title: Long-term soft-tissue response to orthodontic treatment with early cervical headgear--a randomized study.
abstract: BACKGROUND
  The purpose of this longitudinal randomized investigation was to determine the long-term changes in the soft-tissue profile during orthodontic treatment when treatment is started with headgear (HG) in the early mixed dentition.
  
  
  METHODS
  The subjects were 68 children (28 girls, 40 boys; mean age, 7.6 years; SD, 0.3 years) with a Class II tendency in occlusion and moderate crowding. They were randomly divided into 2 groups. In the HG group, treatment began immediately. No other appliances were used during the first 2 years. In the control group, only minor interceptive procedures were performed during the first follow-up period of 2 years. During the 8-year follow-up, orthodontic treatment, if needed, comprised fixed appliances and possible extractions in both groups. Twenty linear and 5 angular soft-tissue measurements were registered from lateral cephalograms taken before treatment and after follow-up-periods of 2, 4, and 8 years.
  
  
  RESULTS
  The major findings were that, at the 8-year follow-up, the soft-tissue chin and the lower lip were significantly thicker, and the mentolabial sulcus was significantly deeper in the HG group than in the control group. In the control group, a larger variation in the upper lip position was found because of more extractions in this group.
  
  
  CONCLUSIONS
  Early HG treatment has only a minor effect on the soft-tissue profile. The main effects are on the thickness of the soft-tissue chin and the contour of the lower lip. The differences were not otherwise significant during the long-term follow-up.
authors.affiliation: Department of Orthodontics and Oral Development, Institute of Dentistry, University of Oulu, Oulu, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Virkkula
authors.forename: Tuomo
authors.initials: T
authors.lastname: Kantomaa
authors.forename: Johanna
authors.initials: J
authors.lastname: Julku
authors.forename: Pertti
authors.initials: P
authors.lastname: Pirttiniemi
mesh_terms: D002508:Cephalometry / Q000706:statistics & numerical data; D002648:Child; D002680:Chin / Q000033:anatomy & histology*; D003818:Dentition, Mixed; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000033:anatomy & histology*; D008137:Longitudinal Studies; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D009971:Orthodontics, Corrective / Q000295:instrumentation*