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Gero Stefan Michael Kinzinger - One of the best experts on this subject based on the ideXlab platform.

  • soft tissue profile changes after functional mandibular advancer or Herbst Appliance treatment in class ii patients
    Clinical Oral Investigations, 2018
    Co-Authors: Jan Hourfar, Jorg Alexander Lisson, Ulrich Gross, Linda Frye, Gero Stefan Michael Kinzinger
    Abstract:

    The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either “Functional Mandibular Advancer” (FMA) or Herbst Appliance. The study included n = 42 patients treated with either FMA (n = 21) or Herbst Appliance (n = 21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements. The actual therapeutic effect was calculated using data from a growth survey. After testing for normal distribution and homogeneity of variance, data were analyzed by one-sample Student’s t tests and independent Student’s t tests. Statistical significance was set at p < 0.05. For both FFAs, significant upper lip retrusion, increase in lower lip’s thickness, and length of the lower face occurred. Additionally, significant lower lip retrusion and straightening of the profile were found in FMA and Herbst Appliance patients. All remaining variables revealed no significant differences. Treatment-related changes on the facial soft tissue profile could be regarded similar in class II patients treated with FMA or Herbst Appliance. No treatment-related changes that were specific for FMA or Herbst Appliance could be identified. Only moderate changes were noted comparing pre- and posttreatment soft tissue profiles. Despite proven differences in skeletal and dental treatment effects, the facial profile has not to be taken into consideration when choosing between FMA and Herbst Appliance for class II treatment.

  • a retrospective cephalometric investigation of two fixed functional orthodontic Appliances in class ii treatment functional mandibular advancer vs Herbst Appliance
    Clinical Oral Investigations, 2018
    Co-Authors: Gero Stefan Michael Kinzinger, Ulrich Gross, Jorg Alexander Lisson, Linda Frye, Jan Hourfar
    Abstract:

    Objective The objective of the study is to compare skeletal and dental changes in class II patients treated with fixed functional Appliances (FFA) that pursue different biomechanical concepts: (1) FMA (Functional Mandibular Advancer) from first maxillary molar to first mandibular molar through inclined planes and (2) Herbst Appliance from first maxillary molar to lower first bicuspid through a rod-and-tube mechanism.

  • Soft tissue profile changes after Functional Mandibular Advancer or Herbst Appliance treatment in class II patients.
    Clinical Oral Investigations, 2017
    Co-Authors: Jan Hourfar, Jorg Alexander Lisson, Ulrich Gross, Linda Frye, Gero Stefan Michael Kinzinger
    Abstract:

    The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either “Functional Mandibular Advancer” (FMA) or Herbst Appliance. The study included n = 42 patients treated with either FMA (n = 21) or Herbst Appliance (n = 21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements. The actual therapeutic effect was calculated using data from a growth survey. After testing for normal distribution and homogeneity of variance, data were analyzed by one-sample Student’s t tests and independent Student’s t tests. Statistical significance was set at p 

Jan Hourfar - One of the best experts on this subject based on the ideXlab platform.

  • soft tissue profile changes after functional mandibular advancer or Herbst Appliance treatment in class ii patients
    Clinical Oral Investigations, 2018
    Co-Authors: Jan Hourfar, Jorg Alexander Lisson, Ulrich Gross, Linda Frye, Gero Stefan Michael Kinzinger
    Abstract:

    The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either “Functional Mandibular Advancer” (FMA) or Herbst Appliance. The study included n = 42 patients treated with either FMA (n = 21) or Herbst Appliance (n = 21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements. The actual therapeutic effect was calculated using data from a growth survey. After testing for normal distribution and homogeneity of variance, data were analyzed by one-sample Student’s t tests and independent Student’s t tests. Statistical significance was set at p < 0.05. For both FFAs, significant upper lip retrusion, increase in lower lip’s thickness, and length of the lower face occurred. Additionally, significant lower lip retrusion and straightening of the profile were found in FMA and Herbst Appliance patients. All remaining variables revealed no significant differences. Treatment-related changes on the facial soft tissue profile could be regarded similar in class II patients treated with FMA or Herbst Appliance. No treatment-related changes that were specific for FMA or Herbst Appliance could be identified. Only moderate changes were noted comparing pre- and posttreatment soft tissue profiles. Despite proven differences in skeletal and dental treatment effects, the facial profile has not to be taken into consideration when choosing between FMA and Herbst Appliance for class II treatment.

