| Field | Value |
|---|---|
| ID | OA-0138 |
| Type | functional_appliance |
| Category | functional_appliance |
| Fixed/removable | removable (patient-worn, extra-oral) |
| Primary function | upper molar distalization; maxillary growth restraint |
| Malocclusion target | Class II malocclusion; maxillary excess; molar anchorage |
| Compliance required | yes — 12–14 hours/day |
| Uses TADs | no |
Headgear is an extraoral appliance applying force from outside the mouth (via a neck strap or head cap) to the upper arch through a facebow (inner bow engaging upper molar tubes + outer bow with strap attachment). Cervical-pull headgear uses a neck strap, directing force distally and downward — corrects Class II by distalizing upper molars and restraining maxillary forward growth, but can extrude the molars (unfavorable in high-angle cases). High-pull headgear uses a cranial strap, directing force distally and upward — controls vertical molar position and restrains maxillary growth (preferred in high-angle/open bite cases). Required wear: 12–14 hours/day for distalization; less for anchorage only.
The outer bow transmits force from the strap to the inner bow, which inserts into the headgear tubes on the upper first molar bands. The direction of force is determined by the strap type and outer bow angulation. Cervical pull: distal + downward force on molars → molar distalization + extrusion → mandibular rotation. High pull: distal + upward force → molar intrusion/restraint + sagittal maxillary growth restraint. Both types restrain forward maxillary growth in growing patients.
Class II correction in growing patients; upper molar anchorage reinforcement during retraction; maxillary excess with horizontal excess (cervical) or vertical excess (high-pull); combined with fixed appliances or used as orthopedic pre-treatment; early treatment for significant maxillary excess.
Entirely compliance-dependent; extraoral appliance visible when worn; safety concerns (eye/face injury if facebow released under tension) — modern headgear includes safety releases; not effective in non-growing adults; social compliance difficulty in teenagers.
Facebow is manufactured by orthodontic suppliers (Ormco, TP Orthodontics, American Orthodontics) — purchased by the practice and fit chairside. No lab fabrication of the facebow required. Molar bands with headgear tubes are lab-fabricated.
mild extrusive molar force
molar force; preferred in hyperdivergent cases
cervical; intermediate force vector
force to upper incisors or canines directly
for midline correction or unilateral Class II
Clinic](https://my.clevelandclinic.org/health/treatments/orthodontic-headgear)
Orthodontics](https://speaksorthodontics.com/headgear-101/)
Mouth](https://www.newmouth.com/orthodontics/treatment/headgear/)
force vectors, anchorage vs distalization, compliance requirements.