{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:16:26Z","timestamp":1780481786335,"version":"3.54.1"},"reference-count":62,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives:<\/jats:title>\n The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = \u22121.925\u00b0,\n P<\/jats:italic>\n < .0001; FH-NA = \u22123.042\u00b0,\n P<\/jats:italic>\n < .0001; linear measurement A-point to Vertical Reference = \u22123.859 mm,\n P<\/jats:italic>\n < .0001) and reduction of the ANB angle (\u22121.767\u00b0,\n P<\/jats:italic>\n < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/091517-620.1","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T08:20:37Z","timestamp":1524039637000},"page":"530-537","source":"Crossref","is-referenced-by-count":14,"title":["Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions"],"prefix":"10.2319","volume":"88","author":[{"given":"E. Erin","family":"Bilbo","sequence":"first","affiliation":[{"name":"Private Practice, Birmingham, AL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Visiting Professor, Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin A.","family":"Southard","sequence":"additional","affiliation":[{"name":"Professor Emeritus, Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verrasathpurush","family":"Allareddy","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Orthodontics; and Collegiate Director of Clinical Research, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Holton","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyn M.","family":"Thames","sequence":"additional","affiliation":[{"name":"Private Practice, Auburn, AL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene S.","family":"Otsby","sequence":"additional","affiliation":[{"name":"Private Practice, Billings, MT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Southard","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-5-530-b01","series-title":"Am J Orthod","first-page":"294","article-title":"Physiologic recovery after cervical retraction therapy","volume":"66","author":"Wieslander \n L,","year":"1974","unstructured":"Wieslander \n L, \n \n \n Buck \n D. \n \n \n Physiologic recovery after cervical retraction therapy. Am J Orthod. 1974;66:294\u2013301."},{"key":"i0003-3219-88-5-530-b02","series-title":"Am J Orthod","first-page":"526","article-title":"Effects of cervical anchorage during and after treatment: an implant study","volume":"73","author":"Melsen \n B.","year":"1978","unstructured":"Melsen \n B. \n \n \n Effects of cervical anchorage during and after treatment: an implant study. Am J Orthod. 1978;73:526\u2013540."},{"key":"i0003-3219-88-5-530-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"374","article-title":"Distal molar movement with Kloehn headgear: is it stable?","volume":"123","author":"Melsen \n B,","year":"2003","unstructured":"Melsen \n B, \n \n \n Dalstra \n M. \n \n \n Distal molar movement with Kloehn headgear: is it stable?\n Am J Orthod Dentofacial Orthop. 2003;123:374\u2013378."},{"key":"i0003-3219-88-5-530-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"321","article-title":"Nonextraction orthodontic therapy: posttreatment dental and skeletal stability","volume":"92","author":"Glenn \n G,","year":"1987","unstructured":"Glenn \n G, \n \n \n Sinclair \n PM, \n \n \n Alexander \n RG. \n \n \n Nonextraction orthodontic therapy: posttreatment dental and skeletal stability. Am J Orthod Dentofacial Orthop. 1987;92:321\u2013328."},{"key":"i0003-3219-88-5-530-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"276","article-title":"Long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at end of active treatment","volume":"107","author":"Fidler \n BC,","year":"1995","unstructured":"Fidler \n BC, \n \n \n \u00c5rtun \n J, \n \n \n Joondeph \n RD, \n \n et al. \n Long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at end of active treatment. Am J Orthod Dentofacial Orthop. 