Journal Article

Effects of activator and high-pull headgear combination therapy: skeletal, dentoalveolar, and soft tissue profile changes

Gülnaz Marşan

in The European Journal of Orthodontics

Published on behalf of European Orthodontics Society

Volume 29, issue 2, pages 140-148
Published in print April 2007 | ISSN: 0141-5387
Published online April 2007 | e-ISSN: 1460-2210 | DOI:

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The aim of this study was to evaluate skeletal, dentoalveolar, and soft tissue profile changes with activator and high-pull headgear combination therapy in patients with Class II malocclusions caused by maxillary prognathism and mandibular retrognathism. The subjects, all in the mixed dentition, were selected from a single centre and were divided into two groups: 28 patients were treated with an incisor double capping activator and a high-pull headgear combination appliance (13 girls, 15 boys mean chronological age 11.7 ± 1.2 years, skeletal age 12.1 ± 1.4 years) and an untreated group of 28 subjects (14 girls, 14 boys mean chronological mean age 11.9 ± 1.1 years, skeletal age 12.3 ± 1.3 years). The skeletal, dentoalveolar, and soft tissue profile changes that occurred were compared on lateral cephalograms taken before treatment (T0) and after 1.1 ± 0.3 years when the combination appliance was removed (T1). In the control group, the radiographs were obtained at the start (T0) and after an observation period 1.2 ± 0.4 years (T1). Statistical analysis was undertaken with Wilcoxon's ranked-sum test for intra-group comparisons and differences between groups with t-test and Bonferroni's test at a level of significance of P < 0.05.

Activator and high-pull headgear combination treatment in these growing patients resulted in a correction of the skeletal Class II relationship (ANB −3.4 degrees), a restriction of maxillary growth (SNA −2.0 degrees, OLp–A −2.3 mm), an advancement of the mandibular structures (SNB +2.6 degrees, FH–NPg +2.3 degrees, OLp–B +2.7 mm, OLp–Pg +2.2 mm), an increase in lower face height (ANS–Me +3.9 mm), a correction of the overjet (−5.4 mm), an improvement in overbite (−2.2 mm), uprighting of the maxillary incisors (U1–FH −5.3 degrees, OLp–U1 −2.5 mm), protrusion of the mandibular incisors (IMPA +2.0 degrees, OLp–L1 +2.7 mm), and a correction of the dental Class II malocclusion (OLp–L6 +3.5 mm). The soft tissue profile changes were a correction of facial convexity (G'–Sn–Pg' angle 2.3 degrees, Mlf–Li–x-axis angle 9.1 degrees), and an increase in lower antero-posterior (Mlf–y-axis 5.6 mm, Pg'–y-axis 5.3 mm), and lower vertical (Sls–x-axis 3.8 mm, Pg'–x-axis 3.8 mm, Me'–x-axis 5.1 mm) soft tissue dimensions. The mentolabial fold depth (Mlf–E line) also significantly decreased, −0.8 mm in the treated group.

The activator and high-pull headgear combination appliance was effective in treating growing patients with maxillary prognathism, mandibular deficiency, and facial convexity by a combination of skeletal and dentoalveolar changes and improvement in the soft tissue facial profile.

Journal Article.  4787 words.  Illustrated.

Subjects: Restorative Dentistry and Orthodontics

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