Vaasa Social Services and Health Care Division, Dental Service, Vaasa, Finland.
Faculty of Health Sciences, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Eur J Orthod. 2022 Mar 30;44(2):146-154. doi: 10.1093/ejo/cjab051.
To study the influence of different force magnitudes on dental arches in cervical headgear (CHG) treatment.
In this controlled clinical trial, patients (n = 40) were treated with CHG with light (L, 300 g, n = 22) or heavy force (H, 500 g, n = 18) magnitude. Subjects were asked to use CHG for 10 hours a day for 10 months. The outer bow of the CHG facebow was raised 10-20 degrees and the inner bow expanded 3-4 mm. Adherence to instructions and force magnitude were monitored with an electronic module (Smartgear, Swissorthodontics, Switzerland). Impressions for study models were taken before (T1) and after (T2) treatment and the study models were scanned into digital form (3Shape, R700 Scanner, Denmark). Measurements were made using the digital models (Planmeca Romexis, Model analyser, Finland).
During the treatment (T1-T2) the upper inter-canine distance increased by 2.83 mm (P = 0.000) and 2.60 mm (P = 0.000) in the L and H force magnitude groups, respectively. Upper inter-molar width increased by 3.16 mm (P = 0.000) and 2.50 mm (P = 0.000) in the L and H groups, respectively. Maxillary total arch perimeter increased by 6.39 mm (P = 0.001) and 6.68 mm (P = 0.001) in the L and H groups, respectively. In the amount of change over time, T1-T2, in the upper arch measurements, no significant difference was found between the groups. Lower inter-canine width increased by 0.94 mm (P = 0.005) and 1.16 mm (P = 0.000) in the L and H groups, respectively; no difference between the groups. Lower inter-molar distance increased by 2.17 mm (P = 0.000) and 1.11 mm (P = 0.008) in the L and H groups, respectively. At the end of the study, upper and lower inter-molar width was larger in the L group than in the H group (P = 0.039 and P = 0.022, respectively).
CHG therapy is an effective method for expanding and releasing moderate crowding of the upper dental arch. The lower arch spontaneously follows the upper arch in widening effects, and minor expansion can also be seen on the lower arch. In the L group, larger inter-molar width was achieved on the upper and lower arch; probably due to better adherence to instructions. Light force is recommended for use in CHG therapy.
研究不同力值大小对颈头帽（CHG）治疗中牙弓的影响。
在这项对照临床试验中，40 名患者（n=40）接受 CHG 治疗，力值大小分别为轻（L，300g，n=22）或重（H，500g，n=18）。要求患者每天使用 CHG 10 小时，持续 10 个月。CHG 面弓的外弓抬高 10-20 度，内弓扩展 3-4 毫米。使用电子模块（Smartgear，Swissorthodontics，Switzerland）监测对指令的遵守情况和力值大小。在治疗前（T1）和治疗后（T2）取研究模型的印模，并将研究模型扫描成数字形式（3Shape，R700 Scanner，丹麦）。使用数字模型（Planmeca Romexis，Model analyser，芬兰）进行测量。
在治疗期间（T1-T2），L 组和 H 组的上中切牙间距分别增加了 2.83mm（P=0.000）和 2.60mm（P=0.000），上磨牙宽度分别增加了 3.16mm（P=0.000）和 2.50mm（P=0.000）。上颌总牙弓周长分别增加了 6.39mm（P=0.001）和 6.68mm（P=0.001）。在上颌弓测量的时间变化量（T1-T2）中，组间无显著差异。L 组和 H 组的下中切牙宽度分别增加了 0.94mm（P=0.005）和 1.16mm（P=0.000）；组间无差异。L 组和 H 组的下磨牙间距分别增加了 2.17mm（P=0.000）和 1.11mm（P=0.008）。研究结束时，L 组的上、下磨牙宽度均大于 H 组（P=0.039 和 P=0.022）。
CHG 治疗是一种有效扩展和释放上颌牙弓中度拥挤的方法。下牙弓会自动跟随上牙弓变宽，在下牙弓也可以看到轻微的扩展。在 L 组中，上颌和下颌牙弓的磨牙宽度更大；这可能是由于更好地遵守了指令。建议在 CHG 治疗中使用轻力。
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