MADE BY:

SUMERA HASHMANI
ROLL NUMBER:38
JABBAR AHMED
ROLL NUMBER: 50
Orthodontic headgear is a type of
orthodontic appliance attached to
dental braces or a palatal expander that
aids in correcting severe bite problems.

The apparatus encircling the head or neck

and providing attachment for an intraoral
appliance in use of extraoral anchorage.
 Distalizing maxillary or mandibular arch.

 Increasing anchorage.
 High pull headgear( occipital pull)
 Cervical headgear
 Combi pull
 Reverse pull
INDICATIONS:
 Anterior position of maxilla( class II)
 Anterior position of maxillary teeth
 Mandibular skeletal retrusion in absolute
size or relative position.
 Excess or deficient vertical development.
 It consists of a headcap connected to a
facebow.
 The appliance places a distal and upward
force on maxillary teeth and maxilla.
 Should be worn regularly for at least 10 to
12 hours per day.

 Contraindications:
 short face
 It is made up of a neckstrap connected to
a facebow.
 It produces a distal and downward force
against the maxillary teeth and maxilla
 Should be worn regularly for at least 10 to
12 hours per day.

 CONTRAINDICATION:
 long face
 The recommendation is a force of 12 to 16 0unce
(350 to 450) per side.
 The growth hormone released that occurs in the
early evening strongly suggests that as the
functional appliances putting the headgear on right
after dinner and wearing it until the next morning
not waiting until bed to put it on, is an ideal
schedule.
 Extremely heavy forces greater than 1000gm are
un-necessarily traumatic to the teeth and their
supporting structures.
 While, lighter forces may produce dental but not
skeletal changes.
If desired, cervical and high-
pull headgear can be
combined to produce a
straight distal force.
The reverse pull headgear
is used to place the upper
teeth and upper jaw in a
more forward position with
respect to the lower teeth.
This device is often used to
help correct for an
"underbite".
 For child with antero posterior and
vertical maxillary deficiency( class III)
the prefered treatment is to use a
“reverse pull headgear”(facemask).
 It move the maxilla into more anterior
and inferior position.
 Increases its size as bone is added at the
posterior and superior sutures.
 It rotate the mandible downward and
backward.
 Contraindicated if lower face height is
already large.
 Backward displacement of mandibular
teeth and forward displacement of
maxillary teeth also typically occur.
 The facemask obtains anchorage from the
forehead, chin and permanent first
molars.
 MANDIBULAR EXCESS:
 The treatment of choice would appear to
be a restraining device ( chin cup/ chin
cap) to inhibit the growth of the
mandible.
 It rotate the chin downward and
backward.
 Lingual tipping of the lower incisors
occurs as a result of the pressure of the
appliance on the lower lip and dentition.
 Contraindication for a child who has
excessive lower face height.
 Decreasing the anteroposterior
prominence of the chin and increasing
face height.
 Facebow
Safety Modules Neck Pads
 Chin cup
 Forehead rest
 Facebow
1.Accidental Dis-engagement while playing
(proper patient instructions and education).
2.Incorrect handling during fitting and
removal(proper patient instructions and
education).
3.Bully pulls headgear (releasable headgear
modules / aggressive violance).
4.Un-intentional night time dis-engagement.
(locking facebow)…locking mechanism to
prevent facebow detachment during night…
 Patients Needs:  Orthodontist
 Comfortable Needs:
 Easy to use  Patient
 Attractive cooperation
 Easy to clean
 Right force level
 Safety to use
 Safety to use
 Comfortable
 Small inventory
 Three major decisions to be made in the
selection of headgear:
 First, the headgear anchorage location must
be chosen to provide a preffered vertical
component of force to the skeletal and
dental structures.
 Second decision is how the headgear is to be
attached to the dentition.
 Finally a decision must be made as to
whether bodily movement or tipping of the
teeth is desired.
 For headgear treatment in a predolescent
child molar bands with headgear tubes are
fitted and cemented.
 As a class II molar relationship is corrected
the relative forward movement of the lower
arch will produce a cross bite tendency
unless the upper arch width is expanded.This
must be taken into account from the
beginning of treatment.
 The outer bow should rest passively between
the lips and several millimeters from the
cheeks.
 It must be cut to the proper length have a
hook formed at the end.
 Children should be instructed that if anyone
grabs the outer bow,they should also grab
the bow with the hands, this will prevent the
breakage and injury.
 The headgear straps must be equipped with
a safety-released mechanism to prevent the
bow from springing back at the child and
injuring him or her if it is grabbed and pulled
by a playmate.
 The need for headgear in orthodontics and its
application by practitioners has decreased in
recent years as more orthodontists use
temporary implants (i.e., temporary anchorage
devices) inside the patient's mouth to perform
the same tooth movements.

 Orthodontic headgear has some unpleasant side-

effects. These include a child's fear of mockery
and harassment with regard to the appearance of
the headgear; difficulty when eating, sleeping,
and performing head-and-neck motions. In some
cases, eye injuries have been reported, which is
minimized with the use of safety release straps.
 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).