scholarly journals Evaluation of Profile Changes in Class II Individuals Treated by Means of Herbst Miniscope Appliance

2020 ◽  
Vol 8 (1) ◽  
pp. 27 ◽  
Author(s):  
Stefano Martina ◽  
Maria Luisa Di Stefano ◽  
Francesco Paolo Paduano ◽  
Domenico Aiello ◽  
Rosa Valletta ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Class Ii ◽  
Maturation Stage ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Lower Lip ◽  
Lower Jaw ◽  
Profile Changes ◽  
The Difference ◽  
Mandibular Retrusion

Background: To evaluate the profile changes following orthopedic/orthodontic treatment with the Herbst Miniscope® appliance in subjects affected with Class II malocclusion with mandibular retrusion. Methods: A total of 44 patients presenting a skeletal Angle Class II malocclusion (ANB > 4°) due to mandibular retrusion and a cervical maturation stage between CS2 and CS3 were included in the study. Of these 44 patients, 22 (mean age 11.9 ± 1.3, HBT group) were treated using the Herbst appliance, while 22 (mean age 10.6 ± 1.3, CTR group) were followed for a 12-month observational period. A cephalometric tracing was performed at the beginning of treatment (T0) and after 12 months (T1). Results: In both groups there was a significant advancement of soft tissue pogonion (HBT = 3.5 ± 3.0 mm, p < 0.001; CTR = 2.2 ± 2.9 mm, p < 0.001), but the difference between the two groups was not significant (p = 0.172). On the contrary, both groups had a significant advancement of the mandibular sulcus (HBT = 3.7 ± 2.8 mm, p < 0.001; CTR = 1.2 ± 2.2 mm, p < 0.001) and a lower lip protrusion (HBT = 3.45 ± 2.51 mm, p < 0.001; CTR = 1.7 ± 2.7 mm, p = 0.008), but in both cases the HBT group showed a statistically significant greater increase in sulcus protrusion (p = 0.002) and lower lip protrusion (p = 0.029) than controls. There were no statistically significant effects on the upper jaw. Conclusions: The Herbst appliance advanced the lower jaw soft tissues.

scholarly journals Growth Modification in Class II Malocclusion: A Review

2015 ◽  
Vol 4 (2) ◽  
pp. 23-26
Author(s):  
Sufia Nasrin Rita ◽  
SM Anwar Sadat
Keyword(s):  
Soft Tissues ◽  
Cervical Vertebrae ◽  
Class Ii ◽  
Treatment Modalities ◽  
Optimal Time ◽  
Maturation Stage ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Growth Modification

Class II malocclusion is the condition in which the mandibular first molars occlude distal to the normal relationship with the maxillary first molar. The etiology of class II malocclusion varied between skeletal, soft tissues, dental factors and habits. Skeletal class II could be because of protrusion of maxilla, retrusion of mandible and combination of both. The treatment modalities of any skeletal problem include Growth modification, Dental camouflage and Orthognathic surgery. The optimal time for treatment of patients with Class II malocclusions therapy should be initiated at the beginning of cervical vertebrae maturation stage CS3 to maximize the treatment effects. Age of treatment is approximately 8-14 years. The growth modification of moderate to severe skeletal class II malocclusion can be done by head gear, bionator, activator, twin block, herbest appliance, Frankel II regulator. The ultimate goal of growth modification depends on treatment timing, length of treatment, working mechanism of appliance, patient’s skeletal and dental condition we want to treat and the compliance of the patient.Update Dent. Coll. j: 2014; 4 (2): 23-26

Mandibular propulsion appliance for adults with Class II malocclusion: a systematic review and meta-analysis

2019 ◽  
Vol 42 (2) ◽  
pp. 163-173 ◽  
Author(s):  
Daybelis González Espinosa ◽  
Milena Santos ◽  
Sissy Maria dos Anjos Mendes ◽  
David Normando
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Skeletal Changes ◽  
Before And After ◽  
Mandibular Retrusion

