Efeitos dentoesqueléticos do tratamento da classe II utilizando o aparelho de Herbst associados à mecânica Straight-wire

This study compared the effect of the treatment protocol for correcting Class Il malocclusion using the Herbst appliance followed by full fixed Straigh-wire mechanics, in two populations, one Brazilian and one of North American origin As a untreated control sample the data from the University of Michigan Elementary and Secondary School Growth Study (UMGS) was used. Our sample was composed of 12 males and 12 females, with initial mean age of 12 years 7 months and final mean ages of 15 years and 3 months. The Michigan patients comprised 21 females and 7 males, with an initial mean age of 11 years and 9 months and final mean age of 14 years and 4 months. The control sample was paired in number, sex and age to the treated Michigan sample. ln both treated groups, lateral cephalometric radiographs were obtained before the Herbst appliance was cemented and at the end of the fixed appliance phase, The first comparison involved the Brazil group and the untreated controls, which demonstrated that the association of the Herbst appliance followed by fixed Straight-wire appliances provoked positive effects on the dentofacial complex, improving pre-existing maxillo-mandibular relationships, besides increasing dentoalveolar compensations which contributed to correct the malocclusion. The second comparison, involved the Brazl1ian and North-American patients treated with the same protocol. Although the pre-treatment comparison showed that the two groups were not similar in all aspects, they presented almost identical therapeutic modifications, which indicate that the effect of' treatment was very similar. These results point out that, in Class ll treatment, the combination of Herbst/Straight-wire mechanics produce consistent and systematic effects, correcting or minimizing possible skeletal imbalances

Efeitos do aparelho de Herbst no tratamento proecoce da má oclusão classe II de Angle

Due to its high prevalence in general population, Angle Class II malocclusion has been widely studied by several authors, as well as the methods for its treatment. Among the possible treatment methods stands out the Herbst appliance. Reintroduced more than three decades ago in the orthodontics community, it became the most utilized appliance because it does not require patient compliance, and provides continued action through bilateral telescopic tubes. The objective of the present article was to demonstrate the early treatment of Class II Division 1 malocclusion with mandibular retrusion using Herbst appliance.

Estudo em telerradiografia em norma de 45º no tratamento da classe II com aparelho de Herbst

The aim of this retrospective study was to evaluate mandibular and maxillary changes induced by the use of Herbst applianceand by natural growth through oblique cephalometric radiographs in children with Class II division 1 malocclusion with mandibular retrusion. A sample of 49 individuals with age ranging from 8 to 10 years old (before growth peak) with Class II division 1, were into two groups: Herbst treated group (n=24) and control group (n=25). Both groups were paired for gender and chronological age. Statistical analysis was performed through Student’s t test. The Herbst appliance promoted the Class II correction in a 7 months period by mesialization of lower permanent first molars and distalization of upper permanent first molars. The Herbst appliance had no influence over the mandibular structure or the mandibular length. It was concluded that early treatment with Herbst appliance corrected the Class II malocclusion by means of dentoalveolar changes.

Tratamento da classe II divisão 2 com aparelho de Herbst após o pico de crescimento puberal

Patients with Class II division 2 malocclusion and mandibular retrusion have limited treatment options after the growth peak, such as surgical-orthodontic treatment or mandibular advancement devices. Among bite-jumping devices, the Herbst appliance allows greater increase of mandibular growth since it does not require patient compliance and allows continuous use. This case report presents the treatment of a Class II division 2 malocclusion in a patient after growth peak, performed in two stages. The first stage included the upper incisors proclination and overjet increase with multibracket appliance to benefit next stage. The second stage involved mandibular advancement using Herbst appliance aiming to correct the Class II molar relationship. The treatment resulted in a stable occlusion with periodontal health, normal functions and facial aesthetics improvement. Dental and skeletal changes arising from treatment could be assessed by cephalometric analysis and superimposition of pretreatment and post-treatment cephalometric tracings. Antero-posterior discrepancy was corrected by means of dental movement as well as by mandibular growth increment stimulated by the Herbst appliance.

Aparelho de Herbst associado a aparelhos fixos: descrição de técnica

This paper aims at describeconstruction and installation sequences of a new design of appliance that allows continuously protraction of the mandible, using the telescopic mechanism of the Herbst appliance. This appliance has the advantage to be easily assembled by the orthodontist, without the necessity of molding and the assistance of a specialized laboratory, as well as the constant permanence in the mouth of the patient for being fixed.

Avaliação das alterações dentárias e esqueléticas induzidas pelo uso do aparelho de Herbst no tratamento da classe II na dentadura mista: Revisão sistemática

Objective: evaluate the immediate dental and skeletal changes induced by the Herbst appliance on early treatment of Angle´s Class II malocclusion. Material and Method: several electronic databases such as Scopus, Pub Med, Medline, Cochrane Library, Lilacs and Scielo were searched. The abstracts that fullfilled the selection criteria were selected and those that did not provide enough information about these criteria were selected but the final decision of including them or not on the research, was taken after the complete reading of the article. The selection criteria were: clinical studies with Class II individuals, both male and female, with initial age of 7 to 10 years, treated with the Herbst appliance that analysed the dental and/or skeletal changes evaluated on lateral cephalometric radiographs; researches where the treatment performed did not involve extractions or surgical interventions; studies that included patients without syndromes or health concerns and articles published in English or Portuguese. Results and Conclusions: five articles were selected. The articles showed that significant changes happened in the mandibular sagittal lenght, on facial convexity angle, on maxillo-mandibular relationship, on retroclination of the upper incisors and on distal movement of the upper molars, on proclination of the lower incisors and on extrusion of the lower molars. The appliance exerted a limited effect on the anterior relocation of the maxillary complex and on facial heights. However, more studies about the performance of the Herbst appliance on early treatment of Class II are needed.

