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Related Experiment Videos

Long-term efficacy of reverse pull headgear therapy.

Andrew P Wells1, David M Sarver, William R Proffit

  • 1School of Dentistry, Department of Orthodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA.

The Angle Orthodontist
|November 9, 2006
PubMed
Summary

Long-term success with reverse pull headgear (RPHG) for Class III malocclusion is 70-75%, with relapse due to mandibular growth. Early treatment before age 10 does not guarantee better outcomes.

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Area of Science:

  • Orthodontics
  • Craniofacial Growth

Background:

  • Class III malocclusion is a common dental anomaly.
  • Early intervention with orthopedic devices like reverse pull headgear (RPHG) is often employed.
  • Long-term outcomes and predictors of failure for RPHG treatment require further investigation.

Purpose of the Study:

  • To evaluate long-term outcomes of reverse pull headgear (RPHG) treatment for Class III malocclusion.
  • To identify variables predicting long-term treatment failure.

Main Methods:

  • Cephalometric analysis of 41 children with Class III malocclusion treated with RPHG.
  • Radiographs assessed pre-treatment, post-treatment, 5 years post-treatment, and 10 years post-treatment (for 18 patients).
  • Success defined by positive overjet at longest recall; failure by negative overjet.

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Main Results:

  • 70-75% of patients maintained positive overjet long-term; 25-30% relapsed.
  • Predictors of relapse included a large mandible and vertical growth patterns leading to horizontal mandibular growth.
  • Downward-backward mandibular rotation during treatment correlated with failure.
  • Treatment initiated after age 10 was associated with decreased success rates.

Conclusions:

  • RPHG is effective for 70-75% of Class III malocclusions treated in early mixed dentition.
  • Relapse is primarily due to late, horizontally directed mandibular growth.
  • Treatment timing before age 10 is not a significant factor for long-term success.