Summary Background The effects of mandibular propulsion appliances in adults have some controversial results. While some authors claim that its use in non-growing patients could produce some dentoskeletal effects, other studies indicate that Class II correction occurs only through significant dental effects. Objective To evaluate the effects in non-growing Class II patients with mandibular retrusion, promoted by the treatment with mandibular propulsion appliances and determine if they produce mandibular changes. Methods The research was carried out in nine electronic databases and additional manual searches up to July 2019. Selection criteria were no restriction was placed on date and publication language. Randomized or non-randomized clinical trials with/without control were included. They must evaluated non-growing patients with Class II malocclusion, treated with mandibular propulsion appliances; outcomes were assessed before and after treatment. Data collection and analysis Data were extracted by two independent examiners in duplicate. The ROBINS-I tool was used to assess the methodological quality of the included studies. Results Of the 2824 articles identified, 11 non-randomized clinical articles were selected for qualitative analysis and 8 for quantitative analysis. SNB (0.87°, CI 95% 0.08, 1.66), ANB (−0.82°, CI 95% −1.24 to 0.40) and Pg/OLp [2.3 to 1.2 mm (P &lt; 0.001)] presented smallest but significant mandibular changes with some differences regarding the used appliance. The Herbst appliance showed the largest mandibular changes followed by the SUS appliance when evaluated through Ar-Pg. SNA showed non-significant changes. Overbite (−2.85. CI 95% −3.06, −2.64), Overjet (−5.00.CI 95% −5.45, −4.55) showed significant changes in all devices. Class II correction occurs through a significant labial movement of the mandibular incisors, some lingual inclination of the maxillary incisors and minor skeletal changes. Conclusions All mandibular propulsion appliances examined, showed efficiency in normalizing the Class II malocclusion in adult patients; however, changes were acquired mainly through dentoalveolar changes. Some minor mandibular forward changes was noted, mainly in patients treated with the Herbst appliance. Randomized clinical trials are needed to improve scientific evidence. Registration PROSPERO (code CRD42017067384).

scholarly journals Esthetic perception of facial profile changes in Class II patients treated with Herbst or Forsus appliances

2020 ◽  
Vol 90 (4) ◽  
pp. 571-577 ◽  
Author(s):  
Alexa Helena Kohler Moresca ◽  
Nathaly Dias de Moraes ◽  
Francielle Topolski ◽  
Carlos Flores-Mir ◽  
Alexandre Moro ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Random Sequence ◽  
Treatment Method ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Analog Scale ◽  
Herbst Appliance ◽  
Facial Profile ◽  
Significant Difference ◽  
Profile Changes

ABSTRACT Objective To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances. Materials and Methods Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used. Results In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047). Conclusions Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.

Tratamento da Classe II com propulsor mandibular Herbst modificado – relato de caso

2021 ◽  
Vol 14 (53) ◽  
pp. 28-34
Author(s):  
Guaracy Lyra da Fonseca Júnior ◽  
Flávia Tavares Japiassú ◽  
Ney Tavares Lima Neto ◽  
Gurgiane Rodrigues Gurgel Cavalcante ◽  
Carmen Cristina Zimmer de Assis ◽  
...  
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Clinical Case ◽  
Circuit Breaker ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Considerable Part ◽  
Dental Clinics ◽  
Mandibular Retrusion

Class II represents a considerable part of orthodontic problems to be treated in dental clinics. To correct this malocclusion, there are currently several forms of treatment. Among the functional orthopedic devices, the Herbst device has stood out due to its efficiency and practicality for being fixed and not requiring the collaboration of the patient. The purpose of this article is to present, through a clinical case report, the treatment of class II malocclusion with a modified Herbst appliance with a lower acrylic splint. The female patient initially had 11 years and 11 months, permanent dentition, mandibular retrusion and atresia of the arches. Initially, a maxillary circuit breaker and lower expander were used, followed by the Herbst appliance and finished with fixed orthodontics. At the end of the treatment, the modified Herbst appliance proved to be effective, providing a class I molar relationship, improving the patient’s profile and decreasing the space between the resting lips.

scholarly journals No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report

2018 ◽  
Vol 12 (1) ◽  
pp. 605-613 ◽  
Author(s):  
M. Portelli ◽  
A. Militi ◽  
M. Cicciù ◽  
A. Lo Giudice ◽  
G. Cervino ◽  
...  
Keyword(s):  
Class Ii ◽  
Class I ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Functional Therapy ◽  
Deep Bite ◽  
Mandibular Growth ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Mandibular Retrusion

Background:Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient’s compliance; for this reason, some clinicians prefer to use no compliance apparatus.Objective:Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion.Methods:In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained.Results:In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved.Conclusion:Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient’s cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.

scholarly journals Facial profile esthetics change of class II malocclusion patients treated with the Herbst appliance as perceived by orthodontists and laypersons

2017 ◽  
Vol 145 (9-10) ◽  
pp. 446-451
Author(s):  
Jovana Milutinovic ◽  
Nenad Nedeljkovic ◽  
Nenad Korolija ◽  
Biljana Milicic
Keyword(s):  
Age Groups ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Facial Profile ◽  
Skeletal Class ◽  
Female Patients ◽  
Skeletal Class Ii ◽  
Significant Difference ◽  
The Difference

