Estudo comparativo de complicações durante o uso do aparelho de Herbst com cantiléver e com splint inferior de acrílico removível

Moro, Alexandre; Janson, Guilherme; Moresca, Ricardo; Freitas, Marcos Roberto de; Henriques, José Fernando Castanha

doi:10.1590/s2176-94512011000100005

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Similar percentages of complications were also reported by several other investigations regarding the robustness of Herbst appliances: Moro et al reported a complication-free proportion of 33 % of subjects treated with a cantilever-bite-jumper Herbst appliance, and 14 % of Herbst appliances supported by a mandibular splint [13]. Latkauskiene et al reported a total of 46 Herbst appliance fractures for a sample of 175 subjects (26.3 %) undergoing fixed functional pre-treatment prior to initiation of multi-bracket treatment in some cases [24].…”

Section: Discussionsupporting

confidence: 79%

“…Hägg et al reported a proportion of 14 % of complication free instances for the cast Herbst appliance and 21 % for the band-supported Herbst [12]. Accordingly, the mean complication rate per case or individual treatment was reported, respectively, to be 1.1 or 2.5 by Moro et al, and 3.7 or 2.9 by Hägg et al [12, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…Equivalently, severe complications in comparison studies included e.g., crown/splint/trans-palatal arch-failure or –fractures, or telescope rod distortions. It should be borne in mind that the appliances compared here (and also compared in some of those studies) serve the same purpose, but are markedly different in design of their componentsVestibular appliance + HerbstLingual appliance + HerbstAppliance specificationsUpper/lower cast-splintUpper/lower cast-splint(A) Upper steel crowns (1 st molars), lower removable acrylic splint (B) Upper/Lower steel crowns (1 st molars)(A) Upper steel crowns (1 st molars), lower removable acrylic splint (B) Upper/Lower steel crowns (1 st molars)Upper/lower fully customised Incognito Herbst/bracket systemUpper/lower fully customised WIN Herbst/bracket systemMode of appliance activationNot reported in detailNot reported in detailNot reported in detailBite-jumpingStep-wiseStep-wiseNumber of patients (n)28316421595735Frequency of severe complications (n)94755772191598Proportion of subjects with severe complications (%)82.163.376.244.778.917.1Duration of Herbst treatment (months)6-771212126Cumulative treatment time (months)1892.2125041.908684222Mean interval without severe complications (months)2.02.97.68.74.327.8ReferenceHägg et al 2002 [12]Sanden et al 2004 [14]Moro et al 2011 [13]Silva et al 2014 [16]O’Keefe 2013 [21]This study…”

Section: Discussionmentioning

confidence: 99%

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Clinical complications during treatment with a modified Herbst appliance in combination with a lingual appliance

Wiechmann

Vu²,

Schwestka-Polly

et al. 2015

Head Face Med

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ObjectiveTo assess the types and frequencies of clinical complications experienced when using a modified lingual Herbst appliance and to compare these with those associated with conventional Herbst appliances reported in the literature.MethodsTreatment records for 35 consecutive subjects treated during the observation period from October 2013 to August 2014 who received a combination of a lingual appliance and a modified Herbst appliance (WIN, DW LingualSystems) were assessed for complications linked to Herbst treatment phase. Complications were analyzed descriptively, and complication-free intervals were calculated using Kaplan-Meier plots. To enable a comparison with data reported in the literature, the cumulative treatment time for all subjects was divided by the total number of complications.Results71.4 % of Herbst treatments were free from complications (n = 25). Complications were seen on 13 occasions (8 instances of Herbst attachment loosening, 5 L-Pin fractures). Most of these complications could be fixed chair side utilizing simple clinical measures. Considering all complications as identical statistical events, the percentage of treatments free from complications would be 88 % for 100 days, 70 % for 200 days and 56.8 % for 300 days. For severe complications, the averaged complication-free treatment interval was found to be 27.8 months.ConclusionIn terms of clinical sturdiness, and taking into consideration the step-wise mode of activation used here as well as the differences in the design of the various Herbst appliances, the WIN-Herbst appliance was found to be superior to comparable vestibular Herbst appliances, as well as the banded Herbst appliance belonging to the preceding generation of customized lingual systems. Success in treatment of non-compliant Angle Class II correction is considered to have better predictability using the modified anchorage strategy of the WIN-Herbst appliance.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical complications during treatment with a modified Herbst appliance in combination with a lingual appliance

Wiechmann

Vu²,

Schwestka-Polly

et al. 2015

Head Face Med

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Treatment effects of mandibular anterior position training versus a fixed Class II corrector in growing patients with skeletal Class II malocclusion

Kamoltham

Charoemratrote²

2018

Orthodontic Waves

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Additional appointments and discomfort associated with compliance-free fixed Class II corrector treatment: a systematic review

Phuong

Fagundes

Abtahi

et al. 2018

European Journal of Orthodontics

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Summary Objective A critical analysis of the literature to determine the prevalence and type of emergency/additional appointments, and discomfort levels associated with fixed Class II correctors. Methods Studies examining patient’s sources of discomfort or emergency appointments associated with compliance-free Class II correctors were included. Comprehensive searches up to July 2018 were conducted using the following databases: MEDLINE (OvidSP), PubMed, Web of Science, and Embase. A partial grey literature search was taken using Google Scholar and OpenGrey. Two reviewers independently performed the selection process and risk of bias assessment. The Newcastle-Ottawa Scale for cross-sectional studies were used. A summary of the overall strength of evidence was presented using ‘Grading of Recommendations, Assessment, Development and Evaluation’ (GRADE) tool. Included studies were evaluated according to their design, study quality, consistency, and directness. Results The selected studies were published between 2001 and 2018, and the number of patients per studied group ranged from 8 to 182. One thousand five hundred forty-two patients were evaluated in total. The patients’ mean age at start of treatment ranged from 10 to 16.9 years and the fixed Class II corrector treatment duration ranged from 4 to 12 months. The included studies in this systematic review were too clinically heterogeneous (different appliances, different data recollection processes) to justify a meta-analysis. Limitations This review was not previously registered. A low level of evidence was observed among the two randomized trials, the 10 cohorts and three cross-sectional studies identified. Conclusions The main source of discomfort from Forsus-type appliances appears to be soreness in the cheeks (low level of evidence with a weak recommendation strength). Most evaluated patients treated with a Herbst appliance, regardless of design, will experience complications (fractures and/or dislodging) requiring emergency appointments (low level of evidence with a weak recommendation strength). Registration The review protocol was not registered.

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Estudo comparativo de complicações durante o uso do aparelho de Herbst com cantiléver e com splint inferior de acrílico removível

Cited by 8 publications

References 7 publications

Clinical complications during treatment with a modified Herbst appliance in combination with a lingual appliance

Clinical complications during treatment with a modified Herbst appliance in combination with a lingual appliance

Treatment effects of mandibular anterior position training versus a fixed Class II corrector in growing patients with skeletal Class II malocclusion

Additional appointments and discomfort associated with compliance-free fixed Class II corrector treatment: a systematic review

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