  • a retrospective cephalometric investigation of two fixed functional orthodontic Appliances in class ii treatment functional mandibular advancer vs Herbst Appliance
    Clinical Oral Investigations, 2018
    Co-Authors: Gero Stefan Michael Kinzinger, Ulrich Gross, Jorg Alexander Lisson, Linda Frye, Jan Hourfar
    Abstract:

    Objective The objective of the study is to compare skeletal and dental changes in class II patients treated with fixed functional Appliances (FFA) that pursue different biomechanical concepts: (1) FMA (Functional Mandibular Advancer) from first maxillary molar to first mandibular molar through inclined planes and (2) Herbst Appliance from first maxillary molar to lower first bicuspid through a rod-and-tube mechanism.

  • Soft tissue profile changes after Functional Mandibular Advancer or Herbst Appliance treatment in class II patients.
    Clinical Oral Investigations, 2017
    Co-Authors: Jan Hourfar, Jorg Alexander Lisson, Ulrich Gross, Linda Frye, Gero Stefan Michael Kinzinger
    Abstract:

    The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either “Functional Mandibular Advancer” (FMA) or Herbst Appliance. The study included n = 42 patients treated with either FMA (n = 21) or Herbst Appliance (n = 21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements. The actual therapeutic effect was calculated using data from a growth survey. After testing for normal distribution and homogeneity of variance, data were analyzed by one-sample Student’s t tests and independent Student’s t tests. Statistical significance was set at p 

James A Mcnamara - One of the best experts on this subject based on the ideXlab platform.

  • Three-dimensional assessment of the middle cranial fossa and central skull base following Herbst Appliance treatment
    Angle Orthodontist, 2018
    Co-Authors: Karine Sayure Okano, Lorenzo Franchi, James A Mcnamara, Lucia H. S. Cevidanes, Antônio Carlos De Oliveira Ruellas, Marilia Yatabe, Tung Nguyen, Paula Loureiro Cheib, Bernardo Quiroga Souki
    Abstract:

    ABSTRACT Objectives: The purpose of this three-dimensional (3D) study was to assess retrospectively the middle cranial fossa and central skull base of patients treated with the Herbst Appliance (HA). Materials and Methods: 3D surface virtual models of 40 Class II, division 1 malocclusion patients were generated from cone-beam computed tomography (CBCT) acquired before treatment (T0) and after 8 months of HA treatment (T1). T0 and T1 3D models were superimposed volumetrically at the anterior cranial fossa. Twenty subjects who had been treated with the Herbst Appliance (HAG) were compared to 20 subjects who were not treated orthopedically. The latter group served as a comparison control group (CG). Quantitative assessments of the location and directional changes were made with linear and angular measurements between anatomical landmarks. Qualitative assessments of the spatial behavior of the middle cranial fossa and central skull base relative to the anterior cranial fossa were displayed graphically for vis...

  • Three-dimensional skeletal mandibular changes associated with Herbst Appliance treatment
    Orthodontics & Craniofacial Research, 2017
    Co-Authors: Bernardo Quiroga Souki, Lorenzo Franchi, James A Mcnamara, Paula Loureiro Cheib Vilefort, Dauro Douglas Oliveira, Ildeu Andrade, Antônio Carlos De Oliveira Ruellas, Marilia Yatabe, Tung Nguyen, Lucia H. S. Cevidanes
    Abstract:

    Objectives Three-dimensional evaluation of skeletal mandibular changes following Herbst Appliance treatment. Setting and Sample Population Retrospective case–control study, based on a sample size calculation. Twenty-five pubertal patients treated with Herbst Appliance (HAG), and 25 matched Class II patients who received other non-orthopaedic dental treatments (CG). Material and Methods Three-dimensional models were generated from pre-treatment (T0) and post-treatment (T1) cone beam computed tomograms. Volumetric registration on the cranial base was used to assess mandibular displacement; volumetric regional registration was performed to evaluate mandibular growth. Quantitative measurements of X, Y, Z and 3D Euclidian changes, and also qualitative visualization by colour-mapping and semi-transparent overlays were obtained. Results Downward displacement of the mandible was observed in both HAG and CG (2.4 mm and 1.5 mm, respectively). Significant forward displacement of the mandible was observed in the HAG (1.7 mm). HAG showed greater 3D superior and posterior condylar growth than the CG (3.5 mm and 2.0 mm, respectively). Greater posterior growth of the ramus was noted in the HAG than in CG. Conclusions Immediately after Herbst therapy, a significant mandibular forward displacement was achieved, due to increased bone remodelling of the condyles and rami compared to a comparison group. Three-dimensional changes in the direction and magnitude of condylar growth were observed in Herbst patients.