1995;107:276\u2013285."},{"key":"i0003-3219-88-5-530-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"386","article-title":"Long-term stability of Class II, Division 1, nonextraction cervical face-bow therapy: II. Cephalometric analysis","volume":"109","author":"Elms \n TN,","year":"1996","unstructured":"Elms \n TN, \n \n \n Buschang \n PH, \n \n \n Alexander \n RG. \n \n \n Long-term stability of Class II, Division 1, nonextraction cervical face-bow therapy: II. Cephalometric analysis. Am J Orthod Dentofacial Orthop. 1996;109:386\u2013392."},{"key":"i0003-3219-88-5-530-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"83","article-title":"Mandibular changes in skeletal Class II patients treated with Kloehn cervical headgear","volume":"124","year":"2003","unstructured":"Lima Filho RMA, Lima AL, de Oliveira Ruellas AC. Mandibular changes in skeletal Class II patients treated with Kloehn cervical headgear. Am J Orthod Dentofacial Orthop. 2003;124:83\u201390."},{"key":"i0003-3219-88-5-530-b08","series-title":"Angle Orthod","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","year":"2003","unstructured":"Lima Filho RMA, Lima AL, de Oliveira Ruellas AC. Longitudinal study of anteroposterior and vertical maxillary changes in Skeletal Class II patients treated with Kloehn cervical headgear. Angle Orthod. 2003;73:187\u2013193."},{"key":"i0003-3219-88-5-530-b09","series-title":"Angle Orthod","first-page":"174","article-title":"Effects of orthodontic treatment on mandibular rotation and displacement in Angle Class II division 1 malocclusions","volume":"74","author":"Phan \n XL,","year":"2004","unstructured":"Phan \n XL, \n \n \n Schneider \n BJ, \n \n \n Sadowsky \n C, \n \n et al. \n Effects of orthodontic treatment on mandibular rotation and displacement in Angle Class II division 1 malocclusions. Angle Orthod. 2004;74:174\u2013183."},{"key":"i0003-3219-88-5-530-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"219","article-title":"Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis","volume":"127","author":"Ciger \n S,","year":"2005","unstructured":"Ciger \n S, \n \n \n Aksu \n M, \n \n \n Germec \n D. \n \n \n Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis. Am J Orthod Dentofacial Orthop. 2005;127:219\u2013223."},{"key":"i0003-3219-88-5-530-b11","series-title":"Angle Orthod","first-page":"857","article-title":"Treatment and posttreatment changes with combined headgear therapy","volume":"77","author":"Tortop \n T,","year":"2007","unstructured":"Tortop \n T, \n \n \n Yuksel \n S. \n \n \n Treatment and posttreatment changes with combined headgear therapy. Angle Orthod. 2007;77:857\u2013863."},{"key":"i0003-3219-88-5-530-b12","series-title":"Semin Orthod","first-page":"174","article-title":"An evidence-based comparison of headgear and functional appliance therapy for the correction of Class II malocclusions","volume":"19","author":"Southard \n TE,","year":"2013","unstructured":"Southard \n TE, \n \n \n Marshall \n SD, \n \n \n Allareddy \n V, \n \n et al. \n An evidence-based comparison of headgear and functional appliance therapy for the correction of Class II malocclusions. Semin Orthod. 2013;19:174\u2013195."},{"key":"i0003-3219-88-5-530-b13","series-title":"Am J Orthod","first-page":"446","article-title":"Cephalometric evaluation of treatment effect on Class II, division 1 malocclusions","volume":"53","author":"Jakobsson \n S.","year":"1967","unstructured":"Jakobsson \n S. \n \n \n Cephalometric evaluation of treatment effect on Class II, division 1 malocclusions. Am J Orthod. 1967;53:446\u2013457."