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

Authors

DOI:

https://doi.org/10.33448/rsd-v11i7.29953

Keywords:

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

Abstract

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.

References

Baysal, A., & Uysal, T. (2013). Soft tissue effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy. Eur J Orthod, 35(1), 71–81.

Bishara, S.E. (2001) Textbook of Orthodontics. WB Saunders.

Björk, A., & Helm, S. (1967). Prediction of age maximum pubertal growth in body height. Angle Orthod, 37(2),134–143.

Björk, A., & Skieller, V. (1983). Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod, 5(1), 1–46.

Bock, N. C., Santo, C., & Pancherz, H. (2009). Facial profile and lip position changes in adult Class II, Division 2 subjects treated with the Herbst-Multibracket appliance. A radiographic cephalometric pilot study. J Orofac Orthop, 70(1), 51–62.

D'Antò, V., Bucci, R., Franchi, L., Rongo, R., Michelotti, A., & Martina, R. (2015). Class II functional orthopaedic treatment: a systematic review of systematic reviews. J Oral Rehabil, 42(8), 624–642.

de Almeida, M. R., Flores-Mir, C., Brandão, A. G., de Almeida, R. R., & de Almeida-Pedrin, R. R. (2008). Soft tissue changes produced by a banded-type Herbst appliance in late mixed dentition patients. World J Orthod, 9(2), 121–131.

Flores-Mir, C., Major, M. P., & Major, P. W. (2006). Soft tissue changes with fixed functional appliances in Class II division 1. Angle Orthod, 76(4), 712–720.

Franchi, L., Baccetti, T., & McNamara, J. A., Jr (1999). Treatment and posttreatment effects of acrylic splint Herbst appliance therapy. Am J Orthod Dentofacial Orthop, 115(4), 429–438.

Lange, D. W., Kalra, V., Broadbent, B. H., Jr, Powers, M., & Nelson, S. (1995). Changes in soft tissue profile following treatment with the bionator. Angle Orthod, 65(6), 423–430.

Martins, F. da S., Silva, M. F. da., Souza, D. S., Farias, R. R. S. de., & Ramos, P. F. C. (2021). Malocclusion and speech therapy and associated factors: integrative review. Res Soc Dev, 10(1), e27610111714.

McNamara, J.A. & Brudon, W.L. (2001) Orthodontics and Dentofacial Orthopedics. Needham Press Inc, Ann Arbor.

Meyer-Marcotty, P., Kochel, J., Richter, U., Richter, F., & Stellzig-Eisenhauer, A. (2012). Reaction of facial soft tissues to treatment with a Herbst appliance. J Orofac Orthop, 73(2), 116–125.

O'Brien, K., Wright, J., Conboy, F., Chadwick, S., Connolly, I., Cook, P., Birnie, D., Hammond, M., Harradine, N., Lewis, D., McDade, C., Mitchell, L., Murray, A., O'Neill, J., Read, M., Robinson, S., Roberts-Harry, D., Sandler, J., Shaw, I., & Berk, N. W. (2003). Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 2: Psychosocial effects. Am J Orthod Dentofacial Orthop, 124(5), 488–495.

Pancherz, H., & Anehus-Pancherz, M. (1994). Facial profile changes during and after Herbst appliance treatment. Eur J Orthod, 16(4), 275–286.

Pancherz, H., & Bjerklin, K. (2014). Mandibular incisor inclination, tooth irregularity, and gingival recessions after Herbst therapy: a 32-year follow-up study. Am J Orthod Dentofacial Orthop, 146(3), 310–318.

Pancherz, H., & Hansen, K. (1986). Occlusal changes during and after Herbst treatment: a cephalometric investigation. Eur J Orthod, 8(4), 215–228.

Proffit, W. R., Fields, H. W., Jr, & Moray, L. J. (1998). Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg, 13(2), 97–106.

Quintão, C., Helena, I., Brunharo, V. P., Menezes, R. C., & Almeida, M. A. (2006). Soft tissue facial profile changes following functional appliance therapy. Eur J Orthod, 28(1), 35–41.

Rains, M. D., & Nanda, R. (1982). Soft-tissue changes associated with maxillary incisor retraction. Am J Orthod Dentofacial Orthop, 81(6), 481–488.

Rego, M. V., Martinez, E. F., Coelho, R. M., Leal, L. M., & Thiesen, G. (2017). Perception of changes in soft-tissue profile after Herbst appliance treatment of Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop, 151(3), 559–564.

Ruf, S., & Pancherz, H. (2004). Orthognathic surgery and dentofacial orthopedics in adult Class II Division 1 treatment: mandibular sagittal split osteotomy versus Herbst appliance. Am J Orthod Dentofacial Orthop, 126(2), 140–255.

Schaefer, A. T., McNamara, J. A., Jr, Franchi, L., & Baccetti, T. (2004). A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst appliances followed by fixed appliance therapy. Am J Orthod Dentofacial Orthop, 126(1), 7–15.

Siara-Olds, N. J., Pangrazio-Kulbersh, V., Berger, J., & Bayirli, B. (2010). Long-term dentoskeletal changes with the Bionator, Herbst, Twin Block, and MARA functional appliances. Angle Orthod, 80(1), 18–29.

Silva, S. R. C. da, Moura, V. S. de, Oliveira, L. K. B. F., Andrade, A. M. da C., Santos, L. R. S., Silva, J. M. de L., Rastelli, A. S., Passos, J. E. M. dos S., & Romão, D. A. (2021). Impacts of malocclusion on the quality of life of children and adolescents: An integrative review. Res Soc Dev, 10(8), e4510816910.

Silvestri, A., Ferraris, L., & Vernucci, R. (2004) Analisi cefalometrica in laterale del paziente in crescita e adulto. Mondo Ortod, 29, 175–195.

Subtelny, J. D. (1959) A longitudinal study of soft tissue facial structures and their profile characteristics, defined in relation to underlying skeletal structures. Am J Orthod Dentofacial Orthop, 45(7),481-507.

Tung, A. W., & Kiyak, H. A. (1998). Psychological influences on the timing of orthodontic treatment. Am J Orthod Dentofacial Orthop, 113(1), 29–39.

Valant, J. R., & Sinclair, P. M. (1989). Treatment effects of the Herbst appliance. Am J Orthod Dentofacial Orthop, 95(2), 138–147.

Veltkamp, T., Buschang, P. H., English, J. D., Bates, J., & Schow, S. R. (2002). Predicting lower lip and chin response to mandibular advancement and genioplasty. Am J Orthod Dentofacial Orthop, 122(6), 627–634.

Zymperdikas, V. F., Koretsi, V., Papageorgiou, S. N., & Papadopoulos, M. A. (2016). Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod, 38(2), 113–126.

Downloads

Published

27/05/2022

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: 26 nov. 2024.

Issue

Section

Health Sciences