Cervical Headgear Treatment and Growth Patterns: Analysis by Lateral Cephalometry

Abstract

Retrospective cephalometric study of changes in vertical and sagittal relations after headgear treatment depending on preexisting growth patterns. Lateral cephalograms obtained from 119 patients before and after headgear treatment were analyzed. All patients were treated with headgears exclusively. Only cases were included that showed bilateral improvement of least 4 mm in Class II occlusion after headgear treatment lasting at least 6 months. Patients were assigned to six groups based on y-axis values obtained at baseline. Almost all groups revealed substantial improvements in skeletal Class II relations, including 1.38 degrees-1.72 degrees reductions in ANB angles and 0.62-0.81 mm reductions in Wits values. SNA values fell by 0.51-1.25 degrees. SNB angle values increased by 0.21 degrees-0.95 degrees. SN-MeGo angles and mandibular angles were reduced, while y-axis values remained essentially unchanged during headgear treatment. Different results were only obtained in the group with the most pronounced horizontal growth pattern. Those patients revealed lower SNB angle values (-0.93 degrees ) and increased vertical relations (y-axis: +1.39 degrees ; SN-MeGo angle: +1.22 degrees; mandibular angle: +0.01 degrees) after headgear treatment. All groups showed a reduction in basal plane angles and maxillary retroinclination after treatment. Our results do not support the conventional recommendation that cervical headgears should not be used in the presence of vertical growth patterns.