Effects of reverse headgear treatment on sagittal correction in girls born with unilateral complete cleft lip and cleft palate–skeletal and dental changes
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Comparative Study
. 1996 Feb;109(2):140-7.
doi: 10.1016/s0889-5406(96)70174-9.
L L So
1
Affiliations
Affiliation
- 1 Department of Children’s Dentistry and Orthodontics, Faculty of Dentistry, University of Hong Kong.
PMID:
8638559
DOI:
10.1016/s0889-5406(96)70174-9
Comparative Study
L L So.
Am J Orthod Dentofacial Orthop.
1996 Feb.
. 1996 Feb;109(2):140-7.
doi: 10.1016/s0889-5406(96)70174-9.
Author
L L So
1
Affiliation
- 1 Department of Children’s Dentistry and Orthodontics, Faculty of Dentistry, University of Hong Kong.
PMID:
8638559
DOI:
10.1016/s0889-5406(96)70174-9
Abstract
Patients with cleft lip and cleft palate often develop maxillary retrognathism. This is due to the combined effects of the congenital deformity and surgical repairs. Early protraction of the maxilla with extraoral forces helps to achieve more balanced skeletal harmony and favorable occlusion for future growth to occur. The purpose of the present study is to investigate the proportion of the skeletal and dental changes contributing to the improvement in a group of Southern Chinese girls born with unilateral complete cleft lip and cleft palate treated by the reverse headgear. This study only focused on treating a homogenous sample group, i. e., only girls with unilateral complete cleft lip and cleft palate. This design was deliberate so as to avoid having boys and girls with various types of cleft all pooled together for analyses as seen in most of the previous reports. In addition, comparison was made with girls matched in having a similar deformity, presenting a similar skeletal structure and maturity status to reveal the genuine treatment effect. The 9.7 months of reverse headgear treatment improved the sagittal jaw relationship (p < 0.01) and overjet (p < 0.01), which was effected by about two-thirds skeletal and one-third dental changes.
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Are Orthodontic Headgear Braces Worth it?
Do people still wear orthodontic headgear? Braces patients may not see people wearing headgear left and right like they did decades ago, but it’s not completely extinct. Even today, when your orthodontist uses modern headgear, braces can be more effective for severe malocclusion needs. When used, these oral appliances can lower the chances of needing jaw surgery or major treatments that can’t be corrected by just using braces.
Although orthodontic headgear is way less common, someone with a serious underjet, overbite, or deep bite may still need it from time to time.
Orthodontic Headgear
With headgear, braces can work more effectively to correct bite concerns outside of the normal crooked or gapped teeth. When you use modern headgear, braces have an “anchor” to grip onto, to help guide teeth and jaw growth/placement. Whereas without headgear, braces can only attach teeth to other teeth, pulling both of them at the same time instead of just one tooth. [1]
Since headgear provides an anchor to pull against, it’s possible to adjust “bigger” jaw and tooth positioning issues that require extra force to ensure proper movement.
There are different types of headgear, with some attaching behind the back of your neck and others attaching higher up, near the crown. Depending on which part of your mouth needs to be adjusted, the headgear selected will pull in that direction.
What Are Braces with Headgear?
Headgear has a strap that goes around the back of your head, then stretchy elastic bands or metal orthodontic bands attach on either side. These attachments loop onto a wire arch, which is also attached to your orthodontic appliance. If you have “bands” around any teeth, that’s where the mouth portion of your headgear usually attaches. From the outside, it looks like a wire arch that goes from one ear to the other, attaching to the head strap.[2]
Wearing headgear creates an anchor to pull teeth against and to modify jaw growth patterns. Since your skull doesn’t move, it makes a great structure to use for guiding your teeth. Especially when everything in your mouth is still growing, forming, developing, or moving.
With headgear, braces wearers don’t usually have to keep the appliance on all day long. You could compare it to using elastics or if you need TADs (a type of mini dental implant or screw), which serve a temporary purpose.
Do We Still Use Headgear Today? Why?
Orthodontists will still occasionally use headgear. Especially if you have a major bite misalignment, atypical jaw growth patterns or to correct tooth spacing. Orthodontic headgear can effectively correct malocclusion without surgeries. By using headgear, braces can work without the additional need for corrective surgeries. Although surgery is still used from time to time, incorporating orthodontic treatment like headgear early enough in a child or teen’s development can reduce the risk of needing surgery to correct their jaw shape. magonlinelibrary.com/doi/abs/10.12968/denu.2016.43.1.74″ websitename=”Dental Update”>[3]
You might ask, “But why can’t the braces or other oral appliances move the teeth?”
