title: Immediate skeletal and dentoalveolar effects of the crown- or banded type Herbst appliance on Class II division 1 malocclusion.
abstract: OBJECTIVE
  To evaluate the relative skeletal and dental changes produced by the crown- or banded-type Herbst appliance in growing Class II division 1 malocclusion cases.
  
  
  METHODS
  Several electronic databases were searched with the help of a health sciences librarian, without language limitation. Abstracts that appeared to fulfill the initial selection criteria (Herbst use and clinical trial) were selected by consensus, and their original articles were then retrieved. Clinical trials were selected that used lateral cephalograms to assess immediate skeletal and dental changes from the use of either crown or banded Herbst appliances. Clinical trials that employed other simultaneous potentially growth-modifying appliances or surgery were excluded. A comparable untreated Class II division 1 malocclusion control group was required to factor out normal growth changes. References from the selected articles were also hand searched.
  
  
  RESULTS
  Only three articles meet the selection criteria. Proclination and anterior movement of the lower incisors, overjet reduction, and improvement of first molar relationship thorough mesial movement of the first molars, reduction of ANB angle, and an increase in the mandibular plane angle were reported. There were mixed findings as to mandibular sagittal length and position and increases in lower face height, both anteriorly and posteriorly. No statistically significant changes were noted in the sagittal length or position of the skeletal maxilla.
  
  
  CONCLUSIONS
  Dental changes have more impact than skeletal changes in the correction of Class II division 1 malocclusions with the crown or banded Herbst appliance.
authors.affiliation: Private Practice, Calgary, Alberta, Canada.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Barnett
authors.forename: Duncan W
authors.initials: DW
authors.lastname: Higgins
authors.forename: Paul W
authors.initials: PW
authors.lastname: Major
authors.forename: Carlos
authors.initials: C
authors.lastname: Flores-Mir
mesh_terms: D002508:Cephalometry; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D017289:Orthodontic Appliances, Functional; D009971:Orthodontics, Corrective / Q000295:instrumentation*; D016896:Treatment Outcome