Comparison between Herbst appliances with or without miniscrew anchorage

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Abstract

Background:

Herbst appliance is largely used in orthodontics for the correction of Class II. The aim of this paper was to analyze dental and skeletal effects of a splints Herbst-miniscrews combined device in comparison to a mandibular splints Herbst appliance.

Materials and Methods:

Fifty Class II division 1 patients (27 males and 23 females with a mean age of 11.8 ± 1.7 years) were included in the study. Lateral headfilms of 25 patients with a mandibular resin splint and a miniscrew anchorage (test group) and of 25 patients with mandibular acrylic resin splints (control group) were analyzed before (T0) and after (T1) the Herbst treatment. The mean and standard deviation (SD) of each variable were calculated; paired t-test was used to evaluate statistical changes before and after the treatment, in each group and Student t-test was used to compare the two groups.

Results:

Significant differences were observed for P < 0.05. At the end of the Herbst treatment, mandibular incisor proclination was significantly lower in the test group (2.8°) in comparison to the control group (7.4°).

Conclusions:

The miniscrew-Herbst system, described in the present study, allows correction of Class II malocclusion, with a lower anchorage loss, in form of mandibular incisor proclination, during the treatment, in comparison to mandibular acrylic splints Herbst.

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Most cited references 28

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The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation.

H Pancherz (1982)

Sagittal skeletal and dental changes contributing to Class II correction in Herbst appliance treatment were evaluated quantitatively on lateral roentgenograms. The material consisted of forty-two Class II. Division 1 malocclusion cases. Twenty-two of these were treated with the Herbst appliance for 6 months. The other twenty cases served as a control group. The results of the investigation revealed the following: (1) Bite jumping with the Herbst appliance resulted in Class 1 occlusal relationships in all treated cases. (2) The improvement in occlusal relationships was about equally a result of skeletal and dental changes. (3) Class II molar correction averaging 6.7 mm. was mainly a result of a 2.2 mm. increase in mandibular length, a 2.8 mm. distal movement of the maxillary molars, and a 1.0 mm. mesial movement of the mandibular molars. (4) Overjet correction averaging 5.2 mm. was mainly a result of a 2.2 mm. increase in mandibular length and a 1.8 mm. mesial movement of the mandibular incisors. (5) Anterior condylar displacement (0.3 mm.), redirection of maxillary growth (0.4 mm.), and distal movement of the maxillary incisors (0.5 mm.) were of minor importance in the improvement in molar and incisor relationships seen. (6) A direct relationship existed between the amount of bite jumping at the start of treatment and the treatment effects on the occlusion and on mandibular growth. For a maximal treatment response, it is suggested that the Herbst appliance be constructed with the mandible jumped anteriorly as much as possible, namely, to an incisal edge-to-edge position. The clinician should be aware of the dental changes occurring during Herbst appliance treatment and make sure that these changes are not incongruous with his over-all treatment goal.

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Efficiency of a skeletonized distal jet appliance supported by miniscrew anchorage for noncompliance maxillary molar distalization.

Gero Kinzinger, Norbert Gülden, Faruk Yildizhan … (2009)

Conventional anchorage appliances rely exclusively on intraoral anchorage for noncompliance molar distalization. The partial coverage of the palate, in particular, often results in compromised oral hygiene. An innovative alternative combines a skeletonized distal jet appliance with 2 paramedian miniscrews for additional anchorage. The objectives of this study were to investigate the suitability of the skeletonized distal jet for translatory molar distalization and to check the quality of the supporting anchorage setup. Two paramedian miniscrews (length, 8-9 mm; diameter, 1.6 mm) were placed into the anterior area of the palate in 10 patients. Skeletonized distal jet appliances fitted with composite to the first premolars and the collars of the miniscrews were used for bilateral molar distalization, and the coil springs were activated with a distalization force of 200 cN on each side. The study confirmed the suitability of the appliance for translatory molar distalization (3.92 +/- 0.53 mm) with slight mesial inward rotation (on average, 8.35 degrees +/- 7.66 degrees and 7.88 degrees +/- 5.50 degrees ). The forces acting reciprocally on the anchorage setup were largely absorbed by the anchorage unit involving 2 anchorage teeth and 2 miniscrews. Significant anchorage loss, in the form of first premolar mesialization of 0.72 +/- 0.78 mm, was found. The skeletonized distal jet appliance supported by additional miniscrew anchorage allows translatory molar distalization. Although the anchorage design combining 2 miniscrews at a paramedian location and the periodontium of 2 anchorage teeth does not offer the quality of stationary anchorage, it achieves greater molar distalization in total sagittal movement than conventional anchorage designs with an acrylic button.

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Factors influencing the stability of miniscrews. A retrospective study on 300 miniscrews.

Anna Menini, Fabio Tamborrino, Antonio Manni … (2011)

The aim of this study was to investigate, over a period of approximately 3 years, the reactions to orthodontic loading of a type V titanium miniscrew. In this retrospective study, conducted in a private practice, the records of 300 miniscrews inserted in 132 consecutive patients (80 females, 60.6 percent) by the same surgeon were evaluated. The mean age of the patients was 23.2 years. Three types of miniscrews (type A: diameter 1.5 mm, length 9 mm; type B: diameter 1.5 mm, length 11 mm; and type C: diameter 1.3 mm, length 11 mm) were used. The clinical variables evaluated included the loading time and location of the miniscrew in relation to the gingiva and root. The success rates with different variables were compared using chi-square or Fisher's exact test where appropriate. A cumulative survival rate of 81 percent (243/300) was found using Kaplan-Meier analysis, with an optimum success rate for the 1.3 mm wide miniscrew inserted in the attached gingiva, with immediate loading applied. Cox proportional hazard regression showed significant differences between success rate and the following parameters: gender, loading time, gingival or bone localization, and diameter of the miniscrews. Considering the clinically controllable parameters, and within the limits of this retrospective study, 1.3 mm diameter miniscrews inserted in attached gingiva and immediately loaded had the most favourable prognosis.

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Author and article information

Journal

Journal ID (nlm-ta): Dent Res J (Isfahan)

Journal ID (iso-abbrev): Dent Res J (Isfahan)

Journal ID (publisher-id): DRJ

Title: Dental Research Journal

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 1735-3327

ISSN (Electronic): 2008-0255

Publication date (Print): December 2012

Volume: 9

Issue: Suppl 2

Pages: S216-S221

Affiliations

[1 ]Dentist, Private Practice, Lecce, Italy

[2 ]Dentist, Private Practice, Massa, Italy

[3 ]Dentist, Private Practice, La Spezia, President, Scientific Committee, UO Odontoiatria IRCCS G. Gaslini Largo G. Gaslini 5 16100 Genova, Italy

Author notes

Address for correspondence: Dr. Cozzani Mauro, Via Fontevivo, 21N, La Spezia (SP), 19125, Italy. E-mail: maurocozzani@ 123456gmail.com

Article

Publisher ID: DRJ-9-216

DOI: 10.4103/1735-3327.109762

PMC ID: 3692177

PubMed ID: 23814587

SO-VID: 65254528-66b8-477c-87d7-996f35cdd2ae

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Comparison between Herbst appliances with or without miniscrew anchorage

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Abstract

Background:

Materials and Methods:

Results:

Conclusions:

Related collections

Arab Journal of Forensic Sciences & Forensic Medicine (AJFSFM)

Most cited references 28

The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation.

Efficiency of a skeletonized distal jet appliance supported by miniscrew anchorage for noncompliance maxillary molar distalization.

Factors influencing the stability of miniscrews. A retrospective study on 300 miniscrews.

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