Cephalometric Analysis of Changes Produced by a Modified Herbst Appliance in the Treatment of Class II Division 1 Malocclusion

This study investigated treatment changes produced by the Herbst appliance in a sample of severe Class II division 1 cases, over a period of 8 months. The sample consisted of 16 girls, of whom eight were treated by the Herbst appliance, whilst eight served as controls. All cases were matched with respect to age, sex, skeletofacial morphology, and length of treatment/observation period. Twenty-two skeletal and 19 dental parameters were recorded on pre- and post-treatment cephalograms. The net treatment effect of Herbst therapy was evaluated, taking into account the growth that occurred in the control sample. The study revealed that during 8 months of Herbst therapy there was a significant increase in mandibular length, along with sagittal repositioning. The skeletal changes in the mandible were mainly responsible for overjet and molar relation correction. A slight, favourable forward rotation of the mandible was identified. Dentoalveolar features included flaring of lower incisors and distalization of upper molars. The appliance did not have any retrusive effect on the maxilla. The modified splint design differed from the original and was cemented rather than bonded.