An orthopedically treated adult case of Class II malocclusion

Held, Arthur-Jean; Spirgi, M; Cimasoni, G.

doi:10.1016/0002-9416(63)90247-1

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…The treatment method should be used cautiously in non-growing individuals as minimal changes will occur in the facial skeleton and most of the alteration will occur in the dentoalveolar area. In addition, increased chance of developing a dual bite and TMJ problems accompany treatment in non-growing individuals 65,66 .…”

Section: Indications For Treatment With the Herbst Appliancementioning

confidence: 99%

Long-term follow-up of patients treated with the edgewise crowned Herbst appliance in the mixed dentition

Wigal¹

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Research has indicated that the bite jumping technique employed by the crowned Herbst appliance can be effective in correcting Class II skeletal abnormalities by promoting growth of the mandible and remodeling of the glenoid fossa. This research investigated the skeletal and dental alterations of Class II patients treated at an early age with the edgewise crowned Herbst appliance and evaluated the long term stability of those effects. Methods: Cephalometric analysis was performed for a treatment group consisting of 22 radiographs taken before phase I treatment (T1), immediately after Herbst removal during phase I treatment (T2), at the completion of phase I treatment (T3), prior to beginning of phase II orthodontic treatment (T4), and immediately following phase II orthodontic treatment (T5). Measurements were compared to a matched control sample of untreated Class II patients from the Bolton-Brush study. The difference in each variable between the treatment and control groups across the five time periods was analyzed for pooled subjects, and separately for male and female subjects. The differences between certain time points were analyzed to investigate treatment changes and their stability over time. For all time periods, the change in the values of the variables for pooled subjects, male subjects, and female subjects in the treatment group were compared to the change in the values of the variables for pooled subjects, male subjects, and female subjects in the control group, respectively. In total, 37 variables were evaluated for each group including sagittal variables, vertical variables, angular variables, and condyle/glenoid fossa variables. In addition, an evaluation of the overjet correction and molar relationship correction for the treatment groups and an evaluation of the net overjet correction and net molar relationship correction for the treatment vs. control groups at each time period for pooled subjects were performed. Results: Treatment of Class II patients treated with the crowned Herbst appliance in the early mixed dentition resulted in the following changes relative to normal growth: The forward movement of the maxillary base (OLp-A pt) was initially restrained after treatment (T2-T1) and gradually became more restrained in the short-term (T3-T1) and long-term (T4-T1) post-treatment periods. An even greater restraint was seen after phase II orthodontics (T5-T1). The mandibular base (OLp-Pg) was initially moved forward after treatment (T2-T1), however, a gradual relapse was seen in the short-term (T3-T1) and long-term (T4-T1) post-treatment periods. Additional Dr. Peter Ngan, for his lifelong commitment to education, encouragement, expertise in the clinic, and general wisdom offered on a daily basis. I consider you not only a mentor, but a true friend. Dr. Chris Martin, for his everyday advice in the clinic, friendship, assistance with practice issues, support provided on the thesis, and full-time commitment to education.

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Section: Indications For Treatment With the Herbst Appliancementioning

confidence: 99%

Long-term follow-up of patients treated with the edgewise crowned Herbst appliance in the mixed dentition

Wigal¹

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“…The Herbst can however be used in non-growing individuals if the desired changes are to occur mostly in the dentoalveolar area. In addition, increased chance of developing a dual bite and TMJ problems accompany treatment in non-growing individuals 56,57 .…”

Section: Indication For Herbst Appliance Therapymentioning

confidence: 99%

A Radiographic Study of Patients Treated with the Reinforced Banded Herbst Appliance

