Treating Class II malocclusion in children. Vertical skeletal effects of high-pull or low-pull headgear during comprehensive orthodontic treatment and retention

Orthod Craniofac Res. 2015 May;18(2):86-95. doi: 10.1111/ocr.12062. Epub 2014 Dec 29.

Abstract

Objectives: To evaluate, in Class II malocclusion children, vertical skeletal changes occurring with high- and low-pull headgear during non-extraction comprehensive orthodontic treatment, and retention.

Setting and sample population: Two groups of thirty Class II malocclusion children (mean age 10.8 years) who had undergone non-extraction comprehensive orthodontic treatment with either high- or low-pull headgear and fixed appliances.

Material and methods: Retrospective longitudinal study, where pre-treatment, post-treatment and at least 2 year post-retention lateral cephalometric radiographs were analyzed. Comparisons were made concerning changes during treatment and retention in high- or low-pull headgear-treated children. Correlation analyses were carried out investigating changes in vertical cephalometric parameters and pre-treatment vertical facial pattern or type of headgear used.

Results: During treatment, sagittal relationships improved in all children and remained stable during retention. Vertically, in both high- and low-pull headgear groups, the intermaxillary angle as well as the maxillary and mandibular plane angles did not show statistically significant changes during treatment or retention, and large variation was seen between patients. When pooling the whole patient sample, change in the vertical facial pattern was independent of the pre-treatment vertical facial pattern or type of headgear used.

Conclusion: When treating Class II malocclusion children non-extraction with high- or low-pull headgear and fixed appliances, changes in vertical skeletal relationships demonstrate wide variation, both during treatment and retention. Dentoalveolar changes brought about by these appliances may not be able to make a predictable difference in vertical skeletal patterns of growing patients.

Keywords: angle Class II; cephalometry; extraoral traction appliances; malocclusion.

Publication types

  • Comparative Study

MeSH terms

  • Case-Control Studies
  • Cephalometry / methods
  • Child
  • Extraoral Traction Appliances / classification*
  • Female
  • Humans
  • Incisor / pathology
  • Longitudinal Studies
  • Male
  • Malocclusion, Angle Class II / therapy*
  • Mandible / pathology
  • Maxilla / pathology
  • Nasal Bone / pathology
  • Orthodontic Appliance Design*
  • Orthodontic Retainers
  • Retrospective Studies
  • Sella Turcica / pathology
  • Stress, Mechanical
  • Treatment Outcome
  • Vertical Dimension