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Facial Profile and Lip Position Changes in Adult Class II, Division 2 Subjects Treated with the Herbst-Multi bracket Appliance. A Radiographic Cephalometric Pilot Study

Änderungen des Gesichtsprofils und der Lippen - position bei erwachsenen Klasse-II/2-Patienten nach Behandlung mit der Herbst-Multi bracket-Apparatur. Eine röntgenkephalometrische Pilotstudie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective:

To examine the treatment and post-treatment effects of the Herbst-Multibracket (MB) appliance on facial profile and lip position in adult Class II, Division 2 subjects.

Material and Methods:

Lateral head films of 16 consecutivelytreated adult Class II, Division 2 subjects (8 males, 8 females) with an average age of 18.8 years pre-treatment were analyzed on three occasions: before treatment (T1), after Herbst-MB treatment (T2) and 2 years post-treatment (T3).

Results:

Treatment period (T2–T1): an increase occurred in the hard tissue profile angle (2.5°; p < 0.001), the soft tissue profile angle excluding the nose (2.6°; p < 0.01), and the soft tissue profile angle including the nose (1.8°; p < 0.05). The upper lip became more retrusive in relation to the Esthetic line (EL) (0.8 mm; p < 0.05) while the lower lip’s position was unchanged. Lower lip coverage of the upper incisors was reduced (0.8 mm; p < 0.05). Post-treatment period (T3–T2): the soft tissue profile angle (excluding the nose) increased (1.6°; p < 0.01), while the hard and soft tissue profile angles including the nose remained unchanged. Both, the upper and lower lips became more retrusive in relation to the EL (0.9 mm; p < 0.01 and 1.0 mm; p < 0.001). The lower lip coverage of the upper incisors remained unchanged.

Conclusion:

The hard and soft tissue profiles were straightened during Herbst-MB treatment, including a brief follow-up period. The lips became more retrusive while the lower lip coverage of the upper incisors was reduced.

Zusammenfassung

Ziel:

Untersuchung der bei erwachsenen Klasse-II/2-Probanden während und nach der Behandlung mit einer Herbst-Multibracket-(MB-)Apparatur auftretenden Veränderungen des Gesichtsprofils und der Lippenposition.

Material und Methodik:

Fernröntgenseitenbilder von 16 konsekutiv behandelten erwachsenen Klasse-II/2-Probanden (8 männliche, 8 weibliche) mit einem Durchschnittsalter von 18,8 Jahren vor der Behandlung wurden zu drei Zeitpunkten ausgewertet: vor der Behandlung (T1), nach der Herbst-MB-Behandlung (T2) und 2 Jahre nach der Behandlung (T3).

Ergebnisse:

Behandlungszeitraum (T2–T1): Es trat eine Vergrößerung des knöchernen Profilwinkels (2,5°; p < 0,001), des Weichteilprofilwinkels exklusive Nase (2,6°; p < 0,01) und des Weichteilprofilwinkels inklusive Nase (1,8°; p < 0,05) auf. Die Oberlippe nahm eine – gemessen in Relation zur Esthetic line (EL) – retrusivere Position ein (0,8 mm; p < 0,05), während sich die Position der Unterlippe nicht veränderte. Die Überdeckung der oberen Inzisivi durch die Unterlippe wurde reduziert (0,8 mm; p < 0,05). Nachuntersuchungszeitraum (T3–T2): Während sich der knöcherne Profilwinkel und der Weichteilprofilwinkel inklusive Nase nicht veränderten, vergrößerte sich der Weichteilprofilwinkel exklusive Nase (1,6°; p < 0,01). Sowohl die Ober- als auch die Unterlippe nahmen eine – gemessen in Relation zur EL – retrusivere Position ein (0,9 mm; p < 0,01 and 1,0 mm; p < 0,001). Die Überdeckung der oberen Inzisivi durch die Unterlippe veränderte sich nicht.

Schlussfolgerung:

Während der Herbst-MB-Behandlung und des kurzen Nachuntersuchungszeitraumes erfolgte eine Begradigung des knöchernen Profils und des Weichteilprofils. Die Lippen nahmen eine retrusivere Position ein, während die Überdeckung der oberen Inzisivi durch die Unterlippe verringert wurde.

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Authors and Affiliations

  1. Department of Orthodontics, Justus Liebig University, Gießen, Germany

    Hans Pancherz

  2. Justus-Liebig-Universität Gießen, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Kieferorthopädie, Schlangenzahl 14, 35392, Gießen, Germany

    Niko Christian Bock

Authors
  1. Niko Christian Bock
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  2. Christina Santo
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  3. Hans Pancherz
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Correspondence to Niko Christian Bock.

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Bock, N.C., Santo, C. & Pancherz, H. Facial Profile and Lip Position Changes in Adult Class II, Division 2 Subjects Treated with the Herbst-Multi bracket Appliance. A Radiographic Cephalometric Pilot Study. J Orofac Orthop 70, 51–62 (2009). https://doi.org/10.1007/s00056-009-8801-0

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