Tratamento da má-oclusão de classe II divisão 1 de Angle, com aparelho de Herbst splint metálico seguido de aparelho fixo, na dentição permanente

The Herbst appliance is currently one of the most used appliances for the correction of Class II division 1 with mandibular retrusion. When used in peak, or just after the peak of growth it can result in some skeletal gain, which is favorable to the correction of anteroposterior discrepancy with effective and stable results. This article aims to report a case of a patient with malocclusion Class II division 1 with mandibular retrusion, associated with maxillary protusion, treated in two stages: with Herbst splint metallic appliance followed by fixed appliance orthodontic treatment.

Avaliação dos efeitos do aparelho Herbst Splint metálico, no tratamento da má oclusão classe II divisão 1, após o surto de crescimento pubertário

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tomografia computadorizada de feixe cônico para avaliação do tratamento da classe II divisão 1ª com o aparelho Herbst no espaço aéreo faríngeo

Pós-graduação em Ciências Odontológicas - FOAR

Eficiência do aparelho Herbst bandado na correção da Classe II divisão 1 -relato de caso

The current reports the case of a young patient with malocclusion Class II division 1 on permanent dentition treated in two stages, rthopedics and orthodontics, respectively. At first, the banded Herbst appliance was used duringa 7 months period, followed by a T4K appliance, Trainer for Kids used as retention, and on the second stage the corrective Orthodontics was performed. The results showed the acquirement of a Class I dental relationship, which was kept stable, with excellent intercuspation, even after 5 years of the removal of the Herbst appliance, as well as the correction of the overjet and the reduction of the facial profile convexity. It can be concluded that the Herbst appliance was very efficient in correcting the Class II malocclusion, long term, also providing a very favorable effect on the facial profile.

Avaliação cefalométrica das alterações esqueléticas, dentárias do perfil facial naturais e induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de Classe II, divisão 1ª

Pós-graduação em Ciências Odontológicas - FOAR

Avaliação cefalométrica das alterações do perfil facial naturais e induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de classe II, divisão 1ª

The aim of this study was to evaluate the facial profile changes due to natural growth and induced by Herbst appliance and Bionator in the treatment of Class II, division 1 malocclusion. In order to do that, we used a sample of 90 lateral radiographs of 45 individuals in pre-pubertal stage, divided up in two experimental groups and one control. The first group, composed of 15 brazilian individuals, with initial mean age of 9.4 years, was treated with the Herbst appliance for a period of seven months. The second experimental group consisting of 15 brazilian individuals, initial mean age of 9.9 years has gone through bionator therapy for an average period of 21 months. The control group of 15 individuals, who were not treated orthodontically, comes up from the Burlington Growth Centre, University of Toronto, Canada. The intragroup comparison was performed using the Student t test and intergroup comparisons by ANOVA complemented by the Bonferroni test. The results have shown that only the group treated with the Herbst appliance presented significant changes in facial profile with improvement of its convexity and lower lip protrusion.

Análise tomográfica da articulação temporomandibular no tratamento com Herbst em adulto jovem

Class II malocclusion features a high prevalence in Brazil, being considered as a routine in orthodontic clinics. A number of appliances are shown in the literature in order to correct Class II malocclusion with mandibular retrusion. Herbst´s fixed functional appliance, idealized by Emil Herbst (1905) and reintroduced, in the 1980´s, by Hans Pancherz is highlighted for maintaining the mandible continuously advanced, showing a shorter active treament time, an immediate esthetic impact on the facial profile, as well as requiring no patient´s commitment. Recent researches indicate the use of this appliance in individuals after pubertal growth surge. The aim of the present study is to show the orthodontics practitioner the option to use this appliance so as to treat Class II in individuals after the growth surge, obtaining satisfactory outcomes and further Class II correction.

Herbst esplinte metálico fundido: novo modelo de confecção com Duralay

A má oclusão de Classe II é originária de vários fatores etiológicos e uma das características mais comum desta má oclusão é a retrusão mandibular3, por esse motivo, os aparelhos de avanço mandibular são eleitos para o tratamento e correção desta má oclusão. Um destes aparelhos é o Herbst, que apresenta várias formas de ancoragens na sua confecção10. Tradicionalmente, as bandas eram o sistema de ancoragem mais usado, no entanto, pela alta frequência de quebras as mesmas foram substituídas por esplinte metálico12. Esse aparelho quando confeccionado de cromo cobalto pelo método da prótese parcial removível, apresenta como desvantagens a quantidade de passos laboratoriais e a possível contração do metal, podendo ocasionar a má adaptação da estrutura metálica à boca do paciente. Dessa forma, este artigo apresenta um novo método de confecção do aparelho de Herbst esplinte metálico fundido com uso da Duralay e liga níquel cromo. Esse método diminui os passos laboratoriais, proporciona maior resistência à tração e minimiza a contração da estrutura metálica, pois a resina química Duralay proporciona menor expansão do que a cera2.

Avaliação tomográfica no tratamento com Herbst em adulto jovem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)