},{"key":"i0003-3219-88-5-530-b14","series-title":"Am J Orthod Dentofac Orthop","first-page":"51","article-title":"Headgear versus function regulator in the early treatment of Class II, Division 1 malocclusion: A randomized clinical trial","volume":"113","author":"Ghafari \n J,","year":"1998","unstructured":"Ghafari \n J, \n \n \n Shofer \n F, \n \n \n Jacobsson-Hunt \n U, \n \n et al. \n Headgear versus function regulator in the early treatment of Class II, Division 1 malocclusion: A randomized clinical trial. Am J Orthod Dentofac Orthop. 1998;113:51\u201361."},{"key":"i0003-3219-88-5-530-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544","article-title":"de Mol van Otterloo JJ, Nanda R. Long term stability and prediction of soft tissue changes after LeFort I surgery","volume":"104","author":"Hack \n GA,","year":"1993","unstructured":"Hack \n GA, \n \n \n de Mol van Otterloo JJ, Nanda R. Long term stability and prediction of soft tissue changes after LeFort I surgery. Am J Orthod Dentofacial Orthop. 1993;104:544\u2013555."},{"key":"i0003-3219-88-5-530-b16","series-title":"Am J Anat","first-page":"157","article-title":"Individual growth in skeletal bigonial diameter during the childhood period from 5 to 11 years of age","volume":"99","author":"Newman, \n K. J.","year":"1956","unstructured":"Newman, \n K. J. \n and Meredith, H. V. \n Individual growth in skeletal bigonial diameter during the childhood period from 5 to 11 years of age. Am J Anat. 1956;99:157\u2013187."},{"key":"i0003-3219-88-5-530-b17","series-title":"Am J Ortho Dentofacial Orthop","first-page":"391","article-title":"The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial","volume":"111","author":"Tulloch \n C,","year":"1997","unstructured":"Tulloch \n C, \n \n \n Phillips \n C, \n \n \n Koch \n G, \n \n et al. \n The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial. Am J Ortho Dentofacial Orthop. 1997;111:391\u2013400."},{"key":"i0003-3219-88-5-530-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"657","article-title":"Outcomes in a 2-phase randomized clinical trial of early Class II treatment","volume":"125","author":"Tulloch \n C,","year":"2004","unstructured":"Tulloch \n C, \n \n \n Proffit \n W, \n \n \n Phillips \n C. \n \n \n Outcomes in a 2-phase randomized clinical trial of early Class II treatment. Am J Orthod Dentofacial Orthop. 2004;125:657\u2013667."},{"key":"i0003-3219-88-5-530-b19","series-title":"Am J Orthod Dentofacial Orthop","first-page":"40","article-title":"Anteroposterior skeletal and dental changes after early Class II treatment with Bionators and headgear","volume":"113","author":"Keeling \n S,","year":"1998","unstructured":"Keeling \n S, \n \n \n Wheeler \n T, \n \n \n King \n G, \n \n et al. \n Anteroposterior skeletal and dental changes after early Class II treatment with Bionators and headgear. Am J Orthod Dentofacial Orthop. 1998;113:40\u201350."},{"key":"i0003-3219-88-5-530-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"9","article-title":"Effectiveness of early treatment of Class II malocclusion","volume":"121","author":"Wheeler \n T,","year":"2002","unstructured":"Wheeler \n T, \n \n \n McGorray \n S, \n \n \n Dolce \n C, \n \n et al. \n Effectiveness of early treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop. 2002;121:9\u201317."},{"key":"i0003-3219-88-5-530-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"481","article-title":"Timing of Class II treatment: skeletal changes comparing 1-phase and 2-phase treatment","volume":"132","author":"Dolce \n C,","year":"2007","unstructured":"Dolce \n C, \n \n \n McGorray \n S, \n \n \n Brazeau \n L, \n \n et al. \n Timing of Class II treatment: skeletal changes comparing 1-phase and 2-phase treatment. Am J Orthod Dentofacial Orthop. 2007;132:481\u2013489."},{"key":"i0003-3219-88-5-530-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"191","article-title":"Treatment effects of headgear biteplane and Bionator appliances","volume":"132","author":"Almeida-Pedrin \n R,","year":"2007","unstructured":"Almeida-Pedrin \n R, \n \n \n Almeida \n M, \n \n \n Almeida \n R, \n \n et al. \n Treatment effects of headgear biteplane and Bionator appliances. Am J Orthod Dentofacial Orthop. 