Incisor position control and mandibular response in growing
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According to this study anchorage control onto maxillary and mandibular incisors was beneficial in Herbst appliance treatment in increasing mandibular bone base length for growing skeletal class II patients.

This study published by the American Journal of Orthodontics and Dentofacial Orthopedics aimed to test whether control in maxillary and mandibular incisor position, during treatment with an acrylic splint Herbst appliance, could influence the mandibular response in growing patients with skeletal Class II malocclusion.

The lateral cephalograms of 61 patients with skeletal and dental Class II malocclusion were retrospectively analyzed both at baseline and after Herbst appliance removal. 45 patients had received miniscrew in the mandibular arch to control mandibular incisor anchorage. In 21 patients, the maxillary incisors had been proclinated before starting the treatment for deepbite and maxillary incisor lingual inclination. All the patients were categorized into 2 homogeneous groups, according to dental overjet reduction: 30 patients with dental overjet reduction (DR) and 31 patients without dental overjet reduction (NDR).

--Both groups presented a significant skeletal correction. However, the change was significantly greater in the NDR group than in the DR group.

--The mandibular bone base reached a median value of 4.0 mm in the NDR group vs 1.1 mm in the DR group.

--The 2 groups were also significantly different in terms of the positional change of maxillary incisor, which was proclinated in group NDR and lingualized in group DR.

Conclusively, dental control of overjet was beneficial to improve the effectiveness of Herbst treatment in increasing mandibular length in growing patients with skeletal Class II malocclusion.

Source: https://doi.org/10.1016/j.ajodo.2020.02.014
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