title: Dentoskeletal effects during Herbst-Multibracket appliance treatment: a comparison of lingual and labial approaches.
abstract: To analyse and compare the effects during Herbst treatment (Tx) when combined with lingual (completely customized) or labial (straight-wire) multibracket appliances (MBA).
  
  
  
  18 Class II division 1 patients (Overjet ≥ 5mm, Class II molar relationship ≥ 0.5 cusp width bilaterally or 1 cusp width unilaterally, median age 16.0 years) treated with lingual (completely customized) MBA in combination with a Herbst appliance were matched (sagittal molar relationship and skeletal maturity) to 18 Class II division 1 Herbst patients treated with labial (straight-wire) MBA. Lateral cephalograms from before, during and after all active Tx were analysed using the SO-analysis and standard cephalometric variables.
  
  
  
  During the Herbst phase (LINGUAL: mean = 13.9 months, LABIAL: mean = 8.5 months) smaller average Overjet and molar relationship changes were seen in the LINGUAL (5.3mm/4.4mm) than in the LABIAL (8.0mm/5.9mm) group. This was due to the fact that the LABIAL patients were treated to overcorrected sagittal relationships. During the total Tx period (Herbst + MBA; LINGUAL: mean = 3.1 years, LABIAL: mean = 1.9 years) the average amounts of Overjet and molar relationship changes were similar in both groups (LINGUAL: 4.0mm/3.3mm, LABIAL: 5.1mm/3.7mm). Overjet correction was achieved by 45% (LINGUAL) and 37% (LABIAL) skeletal changes; the respective amounts for molar relationship correction were 55% (LINGUAL) and 51% (LABIAL).
  
  
  
  For most variables, similar effects occurred during Herbst Tx whether combined with lingual (completely customized) or labial (straight-wire) MBA.
authors.affiliation: *Department of Orthodontics, University of Giessen.
authors.forename: Niko C
authors.initials: NC
authors.lastname: Bock
authors.affiliation: *Department of Orthodontics, University of Giessen, sabine.ruf@dentist.med.uni-giessen.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruf
authors.affiliation: **Department of Orthodontics, Hannover Medical School, ***Private Practice, Bad Essen and.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wiechmann
authors.affiliation: **Department of Orthodontics, Hannover Medical School, ****Private Practice, Wolfratshausen, Germany.
authors.forename: Theresa
authors.initials: T
authors.lastname: Jilek
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry / Q000379:methods; D005260:Female; D006801:Humans; D008046:Lip; D008297:Male; D008312:Malocclusion, Angle Class II / Q000473:pathology / Q000628:therapy*; D008445:Maxillofacial Development; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D009971:Orthodontics, Corrective / Q000295:instrumentation* / Q000379:methods*; D057887:Overbite / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D014059:Tongue; D016896:Treatment Outcome; D055815:Young Adult