BackgroundThe purpose of this study is to present the use of a modified Herbst appliance in association with temporary anchorage devices (TADs) in order to enhance the correction of skeletal class II malocclusions.MethodsTen consecutive adolescents scheduled for Herbst treatment were assigned to two treatment groups. Five cases were treated with a modified miniscrew-supported Herbst appliance (experimental group (EG)) and five cases with a conventional cast Herbst appliance (control group (CG)). In all cases, the Herbst was kept in place for 9 months and was followed by fixed appliances until class I relationships were achieved. The initial (T1) and final (T2) lower incisor inclination on lateral headfilms were analyzed for each case, and the mean increase for the five EG patients and the five CG patients were compared.ResultsThe mean increase in lower incisor inclination at the end of treatment was 1° (range 0° to 2°) for the EG and 7° (range 4° to 10°) for the CG.ConclusionsThe rational association of TADs with the Herbst appliance can optimize treatment efficiency and skeletal response by reducing the occurrence of excessive lower incisor proclination.
Les traitements orthodontiques qui ne font pas appel à la coopération des patients
connaissent un engouement croissant depuis plusieurs années. Contrairement aux appareils
amovibles, l’appareil de Herbst ne requière pas la participation des patients. Ce dernier
est largement utilisé comme un appareil fixe fonctionnel, capable de corriger de manière
prédictible les décalages squelettiques de classe II. Les appareils de propulsion qui
s’appuient sur les dents présentent l’inconvénient majeur de provoquer des déplacements
dentaires indésirables, comme la version corono-vestibulaire des incisives mandibulaires.
Ces compensations dento-alvéolaires peuvent, quand elles ne sont pas contrôlées,
compromettre le résultat final. Cet article décrit le traitement efficace de la classe II
squelettique de deux patients, conduit selon un protocole qui associe le port d’un
appareil de Herbst modifié et des mini-vis d’ancrage osseux temporaire (TSADs).
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