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Randomized Controlled Trial
. 2023 Sep 18;45(5):496-504.
doi: 10.1093/ejo/cjad045.

Effects of headgear timing on dental arch changes from 7 to 18 years of age: a follow-up study

Matti Hannula  1   2 , Mimmi Tolvanen  3 , Pertti Pirttiniemi  1   2   4 , Kirsi Pirilä-Parkkinen  2   4 , Johanna Julku  2   4
Affiliations
Randomized Controlled Trial

Effects of headgear timing on dental arch changes from 7 to 18 years of age: a follow-up study

Matti Hannula et al. Eur J Orthod. .

Abstract

Background: Dental arch effects after cervical headgear (CHG) treatment have been researched from several different perspectives. However, the long-term effects of CHG timing are still unknown.

Objectives: To analyse the long-term effects of CHG timing on dental arches.

Material and methods: A total of 67 children with Angle Class II malocclusion comprised the study group in this trial. The participants were randomized into two equal-sized groups. In the early group (EG, n = 33), treatment was started after the eruption of the first upper molars. In the later-timed group (LG, n = 34), treatment was started 18 months later compared with the early group. Long-term effects were measured from dental casts taken at five time points between 7 and 18 years of age.

Results: The total maxillary dental arch length was achieved earlier, the gained length persisted better in the long term, and significantly more space was achieved in EG compared with LG (P = .048). The intermolar width in the maxillary dental arch was more stable and was reached earlier in EG compared with LG (P = .002). The results showed that in terms of total mandibular arch length increases, EG males benefited the most and LG females the least from CHG treatment (P = .031).

Conclusions: Both genders benefited from earlier CHG treatment. The maxillary dental arches remained longer, and the final width was gained earlier in EG compared with LG.

Keywords: Headgear; dental arch; long-term; timing.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flow chart of the participants in the trial (F: female; M: male). Dental casts at T3 or T4 were available for 7 females and 12 males in EG and 10 females and 17 males in LG, who are included in this study..
Figure 2.
Figure 2.
Landmarks for the dental cast analysis. U1, U4, L1, L4: the distance between the distobuccal cusp of the first permanent molar and the highest point of the canine in the same quadrant. U2, U3, L2, L3: the distance between the highest point of the canine and the most mesial point of the central incisor in the same quadrant. U5, U6, L5, L6: the distance between the distobuccal cusp of the first permanent molar and the most mesial point of the central incisor in the same quadrant. U7, L7: the distance between the highest points of canines. U8, L8: the distance between the distobuccal cusps of the first permanent molars. U9, L9: the shortest distance between the palatal or lingual surfaces of the first permanent molars.
Figure 3.
Figure 3.
Changes in total dental arch lengths (mm) between time points T0–T4 according to group and gender. At T0, mean age of the participants was 7.3 years. The gap between time points was on average 2.2, 2.0, 3.8, and 2.4 years. Values are based on 46 participants who attended either T3 or T4. P-values are given in Table 2.
Figure 4.
Figure 4.
Changes in dental arch widths (mm) between time points T0–T4 according to group and gender. At T0, mean age of the participants was 7.3 years. The gap between time points was on average 2.2, 2.0, 3.8, and 2.4 years. Values are based on 46 participants who attended either T3 or T4. P-values are given in Table 2.
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