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Case Reports
. 2025 Apr 22;12(5):531.
doi: 10.3390/children12050531.

Oral Implications of Herbst Device Modification: A Case Report

Monica Macrì  1 , Mariastella Di Carmine  1 , Antonio Scarano  1 , Felice Festa  1
Affiliations
Case Reports

Oral Implications of Herbst Device Modification: A Case Report

Monica Macrì et al. Children (Basel). .

Abstract

Background: Many studies analyse the effectiveness of the Herbst device in the treatment of dentoskeletal Class II malocclusion due to mandibular retrusion. This fixed device was devised by Emil Herbst for Class II treatment using a bite jumping, i.e., a device that holds the jaw in a forced anterior position. Comparison of the results obtained in numerous studies is difficult because they are often not comparable and not congruent due to a number of variables that prevent standardization.

Methods: The purpose of the present study is to report some clinical-level considerations that may be important in order to obtain more predictable therapeutic outcomes. The simplified design of the Herbst device offers better patient comfort and easier cleanability but may show some disadvantages, such as less anchorage.

Results: The device was evaluated in conjunction with the multi-bracket phase that preceded Herbst therapy and concluded after the device was removed. The therapy was performed in the absence of skeletal anchorage.

Conclusions: In our opinion, standardization of therapy according to precise protocols may positively affect the therapeutic outcomes by achieving faster occlusal stabilization, more proper neuro-muscular balance, less stress on anchor units, and shorter treatment time.

Keywords: Herbst; anterior mandibular repositioning; complications; device management; musculoskeletal structures adaptation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Traditional design of the Herbst appliance.
Figure 2
Figure 2
The extraoral image shows the convex profile, while the intraoral images show the Class II molar and canine relationship and the protrusion of the upper incisors with the presence of diastemas.
Figure 3
Figure 3
Orthopantomography at T0.
Figure 4
Figure 4
Lateral teleradiography at T0.
Figure 5
Figure 5
Simplified design of the Herbst appliance.
Figure 6
Figure 6
The super floss does not easily slice thanks to the space between the metal and the tooth surface.
Figure 7
Figure 7
The left images refer to when the Herbst device was just cemented, after a first phase of the MBA. The right images show the modifications after 1 week.
Figure 8
Figure 8
At T1, a balanced profile was achieved. The intraoral images show the proper intercuspation and dental Class I relationship.
Figure 9
Figure 9
Orthopantomography at T1.
Figure 10
Figure 10
Lateral teleradiography at T1.
See this image and copyright information in PMC

References

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    1. Pancherz H. The effects, limitations, and long-term dentofacial adaptations to treatment with the Herbst appliance. Semin. Orthod. 1997;3:232–243. doi: 10.1016/S1073-8746(97)80056-4. - DOI - PubMed
    1. Pancherz H. Treatment of class II malocclusion by jumping the bite with the Herbst appliance. A cephalometric investigation. Am. J. Orthod. 1979;76:423–442. doi: 10.1016/0002-9416(79)90227-6. - DOI - PubMed
    1. Pancherz H. Activity of the temporal and masseter muscles in class II, division 1 malocclusions. An electromyographic investigation. Am. J. Orthod. 1980;77:679–688. doi: 10.1016/0002-9416(80)90159-1. - DOI - PubMed
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