Protraction headgear
Moderator: bbsadmin
I read your post earlier today and am disappointed that you're depressed right now. This is a circle of friends, when one of us is depressed, others within the group share your pain. I DO understand the world of orthodontia is daunting. There are so many options and trying to make the right decision is a challenge.
The question that I believe you need to have addressed is whether your flat face is due to your jaws or the placement of your teeth in your jaws. RPHG may move your jaw forward at your age. A lot will be based upon your overall physical development. If your issue is jaw based, RPHG may give some desirable movement although there is some debate. No one on this forum has seen you in person. All we can do is give you the best advice we can.
If your flat appearance is due to your teeth being too far rearward in your arch, RPHG should move your teeth and your arch as you desire.
Talk to the two orthos who have suggested RPHG. Ask them to show you on your x-rays what they hope to achieve with the RPHG. Only then will you know whether this is a valid treatment option. As I said in an earlier post, you're too young to not get an appearance that you'll be happy with. If they suggest surgery will give a better result, consider it again. Talk to some people who have been through the surgical process. It is a scary proposition, but for some of us, may be the only option to get a good result.
Deciding to do orthodontics is a hard decision. You have more challenges than most.
I wish you well.
Mike
The question that I believe you need to have addressed is whether your flat face is due to your jaws or the placement of your teeth in your jaws. RPHG may move your jaw forward at your age. A lot will be based upon your overall physical development. If your issue is jaw based, RPHG may give some desirable movement although there is some debate. No one on this forum has seen you in person. All we can do is give you the best advice we can.
If your flat appearance is due to your teeth being too far rearward in your arch, RPHG should move your teeth and your arch as you desire.
Talk to the two orthos who have suggested RPHG. Ask them to show you on your x-rays what they hope to achieve with the RPHG. Only then will you know whether this is a valid treatment option. As I said in an earlier post, you're too young to not get an appearance that you'll be happy with. If they suggest surgery will give a better result, consider it again. Talk to some people who have been through the surgical process. It is a scary proposition, but for some of us, may be the only option to get a good result.
Deciding to do orthodontics is a hard decision. You have more challenges than most.
I wish you well.
Mike
I wore braces (this time) for 1294 days or 3 years, 6 months and 17 days.
But who's counting?
Jaw Surgery June 1, 2009
Thanks for praying for me and thinking happy thoughts.
But who's counting?
Jaw Surgery June 1, 2009
Thanks for praying for me and thinking happy thoughts.
Thanks so much for your advice and wisdom. I'm fine. It's just when I set off I really didnt expect is to be so complicated! I am going to call a few more orthos and then make a choice. The ortho who suggested using headgear told me that bones dont' really totally fus, that there is alwyas some slight movement that can be manipulated...I don't know..
Wow, Meryaten, I'm consistently impressed how on-target your responses are! You've certainly done your homework.
Chiming in as an orthodontist, I don't think you'd see skeletal change using a reverse-pull headgear. Dental compensation would be introduced, similar to those introduced by Class III elastics (rubberbands), but with potentially less vertical consequences.
Your orthodontist should be able to look at your occlusion and assess, using a ceph (radiograph of the side of the head) the difference between your upper and lower jaw. Looking at a measurement called ANB and the current incisor angulations will give insight into whether camoflouge/ dental compensation is appropriate or whether surgery is your only answer. If your upper teeth are crowded or tipped back, you can potentially get some additional profile improvement without advancing the jaw simply by advancing the teeth. Otherwise, surgery may be needed to meet your profile expectations.
Meryaten is correct in stating the mandible is different. While we can't grow it, recent studies by a notable Herbst proponent (Pancherz) have suggested that the Herbst can be an alternative to surgery, with correction obtained via dental compensation/jaw joint remodelling. In one study, patients treated with the Herbst were as satisfied with their results as surgical patients, but the stability of the results over the long-term is still being studied.
Chiming in as an orthodontist, I don't think you'd see skeletal change using a reverse-pull headgear. Dental compensation would be introduced, similar to those introduced by Class III elastics (rubberbands), but with potentially less vertical consequences.
