Herbst appliance anchored to miniscrews in the upper and lower arches vs standard Herbst: A pilot study

Introduction: The aim of this pilot study was to present the preliminary results of Class II malocclusion treatment using a skeletally anchored Herbst appliance with miniscrews inserted in the maxillary and mandibular arches to improve anchorage control and skeletal effects. Methods: The treatment group (TG) consisted of 13 patients (10 males [M], 3 females [F]; mean age of 12.8 years) with Class II Division 1 malocclusion who were treated with the Herbst appliance and miniscrews inserted in the maxillary and mandibular arches. They were compared with a control group (CG) of 13 patients (10 F, 3 M, mean age of 12.2 years) with Class II Division 1 malocclusion treated with the standard Herbst appliance without miniscrews. Lateral cephalograms were taken before and after Herbst treatment, and cephalometric analysis was performed. Results: In the TG group SNB (degrees) increased by 2.9 degrees, whereas in CG group SNB (degrees) increased by 1.1 degrees (P = 0.017). ANB (degrees) decreased in both groups: -3.3 degrees in the TG group vs -1.3 degrees in the CG group (P = 0.014). Pg-OLp distance increased in both groups: 5.70 mm in the TG group and 0.8 mm in the CG group (P = 0.022). Mandibular incisors proclined 1.6 degrees in the TG group and 3.7 degrees in the CG group. Conclusion: Herbst treatment reinforced with 4 miniscrews (2 in each arch) increased the orthopedic effect of treatment in growing patients with Class II malocclusion.