after the compression and twists are removed from the skull. Balancing the maxillae first is like straightening the foundation before building a house. The ultimate objective is for the cranial bones to be in balance when the teeth come together. Occlusal cranial balance is the self-correcting mechanism for balancing the skull.