Introduction/Objective. The recognition of differences in individual assessment of facial attractiveness could be valuable assistance in planning the orthodontic treatment. The aim of this study was to compare facial profile attractiveness changes of patients treated with the Herbst appliance perceived by orthodontists and laypersons. Methods. The patient sample comprised 33 young Caucasian still-growing patients, aged 14?18 years, with skeletal class II malocclusion treated with the Herbst and multibracket appliances. Facial profile photographs before and after the treatment were shown to 54 orthodontists and 50 laypersons. In the esthetics oriented poll, the evaluators rated the change in facial appearance. Results. The attractiveness scores differed between the two rater groups (p < 0.001), with orthodontists being more generous, whereas there was no significant difference between female and male evaluators in both groups (p > 0.05). However, scores differed significantly in grading female and male patients (p < 0.001), so that female patients got higher scores; younger evaluators graded more critically between different age groups of the evaluators (p < 0.001), as well as between the patients with different initial severity of malocclusion (p < 0.001). Conclusion. The difference in attractiveness scores differed between two groups, with laypersons being more critical than orthodontists. Higher scores were given to female patients by both groups, as well as by the evaluators in the older age group.

Comparative analysis of the effectiveness of the use of various orthodontic appliances in the correction of malocclusion of the II class in children and adolescents

2021 ◽  
pp. 12-15
Author(s):  
N.D. Pilipenko ◽  
S.Yu Maksyukov
Keyword(s):  
Comparative Analysis ◽  
Children And Adolescents ◽  
Treatment Process ◽  
Class Ii ◽  
Orthodontic Appliances ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Lower Jaw ◽  
Jaw Position

This study is dedicated to a comparative analysis of effectiveness of using orthodontic appliances when treating class II malocclusion in children and adolescents. It was shown that treatment with the Invisalign system with a change of the lower jaw position is the most effective method for correcting class II malocclusion in growing patients. Using Invisalign aligners showed not only the best efficacy according to teleroentgenograms. but also made the treatment process comfortable for patients at all its stages. Moreover, higher level of compliance was demonstrated with treatment using the Invisalign system compared to the Twin-block appliance.

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

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Maria Rita Giuca ◽  
Marco Pasini ◽  
Sara Drago ◽  
Leonardo Del Corso ◽  
Arianna Vanni ◽  
...  
Keyword(s):  
Growth Pattern ◽  
Class Ii ◽  
Growth Patterns ◽  
Response To Treatment ◽  
Controlled Study ◽  
Class Ii Malocclusion ◽  
Facial Growth ◽  
Herbst Appliance ◽  
Lateral Cephalograms ◽  
Vertical Growth Pattern

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.

Prognostic Indicators for Anterior Mandibular Repositioning in Adolescents with Class II Malocclusion: A Cross-Sectional Cephalometric Study

2020 ◽  
Vol 44 (4) ◽  
pp. 274-282
Author(s):  
Jong-Moon Chae ◽  
Jae Hyun Park ◽  
Seon-Hye Kim ◽  
Utkarsh Mangal ◽  
Hye Young Seo
Keyword(s):  
Soft Tissues ◽  
Class Ii ◽  
Prognostic Indicators ◽  
Class Ii Malocclusion ◽  
Hard Tissue ◽  
Cross Sectional ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Cephalometric Changes ◽  
Cephalometric Study

Objective: To investigate the cephalometric changes following anterior repositioning of the mandible for predicting the treatment effects in Class II adolescent patients. Study Design: Lateral cephalograms of 28 patients (ANB &gt; 4°) were taken in centric occlusion (CO) and edge-to-edge bite (EtoE) before orthodontic treatment. The patients were classified into two groups according to their mandibular plane angle [MPA; low MPA (LMPA) ≤ 28° and high MPA (HMPA) &gt; 28°]. Cephalometric changes of hard and soft tissues were measured and analyzed with an x-y cranial base coordinate system. Results: For CO to EtoE, there were no significant cephalometric changes between HMPA and LMPA, but the horizontal ratio of soft to hard tissue pogonion (H-Pog′/H-Pog) change was significantly greater with LMPA than with HMPA while the vertical ratio (V-Pog′/V-Pog) showed vice versa. For CO to EtoE, MPA showed significant correlations with H-Pog′/H-Pog and V-Pog′/V-Pog. Y-axis angle, V-Pog′/V-Pog and H-Pog′/H-Pog can be used as good tools to discriminate between HMPA and LMPA. Conclusion: Cephalometric findings for CO to EtoE may be useful in predicting the vertical and horizontal changes of hard and soft tissues with the treatment of growing adolescents having various vertical skeletal patterns of Class II malocclusion.

scholarly journals Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report

2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 87-94
Author(s):  
Hilda Fitria Lubis ◽  
Nurhayati Harahap ◽  
Ananda Permata Sari
Keyword(s):  
Class Ii ◽  
Class Ii Malocclusion ◽  
Condylar Cartilage ◽  
Lower Lip ◽  
Mandibular Growth ◽  
Twin Block ◽  
Skeletal Class ◽  
Anterior Teeth ◽  
Skeletal Class Ii ◽  
Lip Bumper

Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.

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