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Orthopedic treatment with the Herbst appliance: do vertical changes occur in the facial growth pattern?

OBJECTIVE: The aim of this prospective study was to evaluate through the exam of cephalograms the occurrence of changes in facial growth pattern. The sample was composed by 32 adolescent with Angle Class II, division 1 malocclusion and mandibular retrognathism. All patients were treated with the Herbst appliance built over bands and metal crowns. METHODOLOGY: Lateral cephalograms were taken at the beginning of treatment (T1) and immediately after 12 months of treatment with Herbst appliance (T2). Jarabak's coefficient and Ricketts' VERT (modified) were used to establish the facial pattern in T1 and T2. RESULTS: According to Jarabak's coefficient, in T1, 84.4% (27 cases) presented hypodiverging pattern and 15.6% (5 cases) presented neutral pattern. The facial growth pattern was maintained in all patients from T1 to T2. When the (modified) Ricketts' VERT was used, 31 patients showed the same growth pattern from T1 to T2. Only one patient exhibited a different pattern. CONCLUSION: Based on the results it can be concluded that, after 12 months of treatment with the Herbst appliance, there were no vertical changes in the facial growth pattern of the studied subjects.

Herbst appliance; Cephalometrics; Facial pattern


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