Comparison of the headgear activator and Herbst appliance--effects and post-treatment changes

The aim of this study was to evaluate the effects of the headgear activator (HGA) and Herbst appliance during active treatment and retention and at follow-up in children with a skeletal Class II malocclusion. The two groups comprised 16 consecutive male patients (mean age 11.6 +/- 1.42 years) treated with a HGA and 16 male patients (mean age 12.6 +/- 1.13 years) treated with a Herbst appliance and Andresen activator (HAA) sampled from a larger pool using similar selection criteria. Growth data were obtained for the two groups. Lateral cephalograms taken at the start, after 6 months of treatment, after 12 months of active treatment or 6 months of retention, and at the 24-month follow-up were analysed. The total changes over the whole observation period (T0-T3) did not differ significantly between the groups; there was, however, a statistically significant increase in jaw prognathism (P < 0.05) and improvement of the molar relationship (P < 0.05) in the HAA group as compared with the HGA group. During the initial treatment phase (T0-T1), the overall treatment effects were statistically more pronounced in the HAA group than in the HGA group. Despite significant differences in treatment effects and changes between the two devices, there were no significant overall changes at follow-up except for the prognathism, i.e. maxillary prognathism decreased with treatment with the HGA while mandibulars prognathism continued to increase with HAA treatment.