Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance

Gerszewski, Camila; Topolski, Francielle; Correr, Gisele M.; Gomes, Rodrigo A. P.; Morais, Nathaly D.; Moro, Alexandre

doi:10.1590/0103-6440201802382

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Article • Braz. Dent. J. 29 (6) • Nov-Dec 2018 • https://doi.org/10.1590/0103-6440201802382 copy

Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to evaluate the effects of the Herbst appliance on the proclination and protrusion of the lower incisors, and to verify if the device causes alveolar bone loss in the anterior region of the mandible. This is a retrospective study. The sample consisted of 35 individuals. The treatment group consisted of 22 individuals (8 girls and 14 boys; initial mean age of 8.2 years) who used the Cantilever Herbst appliance for a period of 12 months. The control group consisted of 13 individuals (3 girls and 10 boys; initial mean age of 8.9 years) who received no treatment and were followed up for a period of approximately 18 months. Cone-beam computed tomography scans were performed at the beginning and at the end of the observational period. The medullary bone thickness (MT), buccal cortical bone thickness (BCT), lingual cortical bone thickness (LCT), and lower incisors proclination and protrusion were evaluated. Data were submitted to statistical analysis (ANCOVA and Student’s t-test) with a significance level of 5%. There was no significant difference in MT, BCT, LCT and incisor proclination between groups. Incisor proclination increased in the treated group with no statistical significance. The treatment group showed a significant increase in the protrusion of the incisors (p = 0.02). The Herbst appliance promoted a small proclination and protrusion of the lower incisors, without relevant clinical implications. The Herbst appliance did not cause bone loss in the anterior region of the mandible during Class II treatment.

Key Words:
Angle class II malocclusion; incisor; tomography

Outcome	Group	n	Initial	Final	Difference	EGU	p*
MT 31-32	Control	13	5.14 ± 0.74	5.26 ± 0.75	0.12 ± 0.68	1.86 ± 0.27	0.27
	Treatment	22	5.59 ± 0.99	5.58 ± 0.74	-0.01 ± 0.80	1.32 ± 0.52	0.47
	p**		0.16	0.16	0.75	-	-
MT 31-41	Control	13	4.89 ± 0.65	5.14 ± 0.70	0.26 ± 0.64	1.86 ± 0.27	0.09
	Treatment	22	5.76 ± 1.14	5.92 ± 0.79	0.16 ± 0.90	1.32 ± 0.52	0.20
	p**		0.02	0.02	0.42	-	-
MT 41-42	Control	13	5.06 ± 0.58	5.26 ± 0.64	0.20 ± 0.54	1.86 ± 0.27	0.10
	Treatment	22	5.58 ± 0.98	5.71 ± 0.93	0.14 ± 0.68	1.32 ± 0.52	0.18
	p**		0.15	0.18	0.85	-	-
BCT 31-32	Control	13	1.26 ± 0.25	1.29 ± 0.28	0.03 ± 0.38	1.86 ± 0.27	0.38
	Treatment	22	1.39 ± 0.39	1.31 ± 0.25	-0.07 ± 0.38	1.32 ± 0.52	0.19
		p**		0.61	0.82	0.54
BCT 31-41	Control	13	1.21 ± 0.18	1.16 ± 0.20	-0.05 ± 0.24	1.86 ± 0.27	0.24
	Treatment	22	1.30 ± 0.35	1.36 ± 0.34	0.06 ± 0.50	1.32 ± 0.52	0.29
	p**		0.29	0.15	0.77
BCT 41-42	Control	13	1.24 ± 0.14	1.24 ± 0.20	0.00 ± 0.27	1.86 ± 0.27	0.48
	Treatment	22	1.31 ± 0.26	1.33 ± 0.27	0.03 ± 0.37	1.32 ± 0.52	0.37
	p**		0.43	0.41	0.93
LCT 31-32	Control	13	1.60 ± 0.36	1.66 ± 0.36	0.05 ± 0.29	1.86 ± 0.27	0.26
	Treatment	22	1.60 ± 0.37	1.63 ± 0.38	0.02 ± 0.23	1.32 ± 0.52	0.33
	p**		0.90	0.68	0.43
LCT 31-41	Control	13	1.58 ± 0.34	1.61 ± 0.28	0.02 ± 0.21	1.86 ± 0.27	0.28
	Treatment	22	1.62 ± 0.38	1.63 ± 0.27	0.01 ± 0.25	1.32 ± 0.52	0.42
	p**		0.76	0.82	0.47
LCT 41-42	Control	13	1.47 ± 0.38	1.51 ± 0.25	0.04 ± 0.30	1.86 ± 0.27	0.32
	Treatment	22	1.56 ± 0.34	1.58 ± 0.30	0.02 ± 0.27	1.32 ± 0.52	0.35
	p**		0.42	0.78	0.45
IMPA	Control	13	93.90 ± 9.33	90.36 ± 11.46	-3.54 ± 12.60	1.86 ± 0.27	0.17
	Treatment	22	96.80 ± 10.36	100.00 ± 8.33	3.20 ± 12.82	1.32 ± 0.52	0.13
	p**		0.26	0.16	0.89
IiPgPerp	Control	13	4.89 ± 2.18	5.20 ± 2.16	0.31 ± 1.18	1.86 ± 0.27	0.18
	Treatment	22	5.78 ± 2.33	4.67 ± 2.8	-1.11 ± 1.41	1.32 ± 0.52	0.001
	p**		0.36	0.65	0.02

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[1] Correspondence: Dr. Alexandre Moro, Rua Prof. Pedro Viriato Parigot de Souza, 5300, 81280-330 Campo Comprido, Curitiba, PR, Brasil. Tel.: +55-41-3317-3180. e-mail: alexandremoro@uol.com.br.