Dentoskeletal Effects of the Maxillary Splint Headgear in the Early Correction of Class II Malocclusion

Overview

Journal Prog Orthod

Publisher Springer

Specialty Dentistry

Date 2020 May 5

PMID 32363550

Authors

Jose Augusto M Miguel

Caterina Masucci

Luciana Quintanilha Pires Fernandes

Flavia Artese

Lorenzo Franchi

Veronica Giuntini

Affiliations

Soon will be listed here.

Abstract

Background: To compare dentoskeletal changes produced by the maxillary splint headgear and cervical headgear appliance during the early phase of Class II treatment, specially the initial overjet and upper incisors position.

Subjects And Methods: In this retrospective study, 28 Class II patients treated with the maxillary splint headgear (MSG, mean age 10.1 ± 1.9 years) and 28 Class II patients treated with cervical headgear (CHG, mean age 9.5 ± 1.9 years) were evaluated before and after treatment. Statistical comparisons between the two groups for cephalometric measurements at T1 and for T2-T1 changes were performed by means of independent sample t tests.

Results: The MSG showed a significantly greater reduction of the overjet in comparison to the CHG (- 2.4 mm and - 0.7 mm, respectively) and a significantly greater maxillary incisor uprighting (- 1.8 mm and 0.4 mm, respectively). In the MSG, overjet correction was due mainly to mandibular advancement (3.5 mm), while the correction of molar relationship (3.9 mm) was 64% skeletal and 36% dentoalveolar. In the CHG, the overjet correction was also more skeletal, due to mandibular growth (1.8 mm), while correction of molar relationship (3.5 mm) was 63% dentoalveolar and 37% skeletal.

Conclusions: Both groups showed favorable skeletal mandibular changes, which was more significant in the MSG. Regarding tooth movement, the maxillary splint headgear was more effective in uprighting upper incisors and reducing the overjet than cervical headgear appliance.

References

Sunnak R, Johal A, Fleming P . Is orthodontics prior to 11 years of age evidence-based? A systematic review and meta-analysis. J Dent. 2015; 43(5):477-86. DOI: 10.1016/j.jdent.2015.02.003. View

Martins R, da Rosa Martins J, Martins L, Buschang P . Skeletal and dental components of Class II correction with the bionator and removable headgear splint appliances. Am J Orthod Dentofacial Orthop. 2008; 134(6):732-41. DOI: 10.1016/j.ajodo.2007.07.022. View

Nguyen Q, Bezemer P, Habets L, Prahl-Andersen B . A systematic review of the relationship between overjet size and traumatic dental injuries. Eur J Orthod. 1999; 21(5):503-15. DOI: 10.1093/ejo/21.5.503. View

Pithon M, Dos Santos R, de Morais Sampaio G, de Meneses I, Coqueiro R . Anteroposterior and vertical changes in skeletal class II patients treated with modified Thurow appliance. Braz Dent J. 2014; 25(2):170-4. DOI: 10.1590/0103-6440201302389. View

Batista K, Thiruvenkatachari B, Harrison J, OBrien K . Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents. Cochrane Database Syst Rev. 2018; 3:CD003452. PMC: 6494411. DOI: 10.1002/14651858.CD003452.pub4. View

THUROW R . Craniomaxillary orthopedic correction with en masse dental control. Am J Orthod. 1975; 68(6):601-24. DOI: 10.1016/0002-9416(75)90096-2. View

Fernandes A, Brunharo I, Quintao C, Costa M, de Oliveira-Costa M . Effectiveness of twin blocks and extraoral maxillary splint (Thurow) appliances for the correction of Class II relationships. World J Orthod. 2010; 11(3):230-5. View

Petti S . Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis. Dent Traumatol. 2014; 31(1):1-8. DOI: 10.1111/edt.12126. View

OBrien K . Is early treatment for Class II malocclusion effective? Results from a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2006; 129(4 Suppl):S64-5. DOI: 10.1016/j.ajodo.2005.09.016. View

10.

Springate S . The effect of sample size and bias on the reliability of estimates of error: a comparative study of Dahlberg's formula. Eur J Orthod. 2011; 34(2):158-63. DOI: 10.1093/ejo/cjr010. View

11.

Ghafari J, Shofer F, Markowitz D, LASTER L . Headgear versus function regulator in the early treatment of Class II, division 1 malocclusion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 1998; 113(1):51-61. DOI: 10.1016/s0889-5406(98)70276-8. View

12.

Jacob H, Dos Santos-Pinto A, Buschang P . Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance. Dental Press J Orthod. 2014; 19(1):19-25. PMC: 4299412. DOI: 10.1590/2176-9451.19.1.019-025.oar. View

13.

Al-Omari I, Al-Bitar Z, Sonbol H, Al-Ahmad H, Cunningham S, Al-Omiri M . Impact of bullying due to dentofacial features on oral health-related quality of life. Am J Orthod Dentofacial Orthop. 2014; 146(6):734-9. DOI: 10.1016/j.ajodo.2014.08.011. View

14.

Franchi L, Baccetti T, McNamara Jr J . Treatment and posttreatment effects of acrylic splint Herbst appliance therapy. Am J Orthod Dentofacial Orthop. 1999; 115(4):429-38. DOI: 10.1016/s0889-5406(99)70264-7. View

15.

Stuani M, Stuani A, Stuani A . Modified Thurow appliance: a clinical alternative for correcting skeletal open bite. Am J Orthod Dentofacial Orthop. 2005; 128(1):118-25. DOI: 10.1016/j.ajodo.2005.02.014. View

16.

Proffit W . The timing of early treatment: an overview. Am J Orthod Dentofacial Orthop. 2006; 129(4 Suppl):S47-9. DOI: 10.1016/j.ajodo.2005.09.014. View

17.

Al-Bitar Z, Al-Omari I, Sonbol H, Al-Ahmad H, Cunningham S . Bullying among Jordanian schoolchildren, its effects on school performance, and the contribution of general physical and dentofacial features. Am J Orthod Dentofacial Orthop. 2013; 144(6):872-8. DOI: 10.1016/j.ajodo.2013.08.016. View

18.

Tulloch J, Phillips C, Koch G, Proffit W . The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 1997; 111(4):391-400. DOI: 10.1016/s0889-5406(97)80021-2. View

19.

Franchi L, Baccetti T, Toffol L, Polimeni A, Cozza P . Phases of the dentition for the assessment of skeletal maturity: a diagnostic performance study. Am J Orthod Dentofacial Orthop. 2008; 133(3):395-400. DOI: 10.1016/j.ajodo.2006.02.040. View

20.

Mantysaari R, Kantomaa T, Pirttiniemi P, Pykalainen A . The effects of early headgear treatment on dental arches and craniofacial morphology: a report of a 2 year randomized study. Eur J Orthod. 2004; 26(1):59-64. DOI: 10.1093/ejo/26.1.59. View