Occlusal stability of adult Class II Division 1 treatment with the Herbst appliance

Introduction: During recent years, some articles have been published on Herbst appliance treatment in adult patients, an approach that has been shown to be most effective in Class II treatment in both early and late adulthood. However, no results on stability have yet been published. Our objective was to analyze the short-term occlusal stability of Herbst therapy in adults with Class II Division 1 malocclusions. Methods: The subjects comprised 26 adults with Class II Division 1 malocclusions exhibiting a Class II molar relationship >= 0.5 cusp bilaterally or >= 1.0 cusp unilaterally and an overjet of >= 4.0 mm. The average treatment time was 8.8 months (Herbst phase) plus 14.7 months (subsequent multi-bracket phase). Study casts from before and after treatment and after an average retention period of 32 months were analyzed. Results: After retention, molar relationships were stable in 77.6% and canine relationships in 71.2% of the teeth. True relapses were found in 8.2% (molar relationships) and 1.9% (canine relationships) of the teeth. Overjet was stable in 92.3% and over-bite in 96.0% of the patients; true relapse did not occur. Conclusions: Herbst treatment showed good occlusal stability 2.5 years after treatment in adults with Class II Division 1 malocclusions. (Am J Orthod Dentofacial Orthop 2010; 138: 146-51)