A cephalometric comparison of two treatment modalities for adolescent patients with Class II malocclusion: cervical headgear versus maxillary first premolar extraction

Abstract

Objective: The primary purpose of this retrospective study was to compare the cephalometric effects of 2 treatment modalities for adolescents with Class II malocclusions and overjets greater than 4 mm. Methods: In 1 group, the subjects were treated with nonextraction cervical headgear therapy (n 43); in the second group, the subjects were treated with extraction of maxillary first premolars (n 43). Lateral cephalograms and dental models were gathered for evaluation. Cephalograms were evaluated at pretreatment and posttreatment; independent t tests were used to compare the headgear and extraction groups with significance set at P .05. The pretreatment mean age of subjects in the cervical headgear group was younger (11.9 years) than the maxillary first premolar extraction group (12.9 years, P .002). There were no significant differences between the groups in pretreatment irregularity index or cephalometric measures. Posttreatment, the only significant difference detected in overall cephalogram measurements was mandibular plane angle, which was 2.7 greater in the extraction group than in the headgear group (P .024). Results: The results of the regiona1 maxillary superimpositions indicated more anterior movement of the maxillary first molar (mean difference, 3.2 mm, P .000), more retraction of the maxillary incisor (mean difference, 1.2 mm, P .007), and more retraction of the upper lip (mean difference, 1.2 mm, P .002) in the extraction group than the headgear group. The magnitude of the incisor and lip changes, however, was small and might not be clinically significant. Conclusion: The findings of this study indicate that both groups underwent similar changes with treatment.