Clinical Trial: Effects of the Herbst Appliance With Skeletal and Dental Anchorage in Lower Incisors in Class II Malocclusion

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Effects of the Herbst Appliance With Skeletal Anchorage and Dental Anchorage in Lower Incisors in Class II Malocclusion: A Randomized Clinical Trial

Brief Summary: The purpose of this study is to determine if the Herbst appliance with indirect skeletal anchorage in mini-implants is capable of preventing excessive inclination of the lower incisors at the end of the treatment when compared to the Herbst appliance with dental anchorage in patients with Class II malocclusion and overjet ≥ 6 mm.

Detailed Summary:

2a. Background

The prevalence of the Angle Class II malocclusion is high, comprising almost half of known orthodontic problems (Silva Filho et al., 1990; Proffit et al., 1998). The Class II malocclusion is frequently responsible for negative aesthetic of the facial profile. This can result in psychosocial problems, principally in the Angle Class II, division I malocclusion because of the pronounced projection of the anterior superior teeth. This projection has also been related to fracture and avulsion of the anterior superior teeth.

Different types of appliances had been developed for the treatment of the Angle Class II malocclusion. Among these, functional orthopedic appliances have been used because they can correct Class II malocclusion with better improvement in the growth of the mandible when compared to headgears, which also can correct the problem, but with better restriction of the growth of the maxilla (Tulloch et al., 1997).

The Herbst appliance is a fixed functional orthopedic appliance that is often used because of its non-compliance-nature and the positive results achieved. Emil Herbst created the Herbst appliance in the 1910s (Pancherz; Ruf, 2008), but it was forgotten for decades. Only in the 1970s, Pancherz began a study of the Herbst appliance, and reported the positive results obtained in treatment of the Class II, division I malocclusion (Pancherz, 1979). Several subsequent studies of the Herbst appliance provided new scientific evidence of its benefits.

Nowadays, the Herbst appliance is often used in the treatment of Class II malocclusions, because of its efficiency (Bremen, Pancherz, 2008) and also because of the positive effects in orthodontic and orthopedic correction (Franchi et al., 1999). However,
Sponsor: Klaus Barretto-Lopes

Current Primary Outcome: Lower incisors position changes as measured by tomographic superimposition of the mandible. [ Time Frame: 12 months ]

Comparison in lower incisors position between the two groups at the end of the treatment.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Morphological mandible changes as measured by tomographic superimposition of the cranial base. [ Time Frame: 12 months ]
    Comparison between the changes of the mandible in the two groups at the end of the treatment.
  • Maxilla changes as measured by tomographic superimposition of the cranial base. [ Time Frame: 12 months ]
    Comparison between the changes of the maxilla in the two groups at the end of the treatment.
  • Changes in relationship between maxilla and mandible as measured by tomographic superimposition of the cranial base. [ Time Frame: 12 months ]
    Comparison between the changes of the relationship between the maxilla and the mandible in the two groups at the end of the treatment.
  • Lower molar position changes as measured by tomographic superimposition of the mandible. [ Time Frame: 12 months ]
    Comparison between the changes of the lower molar in the two groups at the end of the treatment.
  • Upper molar position changes as measured by tomographic superimposition of the maxilla. [ Time Frame: 12 months ]
    Comparison between the changes of the upper molar in the two groups at the end of the treatment.


Original Secondary Outcome: Same as current

Information By: Rio de Janeiro State University

Dates:
Date Received: March 26, 2015
Date Started: August 2015
Date Completion: August 2017
Last Updated: April 4, 2016
Last Verified: April 2016