Mini-implants and the efficiency of Herbst treatment: a preliminary study

BACKGROUND: The purpose of this study is to present the use of a modified Herbst appliance in association with temporary anchorage devices (TADs) in order to enhance the correction of skeletal class II malocclusions. METHODS: Ten consecutive adolescents scheduled for Herbst treatment were assigned to two treatment groups. Five cases were treated with a modified miniscrew-supported Herbst appliance (experimental group (EG)) and five cases with a conventional cast Herbst appliance (control group (CG)). In all cases, the Herbst was kept in place for 9 months and was followed by fixed appliances until class I relationships were achieved. The initial (T1) and final (T2) lower incisor inclination on lateral headfilms were analyzed for each case, and the mean increase for the five EG patients and the five CG patients were compared. RESULTS: The mean increase in lower incisor inclination at the end of treatment was 1° (range 0° to 2°) for the EG and 7° (range 4° to 10°) for the CG. CONCLUSIONS: The rational association of TADs with the Herbst appliance can optimize treatment efficiency and skeletal response by reducing the occurrence of excessive lower incisor proclination.