Effects of activator and high-pull headgear combination therapy: skeletal, dentoalveolar, and soft tissue profile changes
anDepartment of Orthodontics, Faculty of Dentistry, Istanbul University, Çapa, Istanbul, Turkey
Address for correspondence Gülnaz Maran, Department of Orthodontics, Faculty of Dentistry, Istanbul University, Çapa 34093, Istanbul, Turkey, E-mail: gulnaz.marsan{at}yahoo.com
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Abstract |
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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.
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  M. Lerstol, O. Torget, and V. Vandevska-Radunovic Long-term stability of dentoalveolar and skeletal changes after activator-headgear treatment Eur J Orthod, May 28, 2009; (2009) cjp042v1. [Abstract] [Full Text] [PDF]
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