Four TADs supported Herbst mechanics: A case report

Manni, Antonio; Lupini, Daniela; Cozzani, Mauro

doi:10.1016/j.ortho.2019.03.018

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…ese results were obtained in all patients through a distalisation of the upper arch and a mesialisation of the lower arch, and these results are consistent with those of previous studies [8,10,17,[21][22][23]. A slight high-pull headgear effect on the maxillary complex was found in the total sample, while a significant advancement of the mandible was observed (hypodivergents exhibited a slight lower mandibular advancement in comparison to normodivergent and hyperdivergent groups), and these results are in accordance with those of previous studies; Pancherz and Anehus-Pancherz found that the sagittal maxillary jaw base position seemed unaffected by therapy [24].…”

Section: Discussionsupporting

confidence: 92%

“…e advantages include the following: high treatment speed (average treatment time 6-8 months), reduced request for patient's compliance, and effectiveness both on the dental and skeletal component [7]. e effects on the dental component include a distalisation of the upper dental arch and a mesialisation of the lower dental arch [8], while the effects on the skeletal component include a decreased growth of the maxilla [9] and a stimulation of the mandibular growth with an increase in the average length at the end of treatment greater than 2-3 mm [10]. e mechanism permits vertical opening movements and effect on the vertical tooth position [11], and the skeletal effect is most pronounced during puberty rather than before [12].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

Giuca

Pasini

Drago

et al. 2020

International Journal of Dentistry

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Introduction. The Herbst device is widely used for correction of class II malocclusions; however, most of the researches carried out on the Herbst appliance in literature do not take into account patients with a different mandibular divergence. The aim of this study was to investigate the effects of Herbst on dental and skeletal structures and to evaluate possible influence of vertical facial growth patterns. Methods. A retrospective study was conducted on lateral cephalograms of 75 growing patients (mean age: 9.9 ± 1.9 years) with class II malocclusion treated with Herbst. Subjects were divided into 3 groups using the mandibular divergence index (SN and GoMe angle). Cephalometric parameters were evaluated using the modified SO (sagittal occlusion) Pancherz’s analysis. A statistical analysis was conducted to evaluate differences among groups using ANOVA. Results. Our study showed differences in response to treatment depending on patient’s facial vertical growth pattern. Cranial base angle and mandibular rotation were significantly different (p<0.05) between hypodivergent patients and normodivergent patients and between hypodivergent and hyperdivergent subjects. Conclusion. Hypodivergent patients increased their mandibular divergence during treatment to a greater extent than normodivergents; moreover, hyperdivergent patients exhibited a decreased mandibular divergence at the end of the treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

Giuca

Pasini

Drago

et al. 2020

International Journal of Dentistry

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“…Nine studies were selected to be evaluated by full text. Three studies [27][28][29] were excluded with reasons are shown in Appendix 4. At the end, six articles were selected, one RCT and five cohort studies.…”

Section: Study Selectionmentioning

confidence: 99%

Skeletal and dental effects of Herbst appliance anchored with temporary anchorage devices: A systematic review with meta‐analysis

Al-Dboush

Soltan

Rao

et al. 2021

Orthod Craniofacial Res

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Background The aim was to evaluate the efficiency of using temporary anchorage devices (TADs) in minimizing the anchorage loss and increasing the skeletal effects during correction of Class II malocclusion with Herbst appliance. Materials and methods Search without restrictions was performed up to January 2021 in three electronic databases (CENTRAL, MEDLINE and EMBASE) for randomized controlled trials (RCTs), prospective and retrospective cohort studies. The included studies assessed the dental and skeletal changes in Class II malocclusion patients who were treated using Herbst appliance with or without TADs. The strength of evidence was ranked using GRADE. Results Fifty‐five records were initially retrieved. A total of 6 studies with 198 patients were finally considered. 4 studies were included in the meta‐analysis. The meta‐analysis showed that using TADs with acrylic splint Herbst appliance was effective in controlling the inclination of mandibular incisors by a mean difference of −5.49 degrees (95% C.I [−7.36, −3.63], P < .001) when compared to Herbst appliance alone. The results showed also that incorporating TADs with Herbst treatment resulted in greater mandibular skeletal effects including increasing mandibular bone base length by mean difference of 2.22 mm (95% C.I [0.82. 3.61], P = .002) and mandibular length by mean difference of 3.7 mm (95% C.I [1.55, 5.85], P < .001) when compared to Herbst appliance alone. Conclusions Based on a very low level of confidence, it seems that incorporating TADs during orthodontic treatment with Herbst appliance results in minimizing the anchorage loss and increasing the skeletal effects of Herbst appliance during correction of Class II malocclusion.

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“…In addition, it acts on the dentition through distalization of the upper arch and mesialization of the lower one. While skeletal effects are favorable, the typical dental compensations (i.e., lingual tipping of the upper incisors and buccal flaring of the lower ones and distalization of the upper molars and mesialization of the lower ones) caused by anchorage loss ( 8 , 9 ) could reduce the overjet needed for a proper mandibular advancement, partially compromising the final treatment outcome ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Co–Go–Me angle as a predictor in Class II patients treated with Herbst appliance and skeletal anchorage: a retrospective cohort study

Manni,

Migliorati,

Boggio

et al. 2024

Front. Oral. Health

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IntroductionA condylion–gonion–menton (Co–Go–Me) angle threshold of 125.5° has been introduced as a predictive parameter of cephalometric mandibular response in the orthopedic treatment of growing Class II patients with functional appliances, despite some contradictions in the literature. Considering the lack of studies evaluating the role of skeletal anchorage, this study aims to reassess the threshold of 125.5° in the Co–Go–Me angle as a useful predictor in growing skeletal Class II patients treated with acrylic splint Herbst appliance and two mini-screws in the lower arch (STM2).MethodsThirty-five consecutively treated patients (20 males, 15 females; mean age, 11.37 years) with mandibular retrusion were classified into two groups according to their Co–Go–Me baseline values (Group 1, <125.5°; Group 2, >125.5°). The STM2 protocol involved the use of the MTH Herbst appliance with an acrylic splint in the lower arch and two interradicular mini-screws as anchorage reinforcement. Cephalometric analysis was performed by the same operator for each patient at baseline (T0) and at the end of the Herbst phase (T1). The effects of time and group on the variables were assessed by a repeated-measures analysis of variance. The primary research outcome was the difference between the groups in terms of mandibular responsiveness to treatment referred to as the relative difference (T1−T0) in Co_Gn.ResultsThe mean duration of the treatment was 9.5 months. No statistically significant differences between groups were detected at baseline, except from the expected SN/GoMe° (p < 0.001) and Co–Go mm (p = 0.028). No statistically significant changes between groups, which were caused by the treatment, were found considering the mandibular sagittal and vertical skeletal parameters. Similarly, no statistically significant differences were found in the dental changes between the high-angle and low-angle patients, apart from the upper molar sagittal position (p = 0.013).Discussion and conclusionsThe 125.5° threshold in the Co–Go–Me value was not a reliable predictive parameter for the mandibular response in growing patients treated with the MTH Herbst appliance and lower skeletal anchorage. Due to its effective control in the sagittal and vertical planes, the STM2 technique might be an appropriate protocol to use in treating skeletal Class II patients, regardless of the growth pattern.

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Four TADs supported Herbst mechanics: A case report

Cited by 4 publications

References 35 publications

Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

Skeletal and dental effects of Herbst appliance anchored with temporary anchorage devices: A systematic review with meta‐analysis

Evaluation of the Co–Go–Me angle as a predictor in Class II patients treated with Herbst appliance and skeletal anchorage: a retrospective cohort study

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