Face Mask / Reverse Pull

The Face Mask (Reverse Pull Headgear) is an extraoral appliance that applies anterior traction to the maxilla through elastics connected to an intraoral appliance. It is the primary treatment for growing Class III patients with maxillary hypoplasia.

• Extraoral Frame — Adjustable metal frame resting on forehead and chin • Elastic Traction — Heavy elastics (14-16oz) from frame to intraoral hooks • Intraoral Appliance — Typically a bonded Hyrax expander with anterior hooks • Chin Cup and Forehead Pad — Padded contact points for comfort

Heavy elastics pull the maxilla forward at approximately 400g per side. The force direction is 15-30° below the occlusal plane to minimize mandibular clockwise rotation. Forces are transmitted through the teeth to the maxillary sutures, stimulating bone apposition at the circummaxillary sutures.

1. Intraoral: Fabricate bonded expander with anterior traction hooks 2. Extraoral: Adjust face mask frame to fit patient 3. Select appropriate elastic force (typically 14oz, 5/16" heavy) 4. Instruct patient: 14-16 hours daily wear 5. Lab provides intraoral appliance only 6. QC: Hook position, band integrity, solder strength

• Intraoral Appliance: Banded/bonded expander, 0.045" SS anterior hooks • Face Mask: Adjustable frame, medical-grade stainless steel or polymer • Elastics: 14-16oz, 5/16" heavy, latex or non-latex • Force direction: 15-30° below occlusal plane • Wear time: 14-16 hours/day, optimal age: 6-10 years • QC: Hook position, solder/band integrity