Effects of cervical headgear appliance: a systematic review

Henriques, Fernanda Pinelli; Janson, Guilherme; Henriques, José Fernando Castanha; Pupulim, Daniela Cubas

doi:10.1590/2176-9451.20.4.076-081.oar

Cited by 26 publications

(26 citation statements)

References 16 publications

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“…1,2 Recent systematic reviews indicated that HG is a viable and effective appliance in patients with Class II, Division 1 malocclusion with maxillary prognathism. 3,4 The selected and recommended (activated) force in cervical headgear (CHG) varies greatly, from 200 to 1000 g, [5][6][7][8][9] but very little to no information is available on the stability of force during CHG use. Force magnitude of less than 450 g has been considered to produce orthodontic impact, while greater than 450 g results in an orthopedic effect.…”

Section: Introductionmentioning

confidence: 99%

Adherence to instructions and fluctuation of force magnitude in cervical headgear therapy

Talvitie

Helminen

Karsila

et al. 2018

The Angle Orthodontist

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Objectives: To investigate how patients adhere to instructions and how force magnitude fluctuates and influences the use of cervical headgear (CHG) therapy. Materials and Methods: In this controlled clinical trial, subjects (n = 40) were treated with CHG with light (L, 300 g) or heavy (H, 500 g) force. Patients were asked to wear CHG for 10 hours per day for 10 months (ie, during sleep), but the importance for treatment of wearing CHG also in the evening hours was emphasized. Adherence to instructions and force magnitude in CHG use were monitored by electronic module (Smartgear, Swissorthodontics, Switzerland). Results: Force magnitude can be set at a certain level, L or H, even if great individual variability is seen in all subjects (0–900 g). Children in the L group used CHG longer per day than those in the H group (9.3 hours ±1.5 hours and 7.8 hours ± 2.1 hours, respectively, P = .002). During evening hours, CHG was used more (P = .02) in the L group than in the H group. In both groups, CHG was used less in the evening hours during school breaks than in the evening hours during school (P < .001). Conclusions: Children with lower force in CHG seem to adhere better to the instructions for CHG use. Daily rhythm also influences the time of appliance use regardless of force magnitude. The force can be set to a certain magnitude level, even though there is substantial individual variability.

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Section: Introductionmentioning

confidence: 99%

Adherence to instructions and fluctuation of force magnitude in cervical headgear therapy

Talvitie

Helminen

Karsila

et al. 2018

The Angle Orthodontist

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“…For this case several kinds of orthodontic appliances, e.g., headgear, pendulum, and other appliances have been used for molar distalization. 1 2 3 Headgear is the most commonly used extra-oral orthodontic appliance, but headgear is not quite aesthetic and requires patient's compliance. Hence, intra-oral appliances are commonly used for these purposes more effectively.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis of distalization of mandibular molars by placing a mini-plate: A finite element study

Park

Na²,

Park³

et al. 2017

Korean J Orthod

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ObjectiveThe objective of this study was to analyze the patterns of tooth movements when distalization of mandibular molars using a mini-plate took place. A finite element analysis was applied to analyze patterns of tooth movements.MethodsThe model of the mandible and teeth were used to build a finite element analysis model, and a mini-plate was inserted in the mandibular ramus. Two different orthodontic forces were established for displacement of mandibular molars. Orthodontic forces were applied at the level of the bracket and at the level of the cemento-enamel junction in the mandibular canine respectively.Resultsorthodontic forces at the level of the cemento-enamel junction resulted in a greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of the bracket. Applying orthodontic forces to the cemento-enamel junction also resulted in unwanted greater extrusive movements in distalization of the mandibular molars compared to the bracket level.ConclusionsWith considering the mode of orthodontic teeth movement, applying different vertical orthodontic forces for distalization of mandibular molars can lead to more effective distalization of teeth.

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“…Although dental distalizers and skeletal temporary anchorage devices are available, the headgear (HG) appliance is an effective treatment for class II malocclusions in growing patients [ 1 ] and is utilized by more than half of orthodontists [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Tridimensional finite element analysis of teeth movement induced by different headgear forces

et al. 2016

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BackgroundThis study aimed to simulate the actions of low-pull (LP), high-pull (HP), and combined pull (CP) headgears (HGs) and to analyze tooth movement tendencies through finite element analysis.MethodsTomographic slices of a human maxilla with complete permanent dentition were processed by reconstruction software, and the triangular surface mesh was converted into non-uniform rational B-spline (NURBS) curves. An HG facial bow was also modulated in 3D. The teeth and bone were considered to have isotropic and linear behavior, whereas the periodontal ligament was considered to have non-linear and hyperelastic behavior. Data regarding the application points, directions and magnitudes of forces were obtained from the literature and from a dolichofacial patient with class II, division 1 malocclusion, who was treated with a CP HG.ResultsThe CP HG promoted 37.1 to 41.1 %, and the HP HG promoted 19.1 to 31.9 % of LP distalization. The HP HG presented the highest intrusion, and the LP HG presented the highest extrusion of the first molar. The LP HG contracted the distal side, and the HP and CP HGs contracted the lingual and distobuccal roots of the second molar to a lesser degree.ConclusionsThe LP HG promotes the greatest distalization, followed by the CP and HP HGs; the LP HG causes greater extrusion of the first molar, and the HP HG causes greater intrusion of the first molar. The LP HG causes greater contraction of the second molar than the HP HG.

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Effects of cervical headgear appliance: a systematic review

Cited by 26 publications

References 16 publications

Adherence to instructions and fluctuation of force magnitude in cervical headgear therapy

Adherence to instructions and fluctuation of force magnitude in cervical headgear therapy

Biomechanical analysis of distalization of mandibular molars by placing a mini-plate: A finite element study

Tridimensional finite element analysis of teeth movement induced by different headgear forces

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