Stability of Class II treatment with an edgewise crowned Herbst appliance in the early mixed dentition: Skeletal and dental changes

Summary Objectives Our aim was to analyse dentoskeletal effects and long-term stability of Class II treatment carried out with an eruption guidance appliance (EGA) in early mixed dentition. Materials and methods Sixty-five Class II patients (38 females and 27 males), treated with an EGA in early mixed dentition, were compared with 58 children (26 females and 32 males) with untreated Class II malocclusion. The mean age in the treatment group at the start (T1) and end of treatment (T2) was 5.4 years (±0.4) and 8.5 years (±0.9), respectively, and at the final examination in the early permanent dentition (T3) 16.7 years (±0.4). In the control group, the mean age at T1 and T2 were 5.1 years (±0.5) and 8.4 years (±0.5), respectively. The independent and dependent sample t-tests, Chi-square test, and Fisher’s test were used in the statistical evaluation. Results In the treatment group, the frequency of Class II decreased from 100 to 14% during the treatment (T1–T2) and a significant correction took place in all occlusal variables. At T2, the treatment and control groups showed statistically significant differences (P < 0.05) in all occlusal variables. In the treated children, mandibular length increased 5 mm more (P < 0.001) from T1 to T2 compared to the control children, and the ANB angle became significantly smaller (P = 0.006). During the post-treatment period (T2–T3), the frequency of Class II in the treatment group decreased from 14 to 2% (P < 0.05), overbite increased from 2.2 to 3.1 mm (P < 0.05), and lower crowding increased from 2to 14% (P < 0.05). Post-treatment changes in overjet and upper crowding were not statistically significant. At T3, the mean values of the SNA, SNB, and ANB angles were 83.0° (SD 3.9°), 81.3° (SD 3.8°), and 2.4° (SD 1.5°), respectively. Conclusions A clinically significant correction of the molar relationship, overjet, overbite, incisor alignment, and growth enhancement of the mandible were observed after treatment in early mixed dentition. The treatment results remained largely stable in the early permanent dentition. However, an increase was observed in overbite and lower crowding. None of the children treated in early mixed dentition needed a second treatment phase.

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Orthopedic cervical headgear in Class II treatment: case report

Brazilian Dental Journal ◽

10.1590/s0103-64402003000100012 ◽

2003 ◽

Vol 14 (1) ◽

pp. 63-66 ◽

Cited By ~ 1

Author(s):

Carla Enoki ◽

Mírian Aiko Nakane Matsumoto ◽

José Tarcísio Lima Ferreira

Keyword(s):

Case Report ◽

Growth Pattern ◽

Class Ii ◽

Mixed Dentition ◽

Class I ◽

Cephalometric Analysis ◽

Class Ii Malocclusion ◽

Class Ii Treatment ◽

Division 1 ◽

Downward Displacement

Early treatment for Class II malocclusion was undertaken with the objective of correcting skeletal disproportion by altering the growth pattern. A case of Class II, Division 1 malocclusion in the mixed dentition was corrected to Class I molar relationship using orthopedic cervical headgear, with nonextraction edgewise therapy. Cephalometric analysis indicated a reduction in the maxillomandibular discrepancy (ANB) correcting the Class II malocclusion to Class I malocclusion. The treatment showed that this was achieved by downward displacement and inhibition of the forward growth of the maxilla and growth of the mandible. There was no downward rotation of the mandible nor maxillary first molar extrusion. There was improvement in the jaw relationship.

