ALF Crescents Revisited

Dec 21, 2016

Dr. Nordstrom’s recent online presentation highlighted some changes in the basic ALF design from the way we learned it years ago: NO crescents when the focus is on arch development, upper canine crescents for patients with trauma and pain symptoms.

 Online Study Club Creates New Possibilities

 Listening to Dr. Nordstrom’s presentation, I was amongst many thinking, “How could I have missed this? Crescents are not part of the basic ALF design anymore?”

While crescents on the canines or first bicuspids have been working very well for my patients, of course, I am excited to be in the loop again about new insights that Dr. Nordstrom is so generously sharing. The internet makes it possible.



ALF for Arch Development

The ALF has an inner-tube effect, inflating the arches the way the tongue should have done but didn’t get a chance to.

  • NO crescents
  • Resin Ledges (marked in green on illustrations)
    • Maxilla: ledges on canines
    • Mandible: ledges on first bicuspids (this makes it easier to achieve a harmonious anterior arch shape)
    • The location for the ledges may need to be modified if canines or first bicuspids are misaligned due to crowding.
  • Advantages of Ledges
    • The wire can freely wiggle without segmenting the forces (as crescents do). Thus it allows the ALF to work most closely like the tongue, evenly distributing the expansion forces.

Maxillary ALF for Trauma

In the case of trauma, patients start out very unstable. They greatly benefit from cuspid crescents which allow effective manipulation of the premaxilla. By creating stability, this design is powerful in releasing cranial strains and pain symptoms.


  • Cuspid Crescents
    • If needed Dr. Nordstrom checks the adaptation of the crescents using marking powder or spray (as used to test the fit of a crown)
    • One advantage of well-placed and adapted crescents is that they make appliance placement quick and easy.
    • Crescents (in the maxilla or mandible) tend to help the posterior segments to work as a group. Crescents can potentially facilitate molar distalization or verticalization, most useful for adults when uncrowding is not a concern.
  • Auxiliaries to the second molars are designed and placed as needed.

More Information about Dr. Nordstrom’s Online Study Group

Dr. Angie Tyler Tenholder has been hosting the Midliner Study Group and has been involved in organizing the ALF InterFace conferences. She can be reached through her website

Please share your thoughts in the comment box at the very bottom – Thank You!


Warm personal regards,
Ljuba Lemke

P.S. The ALF online seminar is now also available to osteopathic physicians and myofunctional therapists at a reduced price. Please inquire about discount coupons.

ALF Online Seminar

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