Mechanisms of Class II correction induced by the crown Herbst appliance as a single-phase Class II therapy: 1 year follow-up

Abstract

BackgroundThe objective of this study is to evaluate the skeletal and dentoalveolar effects of the crown Herbst appliance used alone for a single phase of therapy followed by a 1-year observation period.MethodsForty patients (mean age 13.6 ± 1.3 years) with a stable Class I occlusion 1 year following the treatment with the crown Herbst appliance were selected from a prospective sample of 180 consecutively treated Class II patients. No other appliances were used during treatment or during the follow-up period. The dentoskeletal changes were compared with a matched sample of untreated Class II subjects (mean age 13.9 ± 1.6 years). Lateral cephalograms were taken before treatment, after Herbst treatment (1 year), and after 1-year follow-up. Overcorrection was avoided intentionally.ResultsTreatment produced an increase in mandibular length, a decrease in ANB angle, and a restriction in the vertical growth of posterior maxilla. The maxillary molars moved backward and tipped distally. The lower incisors proclined markedly, and the upper incisors became retroclined. During the follow-up period, the changes primarily were dentoalveolar in nature, with marked rebound of the upper molars and lower incisors, resulting in some increases in overbite and overjet.ConclusionsThe occlusal correction of Class II malocclusion observed 1 year after the crown Herbst appliance as a single-phase therapy was achieved primary due to the dentoalveolar changes and only limited skeletal change occurred.

Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study

“…In recent years, several techniques have been developed to reduce the dependence on patient compliance, such as intraoral appliances with and without skeletal anchorage. However, even these devices can produce undesirable tipping of the maxillary molars and/or loss of anterior anchorage during distalization [ 3 – 9 ]. In the last decades, increasing numbers of adult patients have sought orthodontic treatment and expressed a desire for esthetic and comfortable alternatives to conventional fixed appliances [ 10 , 11 ].…”

Optimization of Class II Malocclusion Treatments Using the Forsus™ Fatigue Resistance Device and Its Post-Treatment Effect in Adult Patients: A Case Report

“…Other functional appliances, such as the Herbst and the Jasper-jumper, provide, in a long-term run, the same dentoskeletal results as the hybrid appliances [8,11,12,18,19,[21][22][23]25]. However, the Herbst appliance, because it is stiff and restricts mandibular move, it is considered extremely uncomfortable to adult patients, in addition to presenting high breakage levels and complex installation [10,22,26]. The semi-rigid devices, as the Jasper-Jumper, although it allows greater freedom to the functional movements, its flexibility increases the breakage risks [10,11,31].…”

“…The Forsus hybrid functional appliance is not as stiff as the orthopedic devices such as the Herbst [10,22,26], the APM [27,28] and the Mara [29,30], furthermore, it is not as fragile as the "Jasper Jumper" [10,11,31]. It is a comfortable device [7], as it does not completely limit the mandible movement and, in the current version, it shows a very low breakage rate [10,14,[32][33][34].…”

Comparison of Complications in Removable Mandibular Acrylic Splint and Cantilever Herbst for Management of Class II Malocclusion: A Retrospective Study

“…A direct relationship existed between the amount of bite jumping at the start of treatment and the treatment effects on the occlusion and on mandibular growth. 9,10 In this study, we included 142 patients who visited from the year 2010 to 2015 for the treatment of Class II malocclusion. Out of all, 72 patients (40 males and 32 females) were treated with the Herbst appliance with stainless steel crowns on the maxillary first molars and RMS (group I).…”