Dr. Dalia Latkauskiene

Abstract. Effective Class II management

Results of orthodontic Class II malocclusion treatment can be influenced by inherent characteristics such as patient’s age, perception of facial esthetics, malocclusion severity and degree of compliance, or even by factors regarding the orthodontist’s subjective preference such as the treatment protocol.
The crowned Herbst appliance is a routine appliance for Class II treatment in the clinic of the author in case there are no indications for orthognatic surgery, therefore the presentation will focus on scientific and clinical effects of the device. Little doubts exist regarding Herbst effectiveness in achieving Class II correction, controversy remains about the degree of the ratio between the dental and skeletal changes. While the skeletal effects are dependent on the factors such as growth stage, facial characteristics or activation protocol, the dental effects are determined by the appliance design. The presentation will mostly focus on the construction of particular Herbst design used by the author and it’s abilities to facilitate and stabilize Class II correction results.
It has been already known that in Class II patients the upper molars are mesially rotated and derotation of the upper molars would help in correction of Class II and provide about 2 mm per side of space in the upper arch. Scientific data will be shown to reveal the association between rotation and anteroposterior movement of the upper first molars. It is suggested that crowned Herbst appliance has a large advantage over other Class II correction appliances, because it was not attached to other constructions such as other teeth, transpalatal bars or expansion screws in the upper arch. Clinical step by step appliance manipulation will be presented, strategies using crowned Herbst appliance in different Class II cases will be shown.