Treating Class II malocclusion in children. Vertical skeletal effects of high-pull or low-pull headgear during comprehensive orthodontic treatment and retention

ObjectivesTo evaluate, in Class II malocclusion children, vertical skeletal changes occurring with high- and low-pull headgear during non-extraction comprehensive orthodontic treatment, and retention. Setting and sample populationTwo groups of thirty Class II malocclusion children (mean age 10.8years) who had undergone non-extraction comprehensive orthodontic treatment with either high- or low-pull headgear and fixed appliances. Material and MethodsRetrospective longitudinal study, where pre-treatment, post-treatment and at least 2year post-retention lateral cephalometric radiographs were analyzed. Comparisons were made concerning changes during treatment and retention in high- or low-pull headgear-treated children. Correlation analyses were carried out investigating changes in vertical cephalometric parameters and pre-treatment vertical facial pattern or type of headgear used. ResultsDuring treatment, sagittal relationships improved in all children and remained stable during retention. Vertically, in both high- and low-pull headgear groups, the intermaxillary angle as well as the maxillary and mandibular plane angles did not show statistically significant changes during treatment or retention, and large variation was seen between patients. When pooling the whole patient sample, change in the vertical facial pattern was independent of the pre-treatment vertical facial pattern or type of headgear used. ConclusionWhen treating Class II malocclusion children non-extraction with high- or low-pull headgear and fixed appliances, changes in vertical skeletal relationships demonstrate wide variation, both during treatment and retention. Dentoalveolar changes brought about by these appliancesmay not be able to make a predictable difference in vertical skeletal patterns of growing patients.