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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.