Treatment Effects of Herbst Appliance in Skeletal Class II Cases During Prepubertal and Postpubertal Periods

Al-Azhar University36 enrolled

Overview

The study was directed to compare the treatment outcomes of subjects with Class II malocclusion who were treated with Herbst appliance before and after puberty.

Thirty-six Class II patients were randomly selected and divided into two groups based on their stage of skeletal maturation: pre-pubertal group (18 patients, mean age 9.15± 1.5 years) and post-pubertal group (18 patients, mean age 16.3 ± 1.0 years). All patients were treated with metallic splint supported Herbst IV appliance. Pretreatment and post-Herbst IV treatment cone beam CT(CBCT) scans were obtained for both groups. Dentoskeletal and TMJ measurements made on the CBCT scans were analysed.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Class II Malocclusion, Division 1

Interventions

Herbst applianceDEVICE

The bottom line of the study is to investigate the changes after Herbst appliance treatment and relate it to the pubertal status of the skeletal class II patients using CBCT.

Eligibility

Sex: ALLMin age: 8 YearsMax age: 17 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Skeletal Class II malocclusion with retrognathic mandible (ANB \>5°, SNB\<76°) 2. Normal growth pattern (SN/MP angle was in 25°- 35° range) 3. Unilateral or bilateral Class II molar relationship greater than or equal to one-half a cusp width. 4. Minimal or no crowding in the mandibular arch (0-5mm). 5. Average inclination or slight retroclination of the lower incisor. 6. An overjet greater than 5 mm. Exclusion Criteria: 1. Skletal Class I 2. Craniofacial syndrome.

Locations (1)

Al-Azhar university

Cairo, Egypt

Outcomes

Primary Outcomes

Skeletal and dental changes

The DICOM (Digital Imaging and Communications in Medicine) files from the pre and post CBCT scans were imported to Mimics software (Version 10.1, Materialise NV, Leuven, Belgium); and the cephalometric landmarks and planes were defined . Linear sagittal measurements of point A, point B, glenoid fossa, upper incisor, lower incisor, upper molars, and lower molars were recorded in relation to orbital perpendicular plane.

Time frame: 8 months

Secondary Outcomes

Condylar head position

The Most middle-superior point of the mandibular condyle was determined in sagittal, axial and coronal views. In the sagittal slice of the middle condylar head, a line was drowned through the widest measurement of the condylar heads visible on the slice, from this line, three lines were raised crossing the glenoid fossa at 45°, 90°, and 135° . Four linear measurements representing the anterosuperior, superior, posterosuperior, and posterior distance were taken from the glenoid fossa wall to the surface of the condyle

Time frame: 8 months

Data from ClinicalTrials.gov

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