Your orthodontist should be able to look at your occlusion and assess, using a ceph (radiograph of the side of the head) the difference between your upper and lower jaw. Looking at a measurement called ANB and the current incisor angulations will give insight into whether camoflouge/ dental compensation is appropriate or whether surgery is your only answer. If your upper teeth are crowded or tipped back, you can potentially get some additional profile improvement without advancing the jaw simply by advancing the teeth. Otherwise, surgery may be needed to meet your profile expectations.
Meryaten is correct in stating the mandible is different. While we can't grow it, recent studies by a notable Herbst proponent (Pancherz) have suggested that the Herbst can be an alternative to surgery, with correction obtained via dental compensation/jaw joint remodelling. In one study, patients treated with the Herbst were as satisfied with their results as surgical patients, but the stability of the results over the long-term is still being studied.
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Jamesyeats
- Posts: 59
- Joined: Fri Apr 04, 2008 2:34 pm
- Location: UK
Sorry to drag up an old topic. But if the jaw can be moved forwards by a Herbst, could it also be moved backwards by a chin cap headgear? I have always had a slightly protruding chin (mild, but I don't like it!), and would love to move it back a bit, but surgery isn't really an option or me, too much £££.
I am fortunate enough to work from home, so wearing the headgear wouldn't be an image problem for about 22 hours a day if needed.
In my yers of browsinf orthodontist's sites I have never seen reference to an adult using a chin cap, but then I've hardly seen reference to adults in headgear either - and we all know that is workable and gives results.
I've also seen talk of "Jaw repositioning splints" for TMJ - do these actually move the jaw permanently?
As you may have gathered, I am a bit bewildered despite all the research I have done!
I am fortunate enough to work from home, so wearing the headgear wouldn't be an image problem for about 22 hours a day if needed.
In my yers of browsinf orthodontist's sites I have never seen reference to an adult using a chin cap, but then I've hardly seen reference to adults in headgear either - and we all know that is workable and gives results.
I've also seen talk of "Jaw repositioning splints" for TMJ - do these actually move the jaw permanently?
As you may have gathered, I am a bit bewildered despite all the research I have done!
A good portion of correction with a Herbst is dental - it's pushing on the teeth. You wouldn't get much of that with a chin cup. Also keep in mind that Functional appliances like the Herbst (and jaw repositioning splints since you mentioned them) unload the jaw joint, while a chin cup puts pressure into the jaw joint - not something I'd recommend for 22 hours a day! Chin cups aren't used widely, and when they are it's in gowing patients to restrict mandibular growth, not force the lower jaw back. The moral of the story is don't try it!if the jaw can be moved forwards by a Herbst, could it also be moved backwards by a chin cap headgear
This could be true mandibular prognathism, or simply an overdeveloped bony prominence (pogonion) that could be treated with a reduction genioplasty.I have always had a slightly protruding chin
I'd see an orthodontist and find out your diagnosis and treatment options.
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Jamesyeats
- Posts: 59
- Joined: Fri Apr 04, 2008 2:34 pm
- Location: UK
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Soworththeeffort
- Posts: 29
- Joined: Wed Dec 03, 2008 10:34 am
Meryaten, is there something I can say to change your mind? Your dedication to this site and kindness to its members seems to indicate that you consider it to be an avocation - certainly not just "something to do." And you're so good at it:
Please, Meryaten - won't you reconsider? This site won't be the same without you.
That's coming from a guy with a masters in orthodontics (take a look at his website). In many ways, having you here is better than having an orthodontist - they just don't have the time to participate, and/or if they do have the time, they probably get tired of talking shop. Please don't let someone with an axe to grind take you away from us. (And axe-grinder, just because you left this site and came back in with a new screen name and story, your lousy attitude and eagerness to settle an old score with Meryaten have made you incredibly easy to spot.)DrBill wrote:Wow, Meryaten, I'm consistently impressed how on-target your responses are! You've certainly done your homework.
Please, Meryaten - won't you reconsider? This site won't be the same without you.