{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:34:42Z","timestamp":1760189682956},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T00:00:00Z","timestamp":1560124800000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,15]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>The main aim of this study was to study the impact of different force magnitudes on effectiveness in cervical headgear (CHG) therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>Forty patients were treated with CHG with light (L; 300 g) or heavy (H; 500 g) force in this controlled clinical trial. Patients were asked to wear CHG for 10 hours\/day for 10 months. The inner bow of the CHG was expanded (3\u20134 mm) and the long outer bow bent (10\u201320 degree) upward in relation to the inner bow. Adherence to instructions and force magnitude in CHG use was monitored by electronic module (Smartgear, Swissorthodontics, Switzerland). Lateral cephalograms were taken before (T1) and after (T2) the treatment and studied with modified Pancherz analysis using a Planmeca Romexis Ceph module (Planmeca, Finland).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In both groups, skeletal and dental effects were seen. The only statistically significant difference in cephalometric analysis was the inclination of upper incisors at T1 (P = 0.010) and at T2 (P = 0.011). In both groups, a reduction in Sella-Nasion- point A (SNA) angle was found: L group T1 82.7degree (SD \u00b1 3.6degree), T2 82.0degree (SD \u00b1 3.5 degree) and H group T1 82.6 degree (SD \u00b1 4.7 degree), T2 81.5 degree (SD \u00b1 4.5 degree), but no statistically significant difference between the groups. Children in the L group used CHG statistically significantly more than those in the H group (10.0 \u00b1 1.5 hour, and 8.3 \u00b1 2.1 hour, respectively, P = 0.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Children with lower force CHG seem to adhere better to instructions for CHG use. After 10 months of use, no statistically significant differences were found in dental or skeletal outcome. However, in the H group, the outcome was achieved with less daily hours of use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjz022","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T11:20:16Z","timestamp":1554117616000},"page":"646-651","source":"Crossref","is-referenced-by-count":4,"title":["Impact of force magnitude on effectiveness in cervical headgear therapy: a cephalometric analysis"],"prefix":"10.1093","volume":"41","author":[{"given":"Tuula H","family":"Talvitie","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Unit, Tampere University Hospital, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Helminen","sequence":"additional","affiliation":[{"name":"Research, Development and Innovation Centre, Tampere University Hospital, Turku, Finland"},{"name":"Faculty of Social Sciences, Health Sciences, Tampere University Hospital, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Karsila","sequence":"additional","affiliation":[{"name":"Turku Municipal Health Care Services, Dental Teaching Unit, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reeta","family":"Varho","sequence":"additional","affiliation":[{"name":"Turku Municipal Health Care Services, Dental Teaching Unit, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Signorelli","sequence":"additional","affiliation":[{"name":"Clinic for Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pertti","family":"Pirttiniemi","sequence":"additional","affiliation":[{"name":"Department of Oral Development and Orthodontics, Research Unit of Oral Health Sciences"},{"name":"Medical Research Center, Oulu University Hospital, Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Peltom\u00e4ki","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Unit, Tampere University Hospital, Turku, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University"},{"name":"Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,4,24]]},"reference":[{"key":"2019111507001863800_CIT0001","first-page":"D 920","volume-title":"Delivery, Outcome, and Costs of Orthodontic Care in Finnish Health Centres","author":"Pietil\u00e4","year":"2010"},{"key":"2019111507001863800_CIT0002","doi-asserted-by":"crossref","first-page":"584","DOI":"10.2319\/041315-242.1","article-title":"Current trends in headgear use for the treatment of Class II malocclusions","volume":"86","author":"T\u00fcfek\u00e7i","year":"2016","journal-title":"The Angle Orthodontist,"},{"key":"2019111507001863800_CIT0003","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/0002-9416(74)90034-7","article-title":"The effect of force on craniofacial development","volume":"65","author":"Wieslander","year":"1974","journal-title":"American Journal of Orthodontics,"},{"key":"2019111507001863800_CIT0004","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0889-5406(05)81731-7","article-title":"Clinical versus quantitative assessment of headgear compliance","volume":"104","author":"Cureton","year":"1993","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2019111507001863800_CIT0005","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1067\/mod.2001.113407","article-title":"Changes in mandibular growth direction during and after cervical headgear treatment","volume":"119","author":"Kim","year":"2001","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2019111507001863800_CIT0006","first-page":"187","article-title":"Longitudinal study of anteroposterior and vertical maxillary changes in skeletal class II patients treated with Kloehn cervical headgear","volume":"73","author":"Lima Filho","year":"2003","journal-title":"The Angle Orthodontist,"},{"key":"2019111507001863800_CIT0007","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1093\/ejo\/26.1.59","article-title":"The effects of early headgear treatment on dental arches and craniofacial morphology: a report of a 2 year randomized study","volume":"26","author":"M\u00e4ntysaari","year":"2004","journal-title":"European Journal of Orthodontics,"},{"key":"2019111507001863800_CIT0008","doi-asserted-by":"crossref","first-page":"42","DOI":"10.2319\/121305-436R.1","article-title":"Effects of cervical headgear on overbite against the background of existing growth patterns. 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