Early and later timed cervical headgear treatment - a randomized controlled trial

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Remote access: https://oulu.zoom.us/j/322350478

Topic of the dissertation

Early and later timed cervical headgear treatment - a randomized controlled trial

Doctoral candidate

Licenciate of dentistry, specialist in orthodontics Johanna Julku

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research unit of Oral Health Sciences

Subject of study

Oral Development and Orthodontics


Professor David Rice, University of Helsinki


Professor Pertti Pirttiniemi, University of Oulu

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Cervical headgear is suitable for early treatment of Class II malocclusion

The occurrence of dental crowding or abnormal bite, where the lower tooth arch and often the entire lower jaw are located behind the upper dental arch (Class II malocclusion), is one of the most common causes of orthodontic treatment. Class II malocclusions occur in approximately 15–20% of the Nordic population and in cases requiring severe treatment, in about 5% of the population.

The purpose of this study was to investigate changes in dental and facial structures and pharyngeal airways in children with Class II malocclusion treated with cervical headgear when the timing of orthodontic treatment was changed. A further aim was to investigate the effect of gender on the treatment results. The results showed that timing of treatment and gender affected dental changes but not changes in facial bony structures. After cervical headgear treatment, the dental arches were longer and wider. The differences in dental arch widths were significant, especially in earlier treated boys.

This study supports previous studies that cervical headgear treatment controls upper jaw growth and improves inter-jaw relationship, while lower jaw growth follows a closing, forward oriented growth trend. This study did not demonstrate any adverse effects of cervical headgear therapy on the pharyngeal airway structures.

In Finland, the number of people having public orthodontic care has increased fourfold since the 1970s; depending on the municipality, 20–40% of children in certain age groups are undergoing public orthodontic care. Since orthodontic treatment is often long lasting and requires regular visits, the duration and timing of orthodontic treatment has great economic importance.

The timing of orthodontic treatment is a constant topic in orthodontic care. In particular, it has been debated whether early orthodontic treatment is justified for the treatment of Class II malocclusion. Headgear is one of the most commonly used orthodontic devices in Finland for early treatment of dental crowding and Class II malocclusion. There are only a few published longitudinal, controlled follow-up studies looking at the effect and timing of cervical headgear therapy in children with Class II malocclusion.

Based on the results, it was found that cervical headgear mainly has dental effects, having less effect on the structures of the jaws. The earlier treatment period proved to be more effective, particularly in terms of the dental changes in earlier treated boys. According to this study, cervical headgear therapy can be recommended as an early treatment method for Class II malocclusion. The timing of treatment is not so much determined by the age of the patient as by individual growth and development.
Last updated: 1.3.2023