title: Control of mandibular incisors with the combined Herbst and completely customized lingual appliance--a pilot study.
abstract: BACKGROUND
  The traditional Herbst appliance induces mandibular incisor proclination independent of the anchorage system used. The dental effects of the Herbst appliance as an element of a completely customized lingual orthodontic (LO) appliance (Incognito, 3 M) has not been analyzed yet and the aim of this paper was to measure the effect of mandibular incisor proclination using this Herbst-LO device.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  a) Class II >or= 5 mm molar relationship; b) Herbst appliance >or= 9 months in situ; and c) finished active treatment. Incisor position was measured on digital models before treatment, on the digital target setup, and on digital models obtained at the day of debonding. All measurements were performed by one investigator.
  
  
  RESULTS
  Twelve patients (8 females, 4 males) out of 632 cases treated with a lingual appliance were included in the study. The measurement error computed with Dahlberg's formula was 0.2 degrees . Seven cases had planned (target setup) mandibular incisor uprighting (ccr), and five cases had proclination (clockwise rotation). There was no statistical difference (p > 0.05) between planned incisor rotations of the target setup and achieved incisor rotations at the day of debonding. The overall mean difference was 2.2 degrees +/- 1.0 degrees.
  
  
  CONCLUSIONS
  The Incognito-Herbst combination is the first Herbst device with full control over mandibular incisor movement. Using this system, anchorage loss or anchorage gain is independent of the Herbst treatment. It depends only on the planned tooth position of the individual target setup.
authors.affiliation: Department of Orthodontics, Medizinische Hochschule Hannover, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wiechmann
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwestka-Polly
authors.forename: Hans
authors.initials: H
authors.lastname: Pancherz
authors.forename: Ariane
authors.initials: A
authors.lastname: Hohoff
mesh_terms: D000293:Adolescent; D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D007180:Incisor; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D017289:Orthodontic Appliances, Functional; D009971:Orthodontics, Corrective / Q000295:instrumentation*; D010865:Pilot Projects; D012189:Retrospective Studies; D014087:Tooth Movement Techniques / Q000295:instrumentation; D019415:Torque; D055815:Young Adult