Facial, Dental, and Skeletal Responses to Treatment with Headgear and Pendulum, As Compared to a Control Group of Untreated Patients.
Abstract: Abstract: INTRODUCTION: The purpose of this retrospective, cephalometric study is to examine the general dental, skeletal and soft tissue effects of treatment change between headgear and pendulum appliances, versus untreated controls. Specifically, differences in upper incisor proclination and lip protrusion were studied, as were skeletal vertical and sagittal dimensions of the face. MET... read moreHODS: The sample of 77 patients with Class II malocclusion was divided into 3 groups. Group 1 patients (n = 27; treatment time, 2.3 years) were treated with a cervical headgear and fixed orthodontic appliances. Group 2 patients (n = 26; treatment time, 2.3 years) were treated with a pendulum followed by fixed appliances. Group 3 patients (n = 24; observation time, 2.7 years) were orthodontically-untreated adolescents. Subjects were matched to similar Class II skeletal and dental patterns, duration of T1-to-T2 observation interval, and level of skeletal maturation (CVMS). RESULTS: Class II treatment with both appliance protocols during the pubertal growth spurt induced significant, favorable changes, with a high level of success at the occlusal level (correction of overjet, overbite, and molar relationship). Statistically, there were no significant differences in the amount of change between pendulum and headgear groups, except for interincisal angle; however, at the end of treatment, both appliance groups finished with clincally acceptable values. No clinically or statistically significant differences in changes to soft tissue profile were observed between treatment protocols, and both methods produced statistically significant differences from control group changes from T1 to T2 for 5 measures. During the observation period, the initially protrusive maxillary position continued to advance forward (SNA); intermaxillary relationship did not improve (Wits); Y-Axis decreased; and overbite increased. Through the permanent dentition and cessation of the pubertal growth spurt, untreated Class II skeletal and dental patterns did not self-correct. CONCLUSIONS: In an era when clinicians are concerned with maintaining, and even improving, a patient's profile, the results of this paper suggest that correction of a Class II malocclusion with either headgear or pendulum can provide surprisingly similar skeletal, dental, and soft tissue results.
Thesis (M.S.)--Tufts University, 2011.
Submitted to the Dept. of Orthodontics.
Advisor: Jerome Shuman.
Committee: Barry Briss, Vassiliki Cartsos, and Paul Stark.
Keyword: Dentistry.read less