Effects of force magnitude on dental arches in cervical headgear therapy

Abstract

Aim: To study the influence of different force magnitudes on dental arches in cervical headgear (CHG) treatment.

Material and methods: In this controlled clinical trial, patients (n = 40) were treated with CHG with light (L, 300 g, n = 22) or heavy force (H, 500 g, n = 18) magnitude. Subjects were asked to use CHG for 10 hours a day for 10 months. The outer bow of the CHG facebow was raised 10-20 degrees and the inner bow expanded 3-4 mm. Adherence to instructions and force magnitude were monitored with an electronic module (Smartgear, Swissorthodontics, Switzerland). Impressions for study models were taken before (T1) and after (T2) treatment and the study models were scanned into digital form (3Shape, R700 Scanner, Denmark). Measurements were made using the digital models (Planmeca Romexis, Model analyser, Finland).

Results: During the treatment (T1-T2) the upper inter-canine distance increased by 2.83 mm (P = 0.000) and 2.60 mm (P = 0.000) in the L and H force magnitude groups, respectively. Upper inter-molar width increased by 3.16 mm (P = 0.000) and 2.50 mm (P = 0.000) in the L and H groups, respectively. Maxillary total arch perimeter increased by 6.39 mm (P = 0.001) and 6.68 mm (P = 0.001) in the L and H groups, respectively. In the amount of change over time, T1-T2, in the upper arch measurements, no significant difference was found between the groups. Lower inter-canine width increased by 0.94 mm (P = 0.005) and 1.16 mm (P = 0.000) in the L and H groups, respectively; no difference between the groups. Lower inter-molar distance increased by 2.17 mm (P = 0.000) and 1.11 mm (P = 0.008) in the L and H groups, respectively. At the end of the study, upper and lower inter-molar width was larger in the L group than in the H group (P = 0.039 and P = 0.022, respectively).

Conclusion: CHG therapy is an effective method for expanding and releasing moderate crowding of the upper dental arch. The lower arch spontaneously follows the upper arch in widening effects, and minor expansion can also be seen on the lower arch. In the L group, larger inter-molar width was achieved on the upper and lower arch; probably due to better adherence to instructions. Light force is recommended for use in CHG therapy.