Complications during Herbst appliance treatment with reduced mandibular cast splints : a prospective, clinical multicenter study.

OBJECTIVE

To assess and compare the prevalence, type and frequency of complications during Herbst treatment with reduced (canine to 2nd premolars) and total (canine to molars) mandibular cast splints.

SUBJECTS AND METHODS

Fifty consecutive Herbst patients treated with reduced mandibular splints (RMS) were compared to 182 consecutively treated Herbst patients with total mandibular splints (TMS). The prevalence, type and frequency of complications were analyzed.

RESULTS

The prevalence of patients with complications did not differ significantly between the groups, and amounted to 58% in the RMS- and 60% in the TMS-group. The most frequent type of complication in both groups was maxillary splint loosening, making up 56.3% of all complications in the RMS- and 66.9% in the TMS-group. The second most frequent complication was mandibular splint loosening, which amounted to 32.5% of the complications in the RMS- and 26.8% in the TMS-group. We observed telescope breakage twice as often (8.8%) in the RMS- as in the TMS-group (4.3%).

CONCLUSIONS

Loosening of the maxillary splints is the main complication during Herbst treatment with RMS and TMS. A reduction in mandibular splint length does not increase the prevalence of complications, but it does reduce expenses, and can thus be recommended for further use.