title: Thirty-two-year follow-up study of Herbst therapy: a biometric dental cast analysis.
abstract: BACKGROUND
  The aim of this study was to analyze the very long-term effects of Herbst treatment on tooth position and occlusion.
  
  
  METHODS
  Fourteen patients from a sample of 22 with Class II Division 1 malocclusions consecutively treated with the banded Herbst appliance were reexamined 32 years after therapy.
  
  
  METHODS
  Dental casts were analyzed from before (T1) and after (T2) treatment, and at 6 years (T3) and 32 years (T4) after treatment.
  
  
  RESULTS
  Minor changes in maxillary and mandibular dental arch perimeters and arch widths were seen during treatment (T1-T2) and posttreatment (T2-T4). Mandibular incisor irregularity remained, on average, unchanged from T1 to T2 but increased continuously during the 32-year follow-up period (T2-T4). Class II molar and canine relationships were normalized in most patients from T1 to T2. During the early posttreatment period (T2-T3), there was a minor relapse; during the late posttreatment period (T3-T4), molar and canine relationships remained, on average, unchanged. Overjet and overbite were reduced to normal values in all subjects during treatment (T1-T2). After treatment (T2-T4), overjet remained, on average, unchanged, but overbite increased insignificantly.
  
  
  CONCLUSIONS
  Thirty-two years after Herbst therapy, overall, acceptable long-term results were seen. Stability was found in 64% of the patients for sagittal molar relationships, in 14% for sagittal canine relationships, in 86% for overjet, and in 86% for overbite. A Class II relapse seemed to be caused by an unstable interdigitation of the occluding teeth, a persisting oral habit, or an insufficient retention regimen after treatment. Most posttreatment changes occurred during the first 6 years after treatment. After the age of 20 years, only minor changes were noted. Long-term posttreatment changes in maxillary and mandibular dental arch perimeters and widths as well as in mandibular incisor irregularity seemed to be independent of treatment and a result of physiologic dentoskeletal changes throughout adulthood.
authors.affiliation: Professor and chair emeritus, Department of Orthodontics, University of Giessen, Giessen, Germany. Electronic address: hans.pancherz@dentist.med.uni-giessen.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Pancherz
authors.affiliation: Associate professor, Department of Orthodontics, Faculty of Dentistry, University of Malmö, Malmö, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Bjerklin
authors.affiliation: Clinical assistant professor, Department of Orthodontics, University Clinics of Odontology, Public Dental Service, Gothenburg, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Lindskog-Stokland
authors.affiliation: Associate professor, Department of Orthodontics, University Clinics of Odontology, Public Dental Service, Gothenburg, Sweden.
authors.forename: Ken
authors.initials: K
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000367:Age Factors; D001699:Biometry / Q000379:methods; D002508:Cephalometry / Q000706:statistics & numerical data; D003481:Cuspid / Q000033:anatomy & histology; D003724:Dental Arch / Q000033:anatomy & histology; D003768:Dental Occlusion, Centric; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007180:Incisor / Q000033:anatomy & histology; D008137:Longitudinal Studies; D008297:Male; D008312:Malocclusion, Angle Class II / Q000473:pathology / Q000628:therapy; D008334:Mandible / Q000033:anatomy & histology; D008437:Maxilla / Q000033:anatomy & histology; D008875:Middle Aged; D003765:Models, Dental / Q000706:statistics & numerical data*; D008963:Molar / Q000033:anatomy & histology; D017289:Orthodontic Appliances, Functional / Q000706:statistics & numerical data*; D057887:Overbite / Q000473:pathology; D010781:Photography / Q000379:methods; D012008:Recurrence; D014070:Tooth / Q000033:anatomy & histology