2007;132:191\u2013198."},{"key":"i0003-3219-88-5-530-b23","series-title":"Am J Orthod Dentofacial Orthop","first-page":"732","article-title":"Orthodontic treatment changes of chin position in Class II division 1 patients","volume":"130","author":"LaHaye \n MB,","year":"2006","unstructured":"LaHaye \n MB, \n \n \n Buschang \n PH, \n \n \n Alexander \n RG, \n \n \n Boley \n JC. \n \n \n Orthodontic treatment changes of chin position in Class II division 1 patients. Am J Orthod Dentofacial Orthop. 2006;130:732\u2013741."},{"key":"i0003-3219-88-5-530-b24","series-title":"Am J Orthod","first-page":"621","article-title":"A cephalometric evaluation of high-pull molar headgear and face\u2013bow neck strap therapy","volume":"74","author":"Brown \n P.","year":"1978","unstructured":"Brown \n P. \n \n \n A cephalometric evaluation of high-pull molar headgear and face\u2013bow neck strap therapy. Am J Orthod. 1978;74:621\u2013632."},{"key":"i0003-3219-88-5-530-b25","series-title":"Am J Orthod Dentofacial Orthop","first-page":"197","article-title":"Dental and orthopedic effects of high-pull headgear in treatment of Class II Division 1 malocclusion","volume":"102","author":"Firouz \n M,","year":"1992","unstructured":"Firouz \n M, \n \n \n Zernik \n J, \n \n \n Nanda \n R. \n \n \n Dental and orthopedic effects of high-pull headgear in treatment of Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop. 1992;102:197\u2013205."},{"key":"i0003-3219-88-5-530-b26","series-title":"Am J Orthod Dentofacial Orthop","first-page":"522","article-title":"Changes in mandibular growth direction during and after cervical headgear treatment","volume":"119","author":"Kim \n KR,","year":"2001","unstructured":"Kim \n KR, \n \n \n Muhl \n ZF. \n \n \n Changes in mandibular growth direction during and after cervical headgear treatment. Am J Orthod Dentofacial Orthop. 2001;119:522\u2013530."},{"key":"i0003-3219-88-5-530-b27","series-title":"Angle Orthod","first-page":"285","article-title":"Inhibition or stimulation of the vertical growth of the facial complex, its significance to treatment","volume":"37","author":"Creekmore \n T.","year":"1967","unstructured":"Creekmore \n T. \n \n \n Inhibition or stimulation of the vertical growth of the facial complex, its significance to treatment. Angle Orthod. 1967;37:285\u2013297."},{"key":"i0003-3219-88-5-530-b28","series-title":"Am J Orthod","first-page":"384","article-title":"Quantitative analysis of orthodontic and orthopedic effects of maxillary traction","volume":"84","author":"Baumrind \n S,","year":"1983","unstructured":"Baumrind \n S, \n \n \n Korn \n E, \n \n \n Isaacson \n R, \n \n et al. \n Quantitative analysis of orthodontic and orthopedic effects of maxillary traction. Am J Orthod. 1983;84:384\u2013398."},{"key":"i0003-3219-88-5-530-b29","series-title":"Am J Orthod","first-page":"32","article-title":"Mandibular plane changes during maxillary retraction","volume":"74","author":"Baumrind \n S,","year":"1978","unstructured":"Baumrind \n S, \n \n \n Mohhen \n R, \n \n \n West \n E, \n \n \n Miller \n D. \n \n \n Mandibular plane changes during maxillary retraction. Am J Orthod. 1978;74:32\u201340."},{"key":"i0003-3219-88-5-530-b30","series-title":"Am J Orthod Dentofacial Orthop","first-page":"501","article-title":"Vertical changes in high-angle Class II Division 1 patients treated with cervical or occipital pull headgear","volume":"102","author":"Burke \n M,","year":"1992","unstructured":"Burke \n M, \n \n \n Jacobson \n A. \n \n \n Vertical changes in high-angle Class II Division 1 patients treated with cervical or occipital pull headgear. Am J Orthod Dentofacial Orthop. 1992;102:501\u2013508."