Herbst appliance anchored to miniscrews in the upper and lower arches vs standard Herbst: A pilot study

Abstract

The aim of this pilot study was to present the preliminary results of Class II malocclusion treatment using a skeletally anchored Herbst appliance with miniscrews inserted in the maxillary and mandibular arches to improve anchorage control and skeletal effects. The treatment group (TG) consisted of 13 patients (10 males [M], 3 females [F]; mean age of 12.8years) with Class II Division 1 malocclusion who were treated with the Herbst appliance and miniscrews inserted in the maxillary and mandibular arches. They were compared with a control group (CG) of 13 patients (10F, 3M, mean age of 12.2years) with Class II Division 1 malocclusion treated with the standard Herbst appliance without miniscrews. Lateral cephalograms were taken before and after Herbst treatment, and cephalometric analysis was performed. In the TG group SNB (°) increased by 2.9°, whereas in CG group SNB (°) increased by 1.1° (P=0.017). ANB (°) decreased in both groups: -3.3° in the TG group vs -1.3° in the CG group (P=0.014). Pg-OLp distance increased in both groups: 5.70mm in the TG group and 0.8mm in the CG group (P=0.022). Mandibular incisors proclined 1.6° in the TG group and 3.7° in theCG group. Herbst treatment reinforced with 4 miniscrews (2 in each arch) increased the orthopedic effect of treatment in growing patients with Class II malocclusion.