Publication: Ortodontic and orthoredic effects of activator and cervical headgear: a comparative study
Abstract
Klinik deneyler aktivatör ve headgear tedavileri ile elde edilen sonuçların karşılaştırılabilir olduğunu göstermiştir, ancak düzeltim mekanizması hakkında hala tartışmalar devam etmektedir. Bu retrospektif çalışmanın amacı, büyümekte olan sınıf II bölüm 1 malokluzyona sahip hastaların tedavisinde kullanılan activator-tipi fonksiyonel aparey ve servikal headgear ile elde edilen dental ve iskeletsel değişiklikleri karşılaştırmaktı. Örneklem 2 gruptan oluşuyordu. 1.grupda yer alan 11 hasta (3 erkek, 8 kız) activator-tipi fonksiyonel aparey ile tedavi edilirken, 2.grupdaki 11 hasta (7erkek, 4 kız) servikal headgear ile tedavi edildi. Her hastadan tedavi başında ve sınıf II molar ilişkisi düzelir düzelmez alınan iki sefalometrik radiograflar Marmara Üniversitesi Dişhekimliği Fakültesi Ortodonti Yeditepe Üniversitesi Dişhekimliği Fakültesi Ortodonti vlerinden elde edildi. Tedavi başında hastaların ortalama yaşı servikal headgear grubunda 11,45 yıl ve fonksiyonel grubunda 11,18 yaş idi. Bu çalışmada kullanılan radiograflar iki farklı sefalometrik cihaz kullanılarak elde edildiğinden, sefalometrik analiz sırasında magnifikasyon faktörünü ortadan kaldırmak için sadece açısal ölçümler kullanıldı. Sınıf molar ilişkisi elde etmede her iki tedavi yönteminin de etkili olduğu bulundu. Fonksiyonel apareyin hem maksilla üzerinde sınırlayıcı bir etkisinin olduğu ve hem de mandibulanın ileri doğru olan büyümesini tetiklediği bulunurken, servikal headgearin sadece maksilla üzerinde sınırlayıcı bir etkisi olduğu gösterildi. Her iki apareyinde palatal düzlemde saat yönünde bir rotasyona ve maksillar yükseklikte artışa neden olduğu bulundu. Servikal headgearin aksine fonksiyonel aparey alt anterior dişlerin proklinasyonunda artışa neden oldu. Fonksiyonel aparey grubunda daha belirgin olmakla birlikte her iki grupta da üst anterior dişlerin tedaviye bağlı olarak dikleştikleri görüldü. Her iki grup karşılaştırıldığında, pogonion’un ileri hareketinin fonksiyonel aparey grubunda servikal headgear grubuna gore daha fazla olduğu bulundu.
Clinical trials comparing activator and headgear treatment have shown comparable effectiveness in the total result achieved, but the mechanism of correction is still uncertain. The aim of this retrospective study was to compare the dental and skeletal effects of the activator-type functional appliance and the cervical headgear in the treatment of skeletal Class II Division I growing patients. The sample consisted of 2 groups of Class II Div 1 patients. 11 patients (3 male, 8 female) were treated with an activator-type functional appliance, and 11 patients (7 male, 4 female) were treated with cervical headgear. Lateral cephalometric radiographs taken at the beginning of treatment and after Class II molar correction were selected from the archive-files of the Marmara University Faculty of Dentistry Department of Orthodontics and the Yeditepe University, Faculty of Dentistry Department of Orthodontics. The average age of the patients in the cervical HG group was 11,45 years and it was 11,18 for the patients in the functional appliance group. Since the x-rays evaluated in this study were taken by two different machines, during cephalometric analysis only angular measurements were used to exclude the magnification factor. Both groups were found to be successful in correction of Class II molar relationship to Class I. While the functional appliance had a restrictive effect on the maxilla and induced the forward growth of the mandible, the cervical headgear caused only restriction on the maxillary growth. Both appliances tend to rotate the palatal plane in clockwise direction and as sequence increased the maxillary height. Unlike the cervical headgear, functional appliance caused a proclination on the lower anterior teeth. The upper anterior teeth were retroclined in both groups but more significantly in the functional appliance group. When two groups were compared, significant forward advancement of the pogonion was found in the functional group which revealed more horizontal forward growth of the mandible in the functional group than the cervical group.
Clinical trials comparing activator and headgear treatment have shown comparable effectiveness in the total result achieved, but the mechanism of correction is still uncertain. The aim of this retrospective study was to compare the dental and skeletal effects of the activator-type functional appliance and the cervical headgear in the treatment of skeletal Class II Division I growing patients. The sample consisted of 2 groups of Class II Div 1 patients. 11 patients (3 male, 8 female) were treated with an activator-type functional appliance, and 11 patients (7 male, 4 female) were treated with cervical headgear. Lateral cephalometric radiographs taken at the beginning of treatment and after Class II molar correction were selected from the archive-files of the Marmara University Faculty of Dentistry Department of Orthodontics and the Yeditepe University, Faculty of Dentistry Department of Orthodontics. The average age of the patients in the cervical HG group was 11,45 years and it was 11,18 for the patients in the functional appliance group. Since the x-rays evaluated in this study were taken by two different machines, during cephalometric analysis only angular measurements were used to exclude the magnification factor. Both groups were found to be successful in correction of Class II molar relationship to Class I. While the functional appliance had a restrictive effect on the maxilla and induced the forward growth of the mandible, the cervical headgear caused only restriction on the maxillary growth. Both appliances tend to rotate the palatal plane in clockwise direction and as sequence increased the maxillary height. Unlike the cervical headgear, functional appliance caused a proclination on the lower anterior teeth. The upper anterior teeth were retroclined in both groups but more significantly in the functional appliance group. When two groups were compared, significant forward advancement of the pogonion was found in the functional group which revealed more horizontal forward growth of the mandible in the functional group than the cervical group.