},{"key":"i0003-3219-88-5-530-b31","series-title":"Am J Orthod Dentofacial Orthop","first-page":"310","article-title":"The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation","volume":"126","author":"Haralabakis \n N,","year":"2004","unstructured":"Haralabakis \n N, \n \n \n Sifakakis \n IB, \n \n \n The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation. Am J Orthod Dentofacial Orthop. 2004;126:310\u2013317."},{"key":"i0003-3219-88-5-530-b01","series-title":"Am J Orthod","first-page":"294","article-title":"Physiologic recovery after cervical retraction therapy","volume":"66","author":"Wieslander \n L,","year":"1974","unstructured":"Wieslander \n L, \n \n \n Buck \n D. \n \n \n Physiologic recovery after cervical retraction therapy. Am J Orthod. 1974;66:294\u2013301."},{"key":"i0003-3219-88-5-530-b02","series-title":"Am J Orthod","first-page":"526","article-title":"Effects of cervical anchorage during and after treatment: an implant study","volume":"73","author":"Melsen \n B.","year":"1978","unstructured":"Melsen \n B. \n \n \n Effects of cervical anchorage during and after treatment: an implant study. Am J Orthod. 1978;73:526\u2013540."},{"key":"i0003-3219-88-5-530-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"374","article-title":"Distal molar movement with Kloehn headgear: is it stable?","volume":"123","author":"Melsen \n B,","year":"2003","unstructured":"Melsen \n B, \n \n \n Dalstra \n M. \n \n \n Distal molar movement with Kloehn headgear: is it stable?\n Am J Orthod Dentofacial Orthop. 2003;123:374\u2013378."},{"key":"i0003-3219-88-5-530-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"321","article-title":"Nonextraction orthodontic therapy: posttreatment dental and skeletal stability","volume":"92","author":"Glenn \n G,","year":"1987","unstructured":"Glenn \n G, \n \n \n Sinclair \n PM, \n \n \n Alexander \n RG. \n \n \n Nonextraction orthodontic therapy: posttreatment dental and skeletal stability. Am J Orthod Dentofacial Orthop. 1987;92:321\u2013328."},{"key":"i0003-3219-88-5-530-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"276","article-title":"Long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at end of active treatment","volume":"107","author":"Fidler \n BC,","year":"1995","unstructured":"Fidler \n BC, \n \n \n \u00c5rtun \n J, \n \n \n Joondeph \n RD, \n \n et al. \n Long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at end of active treatment. Am J Orthod Dentofacial Orthop. 1995;107:276\u2013285."},{"key":"i0003-3219-88-5-530-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"386","article-title":"Long-term stability of Class II, Division 1, nonextraction cervical face-bow therapy: II. Cephalometric analysis","volume":"109","author":"Elms \n TN,","year":"1996","unstructured":"Elms \n TN, \n \n \n Buschang \n PH, \n \n \n Alexander \n RG. \n \n \n Long-term stability of Class II, Division 1, nonextraction cervical face-bow therapy: II. Cephalometric analysis. Am J Orthod Dentofacial Orthop. 1996;109:386\u2013392."},{"key":"i0003-3219-88-5-530-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"83","article-title":"Mandibular changes in skeletal Class II patients treated with Kloehn cervical headgear","volume":"124","year":"2003","unstructured":"Lima Filho RMA, Lima AL, de Oliveira Ruellas AC. Mandibular changes in skeletal Class II patients treated with Kloehn cervical headgear. Am J Orthod Dentofacial Orthop. 2003;124:83\u201390."},{"key":"i0003-3219-88-5-530-b08","series-title":"Angle Orthod","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","year":"2003","unstructured":"Lima Filho RMA, Lima AL, de Oliveira Ruellas AC. Longitudinal study of anteroposterior and vertical maxillary changes in Skeletal Class II patients treated with Kloehn cervical headgear. Angle Orthod. 2003;73:187\u2013193."