Martin Julia, Pancherz Hans
Department of Orthodontics, University of Giessen, Giessen, Germany.
Am J Orthod Dentofacial Orthop. 2009 Jul;136(1):44-51. doi: 10.1016/j.ajodo.2007.07.027.
The aim of this study was to analyze the effect of the cast Herbst/multibracket (MB) appliance on the position of the mandibular incisors in relation to the amount of mandibular advancement at the beginning of treatment.
We screened 133 patients with Class II Division 1 malocclusions. The subjects were divided into 3 bite-jumping groups: I, 49 subjects with bite jumping of <7 mm; II, 44 subjects with bite jumping of 7.5 to 9.5 mm; and III, 40 subjects with bite jumping of >9.5 mm. Only group I with small (S) and group III with large (L) bite jumping were considered. The average ages of the subjects in the 2 bite-jumping groups were 13.6 +/- 2.4 years in the S group and 14.7 +/- 4.7 years in the L group. The average treatment time with the Herbst/MB appliance was 19 months. Lateral headfilms were evaluated at 3 times: before Herbst treatment, after Herbst treatment, and after MB treatment.
During the Herbst phase, the mandibular incisors were significantly intruded, protruded, and proclined in both bite-jumping groups. Larger tooth movements occurred in group L than in group S. During the MB phase, comparable relapsing incisor tooth movements were seen in the 2 bite-jumping groups. There was moderate correlation between bite-jumping and incisor position changes during the Herbst and the Herbst/MB treatment periods. No associations were found between the amount of bite jumping and the changes of sagittal and vertical jaw relationships, age, and treatment growth period.
During the Herbst treatment period, there was an association between bite jumping and movement of the mandibular incisors: the greater the bite jumping, the larger the intrusion, protrusion, and proclination of teeth. During the MB treatment period, relapsing incisor tooth movements occurred that were independent of the original amount of bite jumping.
本研究的目的是分析铸造式Herbst矫治器/多托槽矫治器（MB矫治器）对治疗开始时下颌切牙位置的影响，该影响与下颌前伸量相关。
我们筛选了133例安氏II类1分类错牙合患者。受试者被分为3个咬合跳跃组：I组，49例咬合跳跃<7mm的受试者；II组，44例咬合跳跃为7.5至9.5mm的受试者；III组，40例咬合跳跃>9.5mm的受试者。仅考虑咬合跳跃小（S）的I组和咬合跳跃大（L）的III组。两个咬合跳跃组受试者的平均年龄在S组为13.6±2.4岁，在L组为14.7±4.7岁。使用Herbst/MB矫治器的平均治疗时间为19个月。在3个时间点评估头颅侧位片：Herbst治疗前、Herbst治疗后和MB治疗后。
在Herbst治疗阶段，两个咬合跳跃组的下颌切牙均明显舌倾、唇倾和前倾。L组的牙齿移动比S组更大。在MB治疗阶段，两个咬合跳跃组出现了类似的切牙复发移动。在Herbst治疗期和Herbst/MB治疗期，咬合跳跃与切牙位置变化之间存在中度相关性。未发现咬合跳跃量与矢状和垂直颌关系变化、年龄及治疗生长发育期之间存在关联。
在Herbst治疗期，咬合跳跃与下颌切牙移动之间存在关联：咬合跳跃越大，牙齿舌倾、唇倾和前倾越明显。在MB治疗期，出现了与初始咬合跳跃量无关的切牙复发移动。
