Dunedin Invisalign Provider Gives Primer on Headgear Types
DUNEDIN AND CLEARWATER, FLORIDA€" It's a safe assumption that virtually no patient wants to be prescribed headgear during orthodontic treatment. It's no picnic for the orthodontist either, because headgear's success relies solely upon a compliant patient who wears it as directed.
Numerous alternatives are on the market today that remove compliance from the equation, and Dr. Albert Fontaine offers an overview of each in this article.
First, let's explain headgear's role: it is used to fix overbite and control jaw growth. It essentially hinders upper jaw growth and gives the lower jaw a chance to catch up.
Herbst Appliance
While disliked by patients the Herbst is the most effective, said Fontaine, a Dunedin Invisalign provider. This appliance is fixed in place and holds the lower jaw in a protrusive position.
This Clearwater orthodontist's opinion is: "The orthodontist won't win friends with this one."
That's because it requires considerable chair time at the orthodontist's office, as well as impressions. It also must be sent to the lab, which means increased costs.
MARA
The MARA- which stands for mandibular anterior repositioning appliance- uses cemented crowns over the molars like the Herbst, but offers more lower jaw lateral freedom.
"The Herbst and MARA are both heavy, hard-core appliances, in my mind," Fontaine said. "They provide predictable results, but I don't use them due to discomfort, chair time, cost and potential joint problems."
Jasper Jumper
The Jasper Jumper features a rubber-coated spring that attaches the top and bottom arches via the patient's normal metal or ceramic braces setup. This reduces cost and chair time, since no impressions and lab costs are involved, Fontaine said. Patients also avoid cheek irritation that is prevalent among other appliances.
"Because they're flexible, they break more frequently," Fontaine said. "You also get more tooth movement and less jaw movement."
The orthodontist's goal in using these appliances is achieving skeletal or jaw movement, so it can be argued that this appliance doesn't give desired results.
Forsus
The Forsus is a metal appliance that uses a piston on either side and attaches to regular braces, so costs and chair time are minimized, Fontaine said. It is rigid, which makes it more solid and durable than the Jasper Jumper. It doesn't have the Jasper Jumper's lateral movement freedom, but it offers more freedom than the MARA or Herbst.
Fontaine views it as a middle ground between the two appliance styles. One negative to the Forsus is it can come apart, but orthodontists instruct patients on putting it back in place because doing so is simple.
"Currently, I use Forsus most often," Fontaine said. "It works effectively and isn't too uncomfortable for the patient."
Twin Force Bite Corrector
This new appliance is getting good reviews, he said. It resembles the Forsus in many ways, but it doesn't come apart. By attaching directly to braces, it eliminates the need for impressions and lab cost.
"All of the fixed bite correctors we've covered here remove most, if not all, the patient compliance factor," Fontaine said. "This is the main issue for orthodontists when trying to correct malocclusion."
A Final Word on Headgear
There is no mistaking that traditional headgear still works, but its success relies on a patient wearing it several hours daily.
Headgear allows free lower jaw movement. It holds back the maxilla and allows the lower jaw to catch up. It doesn't displace the mandible like all of the bite correctors discussed previously.
"The bite correctors push the mandible forward, and I have concerns with pulling the lower jaw out of the socket even though I haven't witnessed any problems so far," Fontaine said. "I guess this is just an orthodontist's worry."
Fontaine advises patients not to get overly concerned about which appliance to use. They all work, and it is more important to use something that works in the orthodontist's hands, he said. Ask questions and see what is available, but remember it is the orthodontist's decision, ultimately.
Numerous alternatives are on the market today that remove compliance from the equation, and Dr. Albert Fontaine offers an overview of each in this article.
First, let's explain headgear's role: it is used to fix overbite and control jaw growth. It essentially hinders upper jaw growth and gives the lower jaw a chance to catch up.
Herbst Appliance
While disliked by patients the Herbst is the most effective, said Fontaine, a Dunedin Invisalign provider. This appliance is fixed in place and holds the lower jaw in a protrusive position.
This Clearwater orthodontist's opinion is: "The orthodontist won't win friends with this one."
That's because it requires considerable chair time at the orthodontist's office, as well as impressions. It also must be sent to the lab, which means increased costs.
MARA
The MARA- which stands for mandibular anterior repositioning appliance- uses cemented crowns over the molars like the Herbst, but offers more lower jaw lateral freedom.
"The Herbst and MARA are both heavy, hard-core appliances, in my mind," Fontaine said. "They provide predictable results, but I don't use them due to discomfort, chair time, cost and potential joint problems."
Jasper Jumper
The Jasper Jumper features a rubber-coated spring that attaches the top and bottom arches via the patient's normal metal or ceramic braces setup. This reduces cost and chair time, since no impressions and lab costs are involved, Fontaine said. Patients also avoid cheek irritation that is prevalent among other appliances.
"Because they're flexible, they break more frequently," Fontaine said. "You also get more tooth movement and less jaw movement."
The orthodontist's goal in using these appliances is achieving skeletal or jaw movement, so it can be argued that this appliance doesn't give desired results.
Forsus
The Forsus is a metal appliance that uses a piston on either side and attaches to regular braces, so costs and chair time are minimized, Fontaine said. It is rigid, which makes it more solid and durable than the Jasper Jumper. It doesn't have the Jasper Jumper's lateral movement freedom, but it offers more freedom than the MARA or Herbst.
Fontaine views it as a middle ground between the two appliance styles. One negative to the Forsus is it can come apart, but orthodontists instruct patients on putting it back in place because doing so is simple.
"Currently, I use Forsus most often," Fontaine said. "It works effectively and isn't too uncomfortable for the patient."
Twin Force Bite Corrector
This new appliance is getting good reviews, he said. It resembles the Forsus in many ways, but it doesn't come apart. By attaching directly to braces, it eliminates the need for impressions and lab cost.
"All of the fixed bite correctors we've covered here remove most, if not all, the patient compliance factor," Fontaine said. "This is the main issue for orthodontists when trying to correct malocclusion."
A Final Word on Headgear
There is no mistaking that traditional headgear still works, but its success relies on a patient wearing it several hours daily.
Headgear allows free lower jaw movement. It holds back the maxilla and allows the lower jaw to catch up. It doesn't displace the mandible like all of the bite correctors discussed previously.
"The bite correctors push the mandible forward, and I have concerns with pulling the lower jaw out of the socket even though I haven't witnessed any problems so far," Fontaine said. "I guess this is just an orthodontist's worry."
Fontaine advises patients not to get overly concerned about which appliance to use. They all work, and it is more important to use something that works in the orthodontist's hands, he said. Ask questions and see what is available, but remember it is the orthodontist's decision, ultimately.
