New Face Pulling Device

I have made a big upgrade to my facepulling headgear over the past few months. The frame of the device now rests on my chest and shoulders, allowing me to load more force on my maxilla. I have built this new frame using a medical neck brace to which I added metal poles. This is inspired from The Crane but it is a better design for a fraction of the cost.

My previous design looked like this:

Head Anchored Facepulling Headgear
Head Anchored Facepulling Headgear

My new headgear looks like this:

Face Pulling Neck Brace
Face Pulling Neck Brace

The forces applied on the maxilla are shown in red:

Face Pulling Neck Brace Forces
Face Pulling Neck Brace Forces

This is used with the same intraoral appliance as before:

Intraoral Appliance
Intraoral Appliance

I can sleep a full night with 500g of forward force and 500g of upwards force on my maxilla. When I raise this to 1000g forward and 1000g upwards, my palate becomes sore and I have to remove the headgear. I am working on making the intraoral appliance more comfortable so that I can apply higher forces. The most important design aspect of this appliance is that all of the load is applied on the maxilla, with zero teeth contact. This is important because the teeth can easily be displaced if forces are applied on them. We want to displace the maxilla while leaving the teeth untouched.

The facepulling headgear is only half of the battle. To achieve maxillary protraction in an adult, you need to develop excellent tongue posture and chewing habits. This is done by chewing hard gum regularly and practising tongue posture on a full-time basis.

We know that maxillary displacement is possible in adults, as Dr. Won Moon has been doing non-surgical palatal expansion on adults on a regular basis. Here is one of his results on a 30+ years old patient:

Won Moon Before After
Won Moon Before After

Adult Maxillary Protraction : A case study

There is an interesting paper that shows the effect of a reverse-pull headgear on a 20-year old female. In these kind of experiments, the method used to to protracting the maxilla is very important and can be the difference between a successful case and a failure.

Reverse-Pull facemask
Reverse-Pull facemask

Usually, facemasks are only used on growing children and attempt to change the direction of growth. As adults, we do not have growth on our side so we have to stimulate bone movement with high forces and long wear times.

BeforeAdultClassIII

This 20-year old woman wore a reverse-pull facemask attached to her braces for 20 hours a day during 4-months. One of her main concerns were her underdeveloped cheekbones, that she wished to improve with a more forward maxilla.
“Her upper lip was slightly retruded. She presented with maxillary hypoplasia and flat malar (cheekbones) eminences.”

Continue reading “Adult Maxillary Protraction : A case study”