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Three-dimensional Treatment Outcomes in Class II Patients Treated with the Herbst Appliance: A Pilot Study

Institution:
1Private Practice, Santa Clarita, CA, USA.
2Department Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA.
3Department of Biostatistics, Gilling School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
4Department of Orthodontics, University of Minnesota, Minneapolis, MN, USA.
5Department of Orthodontics, University of North Carolina, Chapel Hill, NC, USA.
Publisher:
Elsevier Science
Publication Date:
Dec-2013
Journal:
Am J Orthod Dentofacial Orthop
Volume Number:
144
Issue Number:
6
Pages:
818-30
Citation:
Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):818-30.
PubMed ID:
24286905
PMCID:
PMC3999969
Appears in Collections:
NA-MIC
Sponsors:
R01 DE005215/DE/NIDCR NIH HHS/United States
R01 DE024450/DE/NIDCR NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
Generated Citation:
LeCornu M., Cevidanes L.H., Zhu H., Wu C-D., Larson B., Nguyen T. Three-dimensional Treatment Outcomes in Class II Patients Treated with the Herbst Appliance: A Pilot Study. Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):818-30. PMID: 24286905. PMCID: PMC3999969.
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INTRODUCTION: The aims of this study were to analyze 3-dimensional skeletal changes in subjects with Class II malocclusion treated with the Herbst appliance and to compare these changes with treated Class II controls using 3-dimensional superimposition techniques. METHODS: Seven consecutive Herbst patients and 7 Class II controls treated with Class II elastics who met the inclusion criteria had cone-beam computed tomographs taken before treatment, and either after Herbst removal or at posttreatment for the control subjects. Three-dimensional models were generated from the cone-beam computed tomography images, registered on the anterior cranial bases, and analyzed using color maps and point-to-point measurements. RESULTS: The Herbst patients demonstrated anterior translation of the glenoid fossae and condyles (right anterior fossa, 1.69 ± 0.62 mm; left anterior fossa, 1.43 ± 0.71 mm; right anterior condyle, 1.20 ± 0.41 mm; left anterior condyle, 1.29 ± 0.57 mm), whereas posterior displacement predominated in the controls (right anterior fossa, -1.51 ± 0.68 mm; left anterior fossa, -1.31 ± 0.61 mm; right anterior condyle, -1.20 ± 0.41 mm; left anterior condyle, -1.29 ± 0.57 mm; P <0.001). There was more anterior projection of B-point in the Herbst patients (2.62 ± 1.08 mm vs 1.49 ± 0.79 mm; P <0.05). Anterior displacement of A-point was more predominant in the controls when compared with the Herbst patients (1.20 ± 0.53 mm vs -1.22 ± 0.43 mm; P <0.001). CONCLUSIONS: Class II patients treated with the Herbst appliance demonstrated anterior displacement of the condyles and glenoid fossae along with maxillary restraint when compared with the treated Class II controls; this might result in more anterior mandibular projection.

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