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Modified Teuscher-type activator combined with high-pull headgear for Class II Division 1 correction: a retrospective controlled study

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Abstract

Objective: To evaluate skeletal and dentoalveolar changes induced by a modified Teuscher-type activator combined with high-pull headgear in growing patients with Class II Division 1 malocclusion due to mandibular retrusion.

Methods: This retrospective controlled observational study included 72 growing subjects with skeletal Class II malocclusion. Thirty-six consecutive patients (TG; 20 females, 16 males; mean age 10.8 ± 1.1 years) were treated with a modified Teuscher-type activator combined with high-pull headgear. Thirty-six untreated subjects (CG; 19 females, 17 males; mean age 10.9 ± 1.0 years) were selected from the Bolton-Brush Growth Study database and matched for age, sex, and baseline malocclusion severity. Lateral cephalograms were obtained at baseline (T0) and after treatment/observation (T1). Skeletal and dentoalveolar changes were compared within and between groups.

Results: The treated group showed significant improvements in sagittal skeletal relationships compared with controls, with reductions in ANB angle and Wits appraisal (p < 0.001). Mandibular advancement was significantly greater in TG, with increased SNB and Co-Gn (p < 0.01), while maxillary sagittal progression was restrained (p < 0.05). Overjet and molar relationship improved significantly in TG (p < 0.001). Vertical skeletal control was also observed.

Conclusion: The modified Teuscher-type activator combined with high-pull headgear is an effective interceptive approach for Class II Division 1 malocclusion, producing favorable skeletal and dentoalveolar changes during growth.

 

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Authors

Eda Fani - Department of Life, Health and Environmental Sciences, Postgraduate School of Orthodontics, University of L’Aquila, L’Aquila, Italy

Martina Ferrillo - Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy

Francesco Paolo De Luca - Private practice, Palermo, Italy

Alfredo De Rosa - Department of Life Science, Health and Health Professions, Link Campus University, Rome, Italy

How to Cite
Fani, E., Ferrillo, M., De Luca, F. P. ., & De Rosa, A. (2026). Modified Teuscher-type activator combined with high-pull headgear for Class II Division 1 correction: a retrospective controlled study. Annali Di Stomatologia, 17(2), 502–506. https://doi.org/10.59987/ads/2026.2.502-506

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