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

Bruno Di Leonardo; Luca Contardo; Riccardo  Riatti

doi:10.5937/sejodr7-28694

Bruno Di Leonardo University Trieste
Luca Contardo University Trieste
Riccardo Riatti

DOI: https://doi.org/10.5937/sejodr7-28694

Keywords: Distalizing, Esthetics, Orthodontic mini-implant, Class II, Functional Appliance, Miniscrews

Abstract

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.

References

1) Herbst E. 1909 Verhandlungen des V. Internationalen Zahnarztlichen Kongresses; 1909; p. 351-3.
2) Pancherz, H.:Treatment of Class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation. Am J Orthod 1979;76:423-42.
3) Ruf, S.; Pancherz, H.: Herbst/multibracket appliance treatment of Class II Division 1 malocclusions in early and late adulthood. A prospective cephalometric study of consecutively treated subjects. Eur J Orthod 2006;28:352-60.
4) Tomblyn, T.; Rogers, M.; Andrews, L.2nd.; Martin, C.; Tremont, T.; Gunel, E.; Ngan, P.: Cephalometric study of Class II Division 1 patients treated with an extended-duration, reinforced, banded Herbst appliance followed by fixed appliances. Am J Orthod Dentofacial Orthop 2016;150:818-30.
5) Perinetti, G.; Primožič, J.; Furlani, G.; Franchi, L.; Contardo, L.: Treatment effects of fixed functional appliances alone or in combination with multibracket appliances: A systematic review and meta-analysis. Angle Orthod. 2015 May;85(3):480-92.
6) Weschler, D.; Pancherz, H.: Efficiency of three mandibular anchorage forms in Herbst treatment: a cephalometric investigation. Angle Orthod 2005;75:23-7.
7) Franchi, L.; Baccetti, T.; McNamara, J.A. Jr.: Treatment and posttreatment effects of acrylic splint Herbst appliance therapy. Am J Orthod Dentofacial Orthop 1999;115:429-38.
8) Flores-Mir, C.; Ayeh, A.; Goswani, A.; Charkhandeh, S.: Skeletal and dental changes in Class II Division 1 malocclusions treated with splint-type Herbst appliances. A systematic review. Angle Orthod 2007;77:376-81.
9) Manni, A.; Mutinelli, S.; Pasini, M.; Mazzotta, L.; Cozzani, M.: Herbst appliance anchored to miniscrews with 2 types of ligation: effectiveness in skeletal Class II treatment. Am J Orthod Dentofacial Orthop 2016;149:871-80.
10) Manni, A.; Migliorati, M.; Calzolari, C.; Silvestrini-Biavati, A.: Herbst appliance anchored to miniscrews in the upper and lower arches vs standard Herbst: A pilot study. Am J Orthod Dentofacial Orthop. 2019 Nov;156(5):617-625.
11) Mohammed, H.; Wafaie, K.; Rizk, M.Z.; Almuzian, M.; Sosly, R.: Bearn DR. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis. Prog Orthod. 2018 Sep 24;19(1):36. doi: 10.1186/s40510-018-0225-1.
12) Perinetti, G.; Sbardella, V.; Contardo, L.: Diagnostic reliability of the third finger middle phalanx maturation (MPM) method in the identification of the mandibular growth peak. Eur J Orthod. 2017 Apr 1;39(2):194-201.
13) Ludwig, B.; Glasl, B.; Bowman, S.J.; Wilmes, B.; Kinzinger, G.S.; Lisson, J.A.: Anatomical guidelines for miniscrew insertion: palatal sites. J Clin Orthod. 2011 Aug;45(8):433-41.
14) Perinetti, G.; Primožič, J.; Franchi, L.; Contardo, L.: Treatment Effects of Removable Functional Appliances in Pre-Pubertal and Pubertal Class II Patients: A Systematic Review and Meta-Analysis of Controlled Studies. PLoS One. 2015 Oct 28;10(10):e0141198.
15) Franchi, L.; Baccetti, T.; De Toffol, L.; Polimeni, A.; Cozza, P.: Phases of the dentition for the assessment of skeletal maturity: a diagnostic performance study. Am J Orthod Dentofacial Orthop. 2008 Mar;133(3):395-400.