Tomblyn¹

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Objectives: Orthopedic functional appliances have been shown to be effective in correcting Class II malocclusions with mandibular deficiency. However, most of the studies reported in the literature could not substantiate the effect of the appliance on mandibular growth because the appliance was worn for a short time and most of the studies were short term. In addition, there is also report on the breakage of the appliance with the use of the banded Herbst design. The objective of this study was to investigate the skeletal and dental changes of patients treated with the reinforced banded Herbst appliance during Herbst treatment and after completion of fixed appliance treatment. The results of this research should provide additional information on mode of action and the length of treatment when using the Herbst appliance. Methods: Thirty patients with Class II division 1 malocclusion (mean age = 12.34 years) treated by one of the investigator (M.R.) with Herbst followed by fixed appliance were compared to a matched control sample obtained from the Bolton-Brush study. Cephalometric radiographs were taken before treatment (T1), at the completion of Herbst treatment (T2), and following the removal of all fixed appliances (T3). Data was analyzed using a combination of ANOVA and Tukey-Kramer Test. Results: Treatment with the Herbst appliance (T2-T1) for an average of 1.5 years after growth is subtracted (t2-t1) resulted in a backward movement of the maxilla by 1.2 mm. The mandible moved forward 1.3 mm. The maxillary molars moved backward 4 mm and the maxillary incisors moved backward 4 mm. The mandibular molars moved forward 3.5 mm and the lower incisors moved forward 3.2 mm. The vertical changes were the maxilla moved downward 1.2 mm. The upper molars intruded 1 mm. The lower molar intruded 1mm and the lower incisors intruded 1.1 mm. The overbite decreased by 3.3 mm. The angular changes were SNB increased 3.6°. The SNA and ANB decreased 1° and 4.5°. The occlusal plane increased by about 5°. The upper incisor retracted 5.5° and the lower incisor proclined 8.6°. The Wits decreased by 4.2. The change in overjet was-7.2 mm. The skeletal contribution was-2.5 mm and the dental contribution was-4.7 mm. The change in molar relationship was-7.5 mm. The skeletal contribution was-2.5 mm and the dental contribution was-5 mm. The maxilla, maxillary molars, and maxillary incisors moved backwards. The mandible, mandibular molars, and mandibular incisors moved forward. The total treatment effect of the Herbst appliance and phase II treatment (T3-T1) after growth is subtracted (t3-t1) resulted in a backward movement of the maxilla by .4 mm. The mandible moved forward .9 mm. The maxillary molars moved backward 2.3 mm and the maxillary incisors moved backward 1.5 mm. The mandibular molars moved forward 2.7 mm and the lower incisors moved forward 2.9 mm. The vertical changes were the maxilla moved DEDICATION To my beautiful wife, Jennifer Lynn Tomblyn, who is my best friend and the love of my life. This has been an incredible journey and ...

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“…All functional appliances are aimed at encouraging growth and maximum skeletal results are therefore more likely in a growing individual. 72 In non-growing patients, jumping the bite with any appliance would likely result in maximum dental effects 72 , possibility of developing a dual bite 118 , and possible development of TMD 119 . Fixed functional appliances can be useful in situations that would be difficult for a removable functional appliance such as uncooperative patients and mouth breathers.…”

Section: Indications For the Forsus Frdmentioning

confidence: 99%

Treatment effects of the Forsus Fatigue Resistant Device: A cephalometric investigation

Heinrichs¹

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To evaluate the correction obtained from the Forsus Fatigue Resistant (FRD) device and orthodontic appliances compared to an untreated control group. Methods: Twenty four patients were treated with the Forsus FRD and fixed orthodontic appliances and were compared to twenty two untreated control patients who were matched in age, sex and craniofacial morphology. Lateral Cephalograms were taken before treatment (T1) and after Forsus FRD and removal of orthodontic appliances (T2). Results: Statistically significant differences were found for 12 of the 29 variables measured. Significant differences were found at Co-Gn minus Co-Apt., Wits, Is-OLp, Ii-OLp, overjet, Mi-OLp, Molar relationship, Overbite, Mic-ML, SNA, ANB, and Ii-ML between the treated and control groups. Linear measurements in the net position of the maxilla and mandible showed changes that included a reduction in maxillary forward growth and a stimulation of mandibular forward growth; however, these changes were not statistically significant. Net overjet correction was 4.7mm. 1.9mm (40%) of the correction was skeletal and 2.8mm (60%) was dental. Overjet correction was obtained by decreased maxillary growth (25%), increased mandibular growth (15%), retraction of the upper incisor (32%), and proclination of the lower incisor (28%). Conclusions: The Forsus FRD is successful in treating Class II malocclusions; however, there is a significant proportion of the correction which is dental in nature. ACKNOWLEDGEMENTS Dr. Peter Ngan-For your help with my research and for acting as my committee chairman. No one at this institution works harder than you and we appreciate you for it. Dr. Chris Martin-For your help in the clinic and as a member of my thesis committee. Your advice and humour has been greatly appreciated. Dr. Thomas Razmus-For your help as a member of my thesis committee Dr. Imad Shammaa-for the use of your records and help throughout my project Part time Faculty Drs.

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An orthopedically treated adult case of Class II malocclusion

Cited by 7 publications

References 5 publications

Long-term follow-up of patients treated with the edgewise crowned Herbst appliance in the mixed dentition

Long-term follow-up of patients treated with the edgewise crowned Herbst appliance in the mixed dentition

A Radiographic Study of Patients Treated with the Reinforced Banded Herbst Appliance

Treatment effects of the Forsus Fatigue Resistant Device: A cephalometric investigation

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