Herbst Appliance for Adolescent Angle Class II Division 1 Malocclusion Long-Term Stability: A Systematic Reviews and Meta-Analysis

Abstract

Objective: To conduct a systematic and comprehensive literature search to systematically evaluate and meta-analysis the long-term stability of treatment results obtained after treatment with Herbst functional appliance, and to provide scientific evidence. Methods: CNKI, WANFANG, CBM, VIP, PubMed, Embase, The Cochrane Library and other literature databases were searched as comprehensively as possible. The two groups of researchers formulated inclusion criteria and exclusion criteria according to PICOS principles, screened literature, extracted data, and evaluated the quality of the selected literature according to the MINORS evaluation table. Meta-analysis was performed using data extracted from Review Manager 5.3 software. Results: A total of 12 literatures were included, with a total sample size of 490 cases. The long-term stability of Herbst appliance was analyzed by 11 indexes of SNA, SNB, ANB, ANS-PNS/SN, MP/SN, ANS-PNS/MP, OB, OJ, U1/ANS-PNS, L1/MP, U1/L1. The results showed that SNA, SNB, ANB, ANS-PNS/SN, U1/ANS-PNS, L1/MP, molar relationships were stable in the long run from the end of treatment to follow-up (P>0.05). The MP/SN, ANS-PNS/MP angles decrease, and the OB, OJ, and U1/L1 values increase (P<0.05). Conclusion: The long-term stability of the treatment effect of Herbst orthoses in the adolescent patients classified as Class II division 1 shows that the relative position of the upper and lower jaws is relatively stable, while the Angle of the mandibular plane relative to the anterior skull base plane remains relatively unstable.