title: Signs and symptoms of TMJ disorders in adults after adolescent Herbst therapy: a 6-year and 32-year radiographic and clinical follow-up study.
abstract: OBJECTIVE
  To analyze radiographic signs of temperomandibular joint (TMJ) osteoarthritis and clinical TMJ symptoms in patients 6 years and 32 years after treatment with a Herbst appliance.
  
  
  METHODS
  Fourteen patients were derived from a sample of 22 with Class II division 1 malocclusions consecutively treated with a banded Herbst appliance at the age of 12-14 years old (T1-T2). The subjects were reexamined after therapy at the ages of 20 years (T3) and 46 years (T4). The TMJs of the 14 patients were analyzed radiographically (conventional lateral tomography at T3 and cone-beam computed tomography at T4) and clinically/anamnestically at T3 and T4.
  
  
  RESULTS
  Six years after Herbst therapy, signs of osteoarthritis were seen in one patient. At the 32-year follow-up, two additional patients had developed signs of osteoarthritis. At the 6-year follow-up, TMJ clicking was present in two patients, though none of the patients reported TMJ pain. At the 32-year follow-up, six patients had TMJ clicking and one patient had TMJ pain.
  
  
  CONCLUSIONS
  This longitudinal very-long-term follow-up study after Herbst therapy revealed only minor problems from the TMJ. The TMJ findings 6 years and 32 years after Herbst treatment corresponded to those in the general population. Thus, in the very long term, the Herbst appliance does not appear to be harmful to the TMJ.
authors.affiliation: a  Professor and Chair Emeritus, Department of Orthodontics, University of Giessen, Giessen, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Pancherz
authors.affiliation: b  Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Salé
authors.affiliation: c  Associate Professor, Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Bjerklin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017289:Orthodontic Appliances, Functional; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D013997:Time Factors; D055815:Young Adult
keywords: Herbst therapy; TMJ disorders