The Role of the Headgear in Growth Modification

A review of the literature reveals that the use of a cervical facebow headgear can modify growth of the maxilla. Orthopedic forces that may be employed with headgears not only distalize the molars but may have a restraining effect on growth at the maxillary sutures. Short-term use of the headgear may not produce a sustained growth modification. There is also the “catch-up effect ” once the headgear has been discontinued. Our research has shown that the negative effects attributed to the cervical headgear, such as the downward tipping of the palatal, occlusal, and mandibular planes that may increase the facial convexity and lower anterior facial height, may be avoided or attenuated if the outer facebow is adjusted alternately up and down in relation to the occlusal plane during the treatment. In the treatment of Class II malocclusions, the use of cervical pull headgear deserves special consideration because when used appropriately, it is a reliable method of molar distalization and restraining of maxillary growth without collateral negative effects. However, patient cooperation is an important issue that requires both patient motivation and parental involvement.