History and Development of Herbst Appliance:
- Developed by Emil Herbst in the early 1900s
- Reintroduced in 1979 by Hans Pancherz
- Widely established in today's orthodontics for Class II therapy
- Various designs of the appliance have been developed, such as Sabbagh Spring, Powerscope, and Cantilever Bite Jumper (CBJ)
Modifications and Variants of Herbst Appliance:
- 4 major modifications in the design of Herbst appliances: Herbst 1, Herbst 2, Herbst 3, and Herbst 4
- Variants of the Herbst appliance include cast Herbst appliance and acrylic splint Herbst appliance
Indications for Herbst Appliance:
- Indicated for noncompliance treatment of Class II skeletal malocclusions with retrognathic mandible
- Suitable for high angle patients due to increased sagittal condylar growth
- Effective for patients with deep anterior overbite
- Recommended for cases of mandibular midline deviation
- Beneficial for mouth breathers due to lack of interference while breathing
- Removable Acrylic Herbst Appliance can be used for patients with obstructive sleep apnea
Treatment Timing with Herbst Appliance:
- Critical to initiate Herbst treatment during appropriate skeletal maturation period
- Early treatment before pubertal growth peak leads to normal skeletal and soft tissue morphology
- Treatment in permanent dentition at or just after pubertal growth peak results in more stable occlusion and reduced posttreatment relapse
- Equal results observed in prepubertal and postpubertal patients, but greater anchorage loss expected in postpubertal patients
References:
- Mayes, Joe H. (2006). Orthodontic Treatment of the Class II Noncompliant Patient.
- Pancherz, H.; Anehus-Pancherz, M. (1982). The effect of continuous bite jumping with the Herbst appliance on the masticatory system.
- Yang, Xin; Zhu, Yafen; Long, Hu; Zhou, Yang; Jian, Fan; Ye, Niansong; Gao, Meiya; Lai, Wenli (2016). The effectiveness of the Herbst appliance for patients with Class II malocclusion: a meta-analysis.
- Pancherz H. (1979). Treatment of class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation.
- Howe, Raymond P. (1982). Palatal expansion using a bonded appliance.
The Herbst appliance is an orthodontic appliance used by orthodontists to correct class 2 retrognathic mandible in a growing patient. This is also called bitejumping. Herbst appliance parts include stainless steel surgical frameworks that are secured onto the teeth by bands or acrylic bites. These are connected by sets of telescoping mechanisms that apply gentle upward and backward force on the upper jaw, and forward force on the lower jaw. The original bite-jumping appliance (Herbst appliance) was designed by Dr. Emil Herbst and reintroduced by Dr. Hans Pancherz using maxillary and mandibular first molars and first bicuspids. The bands were connected with heavy wire soldered to each band and carried a tube and piston assembly that allowed mandibular movement but permanently postured the mandible forward. The appliance not only corrected a dental Class II to a dental Class I but also offered a marked improvement of the classic Class II facial profile.
