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Orthodontic headgear is a type of orthodontic appliance typically attached to the patient's head with a strap or number of straps around the patient's head or neck. From this, a force is transferred to the mouth/jaw(s) of the subject.
Headgear is used to correct bite and support proper jaw alignment and growth. It is typically recommended for children whose jaw bones are still growing.
Unlike braces, headgear is worn partially outside of the mouth. An orthodontist may recommend headgear for a patient if their bite is more severely out of alignment. The device typically transfers the force to the teeth via a facebow or J hooks to the patient's dental braces or a palatal expander that aids in correcting more severe bite problems or is used in retention of the teeth and jaws of the patient.
Headgear is most commonly used to correct the bite of the patient. The headgear attaches to the braces via metal hooks or a facebow. Straps or a head cap anchor the headgear to the back of the head or neck. In some situations, both are used.
Elastic bands are used to apply pressure to the bow or hooks. Its purpose is to slow or stop the upper jaw from growing, thereby preventing or correcting an overjet.[ medical citation needed ]
Other forms of headgear treat reverse overjets, in which the top jaw is not forward enough. It is similar to a facemask, also attached to braces, and encourages forward growth of the upper jaw.[ medical citation needed ]
Headgear can also be used to make more space for teeth to come in. In this instance the headgear is attached to the molars, via molar headgear bands and tubes, and helps to draw the molars backwards in the mouth, opening up space for the front teeth to be moved back using braces and bands. Multiple appliances and accessories are typically used along with the headgear, such as: power chains, coil springs, twin blocks, plates or retainers, facemasks, a headgear helmet (a headgear helmet is a cervical headgear with a cap or rigid helmet that covers the entire head), lip bumpers, palate expanders, elastics, bionaters, Herbst appliances, Wilson appliances, other headgear, hybrid twinblocks, positioner retainers, and jasper jumpers. Many patients wear a combination of, or all of these appliances at any given time in their treatment. [1]
Headgear needs to be worn between 12 and 23 hours each day to be effective in correcting the overbite, typically for 12 to 18 months depending on the severity of the overbite, how much it is worn and what growth stage the patient is in. Typically however the prescribed daily wear time will be between 14 and 16 hours a day. [1]
Orthodontic headgear will usually consist of three major components:
Soreness of teeth when chewing or when the teeth touch is typical. Patients usually feel the soreness to 2 to 3 hours later, but younger patients tend to react sooner, (e.g., 1 to 1+1⁄2 hours). The headgear application is one of the most useful appliances available to the orthodontist when looking to correct a Class II malocclusion.
Facemask or reverse-pull headgear is an orthodontic appliance typically used in growing patients to correct underbites (technically termed Class-III orthodontic problems) by pulling forward and assisting the growth of the upper jaw (maxilla), allowing it to catch up to the size of the lower jaw (mandible). These appliances effectively serve to pull the patient's teeth forward. [1]
Facemasks or reverse-pull headgear needs to be worn between 12 and 23 hours per day, but typically a period of 14 to 16 hours each day is effective in correcting the underbite. [2]
Overall wear time is usually anywhere from 12 to 18 months depending on the severity of the bite and how much a patient's jaws and bones are growing over this time. [1]
The appliance normally consists of a frame or a center bars that are strapped to the patient's head during a fitting appointment. The frame has a section which is positioned in front of the patient's mouth, which allows for the attachment of elastic or rubber bands directly into the mouth area. These elastics are then hooked onto the patient's braces (brackets and bands) or appliance fitted in his or her mouth. This creates the prescribed pulling force in order to pull the upper jaw forward.
The orthodontic facemask typically consists of three major components:
In some cases surgery is required in conjunction with a facemask or reverse-pull headgear. Many parents and doctors recommend using early intervention (typically between ages 7 to 13) by using a facemask to avoid costly and painful surgical procedures later. [1]
The appliance is very effective in correcting Class III orthodontic problems in younger or adolescent patients that are still growing. Initially, it can be difficult for children to wear a mask or headgear, however most doctors and parents agree that children and adolescence adapt quickly to such changes and requirements. [2]
Parents should be aware that their child is often better-off wearing a facemask or headgear to avoid later surgery and the patient, friends and school peers normally get used to the new appliance after just a few weeks of wear. [1]
Researchers who have studied the long-term effects of orthodontic headgear have found that it may flatten the face and prevent the chin from coming forward, pushing both the upper and lower jaw down and back, into the airway. In more technical terms, it inhibits the natural growth of the jaws and lead to a reduction in the SNA and ANB angles, which relate to the forward position of the maxilla and the mandible. These measurements are good indicators of the size of a person's airway. [3]
The controversy about headgear intensified beginning in the 1980s when formerly headgear treated patients developed severe health symptoms, such as sleep apnea, breathing problems and acute TMD[ further explanation needed ].
In some cases, eye injuries have been reported, which is minimized with the use of safety release straps and safety facebows. [4]
Teenagers prescribed orthodontic headgear often face social stigma and bullying if seen wearing these appliances. Because of the difficulties in complying with daytime wear of headgear, these appliances are mainly worn in the evenings and while sleeping.
The need for headgear in orthodontics and its application by practitioners has somewhat decreased in recent years as some orthodontists use temporary implants (i.e., temporary anchorage devices) inside the patient's mouth to perform the same tooth movements. However, the headgear is still widely used and a very effective appliance used by orthodontists today.
Soreness of teeth when chewing, or when the teeth touch, is typical. Adults usually feel the soreness 12 to 24 hours later, but younger patients tend to react sooner, (e.g., 2 to 6 hours). Adults are sometimes prescribed headgear but this is less frequent.
Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, as well as misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial orthopedics.
Orthodontic retainers are custom-made devices, usually made of wires or clear plastic, that hold teeth in position after surgery or any method of realigning teeth. Once a phase of orthodontic treatment has been completed to straighten teeth, there remains a lifelong risk of relapse due to a number of factors: recoil of periodontal fibres, pressure from surrounding soft tissues, the occlusion and patient’s continued growth and development. By using retainers to hold the teeth in their new position for a length of time, the surrounding periodontal fibres adapt to changes in the bone which can help minimize any changes to the final tooth position after the completion of orthodontic treatment. Retainers may also be used to treat overjets.
Dental braces are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often used to correct underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces are often used in conjunction with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws.
A dental technician is a member of the dental team who, upon prescription from a dental clinician, constructs custom-made restorative and dental appliances.
Clear aligners are orthodontic devices that are a transparent, plastic form of dental braces used to adjust teeth.
Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics and self-esteem.
Orthodontic separators are rubber bands or metal appliances used in orthodontics. Spacers are placed between the molars at the second orthodontic appointment before molar bands are applied. They are usually added a week before you get your braces, but can sometimes be added after.
In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855–1930), the "father of modern orthodontics", popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet.
Orthodontic technology is a specialty of dental technology that is concerned with the design and fabrication of dental appliances for the treatment of malocclusions, which may be a result of tooth irregularity, disproportionate jaw relationships, or both.
Jaw wiring is a medical procedure to keep the jaw closed for a period of time. Originally, it was used as the mandibular equivalent of a cast, to fix the jaw in place while a fracture healed. Jaw wiring is also used for weight-loss purposes, to prevent the ingestion of solid food.
The splint activator of Soulet-Besombes is a removable appliance for the treatment of dental and jaw anomalies. It is basically a stylized Activator appliance, which is however not fitted individually, but is mass-produced in various shapes and sizes. The device is also known as Position Trainer or Kaukraft-Kiefer-Former.
Headgear, headwear, or headdress is any element of clothing which is worn on one's head, including hats, helmets, turbans and many other types. Headgear is worn for many purposes, including protection against the elements, decoration, or for religious or cultural reasons, including social conventions.
Abdolreza Jamilian is an Iranian orthodontist and a USPTO patent holder for devices including a method and system for treatment of maxillary deficiency using miniscrews, a tongue plat, and an R-appliance.
Lingual braces are one of the many types of the fixed orthodontic treatment appliances available to patients needing orthodontics. They involve attaching the orthodontic brackets on the inner sides of the teeth. The main advantage of lingual braces is their near invisibility compared to the standard braces, which are attached on the buccal (cheek) sides of the tooth. Lingual braces were invented by Craven Kurz in 1976.
Anchorage in orthodontics is defined as a way of resisting movement of a tooth or number of teeth by using different techniques. Anchorage is an important consideration in the field of orthodontics as this is a concept that is used frequently when correcting malocclusions. Unplanned or unwanted tooth movement can have dire consequences in a treatment plan, and therefore using anchorage stop a certain tooth movement becomes important. Anchorage can be used from many different sources such as teeth, bone, implants or extra-orally.
Elastics are rubber bands frequently used in the field of orthodontics to correct different types of malocclusions. The elastic wear is prescribed by an orthodontist or a dentist in an orthodontic treatment. The longevity of the elastic wear may vary from two weeks to several months. The elastic wear can be worn from 12 to 23 hours a day, either during the night or throughout the day depending on the requirements for each malocclusion. The many different types of elastics may produce different forces on teeth. Therefore, using elastics with specific forces is critical in achieving a good orthodontic occlusion.
Activator Appliance is an Orthodontics appliance that was developed by Viggo Andresen in 1908. This was one of the first functional appliances that was developed to correct functional jaw in the early 1900s. Activator appliance became the universal appliance that was used widely throughout Europe in the earlier part of the 20th century.
A facemask is a type of an orthodontic headgear used to treat underbite and other malocclusions where the upper jaw is too far backwards. A metal bar sits in front of the patients face with support from the forehead and chin. Elastics are connected to the metal bar and the teeth - directly through the lips / mouth of the patient. The elastics apply forward and downward pressure on the upper jaw. Thus the force direction is the opposite from a standard headgear which is why this appliance is also known as a reverse-pull-headgear.
John Mew is a British orthodontist. He is the founder of orthotropics and mewing. Orthotropics is a form of oral posture training that claims to guide facial growth and is not supported by mainstream orthodontists. John Mew's son Michael Mew is also an orthodontist and has also practised and promoted the idea of orthotropics.
The Herbst appliance is an orthodontic appliance used by orthodontists to correct class 2 retrognathic mandible in a growing patient, meaning that the lower jaw is too far back. This is also called bitejumping. Herbst appliance parts include stainless steel surgical frameworks that are secured onto the teeth by bands or acrylic bites. These are connected by sets of telescoping mechanisms that apply gentle upward and backward force on the upper jaw, and forward force on the lower jaw. The original bite-jumping appliance was designed by Dr. Emil Herbst and reintroduced by Dr. Hans Pancherz using maxillary and mandibular first molars and first bicuspids. The bands were connected with heavy wire soldered to each band and carried a tube and piston assembly that allowed mandibular movement but permanently postured the mandible forward. The appliance not only corrected a dental Class II to a dental Class I but also offered a marked improvement of the classic Class II facial profile.