Hansen K, Pancherz H, Hägg U
Department of Orthodontics, University of Lund, Malmö, Sweden.
Eur J Orthod. 1991 Dec;13(6):471-81. doi: 10.1093/ejo/13.6.471.
The aim of this study was to analyse the long-term effects of Herbst treatment on the dentofacial complex with special reference to the growth period in which the patients were treated. The sample consisted of 40 male subjects with a Class II, division 1 malocclusion treated successfully with the Herbst appliance for an average period of 7 months. The patients were reinvestigated at the end of the growth period, on average 6.6 years (SD = 1.0 years) after therapy. Nineteen patients were treated before the maximum of pubertal growth (prepeak), 15 at the maximum (peak) and 6 after the pubertal growth maximum (post-peak). Sagittal skeletal and dental changes occurring during and after Herbst treatment were evaluated on lateral radiographs in centric occlusion. At the time of follow-up examination no group differences were seen in sagittal dental arch relationships. During the follow-up period after Herbst treatment maxillary and mandibular growth development were favourable and comparable in all three groups: mandibular growth exceeding maxillary growth by an average of 4.3 mm (SD = 2.4 mm). For natural reasons, however, the amount of jaw growth during the follow-up period was larger in the subjects treated before the maximum of pubertal growth than in the subjects treated at the later stages. The conclusion of this study was that the growth period in which Herbst treatment was performed did not seem to have any conclusive effect on the long-term results. However, in order to favour occlusal stability after treatment and to reduce the time of post-treatment retention, Herbst therapy in the permanent dentition at or just after peak height velocity of growth is recommended.
本研究的目的是分析Herbst矫治器治疗对牙颌面复合体的长期影响，特别关注患者接受治疗时所处的生长阶段。样本包括40名患有安氏II类1分类错牙合的男性受试者，他们成功使用Herbst矫治器治疗了平均7个月。在生长期末期对患者进行复查，平均在治疗后6.6年（标准差 = 1.0年）。19名患者在青春期生长高峰前（高峰前期）接受治疗，15名在生长高峰时（高峰期）接受治疗，6名在青春期生长高峰后（高峰后期）接受治疗。在正中咬合位的侧位X线片上评估Herbst治疗期间及之后发生的矢状向骨骼和牙齿变化。在随访检查时，矢状牙弓关系未见组间差异。在Herbst治疗后的随访期内，三组上颌和下颌的生长发育均良好且具有可比性：下颌生长比上颌生长平均多4.3毫米（标准差 = 2.4毫米）。然而，出于自然原因，青春期生长高峰前接受治疗的受试者在随访期内的颌骨生长量大于后期接受治疗的受试者。本研究的结论是，进行Herbst治疗的生长阶段似乎对长期结果没有任何决定性影响。然而，为了促进治疗后的咬合稳定性并减少治疗后保持的时间，建议在恒牙列生长速度达到高峰或刚过高峰时进行Herbst治疗。