},{"key":"i0003-3219-88-5-530-b09","series-title":"Angle Orthod","first-page":"174","article-title":"Effects of orthodontic treatment on mandibular rotation and displacement in Angle Class II division 1 malocclusions","volume":"74","author":"Phan \n XL,","year":"2004","unstructured":"Phan \n XL, \n \n \n Schneider \n BJ, \n \n \n Sadowsky \n C, \n \n et al. \n Effects of orthodontic treatment on mandibular rotation and displacement in Angle Class II division 1 malocclusions. Angle Orthod. 2004;74:174\u2013183."},{"key":"i0003-3219-88-5-530-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"219","article-title":"Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis","volume":"127","author":"Ciger \n S,","year":"2005","unstructured":"Ciger \n S, \n \n \n Aksu \n M, \n \n \n Germec \n D. \n \n \n Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis. Am J Orthod Dentofacial Orthop. 2005;127:219\u2013223."},{"key":"i0003-3219-88-5-530-b11","series-title":"Angle Orthod","first-page":"857","article-title":"Treatment and posttreatment changes with combined headgear therapy","volume":"77","author":"Tortop \n T,","year":"2007","unstructured":"Tortop \n T, \n \n \n Yuksel \n S. \n \n \n Treatment and posttreatment changes with combined headgear therapy. Angle Orthod. 2007;77:857\u2013863."},{"key":"i0003-3219-88-5-530-b12","series-title":"Semin Orthod","first-page":"174","article-title":"An evidence-based comparison of headgear and functional appliance therapy for the correction of Class II malocclusions","volume":"19","author":"Southard \n TE,","year":"2013","unstructured":"Southard \n TE, \n \n \n Marshall \n SD, \n \n \n Allareddy \n V, \n \n et al. \n An evidence-based comparison of headgear and functional appliance therapy for the correction of Class II malocclusions. Semin Orthod. 2013;19:174\u2013195."},{"key":"i0003-3219-88-5-530-b13","series-title":"Am J Orthod","first-page":"446","article-title":"Cephalometric evaluation of treatment effect on Class II, division 1 malocclusions","volume":"53","author":"Jakobsson \n S.","year":"1967","unstructured":"Jakobsson \n S. \n \n \n Cephalometric evaluation of treatment effect on Class II, division 1 malocclusions. Am J Orthod. 1967;53:446\u2013457."},{"key":"i0003-3219-88-5-530-b14","series-title":"Am J Orthod Dentofac Orthop","first-page":"51","article-title":"Headgear versus function regulator in the early treatment of Class II, Division 1 malocclusion: A randomized clinical trial","volume":"113","author":"Ghafari \n J,","year":"1998","unstructured":"Ghafari \n J, \n \n \n Shofer \n F, \n \n \n Jacobsson-Hunt \n U, \n \n et al. \n Headgear versus function regulator in the early treatment of Class II, Division 1 malocclusion: A randomized clinical trial. Am J Orthod Dentofac Orthop. 1998;113:51\u201361."},{"key":"i0003-3219-88-5-530-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544","article-title":"de Mol van Otterloo JJ, Nanda R. Long term stability and prediction of soft tissue changes after LeFort I surgery","volume":"104","author":"Hack \n GA,","year":"1993","unstructured":"Hack \n GA, \n \n \n de Mol van Otterloo JJ, Nanda R. Long term stability and prediction of soft tissue changes after LeFort I surgery. Am J Orthod Dentofacial Orthop. 1993;104:544\u2013555."},{"key":"i0003-3219-88-5-530-b16","series-title":"Am J Anat","first-page":"157","article-title":"Individual growth in skeletal bigonial diameter during the childhood period from 5 to 11 years of age","volume":"99","author":"Newman, \n K. J.","year":"1956","unstructured":"Newman, \n K. J. \n and Meredith, H. V. \n Individual growth in skeletal bigonial diameter during the childhood period from 5 to 11 years of age. 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Am J Orthod Dentofacial Orthop. 2004;125:657\u2013667."},{"key":"i0003-3219-88-5-530-b19","series-title":"Am J Orthod Dentofacial Orthop","first-page":"40","article-title":"Anteroposterior skeletal and dental changes after early Class II treatment with Bionators and headgear","volume":"113","author":"Keeling \n S,","year":"1998","unstructured":"Keeling \n S, \n \n \n Wheeler \n T, \n \n \n King \n G, \n \n et al. \n Anteroposterior skeletal and dental changes after early Class II treatment with Bionators and headgear. Am J Orthod Dentofacial Orthop. 