title: Facial profile and lip position changes in adult Class II, Division 2 subjects treated with the Herbst-Multibracket appliance. A radiographic cephalometric pilot study.
abstract: OBJECTIVE
  To examine the treatment and post-treatment effects of the Herbst-Multibracket (MB) appliance on facial profile and lip position in adult Class II, Division 2 subjects.
  
  
  METHODS
  Lateral head films of 16 consecutively-treated adult Class II, Division 2 subjects (8 males, 8 females) with an average age of 18.8 years pre-treatment were analyzed on three occasions: before treatment (T1), after Herbst-MB treatment (T2) and 2 years post-treatment (T3).
  
  
  RESULTS
  Treatment period (T2-T1): an increase occurred in the hard tissue profile angle (2.5 degrees; p < 0.001), the soft tissue profile angle excluding the nose (2.6 degrees ; p < 0.01), and the soft tissue profile angle including the nose (1.8 degrees; p < 0.05). The upper lip became more retrusive in relation to the Esthetic line (EL) (0.8 mm; p < 0.05) while the lower lip's position was unchanged. Lower lip coverage of the upper incisors was reduced (0.8 mm; p < 0.05). Post-treatment period (T3-T2): the soft tissue profile angle (excluding the nose) increased (1.6 degrees; p < 0.01), while the hard and soft tissue profile angles including the nose remained unchanged. Both, the upper and lower lips became more retrusive in relation to the EL (0.9 mm; p < 0.01 and 1.0 mm; p < 0.001). The lower lip coverage of the upper incisors remained unchanged.
  
  
  CONCLUSIONS
  The hard and soft tissue profiles were straightened during Herbst-MB treatment, including a brief follow-up period. The lips became more retrusive while the lower lip coverage of the upper incisors was reduced.
authors.affiliation: Justus-Liebig-Universität Giessen, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Kieferorthopädie, Schlangenzahl 14, 35392, Giessen, Germany. niko.c.bock@dentist.med.uni-giessen.de
authors.forename: Niko Christian
authors.initials: NC
authors.lastname: Bock
authors.forename: Christina
authors.initials: C
authors.lastname: Santo
authors.forename: Hans
authors.initials: H
authors.lastname: Pancherz
mesh_terms: D000293:Adolescent; D002508:Cephalometry / Q000379:methods*; D005145:Face / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008046:Lip / Q000000981:diagnostic imaging*; D008297:Male; D008312:Malocclusion, Angle Class II / Q000000981:diagnostic imaging* / Q000534:rehabilitation*; D016910:Orthodontic Brackets; D010865:Pilot Projects; D011859:Radiography