Headgear

Question 1

What are the components of headgear?

Answer 1

• head cap / neck strap
• elastics
• face bow (on distalising)
• face mask (on protraction)
• removable or fixed appliance
• chin caps
• safety mechanisms

Question 2

What are safety features of headgear?

Answer 2

• curved face bow
• locking face bow
• rigid nasal strap
• snap away modules

Question 3

Define headgear

Answer 3

A means of applying posterior directed forces to teeth and skeletal structures from an extra oral force

Question 4

How can headgear wear be monitored?

Answer 4

Clinical
• movement of teeth - spaces, correction of molars, mobility of teeth
• inspect headgear 
• ask patient to fit the headgear
• patient asks for more elastics 
• new size of face bow needed due to movement 
Non clinical 
• ask patient
• time charts 
• anchorage electronic monitoring

Question 5

What is used to measure the force on headgear?

Answer 5

Correx gauge

Question 6

How many hours does headgear need to be worn?

Answer 6

Anchorage - 10-12 hours

Traction - 12-14 hours

Question 7

How much force is needed for headgear?

Answer 7

Anchorage - 250-300g

Traction - 400-500g

Question 8

What are the problems with headgear?

Answer 8

Patient related
• co operation
• biological variety 
• soft tissue injury 
• pain 
• difficulty inserting 
• nickel allergy 
Unwanted tooth movements
• tipping
• too much extrusion

Question 9

What are the different types of distalising headgear?

Answer 9

1. Occipital / high
2. Combination
3. Cervical / low

Question 10

What are the uses of distalising headgear?

Answer 10

Dental
• reinforce anchorage 
• distalise teeth
• intrude teeth
• extrude teeth 

Skeletal
• growth modification - small effect
• suppress maxilla / mandible growth

Question 11

What are the used of protraction headgear?

Answer 11

Dental
• protraction of teeth

Skeletal
• growth modification
• maxillary enhancement
• mandibular suppression

Question 12

What is meant by extra oral traction?

Answer 12

The means of moving teeth from an extra or force

Question 13

What advice would you give to a patient that phoned up and said the headgear arms have broken off the cap?

Answer 13

Do not wear the appliance, book and appointment with the orthodontist to repair

Question 14

What advice would you give to a patient that phoned up and said his face bow had come out their mouth and into their eye?

Answer 14

Visit A&E ASAP - there is a risk of infection to the eye

Question 15

When and why is extra oral traction used?

Answer 15

• headgear
• class II - require distal movements of maxillary molars to reduce overjet
• class II - extrude maxillary molars to reduce overbite

Question 16

Describe instructions given to patient provided with extra oral traction (headgear)

Answer 16

• show patient how to wear - placement and removal
• practice placement and removal
• bring to all appointments
• risk of injuries - soft tissues, eyes
• remove for sports and play
• remove when brushing teeth
• if it dislodges or breaks stop wear and call the practice
• if face bow come s into contact with eye then go to A&E
• any allergic reactions then stop wear

Question 17

How does a Khloen bow get fitted to a removable appliance?

Answer 17

Tubes are soldered onto the cribs for the bow. This is called an adams crib with buccal tubes

Question 18

What are the classifications of headgear?

Answer 18

• distalising

* reverse/protraction