Cephalometric Study of the Effect of “Maxillary Splint with High Pull Headgear” for the Treatment of Class II Division 1 Malocclusion – A 12–18 Months Retrospective Matched-Control Study

Divya Siddalingappa,1,* Divya Pai,1,* Chetan Kumar Chiniwalar,2,* Kalyana C Pentapati,3 Arun S Urala1 1Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India; 2Vajra Multi Speciality Dental Center, Gangavathi, Karnataka, 583227, India; 3Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India*These authors contributed equally to this workCorrespondence: Arun S Urala, Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India, Email arun.urala@manipal.edu Divya Pai, Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India, Email pai.divya@manipal.eduPurpose: To compare the effect of maxillary splint high pull head gear (MSHPH) on dentoskeletal structures in growing Class II division 1 patients with a matched control group.Methods: The treatment group (MSHPH) comprised 20 patients who were evaluated at two stages: pretreatment (T1) and post orthopaedic (T2). The control group consisted of 20 untreated class II patients under observation. Intra-group comparisons were done with paired t test and the inter-group comparisons were analyzed with “Mann–Whitney U-test”.Results: Intra-group comparisons in the treated group showed significant decrease in the mean SNA, ANB, N perpendicular to Point A, Point A vertical, PNS vertical, U1 – NA (angular), U1 – SN, U1 – NA (linear), U1 – NF, PtV – U6, overjet and overbite at T2 when compared to T1. However, there was a significant increase in the mean SNB, N-Pog, EMnL, LAFH, at T2. The control group showed significant increase in the mean SNA, ANB, N perpendicular to Pogonion, Effective MxL, Effective MnL, LAFH, Point A vertical, ANS vertical, PNS vertical, U1 – NA (angular), U1 – SN, U1 – NA (linear), U1 – NF, PtV – U6, and overjet at T2 when compared to T1. Inter-group comparisons (T2-T1) showed significantly higher mean in treated group for SNA, SNB, ANB, N perpendicular to Point A, N perpendicular to Pogonion, Effective MnL, U1 – NA (angular), U1 – SN, U1 – NA (linear), U1 – NF, PtV – U6, overjet, overbite, S line Upper Lip and S line to Lower Lil. However, significantly lower values were seen in treated group for Effective MxL, LAFH, Point A vertical, ANS vertical, and PNS vertical.Conclusion: MSHPH held the maxilla without changes in the palatal plane. Thus, normal skeletal relationships resulted from inhibiting maxillary growth and preserving natural mandibular development in the treatment group.Keywords: dental, malocclusion, maxillary traction splint, skeletal change, maxillary prognathism, SDG 3, SDG 4