Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance

Gerszewski, Camila; Topolski, Francielle; Correr, Gisele Maria; Gomes, Rodrigo A. P.; Morais, Nathaly Dias; Moro, Alexandre

doi:10.1590/0103-6440201802382

Cited by 9 publications

(2 citation statements)

References 19 publications

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“…In PDL of mandibular anterior teeth, slight compressive stress was on the cervical 1/2 on the labial side and apical 1/2 on the lingual side. This was in accord with previous research that functional appliances like Herbst led to maxillary incisor inclination and mandibular incisor proclination [ 35 , 52 ], regarded as the dental compensation in the treatment of Class II malocclusion. It could be minimized through different designs in functional therapy [ 34 , 53 ].…”

Section: Discussionsupporting

confidence: 92%

Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study

Zhu

Yuan

et al. 2022

BMC Oral Health

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Background The Advanced Mandibular Spring (AMS) was newly developed as a dentofacial orthopedic appliance in conjunctive use of clear aligners to treat Class II malocclusion with mandibular retrognathia in adolescents. This study aimed to launch a biomechanical assessment and evaluate whether the stress patterns generated by AMS promote mandibular growth. Methods A three-dimensional finite element model was constructed using images of CBCT and spiral CT. The model consisted of craniomaxillofacial bones, articular discs, retrodiscal elastic stratum, masticatory muscle, teeth, periodontal ligament, aligner and AMS. Mechanical effects were analyzed in three types of models: mandibular postural position, mandibular advancement with AMS, and mandibular advancement with only muscular force. Results The stress generated by AMS was distributed to all teeth and periodontal ligament, pushing mandibular teeth forward and maxillary teeth backward. In the temporomandibular joint area, the pressure in the superior and posterior aspects of the condyle was reduced, which conformed to the stress pattern promoting condylar and mandibular growth. Stress distribution became even in the anterior aspect of the condyle and the articular disc. Significant tensile stress was generated in the posterior aspect of the glenoid fossa, which conformed to the stress pattern stimulating the remodeling of the fossa. Conclusions AMS created a favorable biomechanical environment for treating mandibular retrognathia in adolescents.

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Section: Discussionsupporting

confidence: 92%

Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study

Zhu

Yuan

et al. 2022

BMC Oral Health

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“…Thus, the appliance produces a forward force on the lower teeth and a backward force on the upper teeth. 31 , 32 Gerszewski et al 33 evaluated lower incisor changes after treatment with Herbst appliance, and there was a statistically significant increase in the IMPA in the treated group (3.2°±12.8°).…”

Section: Discussionmentioning

confidence: 99%

Treatment of mild Class II malocclusion in growing patients with clear aligners versus fixed multibracket therapy: A retrospective study

Dianišková

Rongo

Buono

et al. 2021

Orthod Craniofacial Res

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Objective: To compare the dental and skeletal effects of intermaxillary elastics on the correction of mild Angle's Class II division 1 malocclusion with clear aligner treatment (CA) versus fixed multibracket (FMB) in growing patients. Settings and sample population:The study sample consisted of 49 consecutively patients (mean age ± SD 12.9 ± 1.7 years), 32 females and 17 males referred from the School of Orthodontics of the University of Bratislava Comenius (Slovakia). All patients were treated with a non-extraction orthodontic treatment, 25 with FMB and 24 with CA. Methods:The cephalometric analysis was performed at the beginning (T0) and the end of the treatment (T1). The t test for unpaired data was carried out to compare cephalometric values at T0 and changes at T1-T0 between the two groups. The level of significance was set as P < .0035. Results:The two groups showed no statistically significant differences (ANPg = −0.1°; P = .762) in the correction of the sagittal intermaxillary relation. The analysis of vertical skeletal changes showed no statistically significant effects on mandibular inclination (SN/MP = 0.1°; P = .840). The two treatments had a statistically significant and clinically relevant difference in controlling the inclination of the lower incisors (L1/ GoGn = 4.8°, CAG = −0.5°± 3.9°; FMB = 4.3°± 5.8°; P < .001). Conclusions:Class II elastics combined with CA and FMB produce a similar correction on sagittal discrepancies in growing patients. CA presented a better control in the proclination of the lower incisors. CA and elastics might be a good alternative in the correction of mild Class II malocclusion in cases where a proclination of lower incisors is unwanted.

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Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis

Amuk

Yılmaz

2021

European Journal of Orthodontics

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Objectives This controlled study aimed to evaluate the effects of Herbst therapy on the trabecular structure of the condyle and angulus mandible using fractal dimension analysis (FD-A) accompanied by skeletal cephalometric changes. Material and method The panoramic and cephalometric radiographs of 30 patients with skeletal Class II malocclusion treated with the Herbst appliance (C II-H group, mean age: 15.23 ± 1.08), 30 patients with skeletal Class II malocclusion that received fixed orthodontic treatment (C II-C group, mean age: 15.73 ± 1.38), and 30 patients with skeletal Class I malocclusion (C I-C group, mean age: 15.90 ± 1.30) were selected. FD-A was performed on the superoposterior region (C-SP) and centre of the condyles (C-C) and the mandibular angulus (Ang) on the panoramic radiographs taken at the pretreatment (T0), intermediate stage of treatment (T1), and posttreatment (T2) timepoints just like cephalometric analysis. Results Herbst therapy provided a statistically significant increase in SNB, ANS-Me, Na-Me, S-Go, Co-Gn and a decrease in ANB and overjet (P < 0.05). All skeletal changes remained stable during the fixed appliance treatment after Herbst. The FD values in C-C increased (P < 0.05), and C-SP values decreased (P < 0.05) during Herbst therapy, while after removal of the Herbst appliance, no significant change was observed despite an increase in C-SP. The Ang value did not change during Herbst treatment, but then increased significantly (P < 0.05). There was no significant change in the FD values of the C I-C and C II-C groups at any stage of treatment. The C-C and C-SP changes at T1–T0 period, C-SP and Ang changes at T2–T1 period, and C-C, C-SP, and Ang values at T2–T0 period were found higher in C II-H group compared with the C II-C group significantly (P < 0.05). Conclusion Herbst therapy changed the trabecular structure of the condyles in different directions at the superoposterior and central regions of the condyles, while the structural complexity of the angulus mandible, which did not change during the Herbst treatment, increased during the fixed orthodontic treatment after Herbst.

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Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance

Cited by 9 publications

References 19 publications

Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study

Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study

Treatment of mild Class II malocclusion in growing patients with clear aligners versus fixed multibracket therapy: A retrospective study

Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis

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