title: Facial profile changes in early Class II correction with cervical headgear.
abstract: OBJECTIVE
  To characterize the effects of early cervical headgear treatment on the facial profile of children in Class II division 1 malocclusion.
  
  
  METHODS
  Forty children aged 9.1 (7.2-11.5) years with Class II division 1 malocclusion were treated using a cervical headgear appliance. The headgear consisted of a long outer bow bent upward 15 degrees and a large expanded inner bow. Lateral cephalograms were taken before and after treatment, and the facial profile was estimated from the cephalograms. The results were compared to an age- and sex-matched normal cohort of 644 Finnish children.
  
  
  RESULTS
  Class I molar relationship was achieved in all treated children. The treatment time was 1.6 (0.3-3.1) years on average. Compared to the controls, the treatment restricted the forward growth of maxillary A-point, and the SNA angle decreased 1.4 degrees +/- 1.2 degrees per year (P < .00001). Decreased maxillary prognathism was associated with decreased facial convexity, g-sn-pg (P = .02), and the ANB (P < .00001) angles decreased compared to the controls. Upper lip protrusion (distance ls to sn-pg; P < .00001) was decreased, and the nasolabial angle (cm-sn-ls) widened despite the increased facial inclination of the upper incisors (P = .0005). The treatment significantly decreased the gap between the lips (P = .0009) in their relaxed position.
  
  
  CONCLUSIONS
  Cervical headgear treatment in Class II correction is associated with a decreased facial convexity caused by the restriction of forward growth of the maxillary A-point, while the rest of the facial profile, including the mandible, continue to grow forward at a normal rate.
authors.affiliation: Department of Pedodontics and Orthodontics, University of Helsinki, Helsinki, Finland. mirja.kirjavainen@fimnet.fi
authors.forename: Mirja
authors.initials: M
authors.lastname: Kirjavainen
authors.forename: Kirsti
authors.initials: K
authors.lastname: Hurmerinta
authors.forename: Turkka
authors.initials: T
authors.lastname: Kirjavainen
mesh_terms: D002508:Cephalometry; D002648:Child; D004812:Epidemiologic Methods; D004955:Esthetics, Dental; D005115:Extraoral Traction Appliances; D005145:Face / Q000033:anatomy & histology*; D005147:Facial Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D009971:Orthodontics, Corrective / Q000295:instrumentation* / Q000379:methods; D011859:Radiography; D012727:Sex Characteristics