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.

Outline Why use Headgear? Headgear Basic Info Types of Headgear Patient needs vs. Orthodontist’s needs

Why Use Headgear? 1. Increasing Anchorage 2. Distalizing the Maxillary (or mandibular arch 3. Precautionary Use Headgear can create either an orthodontic change or orthopedic change.

Orthodontic Headgear Use 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.

Doctor’s Headgear Recommendations Action Desired Recommended Wear Time - Distalizing 24 hours per day - Holding anchorage 14 hours per day - Precautionary night time wear

Why use Headgear? Headgear has been used Successfully for 150+ years. Dr. Angle’s Headgear from 1894

Timing of treatment related to tooth eruption age Need U6 for molar Band placement Girls = 6.22 years Boys = 6.40 years Other Teeth come in From 6-13 years Chart shows average age of tooth eruption

Headgear Effectiveness = Force Applied X Time worn X Direction Applied X Other Factors

Headgear Wear Result Before and After Headgear: Good headgear wear moved U6 “back” distally

Headgear Components Facebows Release Modules Straps or cushions Other items

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 Headgear is the “outside” part Facebow goes into patient’s mouth Facebow connects to buccal tube’s “headgear tube”

Buccal Tube with facebow Buccal tube’s headgear tube accepts facebow wire Pictured here is the Nitom Locking Facebow

Facebow Styles 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 bow with cushion loop Softer springy Feel

Facebow Styles J-Hook Facebow - Two “J” shaped hooks connect 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 or regular style

Types of Headgear Cervical Pull High Pull (occipital pull) Combi Pull Reverse Pull Vertical Pull J Hook

Cervical Pull Pulls back from the upper molar Direction of Pull

High Pull (occipital pull) Pulls upward from upper first molar Direction of Pull

Combi Pull Pulls upward and back from Direction of Pull Upper first molar Direction of Pull

Reverse Pull Pulls upper arch forward Direction of Pull

Vertical Pull Pulls upward Direction of Pull

Headgear Safety Study 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%) Researcher and Author: Dr. Russel Samuels (UK) Published: JCO, AJO, BJO, EJO

Headgear Safety Strategy Your Actions can reduce Potential Injuries: Proper patient instructions Proper fitting by orthodontic office Proper equipment – Ortho Kinetics Headgear & Facebows

Safety Strategies for each injury cause 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

Ortho Kinetics Corp. Headgear Product Design Philosophy: 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

Force Modules Releasable headgear for modules Aka. Safety modules or safety breaks, etc. Fit onto Cervical and high pull Straps and connect to facebow

Headgear 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

Breakaway Function OKC offers plastic release clips on “Nitro” Brand Modules plastic clips are easier to put together

NewGear™ Breakaway Function NewGear features plastic clips with higher breakaway force It is easy to put together Patented “luggage buckle” style

Headgear Needs Patient Needs: Orthodontist 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

Innovative Orthodontic Force Systems Ortho Kinetics Corporation Exclusively Focused on Innovative Orthodontic Force Systems