Comparisons of soft tissue changes after Herbst appliance treatment in three different growth phases

Juan Francisco Mariscal; Dirceu Barnabé Ravelli; Ary Dos Santos Pinto; Gladys Cristina Dominguez; Luís Antônio de Arruda Aidar; Helder B Jacob

doi:10.1016/j.ejwf.2023.11.002

Comparisons of soft tissue changes after Herbst appliance treatment in three different growth phases

J World Fed Orthod. 2024 Apr;13(2):78-85. doi: 10.1016/j.ejwf.2023.11.002. Epub 2023 Dec 27.

Authors

Juan Francisco Mariscal¹, Dirceu Barnabé Ravelli², Ary Dos Santos Pinto², Gladys Cristina Dominguez³, Luís Antônio de Arruda Aidar⁴, Helder B Jacob⁵

Affiliations

¹ Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil. Electronic address: [email protected].
² Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
³ Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.
⁴ Department of Orthodontics, School of Dentistry, University of Santa Cecília, Santos, São Paulo, Brazil.
⁵ Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas.

PMID: 38155063
DOI: 10.1016/j.ejwf.2023.11.002

Abstract

Background: This study aimed to compare the soft tissue effects of Herbst appliance in Class II malocclusion patients treated in three different craniofacial growth phases: prepubertal (PRE), circumpubertal (CIR), and postpubertal (POS).

Methods: In total, 95 patients with Class II Division 1 malocclusion previously treated with a Herbst appliance were analyzed. Through the cervical vertebral maturation stages method, patients were allocated into three groups depending on the growth craniofacial phase at the beginning of treatment: PRE, CIR, and POS. Seventeen cephalometric measures were evaluated from each lateral radiograph before and after Herbst therapy using the Radiocef 2 software (Radio Memory, Belo Horizonte). Intragroup and intergroup treatment changes were compared statistically using a paired t test and MANOVA test, respectively.

Results: Soft tissue thickness changes were related only to mandible; all three mandibular measurements (L1_LL, B_B', and Pog_Pog') showed thickening for the PRE group ranging from 0.92 mm (Pog_Pog') to 2.02 mm (B_B'), and only lower lip thickened overtime for the POS group (L1_LL = 0.99 mm). Soft and hard tissue pogonion displaced anteriorly, but only the soft tissue showed differences among groups; PRE group presented more anterior displacement than POS group (3.61 mm and 1.39 mm, respectively). Hard and soft tissue facial convexity decreased more in the PRE and CIR groups than in the POS group. Mentolabial sulcus depth reduced more in the PRE (1.07 mm) and CIR (1.29 mm) groups than in the POS (0.55 mm) group. Horizontal movement of the skeletal and soft pogonion presented a moderate-high positive correlation (r = 0.783), and hard and soft facial convexity showed a moderate-low positive correlation (r = 0.403).

Conclusions: Herbst appliance therapy produces soft tissue improvements in the three phases of craniofacial growth, being greater in patients in the PRE and CIR phases.

Keywords: Class II malocclusion; Division 1; Functional; Herbst appliance; Orthodontic appliances.

MeSH terms

Face
Humans
Malocclusion, Angle Class II* / diagnostic imaging
Malocclusion, Angle Class II* / therapy
Mandible / diagnostic imaging
Orthodontic Appliances, Functional*
Treatment Outcome