Long-term evaluation of soft tissue profile changes induced by Herbst appliance followed by fixed appliances





Orthodontics; Malocclusion, Angle Class II; Mandibular Advancement; Cephalometry; Follow-Up Studies.


The present investigation aimed to evaluate, by cephalometric analysis, the soft tissue profile changes in adolescents with Class II Division 1 malocclusion, treated with Herbst appliance (Stage I) and fixed appliances (Stage II), followed-up for an average of 4 years (Stage III). The adolescents were divided into two groups: treated group (TG) - 33 adolescents with Class II malocclusions (17 boys and 16 girls) consecutively treated with Herbst appliance and fixed appliances; control group (CG) - 28 adolescents (13 boys and 15 girls) with untreated Class II malocclusions. Lateral cephalograms were obtained immediately before (T1) and after (T2) Herbst treatment, after fixed appliances (T3), and on average, 4 years after orthodontic treatment. Intergroup comparison was evaluated by t or Mann-Whitney tests. The TG was evaluated by analysis of variance followed by Tukey test or Friedman test followed by Dunn’s test. Compared to the CG, the TG showed significant favorable changes at Stage I: decrease in facial convexity, upper lip retrusion, lower lip protrusion, improvement of soft tissue pogonion and increase in mentolabial angle. The total posttreatment period (T2-T4) of the TG showed: increase in H line-Prn, and upper and lower lips retrusion, while the others variables remained stable. This study suggests that Herbst therapy improved features of soft tissue facial profile, which were maintained after fixed appliances and for an average of 4 years posttreatment, although the convex facial characteristic has prevailed.

Author Biographies

Paulo Guilherme Bittencourt Marchi, Universidade Estadual Paulista

PhD Student, Department of Orthodontics, School of Dentistry at Araraquara.

Juan Francisco Mariscal Muñoz, Universidade Estadual Paulista

PhD Student, Department of Orthodontics, School of Dentistry at Araraquara.

Felipe Gustavo de Bastiani, Universidade Estadual do Oeste do Paraná

Masters Student, School of Dentistry.

Luís Antônio de Arruda Aidar, Universidade Santa Cecília

Professor, Department of Orthodontics.

Luiz Carlos Marchi, Universidade Estadual do Oeste do Paraná

Adjunct Professor, Department of Orthodontics, School of Dentistry.

Gladys Cristina Dominguez, Universidade de São Paulo

Professor, Department of Orthodontics.

Dirceu Barnabé Raveli, Universidade Estadual Paulista

Adjunct Professor, Department of Orthodontics, School of Dentistry at Araraquara.


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How to Cite

MARCHI, P. G. B. .; MUÑOZ, J. F. M. .; BASTIANI, F. G. de; AIDAR, L. A. de A. .; MARCHI, L. C. .; DOMINGUEZ, G. C. .; RAVELI, D. B. . Long-term evaluation of soft tissue profile changes induced by Herbst appliance followed by fixed appliances. Research, Society and Development, [S. l.], v. 11, n. 7, p. e33911729953, 2022. DOI: 10.33448/rsd-v11i7.29953. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29953. Acesso em: 6 jul. 2022.



Health Sciences