Activator headgear therapy.

A method of treatment is described using an activator and cervical headgear simultaneously to correct malocclusions of the Class II, Division 1 type. The case reports of ten treated patients are used to demonstrate the effects of the application of this technique. Changes in the dentition and facial skeleton were analyzed and the significance of the different responses to the application of the same appliances assessed. The hypothesis proposing that a simultaneous application of both appliances may result in a number of desirable effects greater than that induced by each individual appliance is examined. The hypothetical basis for the application of this technique is partially substantiated by the clinical observations. Within a period of about 1 year, correction of the Class II molar occlusion to a Class I molar occlusion is obtained, with a simultaneous reduction of overbite and overjet. Skeletal changes were found to be variable and related to facial type and the rate of facial growth. Brachyfacial and mesofacial types responded most favorably to treatment. The most favorable effects were observed when there was a large quantitative mandibular growth and brachyfacial or mesofacial growth pattern. In dolichofacial types with a slow mandibular growth rate, mandibular rotation was found to be clockwise; cervical traction appears contraindicated, and a combination of activator with occipital medium to high pull is considered more appropriate.