University of Oulu

Johanna Julku, Kirsi Pirilä-Parkkinen, Pertti Pirttiniemi; Airway and hard tissue dimensions in children treated with early and later timed cervical headgear—a randomized controlled trial, European Journal of Orthodontics, Volume 40, Issue 3, 25 May 2018, Pages 285–295, https://doi.org/10.1093/ejo/cjx088

Airway and hard tissue dimensions in children treated with early and later timed cervical headgear : a randomized controlled trial

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Author: Julku, Johanna1,2,3; Pirilä-Parkkinen, Kirsi1; Pirttiniemi, Pertti1,2,3
Organizations: 1Oral and Maxillofacial Department, Oulu University Hospital
2Department of Oral Development and Orthodontics, Research Unit of Oral Health Sciences, University of Oulu
3MRC Oulu, Oulu University Hospital and University of Oulu
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe201901111956
Language: English
Published: Oxford University Press, 2018
Publish Date: 2018-12-08
Description:

Abstract

Background: A Kloehn-type cervical headgear (CH) aims to correct skeletal jaw discrepancy in Class II children. A few studies have reported CH treatment effects on airway dimensions, but none of them have been randomized according to timing.

Objectives: To evaluate related craniofacial structures and pharyngeal airway dimensions in children with a Class II occlusion treated with CH and randomized into early and late treatment groups.

Trial design: Randomized, parallel-group, prospective controlled trial.

Methods: The material comprised 67 seven-year-old children with a Class II occlusion. Sealed-envelope randomization in 1:1 ratio was used to divide the children into two equal groups. In the early group (EG, n = 33), CH treatment was started immediately or after eruption of the first maxillary molars. In the second, late group (LG, n = 34), the active CH treatment was started about one and half year later. The active CH treatment was continued in both groups until normal Class I occlusion on first molars was achieved. Cephalometric radiographs were taken from both groups at the beginning of follow-up (T0), at the beginning of CH treatment of the second group (T1), and at the end of CH treatment of the second group (T2). Changes in cephalometric measurements were used as primary outcomes. Blinding was applicable for outcome assessment.

Results: Fifty-six children completed the study. The posterior change in the position of the maxilla was significant for early treatment males at T0–T1 (SNA; P < 0.001, ANB; P = 0.009) and T0–T2 (SNA; P = 0.012). The palato-mandibular angle (PL-ML) decreased during T0–T1 in early treatment females (P = 0.018) and early treatment males (P = 0.037). The retroglossal airway increased (P = 0.010) in early treatment males at T0–T1. Highly significant positive correlations (P < 0.001) between skeletal and upper airway dimensions during early CH treatment were found in males. No harms were encountered.

Conclusions: Despite the effective CH treatment, no harmful upper airway changes were found.

Clinical registration: NCT02010346.

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Series: European journal of orthodontics
ISSN: 0141-5387
ISSN-E: 1460-2210
ISSN-L: 0141-5387
Volume: 40
Issue: 3
Pages: 285 - 295
DOI: 10.1093/ejo/cjx088
OADOI: https://oadoi.org/10.1093/ejo/cjx088
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Subjects:
Funding: Finnish Dental Society Apollonia.
Copyright information: © The Author(s) 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Orthodontics following peer review. The version of record Johanna Julku, Kirsi Pirilä-Parkkinen, Pertti Pirttiniemi; Airway and hard tissue dimensions in children treated with early and later timed cervical headgear—a randomized controlled trial, European Journal of Orthodontics, Volume 40, Issue 3, 25 May 2018, Pages 285–295 is available online at: https://doi.org/10.1093/ejo/cjx088.