Class II malocclusion treatment with the Herbst appliance in patients after the growth peak

Alvares, José Carlos de Castro; Cançado, Rodrigo Hermont; Valarelli, Fabrício Pinelli; Freitas, Karina Maria Salvatore de; Angheben, Christian Zamberlan

doi:10.1590/s2176-94512013000500008

Cited by 9 publications

(8 citation statements)

References 17 publications

(31 reference statements)

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“…The treatment time was 2.79 (IQR=1.51) years for adults and 3.2 (IQR=1.5) and 4.1 (IQR=0.8) years for adolescents and children in mixed dentition, respectively. Treatment time seems shorter than the 48 months of treatment previously reported for adults treated with MPA (8), but greater than the 30 months described for adolescents treated with the Herbst appliance combined to fixed orthodontic appliances (23) or the 32 months from a pooled sample of children and adolescents treated with MPA associated to fixed orthodontic appliance (24). The longest treatment time in patients whose treatment started in the mixed dentition is probably related to a "waiting period" during the transition from mixed to permanent dentition.…”

Section: Discussionmentioning

confidence: 66%

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

et al. 2017

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The aim of this study was to evaluate the effects of the mandibular protraction appliance (MPA) for treating mild to moderate Class II malocclusion at different stages of dentofacial development. Lateral radiographs were evaluated before (T0) and at the end (T1) of orthodontic treatment with fixed appliance associated with MPA. Sixty-five consecutively treated patients were divided according to the stage of dentofacial development: 21 children in late mixed dentition, 22 adolescents and 22 young adults with full permanent dentition. The differences between and within groups were analyzed by MANOVA at p<0.05. The correction of anteroposterior discrepancy (Wits) was significantly reduced in all development stages (p<0.01), with no difference between groups. Class II was corrected predominantly by dental changes in the mandibular arch, with accentuated proclination of the mandibular incisors and mesial displacement of mandibular molars. The MPA had no skeletal effects in any of the groups, except for a mild reduction of SNA (p=0.018) and ANB angles (p<0.0001) among the mixed dentition children. With regard to soft-tissue profile, facial convexity decreased significantly in all groups (p<0.01). In conclusion, the MPA associated with fixed appliance corrected the Class II occlusion, basically by a mandibular arch protrusion. A mild skeletal maxillary change was significant only when this treatment protocol began during mixed dentition.

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Section: Discussionmentioning

confidence: 66%

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

et al. 2017

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“…This increase was not statistically different between the groups. In previous studies, the range of the increase in the growth of the mandible in the late growth period was reported to be 1–4.15 mm following treatment with functional appliances [ 22 , 31 , 71 , 72 ]. Most researchers have found that craniofacial growth may extend to the late stages of growth and development in both males and females [ 73 – 77 ].…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study Comparing Adolescent and Post-Adolescent Periods Regarding Effects of Activator Appliance in Patients with Class II Mandibular Retrognathia by Using 3dMDface Analysis and Cephalometry

Coşkun

Esenlik

2020

Med Sci Monit

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Background The purpose of this prospective study was to compare adolescent and post-adolescent growth periods regarding the effectiveness of conventional activator appliance in patients with Class II mandibular retrognathia by using lateral cephalometric radiographs and three-dimensional photogrammetry (3dMDface). Material/Methods We enrolled 2 groups: 15 patients in the adolescent growth period and 17 patients in the post-adolescent growth period. All patients had Class II anomaly with mandibular retrognathia and were treated with conventional activator appliances. Lateral cephalometric radiographs and three-dimensional photogrammetric views were obtained at the beginning and end of the activator treatment of Class II patients. Maxillomandibular discrepancy, mandibular protrusion and lengths, convexity angles, facial heights, and dental measurements were evaluated cephalometrically. Projections of the lips and the chin and volumetric measurements of the lip and the mandibular area were assessed using three-dimensional photogrammetry. Results Conventional activator therapy resulted in similar effects in both growth periods regarding improvements in the mandibular sagittal growth and maxillomandibular relationship (ANB° and the SNB° angles). Mandibular effective length was increased (Co-Gn length) and the maxillary horizontal growth was restricted (decreased SNA° angle) in both groups following the treatment. Treatment duration was significantly longer in the post-adolescent group. Increases in the projections of menton, pogonion, and sublabial points were observed in the three-dimensional photogrammetric views. Total lip volume was reduced while the mandibular volume was significantly increased in both groups. Lower gonial angle showed a greater increase in the post-adolescent group. Conclusions Correction of Class II anomaly with mandibular retrognathia was achieved with a combination of dental and skeletal changes in both growth periods. Conventional activator therapy may be an alternative treatment approach in the late growth period as it led to significant skeletal and dental changes.

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“…The Herbst CBJ appliance design was described in detail in previously published article. 20 After removal of the Herbst CBJ appliance, the corrected anteroposterior relationship was retained with 3/16-inch Class II elastics as active retention for a mean period of 3 months. Patients were instructed to use 3/16-inch Class II elastics for 18 hours a day, removing it only for eating, brushing, and contact sports, and patient compliance was monitored monthly.…”

Section: Methodsmentioning

confidence: 99%

“…Few studies to date have analyzed the treatment effects of the Herbst appliance after the growth peak, 19 20 21 and none of these studies have compared these effects with a comparable control group. The aim of the present study is to evaluate the effects of Class II malocclusion treatment with the Herbst Cantilever Bite Jumper (CBJ) appliance, combined with multibracket appliances after the growth peak at pretreatment.…”

Section: Introductionmentioning

confidence: 99%

Treatment Effects of the Herbst Appliance in Class II Malocclusion Patients after the Growth Peak

et al. 2020

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Objective The aim of this study was to evaluate dentoskeletal changes in the treatment of Class II malocclusion with the Herbst Cantilever Bite Jumper (CBJ) appliance, associated with multibracket appliances after the growth peak, at pretreatment. Materials and Methods A sample of 37 individuals was divided into two groups: the experimental group comprised 16 patients treated consecutively for a mean period of 2.52 years with the Herbst CBJ appliance associated with multibracket appliances. A total of 21 subjects (10 males and 11 females) with Class II malocclusion and mean age at T1 of 16.08 years were followed for a mean period of 2.12 years composed the control group. Comparisons between the two groups were performed using initial and final lateral cephalograms. Comparisons between experimental and control groups at pretreatment and of the treatment changes were performed by Mann–Whitney or independent t-tests. Results Experimental group exhibited a significantly greater labial inclination of the mandibular incisors in comparison to the control group. Additionally, significantly greater corrections in overbite, overjet, and molar relationship were observed in the experimental than in the control groups. Conclusion The effects of the Herbst CBJ appliance, associated with fixed appliances after the growth peak in Class II malocclusion treatment are correction in molar relationship toward a Class I relationship, decrease of the overjet, decrease of the overbite, and mandibular incisors labial inclination.

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Class II malocclusion treatment with the Herbst appliance in patients after the growth peak

Abstract: Based on the present results, it was concluded that the effects of treatment performed with the Herbst appliance in patients at post-peak stage of growth are predominantly of dentoalveolar nature.

Cited by 9 publications

References 17 publications

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

A Prospective Study Comparing Adolescent and Post-Adolescent Periods Regarding Effects of Activator Appliance in Patients with Class II Mandibular Retrognathia by Using 3dMDface Analysis and Cephalometry

Treatment Effects of the Herbst Appliance in Class II Malocclusion Patients after the Growth Peak

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