Orthopedeic correction of class3 using protraction of headgear

ORTHOPEDIC CORRECTION OF
CLASS III USING PROTRACTION
HEADGEAR
www.indiandentalacademy.com

ORTHOPEDIC
CORRECTION OF
SKELETAL CLASS III
USING PROTRACTION
HEADGEAR

INTRODUCTION

One of the most perplexing
malocclusion to diagnose and treat is
class III malocclusion particularly in
mixed and late deciduous dentition
Timing of ortho treatment has always
been controversial

Even today many class III cases are
not treated until orthodontist feels that
active growth is complete
Purpose here is to emphasize the need
for early diagnosis and possible
treatment for class III and their
associated facial patterns

COMPONENTS OF
CLASS III

Normal mandible and retrognathic
maxilla
IN SAGITTAL DIRECTION

Normal maxilla and prognathic
mandible

Retrognathic maxilla and prognathic
mandible

MAXILLARY DEFICIENCY
Maxillary deficiency can involve all 3
planes of space
Transverse
Vertical
Horizontal

Usually the deficiency is more
common in one of 2 planes ……..
 A primary transverse deficiency with
horizontal & particularly vertical
dimension less effected

• A horizontal & vertical deficiency
with reasonably normal transverse
dimension

TRANSVERSE DIMENSION
 Opening of mid palatal suture should
provide a way to widen narrow
maxilla . The age of patient is a
factor for obtaining separation of
sutures

• Most of the times the use of
protraction headgear for correction of
maxillary deficiency is accompanied
by palatal expansion using any of
the expansion appliances.

HORIZONTAL-VERTICAL
DEFICIENCY
• If the normal headgear force
compresses the maxillary sutures to
inhibit the froward growth of maxilla.
so the reverse pull headgear by
separating the sutures stimulates the
growth.

VERTICAL DEFICIENCY
Maxillary deficiency in vertical plane
causes auto rotation of mandible
leading to class III

• As the reverse pull headgear applies
a force to mandible ,a downward &
backward rotation of mandible
usually takes place which is also 1 of
the factors for improvement of class
III relationships

Effects of forward traction
against the maxilla

RESPONSE TO FACE MASK
SHOWING THE DOWNWARD
&BACKWARD ROTATION OF
MANDIBLE

DIAGNOSIS
“IT IS ONLY WITH THE BRAIN
THAT ONE SEES RIGHTLY. WHAT
IS ESSENTIAL, IS INVISIBLE TO
THE EYE”www.indiandentalacademy.com

Positive and negative characters are
developed as guidelines for deciding
whether to intercept class III or not
Positive characters-indicates early
interception
Negative characters-indicates that the
case is not appropriate for interception

Convergent facial type
Antero-posterior functional shift
Symmetrical condylar growth with
growth remaining
Mild skeletal disharmony ANB<-2
Good co operation expected
No familial prognathism
Good facial aesthetics
POSITIVE
CHARACTERS

NEGATIVE CHARACTERS
Divergent facial type
No antero-posterior shift
Poor facial aesthetics
Familial pattern established
Severe skeletal disharmony ANB >-2
Poor co operation

APPLIANCE OF
CHOICE
“MAKE SURE YOU ARE RIGHT
&
THEN GO AHEAD”

MIXED
DENTITION
FR-3
Orthopedic chin
cup
Orthopedic face
mask
LATE
PERMANENT
DENTITION
Orthognathic
surgery
Camouflage
treatmentwww.indiandentalacademy.com

CASE PRESENTATION

AJAY BETUR 12yrs / M PRE
TREATMENT

FACE MASK
&
HYRAX SCREW

POST ORTHOPEDIC

POST
TREATMENT

PAVANA 7yrs. / F PRE TREATMENT

FACE MASK
WITH
POSTERIOR BITE
BLOCK
&
TELESCOPIC SCREW

POST
ORTHOPEDIC

PAVANA POST TREATMENT

RAJESHWARI 12yrs. / F PRE
TREATMENT

FACE MASK
WITH
COFFIN SPRING

POST TREATMENT

DEEPA 9yrs / F PRE
TREATMENT

FACE MASK
WITH
BONDED RAPID
MAXILLARY EXPANDER

POST TREATMENT
PRE TREATMENT

Of all the treatment modalities in
mixed dentition it is our opinion that
the orthopedic face mask has
widest application and produces
the most dramatic results in
shortest period of time

ONE SHOULD FOLLOW THE
PHILOSOPHY OF…..
“SELECTING AN APPLIANCE
FOR THE PATIENT NOT A
PATIENT FOR APPLIANCE”
”

CONCLUSION

• Early Orthodontic treatment can be
very rewarding if we are ready to
accept the challenge of anticipating
the changes associated with facial
growth and development and
patient response, with a sound
problem list and treatment goals.

THANK YOU

Orthopedeic correction of class3 using protraction of headgear

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Orthopedeic correction of class3 using protraction of headgear