Great question.
Orthodontic headgear works by pulling against other teeth would also move THOSE teeth. Using headgear eliminates the side-effect of unwanted tooth and jaw movement. That way your orthodontist can focus on a specific area of your mouth. Headgear is commonly used to correct:
- Underbite – headgear is used to gently pull the upper jaw forward, allowing it to align properly with the lower jaw bones
- Excessive horizontal overbite – severe cases where the upper and lower teeth don’t touch (class II malocclusions) the upper jaw is biting significantly ahead of the lower jaw
- Crossbite – Reverse pull headgear shifts the upper jaw forward to realign it with your lower jaw
Today, TADs are extremely common and help reduce the need for wearing orthodontic headgear. TADs are like mini dental implants or screws that also provide an anchor for braces to pull against. But they don’t work on everything and some people just don’t make good candidates for them. Whereas with modern headgear, patients of all ages qualify.
How Long Do You Have To Wear It?
Just like elastics that you wear on certain teeth for set lengths of time, headgear comes with special instructions on how to wear it. You don’t have to walk around with it on 24/7 the whole time you have braces.[4]
Depending on your specific oral anatomy, you may need to wear headgear longer or less often than someone else. Remember, headgear helps prevent the need for surgery, so it’s easier to sort of “tough it out” for a little while than it is to plan a major jaw reconstruction and weeks of recovery.
Your orthodontist will tell you when and how long to wear it. Be sure to wear it as directed, otherwise, you won’t see the results you’re looking for and may have to wear it even longer than originally planned.
What To Expect From Headgear
Great news. Headgear isn’t going to get in the way of your normal lifestyle. Sure, it’s going to catch some attention if you wear it out in public, but the streamlined design isn’t nearly as bulky as it was when your parents or grandparents were kids.
All of that being said, there are times when you should not wear your headgear and there are changes you’ll need to make to your daily routine. As long as you plan appropriately, you can still do what you love and eat what you want. Well, as long as it’s on your braces-approved list of foods.
1. How Long Do You Need To Wear It Each Day?
This is going to be unique to every single orthodontic patient. You may only need to wear your headgear for specific hours of the day. Such as overnight or putting it on immediately after you come home from school. Depending on your anatomy, your orthodontist might even ask that you wear it all day every day, removing it for meals, brushing, etc.
2. How To Overcome Wearing Headgear
Orthodontic headgear is a temporary appliance. Your orthodontist’s office will give you plenty of advice on how to fit and adjust it so that it’s comfortable to wear. By working your way up to wearing it for the prescribed length of time, you’ll get more accustomed to wearing it around the house. You might even feel confident enough to wear it at school (especially if you’re one of those people that doesn’t mind all the extra attention.) Take a deep breath: tooth or jaw soreness does not last forever!
3. Adjustment Period
At first, wearing orthodontic headgear or any other type of removable appliance is—to put it bluntly—probably going to drive you nuts. Whether it’s braces, a Herbst appliance, palatal expander, or even elastics, the first few days are probably going to be a bit irritating if not uncomfortable. Be patient with yourself and just give it time. Work your way up to the prescribed wear time and within about a week or two, it will feel as normal as it possibly can.
4. Setting New Rules
Even though headgear is removable, you’ll need to change some of your daily habits and routine. For example, don’t wear your headgear if you’re about to eat something or play a sport. Take it off, otherwise, you run the risk of a serious injury. Keep it stored in a secure place and put it back on afterward.
How To Sleep With Dental Headgear
If you’re lucky, you’ll only need to wear your headgear at night instead of the daytime. But adjusting to sleeping in orthodontic headgear isn’t easy, especially if you’re a side sleeper or tend to lay on your stomach.
Now comes the hard part. You’ll need to experiment with sleeping on your back and not moving your head to one side.
If your mouth tends to get a little sore and it’s hard to get to sleep, consider taking a Tylenol or Motrin about 20 minutes before you go to bed at night.
How To Brush With Headgear And Clean Headgear
You’ll want to clean your headgear just like any other type of oral appliance. Since it isn’t permanently attached to your mouth, you can remove it whenever it’s time for your normal oral hygiene routine.
