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Orthodontics > Headgear > Flashcards

Headgear Flashcards

1
Q

Define headgear

A
  • Applying posterior directed forces to teeth and skeletal structures from extra oral force
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2
Q

History of headgear

A
  • Introduced in 1800’s but later abandoned as they thought Intra oral elastics would effect same
  • 1940 introduced again after Cephalometric radiographs demonstrated that potentially adverse effect of elastics ( Extrusion of molars, Proclination of lower incisors)
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3
Q

Headgear use

A
  • Anchorage
  • Traction
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4
Q

Classification of headgear

A
  • Distalising HG -
  • Reverse (Protraction) HG
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5
Q

Distalising HG

A
  • Direction of elastic traction has distal component.
    -Most often used in crowded class 2 cases.
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6
Q

Type of Distalising HG

A
  • Occipital directed High pull
  • Combination directed Pull
  • Cervical directed low pull
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7
Q

Reverse Protraction HG and component

A
  • Means of applying ANTERIOR directed forces to the teeth and skeletal structures from an extra oral source.
  • Chin up : Restrain forward growth of mandible by changing direction of force to downward and backward
  • Forehead cap - Support
  • Framework
  • Intra oral splint/ device : for RME
  • Elastics - Traction force to maxilla
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8
Q

Components of HG

A
  • Head cap/ neck strap
  • Elastics
  • Facebow e.g Kloehn bow ( Distalising HG)
  • Face mask e.g Delaire type (Protraction HG)
  • Removable / FA
  • Chin cap
  • Safety straps / mechanism
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9
Q

Reverse pull headgear / Facemask
Type of Facemask

A
  • Hickman
  • Delaire
  • Petit
  • Turbinger
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10
Q

Uses of Distalising HG
Dental and skeletal

A

Dental 70% - Reinforce Anchorage
- Distalise single or block of teeth
- To Extrude single or blocks of teeth ( low pull / cervical HG)
- To intrude single or blocks of teeth (High pull HG).
- Skeletal- small effect 30%
- Maxilla - Suppression of anterior growth 1-2mm over 10 yrs which is permanent even after treatment has been ceased.
- Mandible - Suppression of anterior growth - Retrusion of chin during chin cap treatment, but catch up mandibular growth may occur during pubertal growth .

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11
Q

Which HG bring favourable outcome achieve Dento skeletal ?

A
  • cervical HG
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12
Q

Uses of Reverse protraction HG
Dental and skeletal

A

Dental - Protraction of single or block of teeth
Skeletal -
Maxilla - Enhancement due to accelerated growth. 2mm advancement of maxilla if rapid maxillary expansion (RME) and protraction HG is used in primary dentition.
Mandible - Suppression- effect is relevant than max

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13
Q

Treatment timing

A
  • before age of 8-10years after this age orthodontic movement overwhelms any SK changes
  • Early use skeletally and dentally can be effective
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14
Q

Factor influencing effect :Duration of force and duration for Head Gear

A

Duration:
- 10 - 12 hours Anchorage
- 12-14 hours for traction
- Magnitude force:
Anchorage -250- 300g per side
Traction - 400-500g per side Sk effect

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15
Q

Factor influences effect
Centre of rotation

A
  • Single rooted teeth - Centroid
  • U6 - trifurcation ( split in root)
  • Max - between roots of U45
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16
Q

Centre of resistance

A
  • This is point in body at which resistance to movement .
  • The centre of resistance is on long axis of tooth between one third and half of the root length apical to alveolar crest.
17
Q

Resolution of forces

A

Horizontally-
- Force through centre of resistance - bodily movement
- Force above centre of resistance - distal root tipping
- Force below centre of resistance- Mesial root tipping

Vertically-
- above occlusal plane - Intrudes teeth
- below occlusal plane- Extrudes teeth

18
Q

Problems with HG

A
  • Tooth related
  • Patient related
19
Q

Problem with HG - Tooth related

A
  • Unwanted tooth movement ( tipping, extrusion may cause clockwise rotation of mandible- Pt becomes more sk 2)
  • lingual tipping of lower incisors can cause a clockwise rotation of mandible increasing LAFH and with chin up therapy.
  • Forward movement of maxilla
20
Q

Problem with HG - Pt related

A
  • Pt compliance - Many pt over estimated wear. HG calendar has been shown increase wear of 2.6hours/day
  • Biological variability
  • Extra/ Intra oral soft tissue injuries
  • Pain
  • Difficulty with insertion
  • Nickel allergy
21
Q

Safety feature in HG

A

-BOS recommends 2 safety features together to use
- Safety face bow and release mechanism ( Snap away elastics mechanism) together.
E.g. Masel safety strap, snap release system ( to prevent recoil injuries)
- Written instructions must be given to pt advising them not to wear it if it’s not fitting, removing or of it disengages while they are asleep.
- Seek medical advice if injury should occur.
- Infraorbital injuries may be asymptomatic initially but may exacerbated later can even lead to Cavernous sinus thrombosis.

22
Q

Alternative

A
  • TAD
    Less anterior tooth retraction and more Anchorage loss with HG compared to TAD’s

Orthodontics (53 decks)

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