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