Herbst appliance anchored to miniscrews with 2 types of ligation: Effectiveness in skeletal Class II treatment

Manni, Antonio; Mutinelli, Sabrina; Pasini, Marco; Mazzotta, Laura; Cozzani, Mauro

doi:10.1016/j.ajodo.2015.11.029

Cited by 36 publications

(53 citation statements)

References 24 publications

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“…The results of this study contradict the findings of Martin and Pancherz (7) who reported an increase of more than 3 mm in the protrusion of the lower incisors after treatment with the Herbst appliance. On the other hand, they corroborate the findings of Almeida et al 3 Collectively, these studies show that the Herbst appliance does not promote such a large protrusion of the lower incisors that would require skeletal anchorage (24) to avoid the problem. On the other hand, leveling the lower teeth with a fixed appliance used in conjunction with the Herbst appliance should be avoided.…”

Section: Discussionsupporting

confidence: 88%

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

et al. 2018

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This study aimed to evaluate the effects of the Herbst appliance on the proclination and protrusion of the lower incisors, and to verify if the device causes alveolar bone loss in the anterior region of the mandible. This is a retrospective study. The sample consisted of 35 individuals. The treatment group consisted of 22 individuals (8 girls and 14 boys; initial mean age of 8.2 years) who used the Cantilever Herbst appliance for a period of 12 months. The control group consisted of 13 individuals (3 girls and 10 boys; initial mean age of 8.9 years) who received no treatment and were followed up for a period of approximately 18 months. Cone-beam computed tomography scans were performed at the beginning and at the end of the observational period. The medullary bone thickness (MT), buccal cortical bone thickness (BCT), lingual cortical bone thickness (LCT), and lower incisors proclination and protrusion were evaluated. Data were submitted to statistical analysis (ANCOVA and Student’s t-test) with a significance level of 5%. There was no significant difference in MT, BCT, LCT and incisor proclination between groups. Incisor proclination increased in the treated group with no statistical significance. The treatment group showed a significant increase in the protrusion of the incisors (p = 0.02). The Herbst appliance promoted a small proclination and protrusion of the lower incisors, without relevant clinical implications. The Herbst appliance did not cause bone loss in the anterior region of the mandible during Class II treatment.

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Section: Discussionsupporting

confidence: 88%

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

et al. 2018

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“…In fact, orthodontic treatment with the Herbst appliance with or without skeletal anchorage resulted in effective improvements in class II patients, as determined by the retraction and/or arrest of upper jaw growth, and the development of mandibular growth [ 12 ]. The orthopedic changes were slightly more significant in subgroup 1 than in subgroup 2, which is probably related to the fact that a stronger dental anchorage can allow for greater forward displacement of the jaw, as suggested in the previous studies [ 14 , 15 ]. Furthermore, it appears that, in addition to mandibular growth, there is a slight increase in anterior mandibular rotation in subgroup 1 treated with the Herbst appliance and skeletal anchorage.…”

Section: Discussionsupporting

confidence: 53%

“…In fact, previous studies have shown that the Herbst appliance can be used together with orthodontic miniscrews, anchored into the mandibular bone, in order to ensure better lower incisor anchorage and to reduce flaring of these teeth. It was showed a causal effect between the control of mandibular incisor proclination and the increase in skeletal effects of the Herbst appliance; in fact, a better mandibular incisor proclination control seems to allow a slightly mesial displacement of the mandible [ 14 , 15 ] and consequently could increased the pharyngeal dimension.…”

Section: Introductionmentioning

confidence: 99%

A retrospective cephalometric study on pharyngeal airway space changes after rapid palatal expansion and Herbst appliance with or without skeletal anchorage

Manni¹,

Pasini

Giuca

et al. 2016

Prog Orthod.

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BackgroundThe aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without skeletal anchorage.MethodsA 40-patient study group treated with the Herbst RME combination was included; moreover, a comparison between two subgroups based on whether miniscrews were used was evaluated. A subgroup 1 included 20 patients who were treated with RPE and an acrylic splint Herbst with miniscrews, and subgroup 2 included 20 patients who were treated with RPE and an acrylic splint Herbst. A cephalometric analysis was performed before (T1) and after (T2) treatment. The skeletal parameters of the sagittal occlusion analysis of Pancherz were utilized together with some extra measurements to evaluate the airways.ResultsAn increased nasopharyngeal airway space was observed in group 1 (p < 0.05) from T1 to T2. Furthermore, the increase in nasopharyngeal airway space was significantly higher in subgroup 1 (p < 0.05) in comparison to the subgroup 2. Oropharyngeal (OA) and laryngopharyngeal (LA) dimensions were significantly increased in the subgroup 1 at the end of the treatment. In the subgroup 1, a significant decrease in SNA, a significant increase in SNB, and a significant decrease in ANB were observed from T1 to T2. In the subgroup 2, the treatment resulted in a significant decrease in ANB. In both groups, Pogonion increased significantly from T1 to T2.ConclusionsThe results suggest that the RPE and the Herbst appliance allow a slight improvement of the sagittal dimensions of the airways. The oropharyngeal dimension increased significantly more in the skeletal anchorage group.

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“…23 Among the included studies in the literature, it has been furtherly reported that decreased adverse outcomes (including non-favorable mandibular incisor proclination) were more significantly associated with TAD-supported Herbst appliances. 24 The undesirable arch loss that usually results from unwanted tooth movement during orthodontic treatment was also reported by placing a mini plate and linking the infra zygomatic buttress with the outer bow. 25 This has been reported secondary to allowing protraction of the underlying maxilla.…”

Section: Discussionmentioning

confidence: 99%

Indication and uses of temporary anchorage device in orthodontic

Bawyan

Anzi

Alkhadra³

et al. 2021

Int J Community Med Public Health

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Treating various types of malocclusion is dependant on providing a secure anchorage. In this context, it has been shown that teeth, intramaxillary, and/or extraoral appliances are required to achieve favorable outcomes regarding anchorage treatment. A Temporary anchorage device (TAD) has been introduced in the literature in this context. It has been described as a temporary device that can be used after completing treatment. The aim of the study was to review the indications and uses of TADs in orthodontic treatment. The current evidence shows that introducing TADs in the field of orthodontic treatment has been associated with favorable outcomes that encountered the previous multiple challenges reported with the conventional anchorage approaches. Contemporary orthodontic settings reported various uses for TADs, including corrections in transverse, vertical, and anteroposterior dimensions. Combined use of TADs and conventional approaches were also evaluated with favorable outcomes. These findings indicate the validity of TADs in orthodontic treatment and call for its future implications and clinical applications. However, it should be noted that post-treatment evaluation on a long-term basis was not adequately reported in the current literature, indicating the need for future investigations for further validation.

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Herbst appliance anchored to miniscrews with 2 types of ligation: Effectiveness in skeletal Class II treatment

Cited by 36 publications

References 24 publications

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

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

A retrospective cephalometric study on pharyngeal airway space changes after rapid palatal expansion and Herbst appliance with or without skeletal anchorage

Indication and uses of temporary anchorage device in orthodontic

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