- Remove your headgear at least twice a day to brush and floss like normal. Make sure you’re still using any floss threaders or a water flosser to clean between and around wires and brackets on your teeth
- Use a toothbrush and lukewarm, soapy water to clean any portions of the headgear that go inside your mouth
- Towel off your headgear or allow it to air dry, making sure to keep your device out of the reach of any pets or small children
- If the straps or other parts of the headgear are dirty, use warm soapy water and a soft washcloth to clean them off
Talk With an Orthodontist About a Brace with Headgear
Very few people still require modern headgear. Braces can usually be completed with other growth modification devices or TADs when a firm anchor is necessary. Even if your dentist told you that you needed headgear, it’s best to talk to an orthodontic specialist about the situation. [5]
In most cases, headgear holdings back the growth of the upper jaw helping prevent the need for major jaw surgery, assuming growth patterns are caught early enough. Orthodontists are experts when it comes to jaw development, tooth alignment, and growth modification. They will be able to tell you during your consultation if you’ll need headgear or if another option is available.
Wearing Orthodontic Headgear
Modern headgear is still used today, especially if someone has a major overbite, underbite, or deep bite. Using headgear reduces the chances of needing jaw misalignment surgery later on. Very few people need these appliances (especially now that TADs and Herbst appliances are available) but they still hold a purpose for people with major malocclusion and misaligned teeth issues. Always talk to an orthodontist or get a second opinion if you have any concerns.
Women’s and girls’ headdresses in Rus’
К.Е. Makovsky “Boyarishnya” 1884 Women’s and girl’s headdresses in Rus’.
For centuries in Rus’, all women’s attire was “talking” and because of the way a woman’s head was decorated, it was possible to judge her place of residence, occupation, origin and status.
Each province had its own fashion and decorated the headdress in a special way. By the headdress one could find out the social status of its mistress. Moreover, it was by the headdress that one could find out whether a young lady or a married woman was walking down the street. The headdress also spoke of the wealth of its owner. This was evident because in what techniques and materials the headdress of the Russian beauty was decorated.
Girl’s headdress
Women’s and girl’s headdress in Rus’. Girls’ holiday costume. XIX century. Nizhny Novgorod province Headband, sundress, warm clothes
Hats were sewn depending on what status a woman was. I must say that the girl’s headdress could be quite diverse. It was called a crown, a ribbon, a bee, a whisk, a cloth. In addition to these names, there were others.
Women’s and girl’s hats in Rus’. Ancient girl’s headdress – crown “bangs”
Headwear was made from cloth and brocade, which was folded like a ribbon. Koruna was considered the most solemn headdress. We can call it a crown and its base was made of wire, foil or even plain cardboard. The base was covered with fabric and embroidered with beads, pearls and stones. Mother-of-pearl, coins and shells were also used … Everything that looked beautiful and harmonious on each specific product.
Girls’ festive costume. XIX century. Vologda province Shirt, sundress, bib, bandage, half-shawl
The korunas in the northern provinces were especially beautiful. They were decorated with precious stones. Korunas were worn by marriageable girls until the 20th century.
Headdress for a married woman.
Festive dress for women. XIX century. Nizhny Novgorod province
“Haired”, that is, only a girl could walk without a headdress, and it was impossible in Rus’ to meet a simple-haired woman, that is, a married woman – the head of the clan. Most often, a woman wore a kiku. Kika could have “horns” into which dense fabric was inserted. These “horns” on the headdress were supposed to protect the woman and give her strength and fertility. The older the woman became, the smaller the horns on the kick became.
Russian: Votyachka. 1838
1838
Retrieved
Russian: Album “Clothes of the Russian State”
English: Album “Clothes Of Russian Country”
Magpie.
Women’s Old Believer festive costume. The village of Chernukha, Nizhny Novgorod province Shirt, sundress, belt, apron-string, magpie, breast decoration “beard”, breast decoration – “viteyka”.
The magpie’s headdress could be brocade or velvet. The magpie was decorated with pearls and gold embroidery. Young people put on a magpie on patronal holidays and took care of it as the most expensive outfit. A magpie cost more than a thoroughbred horse.
Kokoshnik.
Perhaps the most famous headdress is the kokoshnik. Today it is mistakenly confused with a girl’s headdress – a crest and a crown. But the kokoshnik is a purely female headdress!
For the manufacture of the kokoshnik, they took a quilted or glued canvas that was covered with an embroidered fabric. Often the fabric was embroidered with beads and stones.
