| Field | Value |
|---|---|
| ID | OA-0139 |
| Type | functional_appliance |
| Category | functional_appliance |
| Fixed/removable | removable (patient-worn, extra-oral) |
| Primary function | maxillary protraction; Class III correction |
| Malocclusion target | Class III malocclusion; maxillary deficiency |
| Compliance required | yes — 14–16 hours/day |
| Uses TADs | no (TAD-assisted protraction facemask is a variant) |
The reverse pull headgear (facemask, protraction headgear) delivers forward force to the maxilla to correct Class III malocclusion in growing patients. A frame rests on the forehead and chin; elastics run from the frame to hooks on the upper arch (usually soldered to the expander or upper molar bands or a palatal expander). The forward traction elastics (14–16 oz per side) pull the maxilla forward, stimulating sutural bone formation at the circummaxillary sutures. Best results are achieved under age 10 (when sutures are still open). Often combined with an upper RME to loosen the circummaxillary sutures before protraction.
Elastics connecting the frame (forehead/chin pads) to intraoral hooks apply a forward and downward force vector to the upper arch. This transmits through the palate to the circummaxillary sutures, stimulating forward maxillary displacement and new bone deposition at the sutures. Simultaneously, the lower jaw tends to rotate posteriorly (increasing lower face height). Maxillary forward movement of 1–3 mm is achievable in cooperative growing patients. Typically combined with RME to "loosen" the sutures.
Class III in growing patients (best under age 10); maxillary deficiency with normal or retrognathic mandible; early treatment before the circummaxillary sutures ossify; patients cooperative enough for 14–16 hours/day wear; combined with RME In-Ovation L; skeletal Class III (not purely dental crossbite).
Effectiveness declines significantly after puberty (sutural ossification reduces response); completely compliance-dependent; extraoral, visible appliance — social challenges; mandibular forward rotation increases lower face height (unfavorable in hyperdivergent cases); relapse risk — long-term retention needed.
anteriorly-directed)
hook)
The facemask frame is manufactured by orthodontic suppliers (Petit type, Delaire type). Intraoral hooks on molar bands or palatal expander are lab-fabricated. No lab fabrication of the frame itself.
reducing dental side effects
facemask
open design; most common type
pads; less bulk than Delaire
expansion opens sutures before protraction force applied
mandibular prognathism component in Class III
arms or molar bands rather than separate connector
ScienceDirect](https://www.sciencedirect.com/topics/nursing-and-health-professions/reverse-pull-headgear)
Clinic](https://my.clevelandclinic.org/health/treatments/orthodontic-headgear)
Mouth](https://www.newmouth.com/orthodontics/treatment/headgear/)
forward direction, RME combination, age effectiveness, Petit vs Delaire design.