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Effective and Efficient Herbst Appliance Therapy for Skeletal Class II Malocclusion Patient with a Low Degree of Collaboration with the Orthodontic Treatment.

Souki BQ, Bastos BD, Araujo LF, Moyses-Braga WF, Pantuzo MG, Cheib PL - Case Rep Dent (2015)

Bottom Line: Two previous treatments failed because patient's collaboration with removable appliances was inadequate.Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment.Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability.

View Article: PubMed Central - PubMed

Affiliation: Graduate Program in Orthodontics, School of Dentistry, Pontifical Catholic University of Minas Gerais, 30535-610 Belo Horizonte, MG, Brazil.

ABSTRACT
The current concept for effective and efficient treatment of skeletal Class II malocclusion prescribes that interceptive approach should be delivered during the pubertal growth stage. However, psychosocial issues and a greater risk of dental trauma are also factors that should be addressed when considering early Class II therapy. This paper reports a case of a patient that sought orthodontic treatment due to aesthetic discomfort with the incisors' protrusion. Two previous treatments failed because patient's collaboration with removable appliances was inadequate. Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment. Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability.

No MeSH data available.


Related in: MedlinePlus

Lateral cephalometric radiography at the end of treatment, and superimposition tracings between the end of the Herbst appliance phase and fixed appliance phase.
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Related In: Results  -  Collection


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fig7: Lateral cephalometric radiography at the end of treatment, and superimposition tracings between the end of the Herbst appliance phase and fixed appliance phase.

Mentions: The simultaneous occurrence of excessive overjet, severe skeletal discrepancy, and the ongoing pubertal growth maturation was the determining factor on the decision for choosing two phases of sagittal activation. Each one comprised of 8 months of HA. The HA was removed for 4 months between the two active activations to allow the patient a treatment break. The cephalometric superimposition displayed significant mandibular growth during HA therapy. By this time, the patient was finishing his pubertal stage (CS4) (Figure 5). To achieve a better dental intercuspation, a 17-month treatment with edgewise multibrackets, immediately following HA, was necessary. For every new alignment and leveling wire, the patient was requested to use 1 week of Class III elastics (3/8), thus reducing the lower incisor's proclination. The end of the treatment occurred in the postpubertal stage (CS5) (Figures 6 and 7), which might have contributed to the long-term occlusal stability.


Effective and Efficient Herbst Appliance Therapy for Skeletal Class II Malocclusion Patient with a Low Degree of Collaboration with the Orthodontic Treatment.

Souki BQ, Bastos BD, Araujo LF, Moyses-Braga WF, Pantuzo MG, Cheib PL - Case Rep Dent (2015)

Lateral cephalometric radiography at the end of treatment, and superimposition tracings between the end of the Herbst appliance phase and fixed appliance phase.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4377456&req=5

fig7: Lateral cephalometric radiography at the end of treatment, and superimposition tracings between the end of the Herbst appliance phase and fixed appliance phase.
Mentions: The simultaneous occurrence of excessive overjet, severe skeletal discrepancy, and the ongoing pubertal growth maturation was the determining factor on the decision for choosing two phases of sagittal activation. Each one comprised of 8 months of HA. The HA was removed for 4 months between the two active activations to allow the patient a treatment break. The cephalometric superimposition displayed significant mandibular growth during HA therapy. By this time, the patient was finishing his pubertal stage (CS4) (Figure 5). To achieve a better dental intercuspation, a 17-month treatment with edgewise multibrackets, immediately following HA, was necessary. For every new alignment and leveling wire, the patient was requested to use 1 week of Class III elastics (3/8), thus reducing the lower incisor's proclination. The end of the treatment occurred in the postpubertal stage (CS5) (Figures 6 and 7), which might have contributed to the long-term occlusal stability.

Bottom Line: Two previous treatments failed because patient's collaboration with removable appliances was inadequate.Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment.Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability.

View Article: PubMed Central - PubMed

Affiliation: Graduate Program in Orthodontics, School of Dentistry, Pontifical Catholic University of Minas Gerais, 30535-610 Belo Horizonte, MG, Brazil.

ABSTRACT
The current concept for effective and efficient treatment of skeletal Class II malocclusion prescribes that interceptive approach should be delivered during the pubertal growth stage. However, psychosocial issues and a greater risk of dental trauma are also factors that should be addressed when considering early Class II therapy. This paper reports a case of a patient that sought orthodontic treatment due to aesthetic discomfort with the incisors' protrusion. Two previous treatments failed because patient's collaboration with removable appliances was inadequate. Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment. Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability.

No MeSH data available.


Related in: MedlinePlus