Kokoshnik on the edges was decorated with pearl threads – cassocks. A mesh of pearls was placed on the front. On the kokoshnik it was possible to wear silk or woolen shawls – ubrus. Nowadays, women also wear hats, only now it is almost impossible to determine where the beauty came from and whether she is married. There was no such confusion in Rus’.
Today you can see real modern headdresses in Moscow in Gostiny Dvor at the address: Gostiny Dvor entrance from Varvarka, house 3, entrance 15. In Gostiny Dvor there is a representative office of Russian fashion designer Valentina Averyanova, who continues to keep Russian headdresses alive. Today you can buy or order a kokoshnik, kiku, crown, korun or other headdress corresponding to your status in order to continue the traditions of Rus’ in the modern world.
Where to go in such a headdress today? You ask. It already depends on your occupation, lifestyle and courage. Today, Russian women’s or girl’s hats are purchased for important celebrations such as weddings or public holidays, meetings with heads of state or for themed holidays and balls. And someone goes to the service in the temple in a Russian headdress …
The choice is yours!
Russian headdress – headband
Russian headdress – headband
Koruna – wedding headdress of Anastasia Averyanova
crown in Russian style
Women’s and girl’s headdresses in Rus’: The traditional modern headdress is the crown.
Women’s and girl’s headdresses in Rus’ Modern headdress bandage.
Women’s and girl’s hats in Rus’. Contemporary Crown
Wedding koruna, mantle and cuffs
Women’s and girl’s headdresses in Rus’. Modern headband
Embroidery lingerie, glass embroidery
Boyar dress and crown from Valentina Averyanova
Head decoration: modern headband
Women’s and girl’s headdresses in Russia: modern crown
Maiden’s vein ets
crown in Russian style
crown and lace hooded shower warmer
Maiden’s crown
maiden crown and headdress
Irina Volina in a crown
lace shower warmer and crown
Kokoshnik, embroidery with stones and glass on gold embroidery
Koruna and headdress
Linen, embroidery with pearls and beads
Russian beauty in a kokoshnik by Valentina Averyanova
showroom of Valentina Averyanova
kokoshnik and handrails
Kokoshnik with pearls, gold embroidery and gems
Contacts of Valentina Averyanova House of Russian Clothes
Please, if possible, call the indicated number one hour before your visit to the Russian style clothing store.
Registration in the showroom: ☎+7(495)114-50-16
The salon is located at: Moscow, st. Ilyinka, 4, Gostiny Dvor, entrance 15. The salon is open from 11:00 to 20:00, Mon-Fri
Women’s hats – Smolensk State Museum-Reserve
Charnets, Yanochka, Charnets,
Yes put the cap on Agatha.
yes for basting,
Cleaned up like a winch…”
Photograph by M.I. Pogodin. Ganna, Glotovka village, Oselsky volost, Elninsky district (forty).
Antique headdresses are a very “speaking” part of the folk costume. They reflected the story about the place of residence, social and family status. Girls did not cover their hair completely, and married women carefully hid it under a headdress. This ancient Slavic custom was preserved in the 19th – early 20th century. Walking with an uncovered head was considered a sin, a shame, belonging to witchcraft (“loose your hair – you fasten demons”).
The ritual change of the bride’s hairstyle and headdress was universally called “tying up the young woman”.
“This time to tie, to sit at the groom’s table, to tie a young woman is called. Yae, they say, they tie it up: it was a girl, and then there will be a woman” (Dukhovshchinsky, Svity)
“They took me away, they tied me in my horns, and the groom began to sit down…” (Yatsevsky, Isakovo).
The collection of women’s headwear in the collection of the Smolensk State Museum-Reserve is quite diverse and interesting;
On the territory of the Smolensk province, the ancient Slavic features of the headdress were preserved for quite a long time. A common female headdress was kichki of various shapes, which had the common name “horns”.
Kichka with horns Smolensk province. 19th century Canvas (left)
Kichka – block. Smolensk province, Vyazemsky district. Mid 19th century Canvas, birch bark, cord. From the collection of E.N. Kletnova (right)
Kichki were sewn from quilted linen canvas, the forehead part was compacted with hemp or birch bark, sometimes they were soaked with hemp oil or whey for hardness. Young peasant women put on smart caps made of calico, printed chintz, and silk over the kichka – “magpies”.
