Clinical Alteration of a Growing Face: A Cephalometric Comparison of Class II Patients Treated with Cervical Headgear, Frankel (FR-2) and Herbst Appliances

Weber URSI, James MCNAMARA JR., Décio Rodrigues MARTINS

This study investigated the treatment effects on the craniofacial growth of Class II patients of three therapies, cervical headgear, Frankel and Herbst. Serial cephalometric radiographs from 30 patients treated with cervical headgear, 35 with the Frankel appliance and 29 with the Herbst appliance were compared with serial radiographs of 29 untreated persons with Class II malocclusions. Treatment effects were identified through the use of 45 variables derived from conventional cephalometric analysis. The results in this study indicated that, in the pre-treatment phase, the 4 groups were well matched cephalometrically and thus amenable to direct comparisons. At the end of the experiment each appliance had provoked specific effects on the various craniofacial components. Maxillary growth was significantly restricted by cervical headgear, with less evident effects by the other two appliances. Mandibular growth and protrusion were significantly more evident in the groups treated with the functional appliances. The three appliances improved the maxillo-mandibular relationship, as a result of their specific effects on the maxillary and mandibular skeletal components. Facial growth direction was not effected by any of the therapies. Anterior and posterior total facial heights were increased in all treatment groups, while lower facial heights were more influenced by the Frankel and Herbst appliances. Greater maxillary dentoalveolar retractive effects were noted in the incisor region in the cervical headgear and Frankel groups, and in the molar region in the Herbst and cervical headgear groups. The mandibular dentoalveolar component showed more effect with the Herbst therapy, with mesial movement of incisors and molars.

Keywords: Growth craniofacial. Cephalometrics. Frankel appliance. Herbst. Class II malocclusion. Class II treatment.

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