1998;113:40\u201350."},{"key":"i0003-3219-88-5-530-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"9","article-title":"Effectiveness of early treatment of Class II malocclusion","volume":"121","author":"Wheeler \n T,","year":"2002","unstructured":"Wheeler \n T, \n \n \n McGorray \n S, \n \n \n Dolce \n C, \n \n et al. \n Effectiveness of early treatment of Class II malocclusion. 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Am J Orthod. 1978;74:621\u2013632."},{"key":"i0003-3219-88-5-530-b25","series-title":"Am J Orthod Dentofacial Orthop","first-page":"197","article-title":"Dental and orthopedic effects of high-pull headgear in treatment of Class II Division 1 malocclusion","volume":"102","author":"Firouz \n M,","year":"1992","unstructured":"Firouz \n M, \n \n \n Zernik \n J, \n \n \n Nanda \n R. \n \n \n Dental and orthopedic effects of high-pull headgear in treatment of Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop. 1992;102:197\u2013205."},{"key":"i0003-3219-88-5-530-b26","series-title":"Am J Orthod Dentofacial Orthop","first-page":"522","article-title":"Changes in mandibular growth direction during and after cervical headgear treatment","volume":"119","author":"Kim \n KR,","year":"2001","unstructured":"Kim \n KR, \n \n \n Muhl \n ZF. \n \n \n Changes in mandibular growth direction during and after cervical headgear treatment. Am J Orthod Dentofacial Orthop. 2001;119:522\u2013530."},{"key":"i0003-3219-88-5-530-b27","series-title":"Angle Orthod","first-page":"285","article-title":"Inhibition or stimulation of the vertical growth of the facial complex, its significance to treatment","volume":"37","author":"Creekmore \n T.","year":"1967","unstructured":"Creekmore \n T. \n \n \n Inhibition or stimulation of the vertical growth of the facial complex, its significance to treatment. Angle Orthod. 1967;37:285\u2013297."},{"key":"i0003-3219-88-5-530-b28","series-title":"Am J Orthod","first-page":"384","article-title":"Quantitative analysis of orthodontic and orthopedic effects of maxillary traction","volume":"84","author":"Baumrind \n S,","year":"1983","unstructured":"Baumrind \n S, \n \n \n Korn \n E, \n \n \n Isaacson \n R, \n \n et al. \n Quantitative analysis of orthodontic and orthopedic effects of maxillary traction. Am J Orthod. 1983;84:384\u2013398."},{"key":"i0003-3219-88-5-530-b29","series-title":"Am J Orthod","first-page":"32","article-title":"Mandibular plane changes during maxillary retraction","volume":"74","author":"Baumrind \n S,","year":"1978","unstructured":"Baumrind \n S, \n \n \n Mohhen \n R, \n \n \n West \n E, \n \n \n Miller \n D. \n \n \n Mandibular plane changes during maxillary retraction. Am J Orthod. 1978;74:32\u201340."},{"key":"i0003-3219-88-5-530-b30","series-title":"Am J Orthod Dentofacial Orthop","first-page":"501","article-title":"Vertical changes in high-angle Class II Division 1 patients treated with cervical or occipital pull headgear","volume":"102","author":"Burke \n M,","year":"1992","unstructured":"Burke \n M, \n \n \n Jacobson \n A. \n \n \n Vertical changes in high-angle Class II Division 1 patients treated with cervical or occipital pull headgear. Am J Orthod Dentofacial Orthop. 1992;102:501\u2013508."},{"key":"i0003-3219-88-5-530-b31","series-title":"Am J Orthod Dentofacial Orthop","first-page":"310","article-title":"The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation","volume":"126","author":"Haralabakis \n N,","year":"2004","unstructured":"Haralabakis \n N, \n \n \n Sifakakis \n IB, \n \n \n The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation. 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