Facial Profile Changes in Early Class II Correction with Cervical Headgear

Objective: To evaluate and compare skeletal effects and the amount of molar distalization in maxilla using modified palatal anchorage plate (MPAP) vs headgear appliances in adolescent patients. Materials and Methods: Pre-and posttreatment lateral cephalograms of 45 Class II malocclusion patients were analyzed; 24 were treated with MPAP appliances (age, 12.4 years) and 21 with headgear (age, 12.1 years). Fixed orthodontic treatment started with the distalization process in both groups. Thirty-two variables were measured and compared between both groups using multivariate analysis of covariates. Results: There was no significant main effect of the appliance type on the treatment results (P 5 .063). Also, there was no significant main effect of the appliance type on both pre-and posttreatment comparisons (P 5 .0198 and .135, respectively). The MPAP and headgear groups showed significant distalization of maxillary first molars (3.06 6 0.54 mm and 1.8 6 0.58 mm, respectively; P , .001). Sagittal skeletal maxillomandibular differences were improved after treatment (P , .001), with no significant differences between the two groups. No significant difference in treatment duration was found between the groups. Conclusions: The MPAP showed a significant skeletal effect on the maxilla. Both MPAP and headgear resulted in distalization of maxillary first molars. Therefore, it is recommended that clinicians consider the application of MPAP, especially in noncompliant Class II patients. (Angle Orthod. 2015;85:657-664.)

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“…In agreement, Kirjavainen et al 30 reported similar results of decreased ANB by 1.3u, using the cervical headgear.…”

Section: Discussionsupporting

confidence: 77%

Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents

Sa'aed

Park

Bayome

et al. 2014

The Angle Orthodontist

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“…The vertical growth of mandibular condyles should be greater than that of posterior alveolar processes and is an important factor in the anti-clockwise rotation of the mandible 21 . Nevertheless, the changes observed in the Y-axis angle revealed the harmonic pattern of face growth in both groups during orthodontic treatment and post-retention phases (Tables 2 and 3) 11, [22][23] . Analysis of the linear measurements CdGo, CdPog and GoPog (Tables 2 and 3) showed a significant increase in T 0 -T 1 and T 1 -T 2 intervals.…”

Section: Discussionmentioning

confidence: 96%

Comparison of 2 types of treatment of skeletal Class II malocclusions: a 5-year post-retention analysis

Lira¹,

Souza²,

Bolognese³

et al. 2014

Braz. J. Oral Sci.

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Aim: To compare 2 types of treatment for Class II malocclusion assessing mandibular behavior in subjects submitted to full orthodontic treatment with standard edgewise appliance and cervical headgear (Kloehn appliance) and those who used cervical headgear in the first period and with full orthodontic appliance in the second period. Methods: The sample consisted of 80 children treated with either cervical headgear combined with full fixed appliances (n=40, group 1), or with cervical headgear at first (n=40, group 2). In both groups, lateral cephalometric radiographs were compared with those made at the beginning of treatment, at its end and at 5-year post-retention phase, in order to quantify the cephalometric measures (8 angular and 3 linear), presenting the mandibular behavior in the antero-posterior and vertical directions. All patients were treated with no extraction and no use of Class II intermaxillary elastics during the full orthodontic treatment. Results: In both groups, the effective treatment of skeletal Class II malocclusion did not interfere in the direction and amount of growth of mandibular condyles and remodeling at the lower border, with no influence on the anti-clockwise rotation of the mandible. The mandibular growth also was observed after the orthodontic treatment, suggesting that it is influenced by genetic factors. Conclusions: These observations may lead to the speculation that growing patients with skeletal Class II malocclusion and low mandibular plane are conducive to a good treatment and long-term stability with one or two periods of treatment.

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“…Treatment of Class II, Division 1 malocclusion in growing patients compromises growth modification by orthopedic appliances such as cervical headgears, although treatment effect is intimately to patient's compliance and motivation. [1][2][3] The skeletal and dental effects of cervical headgear in growing patients depends on magnitude of force and time of daily use. 4,5 Orthodontists currently recommend 'standard' wear times with a broad deviation in practice ranging from 12 to 20 hours daily.…”

Section: Introductionmentioning

confidence: 99%

Compliance and Effectiveness in Cervical Headgear

Trakyali

Dayıoğlu

2019

Cumhuriyet Dental Journal

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The aim of the present study was to evaluate the correlation between headgear wear duration and correction of skeletal and dental Class II malocclusion in preadolescent patients. Materials and Methods: The study material consisted of pre and posttreatment lateral cephalograms, and actual headgear wear hours calculated from data recorded monthly by an electronic timer device, (Compliance Science System (CSS) and Affirm Smart Headgear Modules, Ortho Kinetics, Vista, California, USA) of 30 patients (14 female and 16 male) treated with cervical headgear for 12 months. The mean age was 10.43 ± 1.07 years. Initial and progress cephalograms were analyzed according to skeletal and dental landmarks to evaluate treatment effect of the appliance. The actual number of hours of appliance wear was calculated by data from timer modules collected every monthly visit. Statistical analysis was performed by using SPSS 24.0. Results: While a sagittal growth was still observed in the group using the headgear for less than 12 hours, restriction of sagittal growth of maxilla was achieved in the group using the cervical headgear over 12 hours daily. Conclusions: The cervical headgear is still used in orthodontics to restrict the forward growth of the maxilla in Class II division 1 patients with a normal or low angle profile. By means of objective data for monthly appliance usage, this study showed that in order to achieve the targeted results the cervical headgear should be used at least 12 hours daily.

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Facial Profile Changes in Early Class II Correction with Cervical Headgear

Cited by 26 publications

References 8 publications

Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents

Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents

Comparison of 2 types of treatment of skeletal Class II malocclusions: a 5-year post-retention analysis

Compliance and Effectiveness in Cervical Headgear

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