  • RESEARCH Open Access Mechanisms of Class II correction induced by the crown Herbst Appliance as a single-phase Class II
    2016
    Co-Authors: Gundega Jakobsone, Dalia Latkauskiene, James A Mcnamara
    Abstract:

    Background: The objective of this study is to evaluate the skeletal and dentoalveolar effects of the crown Herbst Appliance used alone for a single phase of therapy followed by a 1-year observation period. Methods: Forty patients (mean age 13.6 ± 1.3 years) with a stable Class I occlusion 1 year following the treatment with the crown Herbst Appliance were selected from a prospective sample of 180 consecutively treated Class II patients. No other Appliances were used during treatment or during the follow-up period. The dentoskeletal changes were compared with a matched sample of untreated Class II subjects (mean age 13.9 ± 1.6 years). Lateral cephalograms were taken before treatment, after Herbst treatment (1 year), and after 1-year follow-up. Overcorrection was avoided intentionally. Results: Treatment produced an increase in mandibular length, a decrease in ANB angle, and a restriction in the vertical growth of posterior maxilla. The maxillary molars moved backward and tipped distally. The lower incisors proclined markedly, and the upper incisors became retroclined. During the follow-up period, the changes primarily were dentoalveolar in nature, with marked rebound of the upper molars and lower incisors, resulting in some increases in overbite and overjet. Conclusions: The occlusal correction of Class II malocclusion observed 1 year after the crown Herbst Appliance as a single-phase therapy was achieved primary due to the dentoalveolar changes and only limited skeletal change occurred

  • Mechanisms of Class II correction induced by the crown Herbst Appliance as a single-phase Class II therapy: 1 year follow-up
    Progress in Orthodontics, 2013
    Co-Authors: Gundega Jakobsone, Dalia Latkauskiene, James A Mcnamara
    Abstract:

    Background The objective of this study is to evaluate the skeletal and dentoalveolar effects of the crown Herbst Appliance used alone for a single phase of therapy followed by a 1-year observation period.

  • Short-Term Treatment Effects Produced by the Herbst Appliance in the Mixed Dentition
    Angle Orthodontist, 2005
    Co-Authors: Marcio Rodrigues De Almeida, José Fernando Castanha Henriques, Renato Rodrigues De Almeida, Weber Ursi, James A Mcnamara
    Abstract:

    This prospective clinical investigation evaluates the dentoalveolar and skeletal ceph- alometric changes produced by the Herbst Appliance during treatment of mixed dentition patients with Class II division 1 malocclusion. Thirty individuals (15 male and 15 female individuals; initial mean age nine years 10 months) were treated with the Herbst Appliance for a period of 12 months. For comparison, the records of 30 untreated Class II children (15 boys, 15 girls; initial mean age nine years eight months) were followed without treatment for a period of 12 months. The results indicated that the treatment effects produced in the mixed dentition patients were primarily den- toalveolar in nature. The mandibular incisors were tipped labially, and the maxillary incisors were retruded; a significant increase in mandibular posterior dentoalveolar height occurred, and there was a restriction in the vertical development of the maxillary molars. There was no difference in the forward growth of the maxilla between the two groups. In comparison with the controls, how- ever, the Herbst treatment produced a modest but statistically significant increase in total man- dibular length. This increase in total mandibular length, however, was less than that observed in adolescent Herbst patients in other studies. (Angle Orthod 2005;75:540-547.)

Hans Pancherz - One of the best experts on this subject based on the ideXlab platform.

  • Dentoskeletal effects and facial profile changes in young adults treated with the Herbst Appliance.
    Angle Orthodontist, 2009
    Co-Authors: Sabine Ruf, Hans Pancherz
    Abstract:

    This prospective Herbst study analyzed the sagittal dental and skeletal changes contributing to Class II correction in young adults. Additionally, the alteration in skeletal and soft tissue convexity occurring during treatment was assessed. Early adolescent subjects in the permanent dentition who had been treated with the Herbst Appliance were used for comparison. Lateral headfilms from before and after an average treatment period of 8.5 months for the young adults and 7.1 months for the adolescents were evaluated. All adult and adolescent subjects were treated to either Class I or overcorrected Class I occlusal relationships. In both groups the improvement in sagittal incisor and molar relationships was achieved more by dental changes than by skeletal ones. The amount of skeletal change contributing to overjet and molar correction was smaller in the young adult group (22% and 25%, respectively) than in the early adolescent group (39% and 41%, respectively). Skeletal and soft tissue facial profile convexity was reduced in adults and adolescents. Facial profile improvement did not differ between the two groups. The results of this study revealed that the Herbst Appliance is most effective in the treatment of Class II malocclusion in young adults. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.

  • the Herbst Appliance research based clinical management
    2008
    Co-Authors: Hans Pancherz, Sabine Ruf
    Abstract:

    This is a research-based book on the clinical use of the Herbst Appliance in the management of Class 2 malocclusions. Different clinical problems and questions are addressed in the light of the corresponding research existing. Thus, in contrast to other Class 2 alternative treatments, the Herbst Appliance approach is based on scientific research.

