Top

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Published in:

01-01-2013 | Original article

Class II treatment by extraction of maxillary first molars or Herbst appliance: dentoskeletal and soft tissue effects in comparison

Authors: J.W. Booij, J. Goeke, E.M. Bronkhorst, C. Katsaros, S. Ruf

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 1/2013

Abstract

Aim

To compare dentoskeletal and soft tissue treatment effects of two alternative Class II division 1 treatment modalities (maxillary first permanent molar extraction versus Herbst appliance).

Methods

One-hundred-fifty-four Class II division 1 patients that had either been treated with extractions of the upper first molars and a lightwire multibracket (MB) appliance (n = 79; 38 girls, 41 boys) or non-extraction by means of a Herbst-MB appliance (n = 75; 35 girls, 40 boys). The groups were matched on age and sex. The average age at the start of treatment was 12.7 years for the extraction and for 13.0 years for the Herbst group. Pretreatment (T1) and posttreatment (T2) lateral cephalograms were retrospectively analyzed using a standard cephalometric analysis and the sagittal occlusal analysis according to Pancherz.

Results

The SNA decrease was 1.10° (p = 0.001) more pronounced in the extraction group, the SNB angle increased 1.49° more in the Herbst group (p = 0.000). In the extraction group, a decrease in SNB angle (0.49°) was observed. The soft tissue profile convexity (N-Sn-Pog) decreased in both groups, which was 0.78° more (n. s.) pronounced in the Herbst group. The nasolabial angle increased significantly more (+ 2.33°, p = 0.025) in the extraction group. The mechanism of overjet correction in the extraction group was predominantly dental (65% dental and 35% skeletal changes), while in the Herbst group it was predominantly skeletal (58% skeletal and 42% dental changes) in origin.

Conclusion

Both treatment methods were successful and led to a correction of the Class II division 1 malocclusion. Whereas for upper first molar extraction treatment more dental and maxillary effects can be expected, in case of Herbst treatment skeletal and mandibular effects prevail.

Al-Nimri KS (2006) Vertical changes in class II division 1 malocclusion after premolar extractions. Angle Orthod 76:52–58PubMed

Anderson BD (1975) Multiple extraction patterns in severe discrepancy cases. Angle Orthod 45:291–303PubMed

Basciftci FA, Usumez S (2003) Effects of extraction and nonextraction treatment on class I and class II subjects. Angle Orthod 73:36–42PubMed

Basdra EK, Stellzig A, Komposch G (1996) Extraction of maxillary second molars in the treatment of Class II malocclusion. Angle Orthod 66:287–292PubMed

Bishara SE, Cummins DM, Zaher AR (1997) Treatment and posttreatment changes in patients with Class II, Division 1 malocclusion after extraction and nonextraction treatment. Am J Orthod Dentofacial Orthop 111:18–27PubMedCrossRef

Bishara SE, Cummins DM, Jakobsen JR (1995) The morphologic basis for the extraction decision in Class II, division 1 malocclusions: a comparative study. Am J Orthod Dentofacial Orthop 107:129–135PubMedCrossRef

Bishara SE (1998) Mandibular changes in persons with untreated and treated Class II division 1 malocclusion. Am J Orthod Dentofacial Orthop 113:661–673PubMedCrossRef

Bishara SE, Zaher AR, Cummins DM et al (1994) Effects of orthodontic treatment on the growth of individuals with Class II division 1 malocclusion. Angle Orthod 64:221–230PubMed

Bock N, Pancherz H (2006) Herbst treatment of Class II division 1 malocclusions in retrognathic and prognathic facial types. Angle Orthod 76:930–941PubMedCrossRef

10.

Bokas J, Collett T (2006) Effect of upper premolar extractions on the position of the upper lip. Aust Orthod J 22:31–37PubMed

11.

Booij JW, Goeke J, Bronkhorst EM et al (2011) Overjet correction and space closure mechanisms for Class II treatment by extracting the maxillary first molars. J Orofac Orthop 72:196–203PubMedCrossRef

12.

Booij JW, Kuijpers-Jagtman AM, Katsaros C (2009) A treatment method for Class II division 1 patients with extraction of permanent maxillary first molars. World J Orthod 10:41–48PubMed

13.

Bravo LA, Canut JA, Pascual A et al (1997) Comparison of the changes in facial profile after orthodontic treatment, with and without extractions. Br J Orthod 24:25–34PubMedCrossRef

14.

Cudovic B (1998) Orthodontic treatment of a Class II, 1 malocclusion including extractions of the 4 first molars. J Orofac Orthop 59:186–191PubMedCrossRef

15.

Darendeliler N, Taner L (2006) Changes in the soft tissue profile after extraction orthodontic therapy. J Dent Child 73:164–169

16.

Erdinc AE, Nanda RS, Dandajena TC (2007) Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop 132:324–331PubMedCrossRef

17.

Flores-Mir C, Major MP (2006) Soft tissue changes with fixed functional appliances in Class II division 1. Angle Orthod 76:712–720PubMed

18.

Goeke J (2009) Dentale und skelettofaziale Veränderungen zweier Therapieformen der Klasse II/1. Begg-technik versus Herbst-Behandlung. Eine röntgenkephalometrische Untersuchung. Med Diss (Giessen)

19.

Katsaros C, Ripplinger B, Hoegel A et al (1996) The influence of extraction versus nonextraction orthodontic treatment on the soft tissue profile. J Orofac Orthop 57:354–365PubMedCrossRef

20.

Katsaros C (1996) Profile changes following extraction vs. nonextraction orthodontic treatment in a pair of identical twins. J Orofac Orthop 57:56–59PubMedCrossRef

21.

