Facemask/Reverse pull headgear

Facemask/Reverse pull headgear-- Class 3 skeletal management

department of Orthodontics

1. CORRECTION OF CLASS 3 SKELETAL PROBLEMS (Reverse pull headgear/facemask) DR. MUHAMMAD sHARIQ SOHAIL HOUSE OFFICER DEPARTMENT OF ORTHODONTICS ZIAUDDIN UNIVERSITY

2. CORRECTION OF CLASS 3 SKELETAL PROBLEM 1)If Maxillary Deficiency --> Frankel FR-3 functional appliance                                           -->Reverse pull headgear                                           -->Class 3 elastics to skeletal anchors 2)If Mandibular excess- -> Class 3 funtional appliance                                        --> Extraoral force to a chincup                                        -->class 3 elastics to skeletal anchors

3. TYPES OF CLASS 3 1)TRUE CLASS 3: Can be due to Maxilla, Mandible or due to both 2)PSEUDO CLASS 3 :  Just because of funtional shift (CO-CR discrepancy)

4. ETIOLOGY OF CLASS 3 1)GENETIC 2)ENVIRONMENTAL:    A)Cleft surgery(Scar, maxilla deficient, growth potential low)    B)Mouth breather: usually class 2 but can be class 3    C)Enlarged tongue: Tongue pushes mandible forward 

5. WHY TO TREAT CLASS 3??? 1)Social well being 2)Prevent progressive soft tissue or bony changes 3)Provide favourable environment to mandibular growth 4)Improve occlusal function and stablize jaw position 5)facial esthetics 6)To simplify Phase 2 treatment.

6. REVERSEPULL HEADGEAR/ FACEMASK DEFINITION: Facemask is an extraoral traction appliance used to correct                      skeletal class 3 malocclusion. Facemask is a method by which                      anterior directed forces to the teeth or skeletal structures are                       delievered from an extraoral source.

7. REVERSEPULL  HEADGEAR/  FACEMASK INDICATIONS:   1) Primarliy used to correct skeletal class 3 due to maxillary retronagthism in     young pateint . 2)Psuedo class 3--> Facemask cane correct CO-CR discrepancy 3)After surgical correction of malocclusion--> facemask as a retainer

8. REVERSEPULL  HEADGEAR/  FACEMASK COMPONENTS OF FACEMASK: 1)Chincup: Restrain forward growth of mandible by changing direction of                      growth downward and backward. 2)Forehead cap/support 3)Framework 4)Intraoral splint/device: For RME 5)Elastics: to give traction force to maxilla

9. REVERSEPULL  HEADGEAR/  FACEMASK TYPES OF FACEMASK : 1)Hickham: Chincup and forehead support 2)Delaire 3)Petit 4) Turbinger

10. REVERSEPULL  HEADGEAR/  FACEMASK FORCE PARAMETERS: 1) 300-500 gms/side of force 2) 30 degree downwards to occlusal plane--> to produce tranlsation of    maxilla 3) Duration: 12-14 hours/day 4) Timing: Eruption of C.I and First Permanent molar.                 8 years--> best result                 below 10 years--> good result                 After 10 years--> dental effect is more as compare to skeletal 5) RME: Activated once daily usually before bedtime for a period of 2 weeks              or till desired expansion os achieved.

11. REVERSEPULL  HEADGEAR/  FACEMASK BIOMECHANICS : Elastic traction --> Pulls maxilla forward TREATMENT COMPLETION INDICATIONS:  1)Attainment of "Positive Overjet"  2)Improvement from "Concave profile" ADVANTAGES OF FACEMASK : 1)Is only extraoral traction device for correction of maxillary defiecny with   rapid improvement and early result 2)Improved complaince and patient confidence.

12. REVERSEPULL  HEADGEAR/  FACEMASK EFFECTS OF FACEMASK: 1)Forward movement of maxilla 2)Forward movement of maxillary teeth 3) Proclination of maxillay incisors 4)Correction of Ap crossbite 5)Downward and Backward rotation of manibile

13. REFERENCES: 1) Proffit 2)Premkumar 3) Balahji .

14. THANKYOU !!!