Bollard Plate Class III Jaw Treatment

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Bollard Plates

Bollard plates, or bone-anchored maxillary protraction (BAMP), use elastic force to pull the upper jaw forward and arrest the growth of the lower jaw. This treatment is suitable for ages 11-14 years old. The elastics attach to the upper jaw using hooks inside the mouth that have been surgically attached to the upper jaw. These elastics can either be anchored to a headgear worn at night, or they can be anchored to hooks surgically attached to the lower jaw.

Bollard plates placed on the upper jaw with night time headgear can produce on average ~5mm of upper jaw forward movement.

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Before/after, upper Bollard plates with headgear:

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Photo credits: Elnagar, AJODO, 2016

For some patients, Bollard plates will be surgically placed on the upper and lower jaw, with no need to use the headgear. Elastics are worn between the upper and lower jaws full time and have been shown to produce on average ~6mm of upper jaw forward movement.

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Before/after Bollard plates on the upper and lower jaws with full-time elastic wear.

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Photo credits: Elnagar, AJODO, 2016

So a patient who is born with a large lower jaw may have facemask treatment when they are young and Bollard plate treatment if needed in their early teens. The goal is to protract the upper jaw so that it fits with the lower jaw. These treatments can only be done in growing patients whose growth plates are open and facial sutures have not yet fused. Successful facemask and Bollard plate treatment can reduce the need for orthognathic jaw surgery at the end of growth.