title: Is Herbst-multibracket appliance treatment more efficient in adolescents than in adults?
abstract: OBJECTIVE
  To determine whether Herbst treatment is more efficient in adolescent than in adult Class II division 1 subjects.
  
  
  METHODS
  All Class II division 1 patients with a full secondary dentition who had been treated at the orthodontic department of the University of Giessen with a Herbst appliance between 1990 and 2000 were considered. The complete records of 77 patients were available. According to their skeletal maturity, as assessed on hand-wrist radiographs, the subjects were divided into an adolescent group (MP3-F to MP3-H; n = 49; mean age 13.5 years) and an adult group (R-IJ to R-J; n = 28; mean age 20.7 years). Pretreatment and posttreatment dental casts were evaluated using the Peer Assessment Rating (PAR) Index. The reductions in PAR scores of the two groups were compared.
  
  
  RESULTS
  Before treatment, both groups had a severe Class II division 1 malocclusion. The average PAR score of the adolescent patients was slightly lower (27.8) than that of the adult patients (28.8). After treatment, good results were reached for both groups, and the average PAR scores of the two groups were comparable (adolescents: 4.5; adults: 4.8). The average reductions in PAR score were 82.7% (23.3 points) for the adolescent group and 82.9% (24.0 points) for the adults, indicating great improvement in both groups.
  
  
  CONCLUSIONS
  Because good treatment results were achieved, with substantial improvement of the pretreatment situation in both groups, Herbst treatment can be considered equally efficient in adolescent and in adult Class II division 1 subjects.
authors.affiliation: Department of Orthodontics, University of Giessen, Germany. julia.v.bremen@dentist.med.uni-giessen.de
authors.forename: Julia
authors.initials: J
authors.lastname: von Bremen
authors.forename: Niko
authors.initials: N
authors.lastname: Bock
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruf
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D017289:Orthodontic Appliances, Functional; D016910:Orthodontic Brackets; D009971:Orthodontics, Corrective / Q000295:instrumentation; D018024:Peer Review, Health Care; D013997:Time Factors; D055815:Young Adult