Straight Talk              

by Dr. Mark H. Kaley

As you may know, the Herbst appliance is an adjunctive treatment method to correct Class II malocclusions caused by retrusive mandibles and/or maxillary dental protrusion.  Along with braces, the Herbst can move the teeth and jaws into a more compatible relationship and achieve a more functional and esthetic result, replacing antiquated headgear, extractions (in most cases), and eventual orthognathic surgery.  We wanted to share a bit of information regarding this appliance.

One of the key components to successful Herbst therapy is experience.  In our practice, we have, combined, over fifteen years of clinical experience with the appliance.  Dr. Jim Kaley studied under Dr. Terry Dischinger, a leader in Herbst innovation in the U.S., and has since been teaching the technique to the orthodontic residents at UNC-Chapel Hill, including his son, Dr. Mark Kaley.  Using five years of Dr. Jim’s results, Dr. Mark went on to complete his master’s thesis reviewing the success of the appliance.  Dr. Mark found remarkable stability in the appliance’s correction.  Below is an abstract from Dr. Mark’s thesis, which was recently published in the December 2007 issue of the American Journal of Orthodontics and Dentofacial Orthopedics.

Long-term posttreatment stability of the Herbst appliance

Mark H. Kaley

University of North Carolina, Chapel Hill

The Herbst appliance is an adjunctive treatment for the correction of Class II malocclusions.  Previous studies have indicated that the correction frequently relapses after treatment.  The pupose of this study was to assess the cephalometric changes during and after a protocol of 12 months of Herbst appliance treatment followed by fixed appliance treatment, and 12 months of retention.  The changes from the end of treatment to the retention recall were, on average, very small.  The only statistically significant changes (mixed linear model; P < .05) observed were relapse in ANB angle (-0.31°; SD = 0.88), overjet (0.49 mm; SD = 0.94), and overbite (0.55 mm; SD = 0.98).  These changes were considered not clinically significant.  The Class II correction effected by this treatment protocol appears stable 1 year out of treatment.

The Herbst appliance has made a tremendous difference in the treatment of Class II malocclusions.  If you have any questions about this method, please contact us.