Cervical headgear effectiveness in distalizing molars in relation to patient compliance.

Objectives: The purpose of this study was to measure the effectiveness of the cervical headgear for distalizing first permanent maxillary molars in relation to hours of use.

Methods: This was a one-centre, prospective, clinical study conducted at the Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece. Participants (N = 26; 17 females, 9 males) were patients with no history of orthodontic treatment, no syndromes or clefts, and Angle's Class II malocclusion, where the treatment plan included a cervical headgear. They were instructed to wear the appliance for at least 12 h per day. A TheraMon® microsensor was embedded in the headgear's strap to objectively measure wear-time. To measure tooth movement, pre- and post-treatment digital models were superimposed, using the palate as a reference area; translation and rotation were measured along three axes. Superimposition and movement measurements were made with the Viewbox 4 software.

Results: Average treatment time and headgear wear were 130 days and 55 days, respectively, i.e. 10.1 h/day. During this period, distal movement averaged 1.75 mm with high variability (min 0.2 mm, max 4.5 mm). Distal tipping and rotation had an average of approximately 5 °C. Cumulative headgear wear was significantly correlated with distal movement (r2 = 0.32, P < .002), distal tipping (r2 = 0.27, P < .01), and distal rotation around the long axis of the tooth (r2 = 0.20, P < .05).

Conclusion: Compliance is critical for having a successful clinical outcome. Distalization of the molar with a cervical headgear is correlated with the cumulative hours of appliance use, with hours per day being a weaker predictor.