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A retrospective cephalometric investigation of two fixed functional orthodontic appliances in class II treatment: Functional Mandibular Advancer vs. Herbst appliance

Clinical Oral Investigations ◽

10.1007/s00784-017-2111-5 ◽

2017 ◽

Vol 22 (1) ◽

pp. 293-304 ◽

Cited By ~ 7

Author(s):

Gero Stefan Michael Kinzinger ◽

Jörg Alexander Lisson ◽

Linda Frye ◽

Ulrich Gross ◽

Jan Hourfar

Keyword(s):

Class Ii ◽

Orthodontic Appliances ◽

Herbst Appliance ◽

Class Ii Treatment ◽

Functional Mandibular Advancer

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

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2015.11.029 ◽

2016 ◽

Vol 149 (6) ◽

pp. 871-880 ◽

Cited By ~ 12

Author(s):

Antonio Manni ◽

Sabrina Mutinelli ◽

Marco Pasini ◽

Laura Mazzotta ◽

Mauro Cozzani

Keyword(s):

Class Ii ◽

Herbst Appliance ◽

Skeletal Class ◽

Class Ii Treatment ◽

Skeletal Class Ii

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Class II treatment by extraction of maxillary first molars or Herbst appliance: dentoskeletal and soft tissue effects in comparison

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-012-0112-1 ◽

2013 ◽

Vol 74 (1) ◽

pp. 52-63 ◽

Cited By ~ 9

Author(s):

J.W. Booij ◽

J. Goeke ◽

E.M. Bronkhorst ◽

C. Katsaros ◽

S. Ruf

Keyword(s):

Soft Tissue ◽

Class Ii ◽

Herbst Appliance ◽

Class Ii Treatment ◽

Tissue Effects

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Effects of Class II treatment with a banded Herbst appliance on root lengths in the posterior dentition

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2009.07.020 ◽

2011 ◽

Vol 139 (4) ◽

pp. 465-469 ◽

Cited By ~ 12

Author(s):

Gero S.M. Kinzinger ◽

Susanna Savvaidis ◽

Ulrich Gross ◽

Norbert Gülden ◽

Björn Ludwig ◽

...

Keyword(s):

Class Ii ◽

Herbst Appliance ◽

Class Ii Treatment

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Does daily wear time of Twin Block reliably predict its efficiency of class II treatment?

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-021-00300-7 ◽

2021 ◽

Author(s):

Michal Sarul ◽

Marek Nahajowski ◽

Grzegorz Gawin ◽

Joanna Antoszewska-Smith

Keyword(s):

Statistical Significance ◽

Characteristic Curve ◽

Class Ii ◽

Class I ◽

Rank Test ◽

Treatment Efficiency ◽

Significance Level ◽

Twin Block ◽

Wear Time ◽

Class Ii Treatment

Abstract Purpose The objective of this study was to investigate how daily wear time (DWT) influences class II malocclusion treatment efficiency. Materials and methods The study group consisted of 55 patients (mean age 10.4 years) diagnosed with a class II/1 malocclusion. Twin block appliances, with built-in Theramon® microsensors (MC Technology, Hargelsberg, Austria) to monitor patients’ cooperation (daily wear time assessment), were used for treatment. Cephalograms were taken and the following initial and final measurements were compared: Co-Gn, Co-Go, Co-Olp, Pg-Olp, WITS, SNA, SNB, ANB, Co-Go-Me, overjet, molar and canine relationships. The Shapiro–Wilk test, Wilcoxon signed-rank test, Student’s t-test, Levene’s test, Mann–Whitney U test, Kruskal–Wallis test, χ2 test, and Spearman’s rank correlation coefficient with p < 0.05 set as the statistical significance level were used to determine the correlation of the outcomes with DWT; a ROC (receiver operating characteristic) curve was calculated to illustrate diagnostic ability of the binary classifier system. Results DWT was very highly positively correlated with change of the Pg-Olp parameter and highly with an improvement in the ANB, SNA, and SNB angles, an increase in the WITS parameter and an increase in Co-Gn distance. DWTs < 7.5 h correlated with significantly less improvement of the investigated variables. However, DWT > 7.5 h did not significantly correlate with the improvement of the overjet and most of the linear parameters in the mandible. The ROC curve and its AUC (area under curve) allowed the determination of a DWT of 7 h and 48 min to be capable of establishing a class I relationship with 83% probability. Conclusions Class II treatment efficiency was influenced by DWT; an 8 h threshold value had an 83% probability of establishing a class I relationship.

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