Dental and skeletal changes in patients with mandibular retrognathism following treatment with Herbst and pre-adjusted fixed appliance

Abstract

ObjectiveTo assess the dentoskeletal changes observed in treatment of Class II, division 1 malocclusion patients with mandibular retrognathism. Treatment was performed with the Herbst orthopedic appliance during 13 months (phase I) and pre-adjusted orthodontic fixed appliance (phase II). MethodsLateral cephalograms of 17 adolescents were taken in phase I onset (T1) and completion (T2); in the first thirteen months of phase II (T3) and in phase II completion (T4). Differences among the cephalometric variables were statistically analyzed (Bonferroni variance and multiple comparisons). ResultsFrom T1 to T4, 42% of overall maxillary growth was observed between T1 and T2 (P < 0.01), 40.3% between T2 and T3 (P < 0.05) and 17.7% between T3 and T4 (n.s.). As for overall mandibular movement, 48.2% was observed between T1 and T2 (P < 0.001) and 51.8% between T2 and T4 (P < 0.01) of which 15.1% was observed between T2 and T3 (n.s.) and 36.7% between T3 and T4 (P < 0.01). Class II molar relationship and overjet were properly corrected. The occlusal plane which rotated clockwise between T1 and T2, returned to its initial position between T2 and T3 remaining stable until T4. The mandibular plane inclination did not change at any time during treatment. ConclusionMandibular growth was significantly greater in comparison to maxillary, allowing sagittal maxillomandibular adjustment. The dentoalveolar changes (upper molar) that overcorrected the malocclusion in phase I, partially recurred in phase II, but did not hinder correction of the malocclusion. Facial type was preserved.

Evaluation of the stability of treatment with Herbst appliance associated with Hyrax expander and fixed orthodontics through counterpart analysis: A longitudinal follow‐up study

“…In T3 (T3‐T2), the inclination remained stable, while it tended to decrease in T4 (T4‐T3), as stated in a previous study 8 (Table 2). The dentoalveolar effects observed from the compensation of the upper and lower incisors are striking in the correction of Class II malocclusions using the Herbst appliance and fixed orthodontics 11,13 …”

“…The effectiveness of the Herbst appliance has been demonstrated, 6 and several studies have shown the skeletal and dental effects of treatment 7–14 …”

“…4,5 The effectiveness of the Herbst appliance has been demonstrated, 6 and several studies have shown the skeletal and dental effects of treatment. [7][8][9][10][11][12][13][14] Regarding facial changes, a study 15 evaluated the effects of Herbst treatment on hard and soft facial tissue using lateral cephalometric radiography. The immediate treatment effects reduced the convexity of the soft and hard-tissue profiles and lip retraction.…”

Evaluation of the nasal shape after orthognathic surgery

“…16 A carpal radiography can be used for this type of diagnosis. The patient in this study, a 14-year-old female, underwent surgery after being assessed by an endocrinologist, when her wrist radiographs were reviewed, upon which it was observed that she was already in the final stage of growth.…”

“…The establishment of the developmental stage and bone growth is of utmost importance for the correct diagnosis, planning, and treatment of individuals, particularly those who are at the pubertal growth stage. 16 A carpal radiography can be used for this type of diagnosis. The patient in this study, a 14-year-old female, underwent surgery after being assessed by an endocrinologist, when her wrist radiographs were reviewed, upon which it was observed that she was already in the final stage of growth.…”