scholarly journals Herbst Appliance palatally anchored in the treatment of dental class II malocclusion

2021 ◽  
Vol 7 (2(S)) ◽  
pp. 21-24
Author(s):  
Bruno Di Leonardo ◽  
Luca Contardo ◽  
Riccardo Riatti

In this case report, Authors describe the correction of a class II malocclusion using only an Herbst appliance palatally anchored with miniscrews. Before sagittal correction in the same appliance we applied a palatal screw to obtain maxillary expansion. The device were removed after 12 months of treatment. The final result included the correction of Class II malocclusion by lower dentoalveolar compensation mainly. The lip function favorite the spontaneous correction of upper frontal torque with consequent improvement of facial esthetics. After a follow up of 12 months the clinical result is satisfactory in terms of occlusion and esthetics. This clinical case showed a simple orthopedic and dentoalveolar approach to correct transversal discrepancy, dental class II malocclusion and also frontal proclination only with one appliance in a very short treatment time.

2021 ◽  
Vol 14 (53) ◽  
pp. 97-106
Author(s):  
Roberto Hideo Shimizu ◽  
Isabela Almeida Shimizu ◽  
Ana Cláudia M. Melo Toyoffuku ◽  
Rebecca Marquesini ◽  
Tatiane Travizan Lima ◽  
...  

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Maria Rita Giuca ◽  
Marco Pasini ◽  
Sara Drago ◽  
Leonardo Del Corso ◽  
Arianna Vanni ◽  
...  

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.


Author(s):  
Abdullah Al Masud ◽  
Muhammad Shohag Shikder ◽  
Mohammad Tofazzal Hossan ◽  
Mohammad Mahfuzul Gani ◽  
Mohammad Wahidul Islam

Vertical maxillary excess is associated with gummy smile, incompetent lip,  bimaxillary proclination, Angle’s class-I or class-II malocclusion with or without retogenia. After proper evaluation preoperative orthodontic treatment was performed in every cases and superior repositioning of the maxilla by Le Fort-I osteotomy is presented. Three patients with maxillary excess associated with retrogenia or microgenia were treated with this technique in combination with genioplasty. The maxillary segment was repositioned a maximum of 7.0 mm superiorly at point A. The mandible autorotated anterosuperiorly to achieve sound occlusion. Point B moved 1.0–3.0 mm anteriorly and 5.0–8.0 mm superiorly. The pogonion moved 4.0 mm anteriorly in a case done without genioplasty and the pogonion moved maximum 8.0mm in case done in combination with genioplasty. All patients obtained sound occlusion and a good profile after the operation. Almost no skeletal relapse was observed during 3 years of postoperative follow-up. Amount of gingiva showing during smile was ranges from 5.0mm –7.0mm which was 0-2.0mm after superior repositioning of the maxilla. Ban J Orthod & Dentofac Orthop, April 2016; Vol-6 (1-2), P.1-5


2021 ◽  
Vol 3 (2) ◽  
pp. 82-87
Author(s):  
Prathyaksha Shetty ◽  
Dipjyothi Baruah ◽  
Amit Rekhawat ◽  
Karthik Cariappa ◽  
Sujala Ganapati Durgekar ◽  
...  

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.


2007 ◽  
Vol 77 (6) ◽  
pp. 1046-1053 ◽  
Author(s):  
Mirja Kirjavainen ◽  
Turkka Kirjavainen

Abstract Objective: To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children. Materials and Methods: Forty children aged 9.1 (7.2–11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15° upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship. Results: A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3–3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P &lt; .05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls. Conclusion: Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.


1997 ◽  
Vol 34 (2) ◽  
pp. 151-153 ◽  
Author(s):  
Kimie Ohyama ◽  
Takafumi Susami ◽  
Yoshiyuki Kato ◽  
Hiromi Amano ◽  
Takayuki Kuroda

Objective This is the first description of long-term follow-up of a case of Freeman-Sheldon syndrome. Microstomia was treated with a mouth expander for 2 to 3 hours per day before active orthodontic treatment. Separate impressions were necessary in each quadrant of both upper and lower jaws because of limited mouth opening. Conclusion Orthodontic treatment improved the patient's Class II malocclusion, which was accompanied by crowding and a deep bite.


2016 ◽  
Vol 21 (4) ◽  
pp. 99-113
Author(s):  
Luís Antônio de Arruda Aidar

ABSTRACT This report describes the correction of a clinical case of malocclusion with anteroposterior discrepancy and transverse, sagittal and vertical deficiencies. A nonextraction technique was used to preserve space in the dental arches and control facial growth for the correction of the sagittal skeletal relationship and of overbite. The mechanics adopted efficiently corrected malocclusion: all functional and esthetic goals were achieved, and results remained stable eight years after treatment completion. This case was presented to the Committee of the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements necessary to obtain the BBO Diploma.


2019 ◽  
Vol 9 ◽  
pp. 190-197
Author(s):  
Matthew Wen Jian Lau

While uncommon in orthodontics, the extraction of central incisors may be indicated when such teeth are of poor prognosis. This report details orthodontic treatment of a 13-year and 5-month-old Chinese female, who presented with Class II/1 malocclusion on a Class II skeletal jaw base relationship. Her maxillary central incisors were ankylosed and had undergone severe external root resorption following a previous traumatic episode. Orthodontic treatment involved removal of the maxillary central incisors and the mandibular first premolars. Pre-adjusted edgewise appliances with MBT prescription were used. To enhance anterior esthetics, prosthetic buildup of the four maxillary anterior teeth was performed before appliance removal. Tight intercuspation of teeth and optimal facial esthetics were achieved at appliance debond and maintained at 2-year follow-up.


2019 ◽  
Vol 42 (2) ◽  
pp. 163-173 ◽  
Author(s):  
Daybelis González Espinosa ◽  
Milena Santos ◽  
Sissy Maria dos Anjos Mendes ◽  
David Normando

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).


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