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The effects of headgear treatment timing on costs and orthodontic outcome: a follow-up study
Matti Hannula1, Mimmi Tolvanen2, Pertti Pirttiniemi3
1Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland. matti.hannula@oulu.fi.
Objective:
To analyze the effects of cervical headgear (CHG) timing on costs and orthodontic outcome.
Material And Methods:
Sixty-seven participants with Class II malocclusion were randomized into two groups. In the early group (EG, n = 33), CHG treatment began after the eruption of first upper molars. In the later-timed group (LG, n = 34), CHG treatment began nearly 2 years later. Orthodontic outcome was evaluated when CHG ended and at the end of follow-up using the Peer Assessment Rating (PAR) index and Little's Irregularity Index (LII). Costs were calculated using medical records, estimated chairside times and average personnel and material costs.
Results:
The mean total costs including personnel and material costs during the follow-up were higher in the EG (€416) compared with the LG (€364) (p = 0.043). No statistically significant differences between the groups were found in the PAR and in the LII scores at the end of follow-up. The number of visits during CHG treatment was higher in the EG (13.3) compared with the LG (10.4) (p = 0.01).
Conclusions:
Earlier initiation of CHG treatment increased the personnel and material costs, number of appointments, and chairside time. Based on the PAR and in the LII scores, the orthodontic outcome of CHG treatment was equal regardless of the timing of the treatment. If orthodontic treatment during mixed-dentition stage is considered, it would be justified from an economic perspective to favor treatment during late mixed-dentition.