  • The Herbst Appliance--its biologic effects and clinical use
    American Journal of Orthodontics, 2004
    Co-Authors: Hans Pancherz
    Abstract:

    The purpose of this article is to survey the Herbst bite-jumping method. An outline of Appliance design and Appliance construction is given. The effects of the treatment method on the dentofacial complex and on the masticatory system have been analyzed with the aid of dental casts, cephalometric roentgenograms, and electromyographic registrations from the masticatory muscles. The use and effectiveness of the Herbst Appliance in the treatment of Class II malocclusions are exemplified by clinical cases, some of which were followed for 5 years after treatment. The Herbst Appliance is most effective in the treatment of Class II malocclusions, provided it is used as indicated. Thus, the Appliance must be limited to growing persons only. The treatment method should not be looked upon as a last resort to be used only when other treatment approaches have failed. Treatment prognosis is best in subjects with a brachyfacial growth pattern. Unfavorable growth, unstable occlusal conditions, and persisting oral habits after treatment are potential risk factors for occlusal relapses. As treatment with the Herbst Appliance is performed during a relatively short period, the hard and soft tissues (teeth, bone, and musculature) would need some time for adaptation to the new mandibular position after the Appliance is removed. Posttreatment retention as a routine with a removable functional Appliance is therefore recommended.

  • Histologic changes associated with the Herbst Appliance in adult rhesus monkeys (Macaca mulatta)
    Seminars in Orthodontics, 2003
    Co-Authors: James A Mcnamara, John E. Peterson, Hans Pancherz
    Abstract:

    Abstract Although most Class II orthopedic treatments have been recommended foruse in juveniles and adolescents, orthopedic intervention with the Herbst Appliance has recently been suggested for use in young adults. Previous experimental studies have suggested that the potential for adaptation in the temporomandibular joint (TMJ) region of the young adult, while diminished compared with that of adolescents, still may be sufficient to allow for the resolution of Class II problems. The purpose of the current study was to evaluate histologically the response of the mandibular condyle, glenoid fossa, and posterior border of the ramus of adult Rhesus monkeys whose mandibles had been positioned forward with a Herbst Appliance. Acrylic splint Herbst Appliances were bonded to the maxillary and mandibular dental arches of 14 female adult animals. The animals were killed at 3-, 6-, 12-, and 24-week intervals after Appliance placement. Seven female adult Rhesus monkeys served as controls. The TMJ regions were removed and analyzed histologically qualitatively and quantitatively by way of the Bioquant IV measuring system (Bioquant Image Analysis Corp, Nashville, TN). Significant variation was observed in the TMJ regions of the control animals, with some animals having identifiable prechondroblastic and chondroblastic layers of condylar cartilage and others with more fibrous coverings of the mandibular condyle. In the experimental animals, adaptive changes in the condylar cartilage were evident as early as 3 weeks, with the dimensions of the condylar cartilage increasing gradually throughout the experimental period. Only minor changes were noted in the articular tissue. All adult control animals had a bony cap, and the bony cap persisted in the experimental animals. Significant bone deposition occurred along the anterior surface of the postglenoid spine only in the 6- and 12-week experimental groups. No significant areas of bone deposition and resorption were noted along the posterior border of the ramus. The result of any study in animals, even in nonhuman primates, obviously cannot be applied directly to human functional orthopedic treatment. Because the tissue types and the morphology of the TMJ generally are similar between monkey and man, however, the findings of the present study may provide some insight concerning the changes occurring within the mandibular condyle and glenoid fossa when a Herbst Appliance is used clinically in young adult patients.

  • Long-term Effects of the Herbst Appliance on the Dental Arches and Arch Relationships: A Biometric Study
    Journal of Orthodontics, 1995
    Co-Authors: Ken Hansen, Pannamas Iemamnueisuk, Hans Pancherz
    Abstract:

    AbstractThe purpose of this study was to evaluate biometrically the treatment and post-treatment effects of the Herbst Appliance on the dental arches and arch relationships. The sample consisted of 53 Class II, division 1 malocclusion patients (33 boys and 20 girls) treated with the Herbst Appliance. The mean age of the patients before treatment was 12·5 years (SD = 1·2 years). Dental casts were analysed before treatment, after treatment, 6 months post-treatment and at the end of the growth period (5–10 years post-treatment). The following variables were assessed: sagittal molar and canine relationships, overjet, overbite, maxillary and mandibular arch perimeters, and inter-molar and inter-canine dental arch widths. During treatment, the overjet, overbite, and sagittal molar relationship were overcorrected in most of the cases, while the sagittal canine relationship was normalized. The maxillary and mandibular arch perimeters increased during treatment, as did dental arch widths (moral and canine).In the ...

Anne Marie Bollen - One of the best experts on this subject based on the ideXlab platform.