Journal article

Publication year: 2021

Pages: 424-431

Journal: European Journal of Orthodontics

Volume number: 43

Issue number: 4

ISSN: 0141-5387

eISSN: 1460-2210

DOI Link: https://doi.org/10.1093/ejo/cjaa052

Publisher: Oxford University Press

Abstract: 

Background: No reliable predictive factors for treatment (Tx) success and outcome quality in Class II:1 Tx have been identified yet.

Objective: To assess the influence of pre-Tx Class II severity and skeletal maturity on outcome quality after Herbst-multibracket appliance (MBA) Tx.

Subjects and methods: All Class II:1 patients who completed Herbst-MBA Tx between 1986 and 2014 at University of Giessen, Germany. Pre-Tx (T0), post-Tx (T1), and (if available) post-retention (>= 24 months; T2) study casts were evaluated using the Peer Assessment Rating (PAR) index and the Ahlgren scale. Three occlusal severity (mild, moderate, and severe) and four skeletal maturity (pre-peak, peak, post-peak, and adult) subgroup categories were defined.

Results: Four hundred eight-five patients (age at T0: 14.4 +/- 3.2 years) could be evaluated; postretention (T3) data were available for 230 patients. For the total sample, the median PAR score was 32.4 +/- 8.85 at T0, 8.0 +/- 4.52 at T1, and 8.8 +/- 5.11 at T2. Very low correlations between the subgroup categories (occlusal severity/skeletal maturity) and PAR-score reduction were detected both during Tx (r= 0.12/r = 0.05) and the total observation period (r= 0.17/r= 0.03).The overall outcome quality according to Ahlgren was: 17.0% excellent, 34.8% good, 43.8% acceptable, 2.2% unacceptable, and 2.2% not assessable. The association with the subgroup categories was: p = 0.019 (occlusal severity)/p = 0.820 (skeletal maturity).

Limitations: Retrospective study design with follow-up data was not available from all subjects and no data from untreated controls.Tx was performed by several physicians using different kind of MBAs.

Conclusion: Class II:1 Herbst-MBA Tx is an effective and successful Tx approach irrespective of pre-Tx skeletal maturity but dependent-to a certain extent-on Class II severity.Thus, when considering a Herbst appliance for Class II correction, neither of the two variables should considerably limit the indication.

Harvard Citation style: Bock, N., Jost, J. and Ruf, S. (2021) Outcome quality of Class II division 1 Herbst-multibracket appliance treatment: influence of pretreatment Class II severity and skeletal maturity, European Journal of Orthodontics, 43(4), pp. 424-431. https://doi.org/10.1093/ejo/cjaa052

APA Citation style: Bock, N., Jost, J., & Ruf, S. (2021). Outcome quality of Class II division 1 Herbst-multibracket appliance treatment: influence of pretreatment Class II severity and skeletal maturity. European Journal of Orthodontics. 43(4), 424-431. https://doi.org/10.1093/ejo/cjaa052