title: The effects, limitations, and long-term dentofacial adaptations to treatment with the Herbst appliance.
abstract: The purpose of this article is to summarize the existing scientific data with respect to the short- and long-term effects of the Herbst appliance on the occlusion and on the maxillo/mandibular complex. The article also discusses the treatment indications and possible treatment limitations. The Herbst method is most effective in the treatment of Class II malocclusions. Long-term stability seems to be dependent on a stable cuspal interdigitation. Marked mandibular morphological changes occur during therapy and sagittal condylar growth is increased. Posttreatment, most of the mandibular morphological changes revert and no long-term influence of Herbst treatment on mandibular growth can be verified. The appliance effect on the maxillary complex can be compared with that of a high-pull headgear. Without proper retention, however, this effect is of a temporary nature. Herbst treatment is especially indicated in the permanent dentition at or just after the pubertal peak of growth. Mixed dentition treatment is not recommended, as a stable cuspal interdigitation after therapy is difficult to achieve and relapses are prone to occur. In the nongrowing patient, the appliance should be used with great caution.
authors.affiliation: Department of Orthodontics, University of Giessen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Pancherz
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000503:physiopathology / Q000628:therapy*; D008445:Maxillofacial Development; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome