Jacob Helder B, Buschang Peter H, dos Santos-Pinto Ary
Texas A&M Health Science Center, TX, USA.
Dental Press J Orthod. 2013 Mar 15;18(2):21.e1-7. doi: 10.1590/s2176-94512013000200009.
To systematically review the scientific evidence regarding the effectiveness of high-pull headgear in growing Class II subjects.
A literature survey was performed by electronic database search. The survey covered the period from January 1966 to December 2008 and used Medical Subject Headings (MeSH). Articles were initially selected based on their titles and abstracts; the full articles were then retrieved. The inclusion criteria included growing subjects with 8 to 15 years of age, Class II malocclusion treatment with high-pull headgear, and a control group with Class II malocclusion. References from selected articles were hand-searched for additional publications. Selected studies were evaluated methodologically.
Four articles were selected; none were randomized controlled trials. All of the articles clearly formulated their objectives and used appropriate measures. The studies showed that high-pull headgear treatment improves skeletal and dental relationship, distal displacement of the maxilla, vertical eruption control and upper molars distalization. One of the studies showed a slight clockwise rotation of the palatal plane; the others showed no significant treatment effect. The mandible was not affected by the treatment.
While there is still a lack of strong evidence demonstrating the effects of high-pull headgear with a splint, other studies indicate that the anteroposterior relations improve due to distalization of the maxilla and upper molars, with little or no treatment effects in the mandible. Greater attention to the design should be given to improve the quality of such trials.
系统评价有关高位牵引头帽在生长发育期Ⅱ类错颌患者中疗效的科学证据。
通过电子数据库检索进行文献调查。调查涵盖1966年1月至2008年12月期间，并使用医学主题词（MeSH）。文章最初根据标题和摘要进行筛选；然后检索全文。纳入标准包括年龄在8至15岁的生长发育期患者、使用高位牵引头帽治疗Ⅱ类错颌以及一个Ⅱ类错颌对照组。对所选文章的参考文献进行手工检索以获取其他出版物。对所选研究进行方法学评估。
选择了4篇文章；均非随机对照试验。所有文章均明确阐述了其目的并采用了适当的测量方法。研究表明，高位牵引头帽治疗可改善骨骼和牙齿关系、上颌远中移位、垂直萌出控制和上颌磨牙远中移动。其中一项研究显示腭平面有轻微顺时针旋转；其他研究未显示出显著的治疗效果。下颌未受该治疗影响。
虽然仍缺乏有力证据证明带夹板的高位牵引头帽的效果，但其他研究表明，由于上颌和上颌磨牙的远中移动，前后关系得到改善，而下颌几乎没有或没有治疗效果。应更加关注设计以提高此类试验的质量。
