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Basics of Orthodontic Headgear
Steve Luse & Craig Jacobson
©Copyright 2010 Ortho Kinetics Corp. This material is the property of OKC and may not be used without written permission. 12/21/10 Length 37 pages.
Why use Headgear? Headgear Basic Info Types of Headgear Patient needs vs. Orthodontist’s needs
Outline
1. Increasing Anchorage 2. Distalizing the Maxillary (or mandibular
arch 3. Precautionary Use
Headgear can create either an orthodontic change or orthopedic change.
Why Use Headgear?
Used to hold or move teeth or entire arch e.g hold upper (maxillary) arch while child
grows e.g move back (distalize) upper molars in
relation to child’s head.
Orthodontic Headgear Use
Action Desired Recommended Wear Time
- Distalizing 24 hours per day - Holding anchorage 14 hours per day
- Precautionary night time wear
Doctor’s Headgear Recommendations
Headgear has been usedSuccessfully for 150+ years.
Why use Headgear?
Dr. Angle’sHeadgear from 1894
Need U6 for molar Band placement Girls = 6.22 years Boys = 6.40 years
Other Teeth come in From 6-13 years
Timing of treatment related to tooth eruption age
Chart shows average age of tooth eruption
Force Applied X Time worn X Direction Applied X Other Factors
Headgear Effectiveness =
Before and After Headgear:
Headgear Wear Result
Good headgear wear moved U6 “back” distally
Facebows Release Modules Straps or cushions Other items
Headgear Components
Headgear is the “outside” part Facebow goes into patient’s mouth Facebow connects to buccal tube’s
“headgear tube”
Headgear connection to patient = Buccal Tube
Headgear is the “outside” part Facebow goes into patient’s mouth Facebow connects to buccal tube’s
“headgear tube”
Headgear connection to patient = Buccal Tube
Buccal tube’s headgear tubeaccepts facebow wire
Buccal Tube with facebow
Pictured here is the Nitom Locking Facebow
Kloehn- Regular- Cushion Loop
J-Hook Asher Bite Plate
Facebow Styles
Kloehn style facebow- .045” diameter inner bow- .072” outer bow- 6 sizes inner bow- 2 sizes outer bow
Rigid Feel
Facebow Styles
Kloehn Loop style- invented by Dr. Andrews- .067 outer bowwith cushion loop
Softer springy Feel
Facebow Styles
J-Hook Facebow- Two “J” shaped hooksconnect to posted archwires
Facebow Styles
Asher Facebow- Used by Dr. Ron Roth- Intrudes anterior teeth- Short or regular outerbow- Pushes on Archwire
Facebow Styles
Bite Plate Facebow- Intrudes anterior teeth- Short or regular outerbow- Pushes on anterior teeth- two main styles:cushion loop style orregular style
Facebow Styles
Cervical Pull High Pull (occipital pull) Combi Pull Reverse Pull Vertical Pull J Hook
Types of Headgear
Pulls back from the upper molar
Direction of Pull
Cervical Pull
Pulls upward from upperfirst molar
Direction of Pull
High Pull (occipital pull)
Pulls upward and back from Upper first molar
Direction of Pull
Combi Pull
Pulls upper arch forward
Direction of Pull
Reverse Pull
Pulls upward
Direction of Pull
Vertical Pull
Four Types of Headgear Injuries In Europe
(23 countries studied)
Accidental disengagement while playing (17%) Incorrect handling during fitting or removal
(8%) Bully Pulls headgear (4%) Unintentional nighttime disengagement (71%)
Headgear Safety Study
Researcher and Author: Dr. Russel Samuels (UK)Published: JCO, AJO, BJO, EJO
Your Actions can reduce Potential Injuries:
Proper patient instructions Proper fitting by orthodontic office Proper equipment – Ortho Kinetics
Headgear& Facebows
Headgear Safety Strategy
Injury Cause & Prevention Strategy:
1. Accidental disengagement while playing (17%)Proper patient instructions and education
2. Incorrect handling during fitting or removal (8%)Proper patient instruction and education
3. Bully pulls headgear (4%)Releasable headgear modules
4. Unintentional nighttime disengagement (71%)
Nitom™ Locking Facebow
Safety Strategies for each injury cause
Our releasable force module’s latches are designed to release at higher force levels than competitive modules when pulled slowly
We try to minimize accidental nighttime headgear module release. (Type 4 injury)
Our design philosophy applies to:◦ Nitro™ Modules◦ NewGear™ Headgear
Ortho Kinetics Corp. HeadgearProduct Design Philosophy:
Releasable headgear for modules◦ Aka. Safety modules or safety breaks, etc.
Fit onto Cervical and high pullStraps and connect to facebow
Force Modules
When you pull strap; a force is applied by the module
When strap is fully extended;module “breaks away”
Headgear Modules
The Further you pull strap(strap extension)= more force
applied
Marks on strap show how far strap is extended (pulled)
Use OKC Force Tool to see relationship between force & extension
Headgear Modules
OKC offers plastic release clips on “Nitro” Brand Modules
plastic clips are easier to put together
Breakaway Function
NewGear features plastic clips with higher breakaway force
It is easy to put together Patented “luggage buckle”
style
NewGear™ Breakaway Function
Headgear Needs
Patient Needs:
• Comfortable• Easy to Use• Attractive• Easy to Clean• Safe to use
Orthodontist Needs:
• Patient Cooperation• Right force level• Safe to use• Comfortable• Minimal Inventory
OKC Need Fulfillment - Patient
NewGear Emphasizes:◦ Ease of Use◦ Attractive – color options◦ Comfort options –
Regular foam cushion Gel cushion Visco cushion
Ortho Kinetics Corporation
Exclusively Focused on Innovative Orthodontic Force Systems