Skeletal Anchorage in Treating Skeletal Class II Malocclusion in Growing Patients Using the Herbst Appliance

Abstract

Skeletal Class II is a common malocclusion affecting the Caucasian population and characterized, in most cases, by a convex profile and mandibular retrusion. Therefore, the treatment plan often requires the use of functional appliances to promote mandibular advancement. In particular, the Herbst appliance is recommended because of its efficiency and minimal need for compliance. However, in addition to skeletal favorable effects, undesired dental compensations could prematurely reduce the overjet needed for a proper orthopedic outcome. The combination of this appliance with skeletal anchorage and elastic ligatures in the lower or both, in the upper and the lower arch, enables effective control of unfavorable tooth movements, improving the therapeutic potential of such a treatment. These improvements have significantly shifted the main focus on facial aesthetics rather than dental occlusion, with the creation of innovative treatment protocols and a new diagnostic approach to Class II malocclusion.