Lo FD, Hunter WS (1982) Changes in nasolabial angle related to maxillary incisor retraction. Am J Orthod 82:384–391PubMedCrossRef

22.

Looi LK, Mills JR (1986) The effect of two contrasting forms of orthodontic treatment on the facial profile. Am J Orthod 89:507–517PubMedCrossRef

23.

Luppanapornlarp S, Johnston LE Jr (1993) The effects of premolar-extraction: a long-term comparison of outcomes in “clear-cut” extraction and nonextraction Class II patients. Angle Orthod 63:257–272PubMed

24.

Nelson B, Hägg U, Hansen K, Bendeus M (2007) A long-term follow-up study of Class II malocclusion correction after treatment with Class II elastics or fixed functional appliances. Am J Orthod Dentofacial Orthop 132:499–503PubMedCrossRef

25.

Nelson B, Hansen K, Hägg U (2000) Class II correction in patients treated with class II elastics and with fixed functional appliances: a comparative study. Am J Orthod Dentofacial Orthop 118:142–149PubMedCrossRef

26.

O’Brien K, Wright J, Conboy F et al (2003) Effectiveness of treatment for Class II malocclusion with the Herbst or twin-block appliances: a randomized, controlled trial. Am J Orthod Dentofacial Orthop 124:128–137CrossRef

27.

Pancherz H, Ruf S (2008) The Herbst-appliance. Research-based clinical management. Quintessence, Berlin

28.

Pancherz H (1982) The mechanism of Class II correction in Herbst appliance treatment. Am J Orthod 82:104–113PubMedCrossRef

29.

Pancherz H (1979) Treatment of class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation. Am J Orthod 76:423–442PubMedCrossRef

30.

Pancherz H, Anehus-Pancherz M (1994) Facial profile changes during and after Herbst appliance treatment. Eur J Orthod 16:275–286PubMedCrossRef

31.

Paquette DE, Beattie JR, Johnston LE (1992) A longterm comparison of nonextraction and premolar extraction edgewise therapy in “borderline” Class II patients. Am J Orthod Dentofacial Orthop 102:1–14PubMedCrossRef

32.

Peterson JE, McNamara JA (2003) Temporomandibular joint adaptations associated with Herbst appliance treatment in juvenile Rhesus monkeys (Macaca mulatta). Sem Orthod 9:12–25CrossRef

33.

Ricketts RM (1960) The influence of orthodontic treatment on facial growth and development. Angle Orthod 30:103–133

34.

Ruf S, Pancherz H (1999) Dentoskeletal effects and facial profile changes in young adults treated with the Herbst appliance. Angle Orthod 69:239–246PubMed

35.

Ruf S, Pancherz H (1998) Temporomandibular joint growth adaptation in Herbst treatment. A prospective MRI and cephalometric roentgenographic study. Eur J Orthod 20:375–388PubMedCrossRef

36.

Ruf S, Pancherz H (1999) Dentoskeletal effects and facial profile changes in young adults treated with the Herbst appliance. Angle Orthod 69:239–246PubMed

37.

Ruf S, Pancherz H (1999) Temporomandibular joint remodeling in adolescents and young adults during Herbst treatment: a prospective longitudinal magnetic resonance imaging and cephalometric radiographic investigation. Am J Orthod Dentofacial Orthop 115:607–618PubMedCrossRef

38.

Ruf S, Pancherz H (1996) The effect of Herbst appliance treatment on the mandibular plane angle: a cephalometric roentgenographic study. Am J Orthod Dentofacial Orthop 110:225–229PubMedCrossRef

39.

Sandler PJ, Atkinson R, Murray AM (2000) For four sixes. Am J Orthod Dentofacial Orthop 117:418–434PubMedCrossRef

40.

Schaefer AT, McNamara JA Jr, Franchi L et al (2004) A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst appliances followed by fixed appliance therapy. Am J Orthod Dentofacial Orthop 126:7–15PubMedCrossRef

41.

Skidmore KJ, Brook KJ, Thomson WM et al (2006) Factors influencing treatment time in orthodontic patients. Am J Orthod Dentofacial Orthop 129:230–238PubMedCrossRef

42.

Stalpers MJ, Booij JW, Bronkhorst EM et al (2007) Extraction of maxillary first permanent molars in patients with Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 132:316–323PubMedCrossRef

43.

Vig PS, Weintraub JA, Brown C et al (1990) The duration of orthodontic treatment with and without extractions: a pilot study of five selected practices. Am J Orthod Dentofacial Orthop 97:45–51PubMedCrossRef

44.

Weichbrodt L, Ingervall B (1992) Treatment of Class II, div. 1 malocclusion with the activator and with the Begg technique. Schweiz Monatsschr Zahnmed 102:1037–1045PubMed

45.

Williams R (1979) Single arch extraction—upper first molars or what to do when nonextraction treatment fails. Am J Orthod 76:376–393PubMedCrossRef

Title: Class II treatment by extraction of maxillary first molars or Herbst appliance: dentoskeletal and soft tissue effects in comparison
Authors: J.W. Booij
J. Goeke
E.M. Bronkhorst
C. Katsaros
S. Ruf
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 1/2013
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-012-0112-1

At a glance: The STEP trials

Springer Medicine

Class II treatment by extraction of maxillary first molars or Herbst appliance: dentoskeletal and soft tissue effects in comparison

Abstract

Aim

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2013

The prevalence of approximal caries in patients after fixed orthodontic treatment and in untreated subjects

Systematic review on self-ligating vs. conventional brackets: initial pain, number of visits, treatment time

Statement in reply to the letters to the editor

Precision of indirect bonding of lingual brackets using the Quick Modul System (QMS)®

DGKFO-Mitteilungen

What’s new on the dental scene?