The headband served as an addition to the magpie; it not only decorated, but also covered the woman’s hair from behind. Its upper part (“box”) was made of canvas, calico or calico, the middle (“threads”) – from parallel red woolen threads, the lower (“bottom”) – from beads. Beautiful samples of the back of the head with geometric ornament (rhombuses, crosses) were collected by M.I. Pogodin in the Elninsky district
Pozatylen.
The magpie was also decorated with strips made of beads – “hanging”, “guts”. As a result, a complex, multi-layered, festive headdress was created.
Magpie with the back of the head. Smolensk province, Elninsky district. !912 Fabric, braid, embroidery, beads. From the collection of M.I. Pogodin.
“Giving, aunties, giving, put on the basting!” – Dukhovshchinsky peasant women sang at the wedding, presenting the bride.
Basting is a linen towel 2-3 meters long and 30-40cm wide. Its ends were richly decorated with stripes of calico, ribbons, lace, “mahr” of red, yellow and green wool, embroidery, woven patterns.
Towel – “basting”. Smolensk region, Dukhovshchinsky district. 1920-1930s Linen, cotton fabric, weaving, embroidery.
Basting (towel, fly) was found in the Smolensk province as the main headdress, and also as an addition to the kichka, magpie, kokoshnik. Most often, the basting, folded in the form of a strip, was wrapped three times over another headdress, and the ends were laid on the sides or tied at the back and dissolved.
As noted by V.N. Dobrovolsky in the “Smolensk ethnographic collection” (1893d.), in the Bizyukovskaya volost of the Dorogobuzh district “married women wear boots (boots), a headdress in the form of an oblique basting, from under which one can see a kokoshnik with crosses. When a year has passed after marriage, this outfit is no longer worn. … The above described outfit, however, is worn by women when they go to church, to fairs, to taverns. The sleeves are starched, and the ends of the basting stick up, in the form of a bow.
Akulina Nikitichna Ivanushkina der. Mitishkovo, Markhotkinskaya volost, Elninsky district. 1928. Photo by M.I. Pogodina
Under towel headdresses, women always wore a cap, which also participated in the wedding ceremony: “Capets – when Ana’s lazhatsa sleep, leave, then the mother-in-law should remove the veil and tie the cap …” (Smolensky district, Arkhipovka)
V .N. Dobrovolsky in the Smolensk Ethnographic Collection notes: “A woman covers her head with a scarf, after twisting her hair in the form of a roll to hold the scarf, sometimes twisting flax into her hair, if the natural decoration is insignificant, the hair is small and sparse. It is put on the hair and a cap made of chintz. A scarf is tied around the cap: the young wear red scarves, the old women are dark in color.
When leaving the yard, they cover themselves with a new scarf of bright color, tying it under the chin.”
Caps from the collection of E.N. Kletnova. “The ornament of weaving these caps is geometric, the basis of which is rhombuses. A rectangular blank woven from threads was sewn on the sides. In front, the edge of the caps was decorated with braid, embroidery with colored threads, and lace. “Horns” made of canvas or fiber were inserted into the corners of the cap. A cap tied at the back with a lace – a volosnik tightly fitted the head ”(L.M. Kozikova“ Items of a peasant costume and life of the Vyazemsky and Dukhovshchinsky counties 19-20 c. from the collection of E.N. Kletnova)
Cap. Smolensk province, Dukhovshchinsky district, Boyarshchina village. 2nd half of the 19th century
A variety of warriors and collections belonged to the costume of a married peasant woman. The collection became widespread at the end of the 19th century.
A young woman in a warrior. Smolensk province, Elninsky district. Photo by M.I. Pogodin.
A common headdress in the Smolensk region was a cap (“cap”) and a slightly different design, also called a “hat”. Such a bonnet was decorated with beads, glass beads, braid, woolen “mahr” bonnets, long wide ties and an elongated back covering the neck.
I.F. Buzanova in the “hat”. Smolensk province, Elninsky district, the village of Korovniki, near the Boldin Monastery. 1929 Photo by M.I. Pogodin.
By the beginning of the 20th century, the folk costume gradually lost its old details, fell into disuse, and changed.
So a resident of the Krasninsky district (Pustoselye village) V.V. Gerasimova recalled: “Mother … then wore an andarak … Mother wore a cap made of a scarf. They dismantled the hair on two sides, twisted it into a tourniquet and laid it on the head. A folded scarf was tied over the top. It turned out, due to highly styled hair, an imitation of a cap.